Reduction of Medical Verbiage: Fewer Words, More Meaning

• Terminology
• Vocabulary
• Unified medical language system
• Problem-based learning
• Problem lists

Air traffic controllers and military personnel use an utterly unambiguous but limited vocabulary in their moment-to-moment operations. Physicians rely heavily upon a much larger, less precise terminology, much of it based in tradition and habit. In an earlier issue, Donnelly (1) reminded us of the repetitive and nonreflective use of rhetorical devices that reveal our biases about the reliability of data sources. Whereas the patient “says,” “reports,” “claims,” or “denies,” the physician “notes,” “observes,” and “finds.” Laboratory and imaging studies “show” and “reveal.”

Lawson and Ingman (2), in writing about terminology in the care of the elderly, suggest that there is “redundancy of language coexisting with poverty of concept.” They echo admonitions by Weed and Feinstein when they write that “  … our taxonomy must honestly express the unresolved and the ambiguous as well as the diagnosed and clearly defined.” Furthermore, our vocabulary has been influenced by the growing needs of financial, quality management, and research interests. It is noteworthy that our colleagues in psychiatry, who operate in what many incorrectly assume to be a “softer” area, have evolved the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, as a diagnostic and research tool that includes not only uniform terminology but criteria for its clinical use.

In this issue, Brown and colleagues (3) describe their elegant and ambitious efforts to distill, from the …