Graceful Health: How's your healthcare vocabulary?

Have you ever heard your health care provider use a word you don't understand? Most of us have. Like other specialized fields, medical professionals use a lot of jargon to communicate with each other. They all understand these words, and sometimes they forget these terms are not familiar to the general public.

A woman named Helen Osborne, who was an occupational therapist and an educator, founded Health care Literacy Month, held every October since 1999, to emphasis the need for medical providers to use plan language that their patients can understand when explaining a diagnosis or recommended treatment.

The Institute for Health care Advancement organizes Health Literacy Month to promote the importance of patients being able to "obtain, process and understand basic health information and services needed to make appropriate health decisions."

People's levels of health literacy skills can vary. Some factors may include trying to communicate in a second language, age, cultural differences, how emotional a patient is during an appointment, and the length of the appointment, thus the time available for asking questions.

These days, it helps to do some research so you are ready to ask your provider questions. Write them down so you don't forget. I'm also here to help — that's one of my jobs as Care Coordinator for Grace Cottage Family Health.

So, how is your health care vocabulary? I get lots of questions about the following terms.

Advance Care Directive and Living Will are essentially the same thing. The second term is older, but both refer to a written document stating one's wishes for the type of health care to be given if one is incapable of communicating because of a terminal illness, serious injury, coma, advanced dementia, or another situation.

These can also specify wishes regarding pain management or organ donation. Remember: a Living Will is about your health care choices, not your material possessions. Another term often used in this context is Durable Power of Attorney for Health Care. This specifically refers to someone(s) designated in writing as the person(s) legally allowed to make health care decisions for you if you can't.

Care Coordination: I could spend lots of words describing what my job as Care Coordinator entails, but basically, it means I help to coordinate all of the information and communication needed between patients and providers, and between providers and other special services needed (diabetes education, counseling, physical therapy, lab tests, etc.) for patients with complex and chronic conditions. It might also include reminding patients about appointments, making sure they understand and follow their providers' instructions, and connecting them with support services needed to do so.

A contusion is a bruise. An abrasion is a scrape.

A critical access hospital is a small rural hospital in a place that would otherwise be medically underserved. The focus is on improving access to health care. A Critical Access Hospital must have a 24/7/365 emergency department and 25 or fewer inpatient beds.

Hypertension is abnormally high blood pressure.

Mid-level providers are also called advanced practice providers. These include nurse practitioners and physician assistants, who are fully qualified to provide primary care services, but who have a shorter training time than physicians. Increasingly, rural hospitals and clinics rely on "mid-levels" to provide care in order to reduce medical provider shortages.

The Patient-Centered Medical Home (PCMH) designation is what it sounds like: a primary care practice that uses a team approach and fully includes the patient in all health care decisions. Instead of just telling a patient what to do, a PCMH provides a patient with information on various choices, and lets the plan of care be directed by the patient. There's more to it than that, but all of the other aspects support that mission.

Primary care refers to health care that does more than just care for people who are sick. A primary care medical provider also emphasizes wellness, prevention, and preventive

health care activities.

Swing bed: A rural hospital with a (federal) "swing bed" designation can use its inpatient hospital beds for either "acute" care (for patients with significant medical needs) or for "swing bed" care (for longer-term skilled care), as patient needs dictate.

Thrombosis: blood clot in a vein or artery; deep vein thrombosis is the most dangerous because the clot is in a deep vein, usually a leg, and it can break loose, travel through the bloodstream and lodge in the lungs, blocking blood flow.

Ultrasound, Magnetic Resonance Imaging (MRI), and CT Scans are medical devices used to diagnose a patient's condition. Ultrasound uses sound waves and creates a moving picture of what is happening within the body, while MRI uses magnetic fields to create cross-sectional images of the body, which can be combined for a three-dimensional view. Ultrasound is quite useful in certain circumstances, especially during pregnancy, but it does not do well in photographing through air or bone. For example, it cannot examine the lung closely because the air there interferes. This is not a problem with MRI. Unlike the other two, a CT Scan uses radiation to make a picture of the interior of the body. It can make a three-dimensional picture, and one major advantage is that it can photograph bone, soft tissue (muscles, tendons, organs, etc.) and blood vessels all in the same photograph. A provider will consider a patient's particular circumstances when choosing which of these devices to use.

How did you do? Did you know these terms? It's always good to learn more about your health and how to achieve it. Any day, whether it's Health Literacy Month or not, is a good day to speak up if your provider uses a medical term you don't understand. Don't ever be afraid to ask for an explanation in plain English!

Claire Bemis, RN, is Care Coordinator with the Grace Cottage Family Health Community Health Team. She helps to coordinate various health care services for patients with chronic and complex needs. Bemis earned her BSN degree from Norwich University in 1991.


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