Presentation reflections

I was surprised that many of my classmates want to pursue their eduction in the medical field. As many of their minor issues were different they all shared one major issue in common. All the students agree that building a strong physician-patient relationship is essential. It is necessary to make this bond with their patient in order to effectively communicate.

Effective communication involves clarity and understanding. A tight bond with a physician eliminates the chance of mistakes. As my classmates stated how doctors should communicate with their patients, I constantly thought of my past experiences with physicians. It reminded me of one incident in particular. Two years ago I was involved in a car accident in which I broke multiple bones in my right hand. Because of the seriousness of my accident, I spent a week in the hospital. I interacted with my doctor on a regular basis during this week.

My classmates informed our class in their presentations that a doctor must build a strong relationship with their patients in order to be successful. One student mentioned that a doctor should be conscience in the manner in which he relays information. The best way a doctor should do this is by stating the benefits or ways they can improve their condition before relaying the "bad news." My physician did just this. He first told me that with multiple surgeries and extensive therapy, my hand would be alright. He then proceeded to tell me that I most likely would not be able to have full range in mobility and that I would not be able to play volleyball for a year. This was obviously devastating to me.

Another classmate shared with the class the different approaches doctors can take; the best approach being the shared approach. My physician carried the shared approach in every decision he made. He made sure that he discussed everything with me before so that he could hear my input. My doctor would listen to my opinion before surgeries or changing up my therapy routine. The openness of my doctors attitude led me to gain trust in him, and assurance that he was making the right choices.

A student that is not wanting to go into the medical field but accounting shared a same issue that is commonly used in healthcare. He stated that visuals such as handouts are a great way to communicate clearly for further understanding. While I was in the hospital and throughout my therapy experience I received handouts. The handouts included the diet I should be on, precautions that should be taken, and stretching instructions. These visuals truly helped me effectively perform all the necessary steps that needed to be taken for a quick and successful recovery.

My experience in the hospital and the reoccurring theme that my classmates presented, further demonstrates the importance of efficient communication skills in healthcare. Proper communication in healthcare embodies qualities of trust, understanding, and respect which ultimately leads to a strong patient-physician relationship.

Bridging the Medical Gap

An increase in globalization contributes to many positive aspects in our world; however this diversification brings challenges among physicians and patients in healthcare. Physicians face the dilemma of communicating effectively with patients who immigrate to the United States and are not proficient in the English Language. Health care professionals must overcome the linguistic and cultural barriers that impede essential communication in the medical field.

Physician and patient communication is crucial. Miscommunications often arise in health care even at times when both parties speak the same language. Nevertheless, there are approximately 311 languages spoken in the United States1 and not a sufficient amount of physicians that speak these languages.

Serious problems develop when non-English-speaking patients do not use an interpreter to communicate with medical staff. Additionally, when patients are not able to fully communicate with their clinician, they feel distanced or excluded2. A sense of mistrust builds within the patient when they are not able to understand their doctor. “Recent immigrants with limited English proficiency... may be more vulnerable to poor quality care2.”

Interacting with patients who have limited English proficiency is always an obstacle but “using a trained medical interpreter is the right medicine1.” Although difficulty in communication exists physicians agree that it can be improved with language interpreters.

The most exceptional kinds of interpreters preferred by physicians include the following: bilingual health care providers, hospital interpreters, bilingual staff, and volunteers3. While it is not recommended, a family member may be used as an interpreter when no other interpretation service is available.

Adequate communication between a physician and patient improves the quality of life. Studies show that an interpreter can increase the patient’s understanding, improve physician-patient relations, overall health status of the patient, and follow-up examinations4. Medical interpreters help resolve the confusion that comes accompanies how patients should properly follow the prescription labels, make appointments, and understand discharge instructions. The main tasks for interpreters are to eliminate misunderstandings and reduce errors. “Bilingual, bicultural social workers and health care advocates may play key roles in improving patient care2.”

Some physicians however oppose the use of medical interpreters. The main issues that arise with the use of interpreters in health care are money, time, and unnecessary errors. Many health care facilities do not have the resources to provide interpretation services. Health care systems with restricted budgets find it difficult to fiscally support interpreter services2.

Clinicians spend a significant amount of time making phone calls and scheduling appointments in an attempt to find appropriate interpretation services. An excessive amount of time is also consumed during the actual process of interpretation between the physician, interpreter, and patient. Various physicians sense it is a waste of time. An anonymous doctor states that finding interpreters are not exactly his duty as a physician; his responsibilities include “diagnosing, treating, looking at the results, analyzing, etc5.” In the mind of some physicians, medical interpreters are seen as a burden.

Interactions between physicians, interpreters, and patients, can cause error in their conversation. Interpreters significantly reduce what is actually being said by physicians and patients. A recent study shows that in a typical conversation, physicians usually speak 49% of the visit, interpreters translate 27%, and patients speak 24%6. In actuality interpreters should be speaking 50% of the conversation.

In addition to reducing the time spent speaking, interpreters also alter the content of the conversation. Interpreters are at fault of omitting and revising content6. In other words, interpreters exclude significant information and modify critical matter in conversation.

Furthermore, “small talk” is almost entirely nonexistent when an interpreter is utilized6. Small talk is a method for physicians to interact with their patients by speaking about issues unrelated to medicine. Without “small talk,” the clinician-patient relation is weakened.

When speaking to individuals who lack proficiency in English, it seems most logical to use a medical interpreter. Although misunderstanding and issues arise as interpreters are employed, it appears that interpreters are responsible for more benefits than disadvantages. Physicians and patients would not be able to communicate in the first place if interpreters were not used. There is more chance of misdiagnosis, deterioration of health, or even death if an interpreter is not present. Although medical interpreters do not completely eliminate the language barrier that exists in the medical field, it certainly does improve the possibility of overcoming this obstacle.


References

1. Chen, A. Doctoring across the language divide. Health Affairs [database]. 2006 [cited 2008 Apr 06]; 25 (3): 808-813. Available at Academic Search Premier: http://web.ebscohost.com.proxy.lib.utk.edu:90/.
2. Ngo-Metzger, Q., Massagli, M., Clarridge, B., Manocchia, M., Davis, R., Lezzoni, L., Phillips, R. Linguistic and cultural barriers to care. Journal of General Internal Medicine [database]. 2003 [cited 2008 Apr 06]; 18 (1): 44-52. Available from Academic Search Premier: http://web.ebscohost.com.proxy.lib.utk.edu:90/.
3. Phokeo, V., Hyman, I. Provision of pharmaceutical care to patients with limited English proficiency. American Journal of Health-System Pharmacy [database]. 2007 [cited 2008 Apr 15]; 64 (4): 423-429. Available at Academic Search Premier: http://web.ebscohost.com.proxy.lib.utk.edu:90/.
4. Wilson, E., Chen, A., Grumbach, K., Wang, F., Fernandez, A. Effects of limited English proficiency and physician language on health care comprehension. Journal of General Internal Medicine [database]. 2005 [cited 2008 Apr 06]; 20 (9): 800-806. Available from Academic Search Premier: http://web.ebscohost.com.proxy.lib.utk.edu:90/.
5. Contextualizing cultural competence training of residents: results of a formative research study in Geneva, Switzerland. Medical Teacher [database]. 2006 [cited 2008 Apr 15]; 28 (5): 465-471. Available at Academic Search Premier: http://web.ebscohost.com.proxy.lib.utk.edu:90/.
6. Aranguri, C., Davidson, B., Ramirez, R. Patterns of communication through interpreters; a detailed sociolinguistic analysis. Journal of General Internal Medicine [database]. 2006 [cited 2008 Apr 15]; 21 (6): 623-629. Available at Academic Search Premier: http://web.ebscohost.com.proxy.lib.utk.edu:90/.

*I had trouble formating the superscripts in the in-text citations so I know they look weird right now. Also I could not get my indentions to line up for my references.

Bridging the Gap in the Medical Field

My ultimate career goal would be in the field of medicine. When I think about issues that surround the medical field, they all relate to misunderstanding. What the physician explains to a patient does not seem all that crystal. Many people who speak to a physician hope to be enlightened. After a conversation with their doctor, however, these patients are more lost than before.

A reoccurring language issue that affects the medical field is the use of technical jargon. Many times physicians do not clarify enough when speaking to their patients. They overlook the fact that the majority of their patients have lower health literacy and do not understand the medical terminology that doctors are accustomed to. Problems occur when doctors explain the conditions of their patients’ health issues and even medical instructions.

An additional issue that appeared often in my research deals with patients with English proficiency. With a rapidly increasing number of immigrants in the U.S., doctors find it more difficult to communicate effectively with their patients.

Doctors may use trained medical translators to aid in the communication process with foreigners. Even bilingual staff members can be off assistance. When these translators are not available, doctors must communicate by themselves. They must use a slower rate of speech, simple diction, and visual aids.

Physicians must communicate clearly by catering to their patients. Doctors must clarify exactly what the health issues are and clearly state how the patients can combat it. If this issue is not addressed, patients are left confused, misguided, and untrustworthy. This confusion can lead to not having full confidence in their doctor or not knowing how to deal with their health problems. This in turn may lead to a diminishing of their health or the possibility of death.

Sophistication

As I recently walked down the magazine aisle of a local grocery store, bold letters on a magazine cover caught my eye. It read, “GQ magazine is for the sophisticated man; or the man who wants to be more sophisticated. GQ has great interviews with celebrities including, Jake Gyllenhaal, Robert DeNiro, Justin Timberlake, and many others. With tips on style, fashion, and how to dress for work, this magazine will get you all set to impress.”

GQ magazine states that appearance determines a man’s level of sophistication. By following a few simple guidelines, you can resemble your favorite celebrity with their similar power to impress. Is this really what the word sophistication means? Is it an attractive or glitzy state that can be created with a few easy tips?

The American culture has twisted the definition of the word sophistication to mean almost anything. Because of its stretch in meaning, this word can be considered a weasel word. It has become problematic that sophistication is used carelessly in the English Language and strays so far from its original meaning.

The word sophistication has two distinct meanings in our history. These two meanings are not at all consistent and are in fact completely opposite. In the English language, sophistication first meant deception or dishonesty. The more familiar definition, meaning wise or experienced, appeared later on.

Although it is ironic that the definition of sophistication has changed so greatly, there is an interesting reason for this. It all started with the Sophists, who were Greek teachers of philosophy and rhetoric in the fifth century B.C. According to the Online Etymology Dictionary, the name "Sophist" comes from the Greek word "sophos," which means both "wise" and "clever." The word sophos carried positive and respectful value.

The Sophists were indeed wise up to a point and certainly clever. However, their teaching of philosophy and rhetoric came to be known more for its creativity than its principles, leading them to develop a dishonest style of argument. The reputation of the Sophists for misleading reasoning eventually gave us the negative connotation for the term "sophistry" (Online Etymology Dictionary).

As the word sophistication entered into the English language, it carried this disapproving implication. According to the Oxford English Dictionary (OED) the first definition in the English Language was, “The use or employment of sophistry; the process of investing with specious fallacies or of misleading by means of these; falsification.” The first account with this particular use was recorded in the fifteenth century (OED).

In 1530, Sir Thomas More wrote, “For such kind of sophisticacion in arguing, was the very cauillacion and shift that the wicked Arrians used” (OED). In this sentence, the word sophistication means controversy or disagreement. More describes the process of arguing as deceptive by linking it to the evil Arians. Arianism is a belief contrary to the Nicene Creed and is considered heretical. The Arians believed if the Son were equal to the Father, there would be more than one God. This unorthodox teaching conflicted with the Trinitarian teaching held by Christianity. The Arians resemble the misleading Sophists by teaching deceptive arguments.

A dramatic shift in Language brought about a new meaning to the word sophistication. This new meaning is clearly an antonym of the first, as it lost its disapproving sense. Shaking off those simple rustic roots, sophistication came to be seen as a good thing. The second definition is “worldly wisdom or experience” (OED). The first record of this new opposing definition with its positive connotation was recorded in the late 19th century (OED).

The America’s Historical Newspaper cited an article in 1895 that employs the positive use of sophistication. The article reads, “There are some men that do not know the value of silence. But this knowledge comes only with sophistication, and the young man lacked experience.” This sentence encompasses the overall new meaning of the word sophistication. It appropriately links sophistication with skill and experience.
In modern English language, however, the word sophistication has changed even further. The gradual change of this word is due to its use in widening range of contexts by different groups of users. The overuse of this word has caused it to lose its connection to its root, meaning wise or experienced.

Linguist Dick Lieth acknowledges the loose definition of sophistication in modern culture. He states, “Many educated speakers of English may try to monitor their use of sophisticated by restricting its use to the descriptions of people; and even then many groups of people may acknowledge the meaning ‘urbane’ without necessarily upholding the values associated with this meaning.” In other words sophistication has carelessly come to mean refined, stylish, or whatever the speaker desires.

The vague connotation of sophistication has transformed it into a weasel word. In most cases it is used as a filler to make claims empty enough to mean almost anything. By simply inserting the word sophistication into a sentence makes the subject much more appealing.

Slogans demonstrate the emptiness that is connected with the word sophisticated. A current commercial for cat food informs, “Tender and moist, Fancy Feast is the only choice for your discriminating cat's sophisticated palate.” Sophisticated in this sentence can be translated as good, worthy, difficult, classy, mature, superior, or just about anything we desire. The advertiser purposely uses this word so that the audience can decipher its meaning for themselves.

Toyota uses the word sophisticated in a similar manner. Their slogan declares, “Prius, the most technically sophisticated car on the road.” Sophistication transforms a dull word into a word that is coveted. It makes an idea better or superior to others.
Our culture wants to be just this. We want to be admired as superior to others.

Sophistication has become a class marker. It separates the wealthy from the poor, the celebrities from the average guy. All those who are referred to as sophisticated are certainly not all wise or experienced. Our society sees the sophisticated as living better, more enjoyable lives.

The official website for Cosmopolitan expresses, “Sophisticated, glamorous and inspirational, Cosmopolitan is a monthly magazine for the young woman who wants it all – good looks, a successful career and great relationships.” This company promises that their product embodies all the qualities of sophistication. This magazine claims that it is essential for women to flip through their pages to acquire the desired, ideal life. This ideal life is centered upon appearance, material goods, and prosperity.

Similar to Cosmopolitan, GQ magazine assures that a few tips or lessens in sophistication will land its readers at the top. The sophisticated man will have celebrity-like qualities. It is in our human nature that we are attracted to all these glamorous promises.

Does our culture value fame or beauty over wisdom? We have to ask ourselves if this is the reason for the change in the modern form of the definition of sophistication.

The best definition is one that resembles the root, “sophos” meaning “wise.” It should promote honorable qualities and value. Most of all, the definition of sophistication should have definite meaning, unlike the weasel word form in modern English. In the 19th century the word sophistication came full circle from its original meaning. This circle needs to repeat itself once again so that the definition of sophistication relates to its appropriate, original Greek form.


Works Cited

America’s Historical Newspapers. 1992. Readex. 10 March 2008

http://infoweb.newsbank.com.proxy.lib.utk.edu:90/iw-search/we/HistArchive?p_action=search.

Cosmopolitan. 2008. Hearst Communication, Inc. 10 March 2008 http://www.cosmopolitan.com/.

Leith, Dick. A Social History of English. London: Routledge, 1997.

Online Etymology Dictionary. 2001. Douglas Harper. 10 March 2008
http://www.etymonline.com/index.php?term=sophist.

Oxford English Dictionary. 05 March 2008. Oxford English Press. 10 March 2008 .
http://dictionary.oed.com.proxy.lib.utk.edu:90/cgi/entry/50231029?single=1&query_type=word&queryword=sophistication&first=1&max_to_show=10 .

Racing for the Right Name

The article “From African to African American” written by Simitherman describes how difficult it is to name a race. It seems to me that choosing a name for a race would be quite simple. An important figure of that race denotes a “group name” and moves on. Our history, however, shows that it is much more complicated than this.

Africans in America have had quite a few names from 1619 to present. These names range from “African” to “negro” to “Negro” with a capital “n” to “Colored” to “Black” to “African American.” This list is infinitely long as with all other race names.

Race names should not be based on appearance. The name should not reflect the group’s hair color, facial structure, height, speech, intelligence, or social status. The name should represent the country or state they are from.

The French are from France, Canadians are from Canada, Hawaiians are from Hawaii, and so on. The name given to Africans in America should reflect this pattern and they should be called “Africans” or “African American.” Referring to a race by where they are from instead of their appearance eliminates racism. Above all, race names should possess respect.

It is through the same respect that you address a person by their appropriate ethnic title. For example my friend is Peruvian and people refer to her as Mexican just because they look similar. She sees others’ carelessness very insulting. The majority of people refer to those who are from South America as Mexican. The problem is that not many people know the difference between Mexican, Latino, and Hispanic.

I have seen this happen with my mother on numerous occasions. My mom is Japanese and people will refer to her as Chinese. I find it humorous that many Americans believe that if you look Asian than you are automatically from China. There is clear difference.

Race names will forever be an issue if we continue to choose names based on traits. Respectful names are the only way people can live in harmony.

Language is Like Clothing

It surprises me that there are so many variations in language. These variations occur depending on certain circumstance. We recognize the formality or informality of the situation, and therefore adapt our language appropriately. We change our language much like the manner in which we change our clothes. Robert MacNeil’s article “English Belongs to Everyone” made me see the relationship between language and attire.

There are comfortable ways of speaking and in these situations we tend to speak informally. We speak informally to our friends and family, those who are close to us. Striving to speak grammatically correct when talking to our friends is not our first priority. We are relaxed in our speech and our clothing reflects this informality. We wear blue jeans, t-shirts, and flip-flops. With our friends, we wear and speak however makes us feel most comfortable.

In formal occasions, we speak properly. We alter our language in situations such as a meeting or a job interview. In a meeting it is important to speak grammatically correct. Speaking “correct” English demonstrates our knowledge and qualifications. A sharp, clean suit is proper meeting attire. Another example of when we should pay attention to language is at church. In church it is inappropriate to speak loudly or vulgarly just as it is inappropriate to wear jeans and a t-shirt. It is through respect that we adjust our language and clothing in formal situations.

There are clothes of different materials that correspond to different language. Swimsuits are appropriate at the pool or beach. In these two places it is okay to laugh, holler, and scream at the top of your lungs. You can speak informally and relaxed. Jogging shorts, tennis shoes, and t-shirts are common at the gym. When working out it is all right to breath heavily or even grunt when speaking. Speaking with one word sentences is common at the gym because of exhaustion. There are even clothes which help to make an occasion memorable and magical. These include wedding dresses, tuxes, and graduation gowns. The Language spoken at these times are memorable as well.

We should all keep in mind that it is necessary to change our language in addition to our clothing to agree with the circumstance. In many ways using language is like wearing clothes.

T...OCD

When it comes to writing, computers are distracting. Well at least for me. There have been numerous occasions when I have sat before a blank computer screen, not knowing where to start. I find myself wasting my time perfecting the appearance of my paper rather than concentrating on the content of my paper.

I have come to the conclusion that I have a typing disease. I have condition called typing obsessive-compulsive disorder. Although it is frustrating at times perfecting the outrageous range of fonts and graphics that accompany Microsoft Word, it is comforting to know that I am not the only victim of this disorder. Sharon Cogdill shares her view on this topic in “Computers and Writing.” Cogdill explains, “All writers who use a computer fall in love with the neatness, the orderliness, brought to their pages by the screen and the curser.” Formatting my paper precisely consumes the majority of the writing process.

After reading her article, I have noticed in my writing that the lower order concerns take priority over the higher order concerns. With a click of a button, it is easy to take care of the lower order concerns on a computer. Grammar and spell check is automatic and fonts are easily changeable. A thesaurus is accessible as well.

Often times I fall into a trap and cannot write more than one sentence without rereading and revising it. I feel that it is necessary for writing on the computer to look professional so I am therefore consumed in perfecting sentence by sentence.

Cogdill shares an important aspect of the revising process that I had never thought about before. She mentions that students who revise only on the computer receive worst grades than those students who revise on an 8 ½ by eleven sheet of paper. This makes sense because you are limited in your view of your paper when you are simply looking at the screen. On a hardcopy however, you can look at your paper as a whole and make larger revisions.

Keeping Cogdill’s suggestions in mind, I now only write my first drafts on paper. This eliminates a significant amount of distractions which leads me to concentrate more on content. The best advice within Cogdill’s article is, “The danger is twofold: time spent on the surface is time taken away from the depth, and neat, decorated pages look like finished pages to a vulnerable writer.”