Hot-Button Words to Avoid in Healthcare

A West-Coast internist wrote that health-care professionals could benefit from “interventional marriage counseling” because they talk at rather than to each other, not hearing what the other side is saying. Although the reasons are multifactorial, hot-button words, such as “but,” “just,” and “you” can stress relationships and interfere with collaboration.

But
How many of us have at some point in our life felt damned by faint praise that begins, “You did a great job, but …” What do we remember? The next time that person interacts with us, we put up an invisible shield, expecting criticism. My daughter became so infuriated by this approach that she yelled, “Don’t wave your ‘but’ at me!” She has taught the family to use more emotionally neutral words like “and” or “at the same time” to make contrasting statements.

Just
At least once a year, a well-meaning person asks me, “What type of surgeon are you? Do you specialize, or are you just a general surgeon?” I parrot the words “just a general surgeon.” Perhaps “just” should be used to apply to justice rather than to describe another professional’s actions, attributes, or implied value.

You
“You suck,” a young family practice physician roared at an older physician whom he felt was patronizing him at an off-site retreat. The silence in the room was palpable. After approximately 20 seconds, which felt like 20 minutes, the new department chairman tentatively said, “Dr. Cohn taught us to send ‘I’ messages.” The young physician glared at me and, with reddened face and neck, looked the older family practice physician in the eye and said, “I feel you suck.” Everyone in the room laughed in relief and, from then on, understood the difference between “I messages” and the more accusatory “you” messages.

Points to remember include:

• Conflict is inevitable in rapidly changing settings like healthcare
• Being conscious of hot-button words can decrease the chance of conflict escalating to the point that it interferes with providing collaborative, patient-centered care

©2007 Kenneth H. Cohn, M.D., MBA, FACS

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