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Curbside Consult with Dr. Jayne 7/16/18

July 16, 2018 Dr. Jayne 12 Comments


I’m a voracious reader and enjoy many kinds of literature. I’m part of a book club, largely composed of women in healthcare IT, that meets monthly via Webex to talk about a good read. I see hundreds of manuals, summaries, and business documents come across my desk every year.

Given all these things, I’m a firm believer in the concept that words mean something. Unfortunately, I don’t think this belief is shared by some of our fellow travelers in healthcare IT. We may understand how a claim needs to be properly formulated for it to be paid, or a lab result so it can be delivered through an interface, but sometimes we fall short in the realm of communicating with people.

Almost every end user has complained about user guides or technical manuals at one point in their career. There are hazards in trying to convert a technical process into something that clinical people can follow, or that distracted physicians are willing to sit and read. My first EHR vendor put out a 1,000-page user manual that was nearly unreadable and would rival any piece of federal legislation for its sleep-inducing properties. They blamed its size on the included screenshots, but part of it was the overly-wordy description of a complicated documentation system that was a hybrid between legacy green screens and something more graphical.

My undergraduate institution’s English department has a program in technical writing. I’m surprised they don’t turn out more than the one or two graduates who earn degrees each year because it should be a skill that is in demand.

The language of healthcare itself often gives physicians something to chat about in the physician lounge. “Reimbursement” implies that someone is getting paid back for something  in an amount equal to a previous expenditure. It’s fancier than saying “payment” and tries to mask the transactional nature of the business of healthcare. Many physicians agree that those reimbursements don’t adequately cover the time, effort, supplies, and overhead required in delivering the service, especially when looking at payers such as Medicaid. Can you imagine your HVAC contractor or auto mechanic talking about reimbursement for their time as opposed to just delivering a bill for services rendered?

I also hear physicians complaining about marketing campaigns directed towards them, and there are certainly plenty of those to make fun of. We’ve grown out of having photos of physicians playing golf and fishing as a proxy for the free time that technology solutions are going to give them. Instead we’re depicting them in the office seeing patients, which is where they belong, but that does agree with how physicians see themselves working increasingly long hours. There’s greater emphasis on showing physicians and providers of various demographics, old and young, male and female, and of diverse racial and ethnic backgrounds. Although vendors have done better with some of their pictorial efforts, there are still issues with the words they use.

One of my bigger pet peeves is the overuse of the word “holistic.” Newsflash for marketeers: holistic means something that has parts that are interconnected and that the whole is greater than the sum of the parts. A holistic approach to a problem does not mean providing a laundry list of solutions that a client might want to purchase in order to solve a business problem. Holistic also has a certain connotation in medicine that I think vendors fail to understand. A reference to holistic medicine often implies complementary and alternative therapies, non-western medicine, naturopathy, and other modalities. Depending on the beliefs of the physician you are marketing to, use of the word holistic can either be a blessing or a curse. Beyond that, if your “holistic solution” doesn’t provide any benefit beyond that of its parts, then it’s not holistic and you just look confused about how you are describing your offering.

Other words that have lost their sparkle include innovative, novel, revolutionary, and cutting-edge. Everyone claims that their solutions and offerings fall into these categories, to the point where the words no longer have meaning. I had a rep recently pitching a tabletop lab analyzer machine which was similar to the one we already have in the office. He acted like it was something groundbreaking when there are multiple competitors in the field that offer similar devices. The real difference between his offering and others was the price point, which in his case was a disadvantage. Costing almost twice as much as the nearest competitor might be novel, but the data trying to show it as a better device wasn’t going to swing us into buying 36 of them.

Then there are the folks who are killing us with mostly meaningless buzzwords: artificial intelligence, blockchain, synergy, cloud-based, mobile, virtual reality, and more. I think people assume that if they include one of those words in an email that it means people’s ears will perk up and they will instantly be attentive. I think we’re all hyped out on many of those terms, at least until there is proof that their respective technologies can really make a difference.

Words also have meaning with interpersonal communication. I see far too many emails where people respond rapidly and appear that they may have done so without thinking. It feels like people are so concerned with moving messages out of their email boxes that they’re just flinging information back and forth without proofreading or making sure their responses make sense.

I see emails where someone has asked multiple questions and the response addresses only one of the points, or where it’s clear that someone wasn’t reading for comprehension. There are emails that are full of nonsense words – talking about circling back to review deliverables and determine which items are deal-breakers and the like. I once saw an email about “prioritizing show-stoppers” prior to a go-live. By definition, if they are show-stopping defects, aren’t they all of equal priority since they will bring the go-live to a screeching halt? It was worth a number of laughs, so I can’t make too much fun of it because it made several of us smile.

I’m a firm believer that people who are strong readers are better writers. If you’re responsible for creating content, writing blogs for your company, or preparing user guides and manuals, when is the last time you read something non-work-related? I want to challenge people in those roles to read a good book and see if it changes your frame of mind or if it positively influences your work.

What’s the last good book you’ve read? Leave a comment or email me.

Email Dr. Jayne.

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Currently there are "12 comments" on this Article:

  1. I’m currently reading Educated by Tara Westover. I live in eastern Washington which is both topographically and culturally similar to where she grew up and with parents who were nowhere near as zealous, but still had very similar paranoid and isolationist tendencies that were fueled by religious beliefs. Now, while I can appreciate my childhood and adolescence was less traumatic than hers, I also feel pretty inadequate on the educational front.

  2. Yes! Yes! Yes! Technical writing is difficult in that you have to convey in the simplest terms, yet be complete. I try to apply the same mantra in business correspondence, whether it be a quick email to my boss or something more complex to a customer. Keep it simple, yet thorough. I have admittedly struggled with writing out long paragraphs of explanations, but then realize it’s way too much and that nobody’s going to read it all, so I edit/condense. I have also found the higher the title of the recipient(s), the less time they will spend reading.

    The last good book I read was “The Handmaid’s Tale,” by Margaret Atwood. At first I thought the story was so far-fetched and unbelievable, but then I did start to see some similar events happening in real life. It’s a novel so of course you have to suspend reality to truly just enjoy it, but it also made me think. The 1st season of the TV series on Hulu follows the book amazingly close and is as they say is…. “binge-worthy!”

    • I read “The Handmaid’s Tale” in high school and remain so traumatized by it that I can’t bring myself to watch the show, despite outstanding reviews, 27 years later.

  3. Great post. As far as marketing hype and superlative goes, I find it unpleasantly now present in journalism also. Books I wish I hadn’t read so I could read them again are: “All the Light We Cannot See,” by Anthony Doerr and “the magic strings of frankie presto” by Mitch Albom. If you’ve a bent for some crusty old cowboys and women as tough as boot leather some of the characters in “Lonesome Dove” by Larry McMurtry are more developed than some people I know. It’s immensely entertaining and at times, laugh out loud funny. All the Light and Lonesome Dove both won Pultizers, the former heavier than the latter. And, good reading to you good doctor.

    • I am in the middle of Lonesome Dove right now. I’m a historical fiction buff and this has been wonderful. I’ve enjoyed his writing style and great observations. At first I dismissed it as a western tv-movie like book until I saw it won the Pulitzer.

      The last two years I’ve read some classics I read a couple of decades ago: Winds of War and War and Remembrance by Herman Wouk. And Steinbeck’s Grapes of Wrath and East of Eden. Also A Tree Grows in Brooklyn by Betty Smith was my teenage favorite.

      Next up is Americanah by Chimamanda Ngozi Adichie – started during busy spring and put it down, will pick it up again. My daughter (Harry Potter kid who has read that series 10x through since) gave me JK Rowlings The Casual Vacancy for Mother’s Day – I was about half way through, when she grabbed it and finished it, she told me the ending is tragically sad and I shouldn’t finish it….hmmm…

      I agree wholeheartedly about reading. But as a Communications major who fell into HIT – I’ve always believed it’s valuable no matter what your field. My mantra to my kids is “proofread your cover letters and have a tight resume and you’ve already beat >50% of the competition”. I’m astounded by what I see/read from candidates.

  4. My summer reading has included the dense (as in you’ll need a dictionary with you) “Martin Luther” by Eric Metaxas. It was a pretty fascinating look at the beginning of the Reformation, plus Metaxas always does a good job of incorporating the back stories of some of history’s overlooked characters. I followed that up with an extremely fluffy, fictionalized account of Wallace Simpson – just one more reason for me to start binge-watching The Crown, which everyone I know seems to be recommending to me these days. Happy reading!

  5. “Byzantium” by Stephen Lawhead is as good a summer-reading yarn as you’re going to find. Its a long book, but very rich in storytelling and engaging, so it reads up pretty quickly. Its good for the beach.

    I also strongly recommend Ken Liu’s collection of short stories entitled “The Paper Menagerie”.

  6. Here’s one – read this a while ago and re-read it recently. A beautiful piece of writing about the body:

    * Body of Work: Meditations on Mortality from the Human Anatomy Lab, by Christine Montross

    … and a couple of old favorites – lushly descriptive and highly entertaining stories:

    * The Rebel Angels, by Robertson Davies
    * Love in the Time of Cholera, by Gabriel Garcia Marquez

    Good column!

  7. “Autonomous” by Analee Newitz is the first fresh take on Sci Fi I’ve read in a long time. Features robotics, the pharmaceutical industry, and more.

  8. I’d like to craft the word “Synergize” out of steel and use it beat to death anyone who tries to use the word in a meeting. Really, do people think using vapid buzzwords make them look smarter?

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