Healthcare is a heterogeneous environment, so even a diligent clinician may inadvertently employ an incorrect term. When this happens, an effective apology should include actively listening and earnestly considering the other person’s preferences. Most experts recommend expressing regret with a simple statement, and continuing the conversation. While a simple, tactful apology may attenuate the situation, an Pronouns are often viewed as extensions of our identities. Therefore, one should use the correct pronouns to acknowledge an individual’s identity. The incorrect use of pronouns, such as addressing someone using “he” or “she” instead of the preferred pronoun “they,” is referred to as misgendering. In healthcare, the appropriate use of pronouns is an important aspect of providing patient-centered care and building trusting physician-patient relationships. Appropriate use of pronouns when addressing and exaggerated apology may worsen it. Pronouns in Medical Communication referring to patients demonstrates respect and acknowledgement of a patient’s gender identity. Doing so facilitates more positive and open relationships between patients and their providers. Of note, studies have found an inverse association between symptoms of depression, anxiety, and stress and the quantity of endorsed gender affirmation experiences. While incorrect use of pronouns can trigger feelings of discomfort, disrespect, and even post-traumatic stress, inquiring about a patient’s preferred pronouns demonstrates a level of understanding
status, access to healthcare, and environmental factors often play more important roles in disease manifestations. As such, it is important for medical professionals to approach questions regarding race and health with caution, and consider a range of factors when making clinical decisions. Understanding patients’ cultural preferences helps bridge communication gaps and improves patient-provider relationships. For instance, religion can play a significant role in shaping a patient’s medical decisions. Preferences for treatment options, end-of-life care, blood transfusions, organ donations, and abortion may differ considerably depending on a patient’s beliefs and values. For example, in Muslim and Orthodox Jewish communities, religious norms are constantly evolving to align technology with tradition. Understanding why a patient’s decisions may differ from therapeutic standards enables providers to directly communicate with the patient while taking their desires into account. Understanding the cultural background and preferences of patients also improves the way providers communicate and deliver care, ultimately leading to better health outcomes and treatment compliance. Conversely, unconscious bias and racism can influence patient care and medical communication, potentially worsening disparities. For this reason, recognizing and respecting the full diversity of racial backgrounds is critical in making patients feel safe. For instance, providers should not assume that every Black patient is African American. This assumption fails to consider the diversity of groups of African descent, including African Caribbeans, African Kenyans, African Surinamese, and many others, and may be offensive. The use of inclusive language and terms can help create a welcoming space for marginalized racial groups. A crucial part of reducing unconscious bias is engaging in active listening to express compassion and understanding of each patient’s lived experience with the healthcare system. Ultimately, establishing an open and welcoming environment that acknowledges an individual’s race and culture is an important aspect of effective communication in patient-centered care. It’s crucial to remember, however, that
that can open multiple communication channels. The use of patient-selected pronouns allows healthcare workers to create a more welcoming and inclusive environment for all patients and can help patients feel more comfortable when discussing sensitive topics. To establish provider social awareness, clinicians may consider introducing themselves with their own pronouns, potentially encouraging others to do the same without discomfort. If you are uncertain about someone’s pronouns, it is generally safe to use “they/them/theirs” unless that person specifies otherwise. Conversely, if a patient’s pronoun preferences are “he” or “she,” using “they/them/theirs” may be unwelcome. The World Professional Association for Transgender Health’s Electronic Medical Record (EMR) Working Group has suggested that a patient’s preferred name, gender identity, and pronoun preference be included as basic demographic variables in the EMR. Acknowledgment of a patient’s preferred pronouns in the EMR can reduce the possibility of misgendering by clinicians. Additionally, the use of appropriate pronouns should extend beyond communication with patients to include communications with fellow staff members and colleagues. Race and Culture in Medical Communication Acknowledging racial and cultural differences in medical communication can help build trust between providers and patients. Effective interpersonal communication, along with culturally appropriate and personalized patient care, can enhance health equity. However, the use of appropriate racial and cultural terminology in medical communication is a complex topic. It requires understanding cultural humility, recognizing biases, and establishing patient- centered care. For instance, a patient’s race is sometimes used in medical standardized test question stems to illustrate a disease process. However, such use of race has been criticized for perpetuating racial stereotypes and biases. In addition, assuming that certain health conditions are more common among people of a particular race can drive medical errors and increase health inequities. Other factors, such as socioeconomic
Healthcare providers must be considerate of an individual’s preferences regarding the use of gender pronouns.
terms involving race and culture are continually changing and mistakes are possible. For example, while the acronyms POC and BIPOC are both used to describe non-White individuals, the more recent term BIPOC specifically highlights the unique experiences of Black and indigenous individuals, two groups in the United States that have been historically marginalized. Among the Hispanic community, the use and acceptance of the terms Hispanic, Latinx, and Latine can vary depending on cultural context and personal preference. The term “Hispanic” reflects the Spanish colonial legacy in Latin America, while both Latinx and Latine attempt to create more gender-neutral and inclusive terminology for people of Latin American origin. It should be noted that only 3% of Hispanics in the United States prefer to use the term Latinx to describe themselves. Other Commonly Used Evolving Terminology in Medical Communication In general, it is preferable to use person-first language rather than condition-first language when describing patients and their diseases, disabilities, or social circumstances. For example, the dehumanizing term “crack baby” was formerly used to describe children who were exposed to drugs in utero. Terms such as “addict” or “drug abuser” imply moral failure, and terms such as “crazy” or “insane” often stigmatize people with mental health conditions. In addition, terms such as “midget” or “Downs” are derogatory qualifiers for people with dwarfism and Down’s Syndrome, respectively. Instead of using such terminology,
An excessive apology is unnecessary when one makes an error in using gender pronouns.
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WHAT DID YOU SAY?
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