There is an increasing tendency in medicine to use language that places the focus on products rather than on patients. This tendency seems particularly noticeable in the field of heart rhythm disorders, perhaps because our therapies often involve devices. The most flagrant example is the use of the phrase “a patient is indicated for product X.” This phrase is not just grammatically incorrect, it focuses on the product rather than on the patient. Although patients may have an indication for something, they are never indicated for something; products are indicated for certain types of patients, not the other way around. The table below shows frequently used terms that place the emphasis on a drug or device in the left column, with more patient-centric alternatives in the right column.
It is not clear where this product-centric language that refers to patients as a commodity came from, but the most likely source is industry. Product-centric language is ubiquitous in industry labeling and marketing materials. Unfortunately, this jargon has crept into the medical literature as well. There are a few possible explanations for this. One explanation is that the language is used so often by industry representatives that it has become adopted by physicians and nurses. Another possible reason is that the fear of FDA rules that prohibit promotion of products for non-FDA-approved indications has led to an obsession with official product labeling and created an environment of constant declaration of product indications and contraindications. A third potential explanation is that industry personnel are often involved in the preparation of journal articles, not necessarily as ghost writers, but as legitimate authors, bringing with them their own language.
Word choices can be revealing. It is important that physicans and other healthcare professionals use language that makes it clear that the focus is on patients. Products are indicated for certain conditions, and patients can have indications for products, but patients do not have indications. Devices are implanted and extracted, not patients. It is not only important that our medical literature remain free from product-centric language, but so should our language during day-to-day patient encounters and physician education. Industry representatives should also consider the message that is delivered when using product-centric language. Patients can sometimes need medications or devices, but products do not need patients. For years, healthcare professionals have had a language that is centered on patients. It is important that it stays that way.
To see Dr. Knight's editorial from last month, please visit "2012 ACCF/AHA/HRS Focused Update of the 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: The Field Takes a Wide, Left Turn."To see last month's editorial by Dr. Knight, please visit: http://www.eplabdigest.com/articles/2012-ACCFAHAHRS-Focused-Update-2008-Guidelines-Device-Based-Therapy-Cardiac-Rhythm-Abnormal