Thread by @tjwebbmd

"Non-Compliant"
"Difficult Patient"
"Poor Historian"
"Unreliable"
"Drug-Seeking"
"Low Health Literacy"
Or the indefensibly still in use, "Poor Protoplasm"

So many of the labels Medicine uses for patients are just a way of saying, "Not one of Our People."

#MedTwitter

2/ Medical Students and Residents, don't accept this terminology; don't allow it to dehumanize your patient, remove their agency, and undermine their care. Phrases like these can and do kill people. Fight back against this; both subtly and explicitly. #MedStudentTwitter

3/ When someone on your team says the patient is non-compliant, ask whether the plan they 'didn't comply' with was guided by shared decision making and realistic considering their healthcare barriers; ask whether the plan was discussed with them, and if they consented to it.

4/ When the attending says the patient has "poor protoplasm," ask what that means in biomedical terms; don't accept hand-waiving and dismissive, patient-blaming answers.

5/ When they say the patient has "low health literacy," question how much effort the team has actually taken to explain things well and empower that patient.

Challenge these narratives. Don't let them persist and become a part of the patient's care; because it might kill them.

6/ And use the power you have to tell the counter-narrative that your patient, whoever they are, absolutely is one of "our people." Use your presentation to tell about their life; how they are a loyal friend, a caring father. Mention their hobbies and interests, their passions.

7/ Medicine is dehumanizing to patients; use your words to humanize them, to bring forth the personhood we ought to see in each patient but so often fail to. You are the one presenting the patient on rounds, building the narratives around them; you have more power than you realiz

8/ This shouldn't be necessary. It's awful that it is. As doctors, who else is "Our People" if not our patients? That bond should be enough. But it isn't; bias, prejudice, and narratives the patients never hear still impact their care on a daily basis in our healthcare system.

9/ We have to change that. Urgently. Let your FIRST loyalty be to your patient, not your attending or your inpatient team. Defend them in rooms they aren't in as though they were your best friend or a member of your family, and you will teach your co-learners to do likewise.

10/ A generation of doctors that are more loyal to the patients they serve than to their profession would revolution medicine. And far from undermining team cohesion, it would build camaraderie on the solid ground of shared purpose.

It all starts with you speaking up on rounds.