Patient-centered language is often sold to medical offices as a simple word swap, but the communication problem between healthcare professionals and patients runs much deeper than that. The problem is more complicated than telling healthcare providers to use person-first language and swap phrases like “diabetic” with “person with diabetes.”
The importance of inclusive language in the healthcare field has less to do with vocabulary policing and more to do with whether your patients trust you enough to return to your practice.
In talks with us, a Colombian-trained physician who has worked in the U.S. as a medical assistant was stunned by some of the things he experienced, such as doctors applying the same protocol to every patient, as if human bodies were mass-produced in a factory.
Standardization has its place, but something ugly happens in the U.S. healthcare system when a patient doesn’t respond to protocols as textbooks predict. The patient hears phrases like “this works for everyone except you,” “you failed treatment,” or “nobody else has this problem.”
Such language can be damaging to patients and often leaves them feeling isolated. Some of these patients start believing their bodies are uniquely broken and start internalizing failure that isn’t their fault.
Inclusive language in a medical practice entails recognizing that it is the treatment that has fallen short when a patient doesn’t respond to this treatment.
Researchers affiliated with Harvard argue that “failure-based language can profoundly discourage patients” and that phrases like “failed treatment” should be removed from the collective medical lexicon. However, the researchers noted that the statement “the treatment failed you” is also problematic because it acts as if there is only a binary solution.
Many patients have encountered this with US physicians who told patients there was no hope after a single attempt at a solution. Likewise, harm by US therapists toward disabled clients is a documented systemic issue.
Studies highlight that disabled individuals frequently face ableist microaggressions, medical gaslighting, and a severe lack of disability competence in mental health care. Many US clinicians receive little to no training on the lived realities of disability, which often includes medical trauma.
Patient anecdotes report that disabled individuals are discouraged by therapists from challenging the medical system, with compliance encouraged; that patient abandonment by physicians as an illegal but common practice is often reinforced as the patient’s fault, that hope is pathologized as failure to adjust; and that patients are sometimes told to give up. This creates issues, and hopelessness correlates with suicidal ideation, while hopefulness creates more resilience.
In my experience as a patient of Colombian therapists who use a humanist approach rather than a disorder-first approach, the difference is stark. They validate and refine the skills that have led you to survive so long and to persist in a broken system, such as your resilience, your determination, and your adaptability. In the US, therapists often discourage such actions from disabled people who are at the bottom of the power structure in the charity-based model of disability and are meant to be passive recipients rather than potential system changers who can develop their own power and fight back.
Many patients with chronic health conditions already know what it feels like to be dismissed by healthcare professionals. These patients have had interactions where their pain was minimized, their symptoms attributed to anxiety or body size, or their concerns dismissed without proper evaluation. This phenomenon is widely termed “medical gaslighting,” and it affects women and people of color at disproportionate rates.
Add blame-oriented language on top of these experiences, and US patients are actively being re-traumatized. Trauma-informed communications flip the script on how healthcare professionals should communicate with patients.
A trauma-informed approach includes:
One woman-founded virtual clinic in the US employs providers who have clearly undergone communication training, especially in the latter point mentioned above. The difference in the patient experience is immense.
Research shows that trauma-informed care improves patient engagement, builds trust, and makes patients more likely to follow through on referrals and follow-ups. You get better clinical results and outcomes when patients stop filtering their symptoms to avoid being judged and self-censoring in institutional settings.
Increasing patient retention by just 5% can boost profits by 25 to 95%. Every patient who walks out of your clinic feeling dismissed or viewed as defective is revenue walking out the door. Inclusive language for patient retention isn’t about warm and fuzzy HR initiatives; it’s a revenue protection strategy. Patients book follow-ups, refer friends, and stick to treatment plans when they feel psychologically safe with their healthcare providers. They often ghost you without any explanation when they feel dismissed or insulted.
A 2022 study found that patients who received culturally competent, inclusive care had an 89.7% retention rate after 90 days, which is roughly 40% higher than baseline rates commonly cited for mental health services.
While that particular study broadly examined cultural competency, it shows that patients really do stay where they feel respected. It is important to note that the term “cultural competency” is also used for disability culture, rural culture, and more. In the US, we tend to focus on ethnicity over all other characteristics, but providers must educate themselves beyond this.
Disabled people of all backgrounds tend to have several experiences in common and may find community based on their disability. People in rural settings likewise face unique barriers and experiences specific to being in settings where community can be a larger part of the social support network, access to healthcare resources can be difficult to manage, and discrimination can take place in metropolitan areas due to rural accents, with examples like Southern accent discrimination.
As another example, weight discrimination highlights the difference inclusive language can make. Adults with higher body weights who are stigmatized in healthcare settings are more likely to delay or avoid getting the care they need altogether, leading to worse outcomes and higher long-term costs for the healthcare system.
A simple shift in language, such as asking “would you like to discuss your weight today?” instead of launching into an unsolicited lecture, can dramatically change how safe a patient feels at your practice. But far greater is a change in practice such as seeing weight as a symptom rather than the cause of all complaints. As someone who has been obese and underweight, neither due to disordered eating but rather other health issues, I have seen the full range of how physicians treated me. Initially, my weight was blamed when I was large for insomnia due to epilepsy with the root cause of my weight gain being neuro-digestive issues. Later, I achieved a healthy weight and much-reduced abdominal pain after having to learn for myself how to eat for poor gut motility. Then, in my 30s, I was ignored despite my pleas for help with figuring out resources while severely underweight due to difficulty eating after my spinal leak worsened. “Patient reports no sudden weight loss” was a frequent and inaccurate comment in my medical notes.
There is no other aspect of medicine where blame-oriented language is more entrenched — and more absurd — than in medication management.
Consider levothyroxine, the standard medication for patients with thyroid dysfunction. Roughly 23 million Americans take it, making it one of the most prescribed drugs in the U.S. However, researchers at Yale found that as many as 90% of those prescriptions may be unnecessary.
This brings us to the question of who to blame if a patient can’t tolerate levothyroxine or sees no improvement. The patient? Or a system that over-prescribes medication that was possibly inappropriate in the first place?
Patient-centered language reframes the conversations healthcare professionals have with their patients. Instead of “you failed levothyroxine,” it becomes “levothyroxine was not the right fit for your body.”
One statement shuts down curiosity while the other opens the door to investigate absorption issues, dosing adjustments, comorbid conditions, or alternate strategies, such as evaluating iodine intake within its established U-shaped benefit curve, where both deficiency and excess create thyroid problems.
The same principle applies across specialities. A patient who can’t tolerate a first-line antibiotic, a chemotherapy regimen, or blood pressure medication hasn’t failed anything. The diagnostic framework, the protocol, or the medication may simply be a poor match.
The national conversation around inclusive language has largely been a surface-level debate over terminology, but it should go much further than that.
Real inclusive language in healthcare requires a deeper shift. It means examining how your practice communicates responsibility, blame, and variation with patients. It requires training every team member at your practice, from front-desk staff to billing, on how blame-saturated language sounds and how to replace it with more inclusive language.
Some steps healthcare professionals who run practices can take to counter blame-saturated language include:
Blame-saturated language erodes patient trust and retention.
Most medical practices lose patients due to poor communication without ever knowing why. Patients simply stop scheduling when they feel like they’re not being heard, or even worse, blamed for their own health problems. Research clearly shows that language that blames, dismisses, or shames patients is a leading — and entirely preventable — driver of patient attrition.
We are here to help if your practice is ready to move beyond surface-level wording changes and build a communication standard that keeps patients coming back.
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