Thursday, August 10, 2006

Jargon, Euphemism, and Acronym

Any English teacher, any book on writing or grammar tells us the same things. Write clearly. Be precise in the terms that we use. Strunk and White warn us to, “Prefer the specific to the general, the definite to the vague, the concrete to the abstract.” If they wee around to revise their handy book, The Elements of Style, surely they would also warn us against the overuse of jargon, euphemism, and acronym.

I work for a non-profit, and in the non-profit world, jargon and acronym are everywhere. At a recent conference, during a rather boring discussion, I began writing down some of the words and phrases that annoyed me the most. On that particular day, the term “skill-set” was being overused, as in “We should find someone for this job that has a strong skill-set.” This sounds pretentious, but pretentious crossed with silly. When the applicant “brings his skill-set to the table,” do we all get to play with it?
Another overused phrase is “at the end of the day,” which is being used as a sort of summation, or wrap up, the way we once used “on the same page.” We also use a lot of acronym in the non-profit world. It can be confusing for those of us who work there, let alone the uninitiated. We insiders have a tendency to think everyone in the room is “on the same page,” so we don’t always provide English to jargon or English to acronym interpretation.

The world of health care has been overrun by jargon. Once we had doctors, nurses, patients, and hospitals. Now we have shareholders, stakeholders, direct care providers, and managed care. Recently NHPR did a series on what they call “consumer driven health care,” a euphemism for new ways to be exploited by insurance companies. The term consumer is undoubtedly the one that offends me most. Once we were patients. Now, suddenly, we are consumers, and we’re supposed to be medical experts and be able to shop around for the best deal on surgical procedures. We hear from “experts” who believe that health care is so costly because people overuse it, and they overuse it because they don’t know how much procedures cost. If we knew how much it cost, we’d stop going out for recreational colonoscopies, apparently.
Much of the jargon around health care is designed to put the blame on the “consumer.” One of my friends recently received a letter from his insurance company, informing him that his doctor was leaving the area, so the company had assigned him a new primary care physician (what we used to call the family doctor). They had mistakenly assigned him a pediatrician, and the letter was to let him know all of the reasons why he couldn’t see a pediatrician, and came close to scolding him – as if he’d been the one who chose the pediatrician in the first place.
Consumers are supposed to have choices in the free market economy, yet it’s the health insurer who narrows the choices, and chooses doctors for us. Health care is not “consumer” driven, it is insurance company driven. The language used around health care seems deliberately intended to obfuscate, so that we don’t ask a lot of questions. It works. We don’t question our status as “consumers” on any level. Once we were patients, once we were citizens. Now we are consumers, and for all of the rhetoric around the concept, it seems we are expected to be passive consumers some of the time, at least when the insurance company is choosing with whom we will have a doctor-consumer relationship.

I work with a man who insists during our planning sessions that we use clear language. He used to drive me crazy at long staff meetings, insisting that we define what we mean when we use a term in a particular way. He won me over, however, and I’ve come to see the value in having clear definitions for the terms we use to describe the work we are doing. It’s a simple concept, if we all understand the terms we are less likely to make mistakes. Unclear language can cause and perpetuate mistakes.

Consider the “Global War on Terrorism,” which has been shortened to the “war on terror.” Webster’s defines terror as “intense, overwhelming fear.” No wonder this war isn’t going well. Let’s begin with the “Global War on Terrorism.” What does this mean? Where will this war be fought? How will we know when it is over? The term “War on Terror” is cleverly designed to prevent us from asking those very questions. The media uses “war on terror” without question – so why shouldn’t we? The obscuring of meaning enables the perpetuation of the war, because the terms aren’t clearly defined. If it were billed as the “Global War on Heathen Brown People,” we might have a different reaction to it.

It is an election year in NH, so we’ll all be tripping over candidates and incumbents everywhere we go. Talk to them – ask questions! As you do, remember to be very clear, and to ask your questions in such a way that calls for a direct answer. Politicians love to give long, rambling, filibuster answers. You do not have to accept this passively! You are not a consumer, you are a voter. You have the power to hire and fire our elected officials. They are not entitled to that seat in the NH legislature or Congress, no matter how long they’ve been there. They serve at our pleasure. The recent events in Connecticut should be a warning and a reminder to all incumbents. If you get a long, rambling answer, ask your question again, and insist on clarity. If we truly understood what some of our politicians were saying, they’d be unemployed.

“The great enemy of clear language is insincerity.” George Orwell

1 comment:

Anonymous said...

Good column! I recently saw a piece on CNN about a project at CVS pharmacy's that have walk in clinics with a schedule of costs for things from cholesterol screening to routine medical examininations and they all have a set cost. I think they take credit cards. All procedures are administered by a Nurse practitioner. I thought this a good idea and it cuts down on the jargon etc associated with the Medical Insurance industry (who'll probably hate it) and it benefits people with no access to routine medical care. Best of all it keeps the government out of people's business and since it's pay as you go it is financially self sustaining. Good idea.