To think that patronising letters do not increase compliance with screening programmes

[Oldsu]

A few months ago I was sent a tester kit for bowel cancer, and promptly lost the bally thing, although I have no symptoms a second cousin did have bowel cancer so had it in the back of my mind to find out how to request a second kit.

Before I could do so I was sent a reminder from the BCSP via my GP.

Now I do realise that these letters should be in plain English with no medical jargon, however these kits are sent out to people like me when we reach 60, so is it really REALLY necessary to send out a letter to a mature adult with the words 'poo' and 'tummy' in?

Quite frankly if it was a test I wasn't really bothered having done, instead of making my own mind up to have one anyway I would have thrown the letter away in disgust, there really must be a way to getting the message across to the public without treating them like a five year olds.

Complain to your GP. Maybe show them a Mensa certificate or something? Then they can put a note on your file which indicates you're VERY clever and don't want to get the same letter as the plebs.

Maybe the NHS could spend some time and money doing postcode analysis as well so people in nice middle class enclaves aren't bothered with letters which are targeted at people who haven't had educational opportunities for whatever reason.

Or maybe just be grateful that they're making the effort to remind you to do a test that might save your life and don't get too hung up on a few words. You understood the letter - someone who struggles to read might not be able to read the word faeces and stomach so they might not do the test, then their cancer might be missed. Are you ok with screening rates dropping as long as the wording on your letter is textbook accurate?

Oldsu you would be amazed what highly educated people don't understand about basic medical terminology.

Loads of people don't know the word 'stool' as it's basically only used in medical situations. Does stomach mean your whole abdomen or a small bag like structure under your diaphragm? Or both? Another favourite is nausea and vomiting - days of treatment can be wasted when you realise that the patient meant something entirely different by 'nausea' to you. Vomiting surely we can all agree on - nope, some people are coughing. Etc, etc...

I always go very basic first, often with drawing a picture. The number of people who haven't understood their treatment or disease turns out to be very high.

Why get fussed over it? It might be faintly irritating or even faintly amusing but why spend energy on it?

It's just good that the service is provided. Very good.

I can totally understand why this happens - and that it's right that it happens this way. But I'll admit I personally feel distanced and infantilised by the tone. If anyone's going to be in that position, though, it's probably best that it's people like me who can effectively and accurately advocate for myself.

What does grate is when HCPs can't or won't alter their 1 to 1 communication style. I've had questions about whether I'm 'medical' (I'm not; I'm interested in scientific subjects, I've worked in fields with medical contexts, I read), but then having commented that I seem to know what I'm on about continue to talk about tummies and the like and almost refuse to engage with the details I'm asking about. I know it irritates them. It undermines my faith in them - if they don't have the skills to listen to and interact effectively with their patients, I have less trust in them. I think that's reasonable.

YABU. The Department of Health spent an awful lot of time and money on the tone and words used for this campaign. Be grateful there is a screening programme and free care on diagnosis. Honestly the complaints people have about the NHS shock me. I have to PAY for all preventative screening as insurance doesn't cover it where I am.

Yabu

There are also patients for whom English is not their first language. They will sometimes ask their children to read letters/interpret for them.

I work in a Gp surgery and had a patient bring back some registration forms which her 8 year old child had filled in, because she was unable to write in English. This child interpreted for her mother too.

My mum asked me to help her google her test results recently because she didn't understand the letter. I understood it but then I studied biology at degree level. My mum isn't stupid at all but I found myself emailing her back in very simple language so she understood what her results said in practical terms, and to stop her worrying. So I think YABU.

I went for a smear and the nurse warned me I might feel some pain in my "tummy" - I hoped she was just over-generalising and wasn't going to go all the way to my stomach...

About 5 million adults in the UK (16% of the population) are functionally illiterate (see here ). Others may struggle with text that contains a lot of long words (readibility).

While a I sympathise with your annoyance, it's easy to forget just how privileged many of us are in terms of our education.

The terms paediatrician and paediatric, are becoming less used now. Replaced by child health and similar words. Plain English.

Dodgy comma.

I have had to revise my company's code of conduct recently. We were advised to reduce the reading age to 13, which isn't easy when you are talking about intellectual priority etc! I got my 10yo son to read it, and he said he understood....but the windows survey has my version as being 16. Aarrrrgh.

Most health communications, especially written ones, are aimed at the lowest common denominator.

I work daily with people that struggle with understanding what I consider basic information. I have to modify my terminology depending on their understanding, which often needs to be based on my interpretation of their facial expressions and verbal responses.

I'd like to think I generally get it right but I imagine sometimes I don't. It's even harder over the phone or in writing.

I have patients who don't know where their kidneys are, or who think you wee out of your vagina. I remember when I was a student nurse we had a patient who had a delayed discharge after bowel surgery because every day when asked by doctors if he'd had his bowels opened said no.

Oops posted too soon - he didn't know what having your bowels opened meant; as soon as someone (me) asked him if he'd had a poo yet he understood what they'd been asking him.

Some years ago I had a GP correct my account of painful urination to "Oh you mean it hurts when you weewee". I was in my 50s!