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Words That Work: Scripts, Jargon and Plain Language
Patients hang on every word their care team says. Yet practices fill those words with abbreviations, policy language and phrases that sound like a closed door. A randomized trial shows how much plain words matter, and a few swaps fix most of it.
Start here: the questions this brief answers
Tap a question for the short answer, then jump to the evidence.
Your words carry more weight than you think, and jargon quietly undoes them. In a randomized trial, patients understood 95% of common medical abbreviations when the terms were spelled out, compared with 62% when they were abbreviated. Even "MI" was understood by only about a third of the abbreviation group. AHRQ warns that asking "Do you understand?" can mislead; the only way to know is to have the patient explain it back. The same principle applies to marketing: insider labels and acronyms mean little to someone new. Write and speak so a first-time patient understands you the first time.
“Five words from you can change a patient's whole week. Don't waste them on jargon. If a twelve-year-old couldn't repeat what you just said, say it again, simpler.”
Do abbreviations really confuse patients?
Yes. In a 2022 randomized trial, comprehension was 95% when terms were spelled out and 62% when abbreviated.
Go to the full answer ↓Isn't "Do you have any questions?" enough?
No. AHRQ says patients may think they understand or be too embarrassed to say otherwise. Use teach-back instead.
Go to the full answer ↓What phrases should my staff stop using?
Phrases like "That's not my job," "Calm down" and "I'm sorry you feel that way." Part 4 has replacements.
Go to the full answer ↓Does this apply to marketing too?
Yes. Acronyms and model labels that insiders know can confuse prospective patients. Describe what patients get, in their words.
Go to the full answer ↓Your words weigh more than you think
Michael Tetreault likes to tell physicians: “Your words weigh 100 pounds.” Staff words weigh less, but they still carry weight.1
He’s writing as a patient, not a physician. And from that side of the exam table, five words from your clinician can lift a whole week, or ruin it.
So here’s the question: if every word matters that much, why do so many of them get spent on abbreviations, policy-speak and phrases that sound like a closed door?
Five words from you mean more to me than fifty words about you.
From No More Waiting Rooms (2024).1
A randomized trial on jargon
Researchers at three U.S. hospitals randomly assigned 60 adults with heart failure to read clinical text that used either common abbreviations or the spelled-out terms.2 Clinical Trial Evidence
The biggest gaps were for HF, hx and HTN. Even “MI” was understood by only 37% of the abbreviation group, compared with 53% when expanded. Among patients who saw abbreviations, those with inadequate health literacy understood fewer of them.2
These were terms clinicians use without thinking. That’s the point.
Michael remembers lying on exam-table paper in a specialist’s office about 15 years ago for hives, while the physician spoke to assistants in rapid abbreviations. “I don’t have a problem with that,” he writes. “What I expect is an explanation of why we’re doing these things.”
Twenty years ago, his first boss handed him a one-page sheet of everyday expressions and better alternatives. He still has it.
From No More Waiting Rooms (2024).1
Stop asking "Do you understand?"
AHRQ describes teach-back as “an evidence-based health literacy intervention that promotes patient engagement, patient safety, adherence, and quality.” Instead of asking whether the patient understands, the clinician asks them to explain the key information or next steps in their own words. It is a check on the clinician’s explanation, not a quiz of the patient.3 Policy and Law
AHRQ’s warning is simple: patients may think they understand, or feel too embarrassed to admit they don’t. “The only way to know for sure that a patient understood the information communicated is to hear them teach back.”3
| Instead of | Try |
|---|---|
| “Do you understand?” | “I want to make sure I explained this well. Can you tell me how you’ll take this medicine?” |
| “Any questions?” | “What questions do you have for me?” |
| “Follow up PRN.” | “Call us if the pain gets worse or isn’t better by Friday.” |
CMT examples applying AHRQ teach-back guidance.3
Phrases that close doors, and ones that open them
| Instead of | Try |
|---|---|
| “That’s not my job.” | “That might be out of my knowledge set. I know [colleague’s name] who can help. Let me tell [first name] about it and get you both connected.” |
| “I’m sorry you feel that way.” | “I certainly understand how frustrated you must be feeling.” |
| “Calm down.” | “That would upset me, too. Here’s how I can help.” |
| “I don’t see a record of that. Are you sure you…?” | “I’d love to help you. Tell me a little more about what you already know.” |
| “You misheard me.” | “I understand what you’re saying. So that we’re both on the same page…” |
| “You’ll have to…” | “While we’re unable to do that, here’s what we can do.” |
| “I don’t know.” | “Great question! I will find the answer for you.” |
CMT original: from the phrase list in No More Waiting Rooms (2024).1 Evidence type: Practice Insight.
Marketing has the same problem
Michael’s background is in marketing and public relations, and he has long warned that model labels and acronyms that insiders know by heart mean little to a prospective patient. His advice: if someone has to learn your code to understand your practice, many won’t bother.1 Describe what patients get, such as same-day visits, time with their own doctor, a phone number that reaches a person, instead of the label for the model.
A plain-language practice
Audit three documents
Your welcome letter, your membership summary and your website home page. Circle every abbreviation and every sentence a first-time patient might not follow.
Spell it out
Expand abbreviations in anything patients read, including after-visit summaries where you control the text.
Use teach-back
For every new medication or plan, ask the patient to explain it back. Make it the team habit, not the exception.
Retire five phrases
Pick five phrases from Part 4 to retire this month. Practice the replacements in huddles until they feel natural.
- Print the phrase swaps and post them at the front desk and in the clinical workroom.
- Read your website home page out loud to someone outside healthcare. Note where they get lost.
- Try teach-back with your next three patients.
Run your marketing message through the planner's message check: does it sound like care, or like a pitch?
Free. No sign-up. Your answers stay in your browser. Step 3 of CMT's Learn, Build, Lead tools. It helps you pick the patient segments that fit your practice, find where they are, plan conversations with local physicians, check that your message sounds like care rather than a pitch, and leave with a 90-day plan.
This brief is educational and is not medical or legal advice. Clinical documentation must still meet professional and legal standards; plain-language summaries for patients supplement, not replace, the medical record.
Words weigh
Patients remember what you say and how you say it.
Spell it out
Comprehension jumped from 62% to 95% in one trial.
Check understanding
Teach-back beats "Do you understand?"
How this brief was built
This brief draws on a randomized clinical trial of abbreviation expansion in health records (JAMA Network Open, 2022), AHRQ's TeamSTEPPS teach-back tool, and CMT's No More Waiting Rooms (2024), including its phrase list and the author's own experiences. The trial involved 60 adults with heart failure reading clinical notes; results may differ for spoken language and other populations.
How to read the evidence types
Every key finding is labeled by evidence type. Labels describe the type of evidence, not its value. Each type answers different questions. Funding is disclosed on every source.
Randomized trials and systematic reviews.Best for cause and effect.
Large observational studies and government data.Best for trends at scale.
Surveys, smaller studies and expert consensus.Best for real-world experience.
Company-sponsored or company-reported data that is not peer-reviewed.Best for early signals and operating data.
Statutes, regulation and official guidance.Best for what is required.
What we don't know
- How much jargon in spoken conversation, rather than written notes, affects understanding in membership practices.
- Whether phrase training changes patient ratings or retention; the phrase list is practice guidance, not tested in trials.
How to cite this brief
External review: this brief has not yet been reviewed by an outside expert. When review is complete, the reviewer is credited by name above with any conflicts of interest, and the version number is updated. Reviewers check accuracy and fairness; CMT is responsible for the final content.
Corrections policy: when an error is identified, CMT corrects it in the open and updates the version number above. Send corrections to the editor through conciergemedicinetoday.net.
Related CMT Research Briefs
References
- Tetreault M. No More Waiting Rooms: A Customer Service Road Map to Help Remarkable Medical Offices Navigate Their Way Towards an Irresistible Practice Where Gratitude Is on Repeat. Concierge Medicine Today, LLC; 2024. Stories are the author's own experiences and accounts told to the author.Funding: Concierge Medicine Today (self-published; no outside funder) CMT original
- Grossman Liu L, Russell D, Reading Turchioe M, Myers AC, Vawdrey DK, Masterson Creber RM. Effect of expansion of abbreviations and acronyms on patient comprehension of their health records: a randomized clinical trial. JAMA Network Open. 2022;5(5):e2212320. 60 adults with heart failure, 3 U.S. hospitals. pmc.ncbi.nlm.nih.govFunding: federal (National Institute of Nursing Research R00NR016275; National Library of Medicine F31LM054013)
- Agency for Healthcare Research and Quality. TeamSTEPPS tool: teach-back. Last reviewed May 2023. www.ahrq.govFunding: federal (Agency for Healthcare Research and Quality publication)
Educational and informational only. This CMT Research Brief does not constitute medical, legal, tax, financial, accounting or other professional advice, and it does not create a professional relationship of any kind. Statements about laws, regulations, tax rules and payer policies are general, may not reflect the rules in your state, and can change after publication. Consult a qualified attorney, accountant, tax adviser, compliance professional or licensed clinician before acting on anything here.
Independence. Concierge Medicine Today is an independent publication. It does not accept payment for favorable coverage, and it does not favor one practice model over another. Company names and products are mentioned for context only and are not endorsements. Funding is disclosed for every source in the reference list.
Accuracy. CMT verifies figures against their original or best available sources at the time of publication. Where a figure is an estimate, an inference or a company-reported number, the brief says so. This content is not without possible error or omission.
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