Melissa Sweet, health journalist and Croakey moderator, writes:
I suffered an adverse reaction at the Royal Australian and New Zealand College of Psychiatrists (RANZCP) conference in Adelaide this week. It happened when one speaker casually referred to “heart sink patients”.
It’s not as if I hadn’t heard the term before. Anyone who regularly reads the medical mags will know that doctors often use this term to refer to patients who make their hearts sink. There are even guides to help doctors deal with heart sink patients.
Sadly, I am not the sort of person who can quickly unpick my reactions on the spot and provide immediate, useful analysis. So I went away and brooded: why do I find this term, and its casual use, so grating?
Here are a few thoughts:
• It’s generally used to refer to patients that doctors regard as “difficult”, whether because of their health problems (think mental health, drug and alcohol, complex or insoluble) or their personalities (think demanding, complaining or – another medical term I detest – “non compliant”).
• Yet these patients are among those most in need of compassion and care that is sensitive to their needs and situations. Framing them as undesirable patients only helps to reinforce the inverse care law so wisely described by Julian Tudor Hart some decades ago. This law holds that “the availability of good medical care tends to vary inversely with the need of the population served”.
When heart sink patients is a term so widely used, it’s not surprising that it is so difficult to recruit doctors and other health professionals to work in demanding but needy areas like mental health, Indigenous health, and the poorer parts of the country/health system.
So here starts my campaign to find another term for “heart sink” patients. “Needy” perhaps, or what about “deserving”?
Would health professionals and services feel more motivated to try to help patients if they thought of them as “deserving” rather than “heart sink” types?
I somehow doubt this little campaign will find wings, but if it makes even one or two people stop and think about the words they use, it will be worth it. Words are so powerful, after all, in influencing how we perceive others and engage with them.