Technical terms and jargon: testing a term against its reader
Whether a technical term belongs in a text depends on the reader in front of it rather than on the term. A term the reader needs is kept, and explained where they may not know it. A term they do not need gives way to the word they already use. Jargon is specialist vocabulary, insider shorthand or slang that this reader cannot recover, and a writer steeped in the vocabulary finds it hard to see.
When technical language becomes jargon
Most professions have their own technical language: an environmental engineer talks about airborne particulate load where others say dust levels, and a doctor describes a fracture to the clavicle where the patient says they have broken their collarbone. Technical language is fine when one professional writes for another in the same field and they understand each other, and then technical terms may make communication quicker and more precise. As soon as a writer moves a little outside their own area, even writing for a colleague in a different department, there may be a problem, and people are often too embarrassed to say that they do not understand what someone has written. Technical language becomes jargon when it is difficult for others to understand.
Medical writing depends on scientific words derived from the classical languages, whose specificity is a benefit and whose complexity can become a curse.
Jargonized writing in the sciences uses nonspecific words or phrases, applies abbreviations and technical terms carelessly or inconsistently, or uses insider terminology not commonly known by other people, so that its message may not be intelligible to the intended readers. Such writing could be described as a language with an uncommon or pretentious vocabulary and convoluted syntax that is vague in meaning. Its most extreme form, often called pidgin English, is a simplified English relying on a few verbs and other words to express more complex issues, which is bad enough in speech and completely unacceptable in written texts, particularly those dealing with science or medicine.
Jargon is not always pejorative. It is also sometimes used to mean the vocabulary peculiar to a profession or trade, as in medical jargon or legal jargon, where it refers to peculiarity rather than to a lack of specificity. Merriam-Webster's Collegiate Dictionary (11th edition) defines it in this sense as the technical terminology or characteristic idiom of a special activity or group, and gives jargony as the adjective. Some might call effective and efficacious, which are interchangeable in lay parlance but carefully differentiated in pharmacology and other disciplines, professional jargon.
Medical jargon can feel like a foreign language to non-medical people. Jargon refers to complicated medical terms that a lay person does not understand, and it can include drug names, disease names, biological terms, procedures and abbreviations.
Jargon need not be very complicated words to make research articles inaccessible to the general public, or sometimes even to researchers outside a specific field. In a sentence describing retinitis pigmentosa as characterised by the progressive loss of photoreceptor cells, for example, photoreceptor is jargon. Heavy metals is jargon too, because not all readers know which metals the class covers and not all heavy metals are toxic, so an editor should ask the writer to name the heavy metals that are part of the study and commonly found to contaminate the soil.
The dividing line between jargon and acceptable terminology is blurred, and whether a word is jargon or a standard term can sometimes be difficult to determine. Some jargon eventually enters normal language: few still insist on writing out laboratory in case a reader does not understand lab, and at some point a writer will write that the patient failed therapy in an oncology report, because insisting on failed to respond to therapy starts to sound silly.
What jargon costs the reader
The use of jargon is discouraged in lay communication because lay audiences find it difficult to understand and confusing. Jargon can create problems for lay readers: a patient who asked what caused the arm pain during their recent heart attack was told by a surgeon that the pericardium is innervated by C3, 4, 5 (phrenic nerve) and that there may be some neuronal connections to the intercostobrachial nerves. Using jargon with members of the public can make them feel excluded from something they should be involved in, and can lead them to do the wrong thing, or nothing at all, because they do not understand what they are supposed to do. A poster meant to help people identify or avoid a dangerous disease that is too technical might be ignored, cause unnecessary panic, or create extra work for staff who have to explain the information more clearly.
A reader who meets a word they have never seen must pause and decide whether to read on in the hope that the writer explains it, look for clues in the surrounding text, consult a dictionary or ask someone, and whatever they decide, their concentration on the argument has been disturbed. If readers arrive at a special term they have never seen before, comprehension stops, so a writer must be confident the audience will understand every special term introduced, or explain each one as soon as it is introduced.
Readers may put up with some jargon in a medical thriller, but readers of a clinical trial summary may simply give up. One plain-language writer who tutors lower-literacy adult learners finds that they typically skip unfamiliar words or read them aloud as nonsense syllables, and has learned first-hand that reading a document is not the same as understanding it.
Many writers have the impression that technical words convey authority. In a survey of 110 Stanford undergraduates about their writing habits, 86% admitted to changing the words in an academic essay to more complicated language to sound more valid or intelligent. One writer of search-optimised health blogs calls it a misconception that medical terminology demonstrates expertise: the right way is to understand those terms and then use terms the audience can understand. One experienced health reporter and journal news editor holds that jargon undermines the work and fails to engage people, and that the more jargon a writer uses, the less professional they seem. In one study, medical fellows who used jargon were rated less professional by actors playing patients, and as the jargon increased the patients perceived the fellows as less empathetic. The reporter finds that result disappointing, because the purpose of communication is to connect with someone else.
The cardiologist Bernard Lown recalled that, as a fellow, he watched his mentor introduce a patient with a mild heart condition to trainees as having TS. She took it to mean terminal situation and did not believe Lown when he explained that it meant tricuspid stenosis and that she was fine; she deteriorated and soon died of heart failure. "The word TS was like a hex," Lown said. "Words matter."
One expert on the musculoskeletal system notes that the term whiplash was intended to describe a motion but has been accepted by physicians, patients and attorneys as the name of a disease, and this misunderstanding has led many physicians and others to misapply it over the years.
Why writers miss their own jargon
The better a writer knows a language, the more prone they are to use jargon and careless formulations. For someone who has worked in science, medicine or nursing for many years, jargon is the water in which they swim. Using short, familiar words is a key tenet of writing for the public, but lab, exam, follow-up and outcome are more familiar to healthcare providers than to the public. When writing for people outside that world, a specialist's fluency in scientific vocabulary is a disadvantage, and a writer steeped in that vocabulary should avoid translating a term in whatever way feels right to them. Plain language sometimes takes more words to translate scientific and medical terms into everyday language.
Recognising and avoiding jargon can be quite difficult, particularly for writers who spend their working hours communicating with people whose technical knowledge is similar to their own. A surgeon interviewed on national radio about weight loss surgery told the public that they should not be calling it weight loss surgery but bariatric metabolic surgery, a term guaranteed to befuddle the public and one that would challenge quite a few people who pride themselves on a reasonably extensive medical vocabulary. The term also does not say what will be done to the patient, and explaining it to the public would require knowing which of several surgical approaches to weight loss it includes. Only a writer who knows what will be done to the patient can begin to explain it in lay terms.
A scientist's specialised knowledge is often a hindrance to effective lay communication, which requires the expert to anticipate the audience's knowledge or perspective. Scientists are trained to publish papers and to discuss findings with peers, which often makes them unable to understand how others think. Scientists also often use specialised language or jargon because they fear being inaccurate.
One experienced health reporter finds that the growing number of words in the language makes it challenging for medical writers to keep their content clear.
Reading a text aloud to non-specialists and using their feedback helps detect jargon and other inaccessible language.
Keeping, explaining or replacing a term
There are several ways to deal with a technical term, and which of them suits depends on what is being written. The writer can:
- leave out an unnecessary technical term, asking whether the reader really needs this information
- explain the term, preferably where it is used, or in a glossary where that is not possible
- replace the term with an everyday word or phrase
Special terms are frequently essential for accurate communication of scientific information, but they have two disadvantages: they are often longer than everyday words, and they exclude people from understanding. Readers whose expertise matches the writer's will understand them, while other readers who need the information but are less familiar with the terms will not have access to it, so even for expert readers it is wise to keep jargon to a minimum. To make information available as quickly and comfortably as possible to the widest possible range of readers, a safety-first policy uses special terms only when they are unavoidable and surrounds them with the shortest, most common general words that will express the meaning adequately. This is not a case for casual, informal language, which is usually inappropriate because it is imprecise, nor for distorting or reducing the information in order to avoid special terms. A text about parameningeal rhabdomyosarcoma or an endoscopic transsphenoethmoid approach is inevitably heavy reading, so it is worth taking every opportunity to use short words and the most direct phrasing around such terms. A text for a professional scientific audience always contains many heavyweight words that cannot be avoided, so it is worth removing accurate special terms that are not essential: a tooth-development programme rather than an odontogenic developmental programme, a sign of rather than pathognomonic of, and a vein on the back of the hand rather than on the dorsum of the hand.
A writer should say exactly what they mean, using the simplest words that fit, which does not necessarily mean only the simplest words but words the reader will understand. One way to avoid baffling or misleading readers is to use common words whose meaning would be obvious to anyone, writing itching rather than pruritus in a piece for a lay audience. Reducing and eliminating jargon helps make scientific content easier to read. Removing unnecessary jargon, along with vague words, abbreviations and clichés, improves clarity.
Jargon may shed light on a subject between colleagues and at conferences, but it can leave patients in the dark about health issues. One communication guide for medical professionals, for example, advises a doctor to say "broken bones, cuts and bruises" rather than "multiple fractures, lacerations and contusions". To build rapport with patients, the same guide suggests less complicated words, of Germanic rather than Latin origin.
Deciding whether a special term will be understood instantly depends on how much the writer knows about the scientific knowledge the audience is likely to hold. The onus for making the meaning clear lies on the writer, not on readers to work out what the writer probably means, and a writer in doubt about whether any word will be instantly and reliably recognised should either explain it or express the meaning in familiar language.
Clarity, in one reviewer's view, is not always achieved by using simple words, and a writer must gauge the audience. Medical journalism requires the utmost simplicity to communicate a difficult subject to a lay audience, whereas intricate documents such as clinical study reports inevitably require a level of complex terminology, especially in describing adverse events. A writer cannot simply say that a subject had the flu, but must document a detailed description of the event, including specific symptoms, diagnostic tests and possible causality, which often necessitates a complex medical vocabulary.
As a general rule, scientific, medical and other technical terms should be used as the scientific literature uses them, because any attempt to modify them leads to confusion or even misunderstanding. Writers told never to repeat a term in creative writing may find it difficult to reiterate a technical term, but scientific writing is not creative writing, and the consistent use of technical terms is a key prerequisite for conveying a scientific message.
One experienced health reporter gives these tips for avoiding jargon:
- Use short, simple words when possible.
- Use direct language when possible, such as in mice rather than in vivo.
- Do not use technical terms unnecessarily.
- Do not use words and acronyms with double meanings, like TS.
- Introduce concepts first and then the technical terms, which improves comprehension.
Introducing a term the reader needs
Where a medical term is not commonly known, one writer of search-optimised health blogs advises starting with the word readers use, such as high blood pressure, and still mentioning hypertension, so that the focus is on their understanding of what it is rather than on getting them to understand and remember medical terms.
One plain-language specialist describes over-jargoning as assuming the audience knows terms it does not, which creates a barrier. Where a term cannot be avoided in a plain language summary, one solution is to explain what it means before using it. In that specialist's view, this also avoids assuming that people are stupid: people can learn, sometimes they just lack the knowledge, and a writer can give them that knowledge in the opening sentences.
Foreign and Latin phrases
George Orwell's rule is never to use a foreign phrase, a scientific word or a jargon word if an everyday equivalent exists. One medical writer sets aside the rule's reference to scientific words: these have to be used when writing for an audience that understands them, but should be avoided when writing for patients. In that writer's view, Orwell was referring to the affected use of foreign phrases such as de trop, deplacé and aficionado where they are not needed, not to foreign terms in widespread use in medical English such as in vitro, de novo and ex vivo. These are so firmly embedded in medical English, as à la carte and resume are in everyday English, that they can be regarded as English and need not be italicised, and fiasco, angst and grand mal are other examples. The safest way to decide whether a foreign term is acceptable is to refer to the literature of one's specialist area, but a writer need not be afraid to substitute a plain English term, especially for a fancy plural: addendums, forums, focuses, memorandums and stomas are not wrong, whatever anyone says in favour of addenda, fora, foci, memoranda and stomata.
Words and phrases borrowed from Latin and other languages present difficulties for native speakers of English as well as for readers using English as a foreign language, so they should be avoided. Dictionaries record per se as meaning by or in itself, intrinsically, essentially and as such, four senses that one author does not count as synonyms, so a writer who meant that the tooth itself is not tender to percussion would have encoded the meaning more reliably with itself. Groups of scientists asked what de novo meant in a set of published sentences gave new, primary, newly, renewed, from scratch and freshly, which cluster round newness but are far from identical. De jure, sine qua non, de rigueur and soi-disant raise the same question of whether all of an audience will share one interpretation. The concern is not necessary special terms for which no adequate familiar vocabulary is available, but expressions likely to puzzle some of a journal's typical readers: a writer who means new should write new.
Insider terms and coinages
Every discipline employs its own secretive words, jargon that allows initiates to communicate with one another in a way that excludes others, and medicine is no exception. Medicine's idioms range from the humorous to terms that seem designed to deliberately obscure the real meaning of the word, and others stand out simply through the incongruous pairing of everyday words. Business too has its own argot, such as business angels for people with money who fund start-up companies and MBWA for management by walking around.
Many accepted medical phrases have meanings that are not obvious at first to a layperson. Among them, idiopathic means of unknown cause; iatrogenic means any adverse condition in a patient resulting from treatment by a health care professional; debridement is the surgical removal of foreign matter and dead tissue from a wound to aid healing; incidentaloma fuses the suffix for a tumour with the manner of its discovery, a tumour found by coincidence, usually during examination and imaging undertaken for other reasons. A nude mouse is a hairless laboratory mouse with a genetic mutation, often used in cancer research because it does not reject tumour cells from other mice or other species; a knockout mouse is one in which researchers have inactivated an existing gene by replacing or disrupting it with an artificial piece of DNA. Creep resistance is a materials science term for a material's ability to resist distortion under a load over an extended period, and an issue in orthopaedic and craniofacial implants. A hangman's fracture is a C2 fracture of the spine that, despite its name, was not often seen in post mortems of people who were judicially hanged; an occult fracture is one where there are clinical signs of fracture but no radiographic evidence; wobbler syndrome is a malformation of the cervical vertebrae that gives dogs and horses an unsteady gait.
One American trauma surgeon used poor protoplasm to mean that the patient's body is a wreck, a term for which, as one online explanation puts it, there is no formal definition, but doctors know it when they see it. He also used donorcycle for a motorcycle, from the supply of brain-dead donors that fatal motorcycle accidents produce, and grantsmanship, which a word processor's spell-checker rejects and the Merriam-Webster dictionary defines as the art of obtaining grants.
New words and meanings enter a language as memes, and they persist if they are catchy enough to enter common vocabulary. Survival of the fittest was coined by Herbert Spencer in 1864 after reading Darwin, and meme by Richard Dawkins in 1976 for an element of culture passed between people by imitation or other non-genetic means. Internet meme was proposed by Mike Godwin in 1993, and Dawkins characterised an internet meme as something deliberately altered by human creativity that goes viral on the internet. Bactin was coined in one laboratory for any bacterial actin-like protein and stayed there, an efficient word that to its users conveyed a great deal of meaning. Independently, Bactin became the registered trade mark of an antibiotic, which one writer likens to convergent evolution. Practical words and phrases used in the pharmaceutical industry share the trait of being less of a mouthful to say, as pharma is, and some convey a great volume of meaning: big data for the very large data sets of drug development, KOL for key opinion leader, vax and mAb.
An ISMPP paper lists common industry jargon that does not belong in a manuscript, mainly because it is too colloquial or even commercial. Two examples on that list are key opinion leader, which suggests influence and bias, where external medical expert or subject matter expert can be used instead, and key messages, where messaging is a commercial term and scientific communication points can be considered instead.
Insider shorthand and slang
Clinicians love medical jargon: they turn nouns into verbs, such as to scope or to surgerize a patient, use cute phrases such as gas passers for anesthesiologists, and turf a patient when transferring care. Much medical jargon originates with young clinicians, sometimes sleep-deprived, as they busily care for patients. Medical jargon is often shorthand that lets clinicians communicate quickly with each other. Sometimes it is meant to let clinicians speak to one another in code without the patient understanding, as with lues for syphilis. It may be derogatory, as with circling the drain for someone whose death is imminent. One definition of jargon is technical expressions used by a profession or cult which by no stretch of the imagination can be considered good English and which are often confusing not only to those outside the fold but often also to those within it. American medical jargon can be especially bewildering to physicians whose first language is not English, who may not know how to interpret slang such as bounce back, crump and frequent flier that is unlikely to confuse any American clinician. The careful medical writer uses such terms rarely, if at all, and a writer who uses jargon or slang for some special reason should make the purpose clear and give the reader the meaning of the word.
One medical writer holds that jargon, which includes many abbreviations, must be avoided in regulatory and medical communication texts. Before the internet, that writer spent hours finding out what had happened when a subject narrative said a patient coded, and finally had to ring a colleague in the USA; it meant that the patient had gone into asystole or suffered cardiac arrest. British bd dosage and American q12 h regimens both mean twice daily, and the careful writer spurns such jargony abbreviations and writes what is clearly understandable, in this case twice daily.
These are examples of medical jargon and slang, with what the writer probably means:
| Jargon or slang | What the writer probably means |
|---|---|
| Digitalize | To initiate therapy with a digitalis derivative or perhaps to perform a digital rectal examination |
| Train wreck | When one thing after another has gone wrong |
| Prepped | Prepared for surgery |
| Acute abdomen | Acute disease affecting an abdominal organ, often requiring surgery |
| Negative | Absence of abnormalities |
| Gland | Lymph node |
| To appendectomize | To perform an appendectomy |
| To buff (a chart) | To be sure the medical record is complete, accurate, and defensible |
| Antibiotic deficiency | Indicating that the patient has an infection that warrants antibiotic use |
| To turf (a patient) | The act of referring a patient to another clinician or institution |
| FLK (pronounced 'flik') | A term that clinicians really should not use, meaning 'funny-looking kid' |
| Shotgunning | Ordering a wide range of tests, hoping to hit upon a diagnosis |
One published paper on slang in medicine highlights terms apparently in use, among them the Dirt Bag Index, the number of a patient's tattoos multiplied by the number of missing teeth, used to estimate the number of days without a bath, and granny dumping, the practice of bringing elderly patients to emergency departments for admission, usually before public holidays.