One day, Jill hears her supervisor say “I wish that addict would be discharged; he’s a frequent flyer and he’s difficult!” Afterwards, Jill finds she is uncomfortable in the patient’s presence. He is polite and respectful to Jill, but she still tends to get out of his room as quickly as possible, because she doesn’t want to encourage him to overstay his welcome on the unit or be on the receiving end of his “difficult” behaviors. 

Reducing rich complexity to simple stereotypes 

Labels such as “addict,” “frequent flyer,” and “difficult,” take our attention away from seeing an individual as a person. For example, the term “frequent flyer” can provoke unfair judgements and may detract from our ability to assess and address systems issues such as inadequate community care. Similarly, if the patient described above was declining his morning medication, it might be attributed to him being “difficult.” By looking beyond labels, we can explore the patient’s behaviour with a sense of curiosity and inquisitiveness. Then, for example, we might learn that he just wants to take his medication later in the day, so he is alert for visits with family.

How labels can affect patients

Defining people by their medical condition(s) overlooks their distinctive characteristics and strengths that, when optimized, can contribute to the work of collaborative care planning, healing and recovery. Likewise, labelling patients fails to respect their inherent dignity, including the right to be treated as distinct individuals with a unique life story.

Patient advocate, Elenor Longden, fondly recalls the first psychiatrist who wanted to know more about her than her diagnosis. “It was the first time I had been given the chance to see myself as a person with a life story, not as a genetically-determined schizophrenic with aberrant brain chemicals and biological flaws that were beyond my ability to heal,” she says.

Patients are persons first and foremost

When we’re describing our patients it’s important to use language that reminds us that they are each individuals worthy of respect.

Alternative language for common labels include:

Addict A person with substance use disorder

Frequent flyer Person with multiple admissions

Difficult A person with a history of interpersonal conflict in hospital (i.e. describe behaviour)