How and Why the Language of Medicine Must Change

What's in a Word?

According to William Shakespeare, "A rose by any other name would smell as sweet" (Romeo and Juliet). Maybe. But if the word used were "thorn" or "thistle," it just would not be the same.

Words comprise language and wield enormous power with human beings. Wars are fought over geographic boundaries often defined by the language spoken by the people; think 2022, Russian-speaking Ukrainians. Think Winston Churchill's massive 1500-page A History of the English-Speaking Peoples. Think about the political power of French in Quebec, Canada.

Thus, it should be no surprise that words, acronyms, and abbreviations become rallying cries for political activists of all stripes: PC, January 6, Woke, 1619, BLM, Critical Race Theory, 1776, Remember Pearl Harbor, Remember the Alamo, the Civil War or the War Between the States, the War for Southern Independence, the War of Northern Aggression, the War of the Rebellion, or simply "The Lost Cause." How about Realpolitik?

Is "medical language" the language of the people or of the profession? Physicians must understand each other, and physicians also must communicate clearly with patients using words that convey neutral meanings and don't interfere with objective understanding. Medical editors prefer the brevity of one or a few words to clearly convey meaning.

I consider this document from the AMA and AAMC to be both profound and profoundly important for the healing professions. The contributors frequently use words like "humility" as they describe their efforts and products, knowing full well that they (and their organizations) stand to be figuratively torn limb from limb by a host of critics — or worse, ignored and marginalized.

Part 1 of the Health Equity Guide is titled "Language for promoting health equity." It lists commonly used words and phrases that are better off not being used, and their equity-focused alternatives (the reader is referred to the Health Equity Guide for the reasoning and explanations for all). Here is a selection:

Commonly Used Words/Phrases and Equity-Focused Alternatives

Better Alternative





Cultural competence

Cultural humility/cultural safety/structural competence

Disadvantaged/under-resourced/ disinvested

Historically and intentionally excluded/ underserved

Disabled person

Person with (whatever) disability

Disparities (or inequalities)




Ethnic or racial groups

People from specific ethnic or racial groups


Formerly incarcerated/returning citizen/persons with a history of incarceration


Social justice

Illegal immigrant

Undocumented immigrant


Native peoples/Indigenous peoples/American Indian/Alaska Native

Master/slave (particularly in software/tech)

Alternatives include active/standby, writer/reader, leader/follower


Historically marginalized or minoritized or BIPOC (Black, indigenous, people of color)





Sex/gender/gender identity

Sex assigned at birth/gender/gender identity


Enslaved person

Target population

Consider the needs of (population of focus) the homeless

The morbidly obese

People with severe obesity

Social problem

Social injustice

Underrepresented minority

Historically marginalized, minoritized, or excluded

War against (disease)

Eliminate (disease)

Vulnerable (or disadvantaged)

Oppressed (or made vulnerable or disenfranchised)

White paper/whitelist/white label/

Reconsider need for white/black adjectives (e.g.,


white/blacklist can easily be changed to allow/deny list

Part 2 of the Health Equity Guide is called "Why narratives matter." It includes features of dominant narratives; a substantial section on the narrative of race and the narrative of individualism; the purpose of a health equity–based narrative; how to change the narrative; and how to see and think critically through dialogue.

Part 3 of the Health Equity Guide is a glossary of 138 key terms such as "class," "discrimination," "gender dysphoria," "non-white," "racial capitalism," and "structural competency."

The CDC also has a toolkit for inclusive communication, the "Health Equity Guiding Principles for Inclusive Communication."

The substantive message of the Health Equity Guide could affect what you say, write, and do (even how you think) every day as well as how those with whom you interact view you. It can affect the entire communication milieu in which you live, whether or not you like it. Read it seriously, as though your professional life depended on it. It may.

That's my opinion. I'm Dr George Lundberg, at large at Medscape.

George Lundberg, MD, is contributing editor at Cancer Commons, president of the Lundberg Institute, executive advisor at Cureus, and a clinical professor of pathology at Northwestern University. Previously, he served as editor-in-chief of JAMA (including 10 specialty journals), American Medical News, and Medscape.

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