It’s not a welcome development, but perhaps it was inevitable. Mansplaining has spawned a medical derivative – docsplaining.
Mansplaining is a conflation of the words ‘man’ and ‘explaining’. It has been defined as characteristic of “a man compelled to explain or give an opinion about everything – especially to a woman. He speaks, often condescendingly, even if he doesn’t know what he is talking about, or even if it’s none of his business.”
Writing in a recent edition of the Postgraduate Medical Journal, columnist Dr John Launer says the past couple of years have also seen the arrival of a parallel term: "docsplaining".
“This is being used to describe equally unwanted, unnecessary or patronising explanations by doctors to non-doctors, whether these are patients or simply members of the general public who suffer from the lamentable lack of a medical degree,” he writes.
Although the word is not yet recognised by the Oxford English Dictionary, it has a growing presence on social media and its own hashtag on Twitter. A quick perusal of #docsplaining will restore humility to any medic who may be feeling full of themselves.
One form of embarrassing docsplaining occurs when doctors take it upon themselves to explain issues to other healthcare professionals who may have vastly more experience and knowledge in relation to the patient or topic being discussed.
According to Launer, most varieties of docsplaining are directed at patients themselves . “Probably the most common of these is to express medical conjecture as certainty (‘there’s absolutely no doubt this is viral’) or to frame a trial of treatment as infallible (‘these pills will fix the problem’),” he writes.
Practising shared decision-making offers some protection against docsplaining. Tuning in to where the patient is at at a given moment in time should ensure we tailor our explanations in a way that matches what a patient needs or wants to hear.
Lecturing patients
Clearly, lecturing patients with a chronic disease who probably know more about the illness than we do is not a good idea. On the other hand, efforts at being patient-centred that involve bombarding patients with the latest research findings may not take into account their ability to absorb the information at that moment in time.
Launer expresses a personal distaste for conversational mannerisms such as “so what you are saying is” and “it sounds to me as if”. I disagree, as I believe that reflecting back and reframing are useful techniques in the consultation. However I share his discomfort with “you seem to be very upset” as the following vignette from the author shows: “A friend saw her general practitioner after her husband had a stroke and was told, ‘you must be very angry about what has happened’. ‘Must I?’ she replied, ‘I’m actually here to discuss how we can get a stair lift’.”
A particularly toxic combination is of docsplaining together with mansplaining. A male gynaecologist who explained to a postmenopausal woman that she was now effectively a man is an example of this deadly combination. And the royal “we” is simply patronising; as in a doctor who says to a patient ‘we do tend to feel that way when we’re anaemic’.
Medical students and doctors are taught communication skills, which one hopes will help to stamp out docsplaining. But not everyone was happy with Launer's contribution. Respected US blogger Dr Bryan Vartabedian did not agree with the characterisation of physicians as condescending and uncaring actors in their communication with patients. "I found the piece insulting but somehow not surprising. Bashing doctors, after all, is the social web's latest spectator sport," he wrote.
Would it help if patients laughed at us at our docsplaining worst? We could also usefully learn to laugh at ourselves.
My docsplaining advice for patients?
The next time you hear the phrase “just a little prick with a needle” from a male doctor, simply nod vigorously in agreement.