Helen Barratt: Talking the talk

I wasn’t a bit surprised to read the report cited in this week’s journal about the use of jargon in public health. In fact, I rather wish I’d come up with the idea for the study myself.
The authors analysed proceedings at the UK Faculty of Public Health’s annual conference in 2007, and recorded uses of management speak and jargon in the presentations. They report that “overall, there was an overwhelming desire to ‘engage’ (27 occurrences),” as well as 26 mentions of being “at risk.” “Working in partnership” was ranked third, with 15 occurrences. The full version of the paper is well worth a read.
While preparing for the first part of our public health membership exams recently, a group of us met regularly for tea, sympathy and the odd bit of revision. When tackling past paper questions, vital extra marks could be gained for liberal use of public health speak” “partnership working” and “stakeholder engagement” scored particularly highly. Looking at the mark scheme for the exam subsequently, I don’t think the examiners were quite so generous, but most of my first year in the specialty has been spent learning how to talk the talk.
What is it about public health that makes it such a minefield of jargon? Is it because the specialty involves a large number of doctors, who – freed from the world of hospital acronyms and abbreviations – feel the need to develop their own language? As medics we are bombarded with technical terms from the first weeks of medical school. Although I’m not conscious of it, my husband reckons I start speaking another language when I’m with medical friends.
Or is it perhaps because public health brings together practitioners from so many diverse backgrounds, who need to develop their own language in order to “engage” and “work in partnership”? The report notes that some traditional examples of management speak were cited, but new and specific phrases are also increasingly being used.
Before applying for public health jobs, I spent some time in a PCT and noted down some of the terms used in conversations that I didn’t recognise, so I could put them to use in interviews. However, when I searched them on Google at home, I was left even more confused. I’m now convinced that most practitioners couldn’t give you exact definitions of some of the terms they use regularly. What on earth is “intelligent commissioning” or “the personalisation agenda,” both cited in the paper?
I look forward to returning to the NHS in the autumn and putting the authors’ BINGO card* to use in the field …
*British Indicator of Nonsense or Grammatically Odd Constructions and Rubbish Dialect.
Helen Barratt, 12 August 2008

  • Justin

    The observation is quite interesting. I ran into serious problems while trying to write a report because I just ran out of vital public health jargons that would have given it the weight it deserves. I even got very confused when I realized that I did know the pricese meaning of some of the terms I had used which increased my fear that my report was not convincing enough and would be discarded by those I was writing it for. Infact, I discarded several drafts I prepared. Is there any dictionary of public health jargons that can help reduce some of these problems?

  • Seye Abimbola

    That’s a good idea you might want to take up, Justin…”The BMJ Dictionary of Public Health (Jargons)” or something. Could even be done by OUP or one of such publishers. It’s going to be necessary for new comers to public health in the future, I’m sure. I hope someone is listening.
    Seye Abimbola

  • Dr. Mary E Black

    Fifteen years ago, over gin and tonics at a Faculty Conference, this article was born.

    Black M E, Connelly J. The next big thing – health futures. The Public Health Physician March 1993; 4: 5 6

    Jim Connelly and I collected the ripest bits of jargon we had heard and wrote them up into a seamless stream. “Surfing the opportunity wave” was my favorite, also “joined up thinking” had made its first appearance. We postulated a future market in health outcomes. We believe that most of the readers were not aware it was a pastiche and took it seriously. Both had migrated over from the Department of Health. Most of what we wrote has, sadly, come true.

    The UN (my recent employer) has an even more extensive vocabulary of jargon. An essential exercise to lighten the mood in training programmes is to write down all the acronyms for UN agencies, and pull them out at random for a team quiz. Recognition rates are well below 100%. The UN jargonometer was popular a few years ago – one piece of paper with 20 lines on it and random phrases across. You can make a sentence of UN speak with any combination of phrases.