Chris Lancelot: Are you fluent in abbreviations?

Everyone I come across nowadays seems to speak in TLAs (three letter abbreviations, to you and me). It's very confusing.

In the old days doctors often used their knowledge to baffle patients, talking in formal Latin or Greek terms just to sound erudite: 'psoriatic arthopathy' and the like. (It was always reckoned that the definition of a dermatology consultant was someone who described your lesion in Latin and charged you £150 for the privilege, but I'm sure that could never be true.)

But now specialists have gone one further - they all talk in acronyms. It started with ECGs and went on to MIBI scans, CABGs and NSTEMIs.

In the old days abbreviations were very much an army thing - NATO, COBRA, SAC and 2IC. Now they've spread to the rest of the world like a new language (or measles) - and, like any new language, one in which it is all too easy to be misunderstood.

The trouble is that TLAs can obscure the meaning of the communication. After all, if you are an AHP (allied health professional) working with a GP who's a GPSI in the MSK clinic run by the local PBC under the watchful eye of the PCT, the SHA, the DoH or HMG you are quite likely to become bewildered by all the TLAs you meet 24/7.

Mind you, it's nothing to what PCT managers and PEC members have to endure under their TORs, deciding how best to distribute the CMO's PCRMP guidelines, or creating SOBCs to be vetted by the IG team prior to being submitted to HMT for approval by the SOB at No.10 ... sorry, that just slipped out. And he doesn't wheeze - honest.

All of which neatly illustrates the problem with TLAs - there are too many of them. Or rather, there are too few of them, so they all double up for different concepts (SOB, for example). PID is another, especially in a woman: was the problem in the back or the salpinges? And that's where the confusion - and the danger - really sets in.

In short (if you'll excuse the expression), abbreviations are lazy ways to communicate, not universally understood, ambiguous and potentially dangerous. They can certainly be confusing, as the cardiology consultant discovered after asking for an FBC. The unit's manager looked puzzled. 'Why do we need a Full Business Case?'

Dr Lancelot is a GP from Lancashire. Email him at

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