To the Editor,

We strongly agree with the authors of the October editorial that a doctor’s choice of words is critically important [1]. In addition to the editorial, we would like to make two small comments.

The word “repair” is used quite often when describing orthopaedic procedures—rotator cuff repair, ACL repair, triangular fibrocartilage complex repair. However, a surgical procedure is followed by rehabilitation. Whereas you can drive your “repaired” car immediately as if nothing was ever wrong, your patient will most certainly not feel “repaired” immediately after surgery. Importantly, when physicians use the word “repair” we may invoke the suggestion that the surgeon does all the work and ignore the patient’s share of responsibility for successful functional recovery.

When patients visit us for a second opinion, we are often faced with a patient who is disappointed with the results of a previous treatment. For example, when radiographs show some shortcomings that transpired during the first treatment, careful thought and utmost care should be employed while addressing this issue with the patient. We believe it is incumbent upon the physician who is giving a second opinion to consider strategies that prevent further harm to the patient while at the same time, avoiding the temptation to simplistically portray the previous treatment as inept. In fact, what we might actually be doing is making the patient lose his or her confidence in medicine, potentially affecting the patient’s ability to recover from his or her current complaints.

We are most pleased that Clinical Orthopaedics and Related Research ® paid attention to the vital issue of doctor-patient communication. Words can be sharper than a surgical knife and capable of inflicting more painful scars than any surgical procedure.