Dear Editor

Professor Haslam's column in the March issue (Practitioner 2011:255 (1738); 34) is, as always, full of wisdom.

I may though debate the use of the term pneumonia. Yes, it potentially scares patients. However, there can also be a problem if the patient is followed up by another practitioner who does use this word and implies that you as the initial doctor missed the diagnosis.

This can be especially difficult when a child gets admitted by the out of hours service and the parent feels that the antibiotics you gave for the chest infection did not work because you missed the fact their child had pneumonia.

A former colleague of mine used the opposite approach.  He warned of the worst but promised the best. So when the child got better his stature would climb.

So often the difference between praise and thanks and criticism and complaint can hinge on just one word or phrase.

Dr John Sharvill

GP Deal, Kent

• The author replies

Thank you for your letter which makes a very fair point and highlights the incredible complexity of communication.

Indeed, I quite often tell people that they had pneumonia when they have got better, and use it as an opportunity to educate patients as to what the word really means. But it's far from easy.

Professor David Haslam
GP Ramsey, Cambridgeshire, Past President RCGP, President Elect BMA