The Secret Hospital Slang Doctors Don’t Want You to Know

The Secret Hospital Slang Doctors Don’t Want You to Know [2025 Guide]

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Introduction

Hospital slang represents a hidden language that permeates medical institutions across the country. According to a 2012 study, 40.3 percent of hospitalists admitted to making fun of other physicians, while 35.1 percent confessed to making fun of attending physicians to colleagues, and 29.8 percent acknowledged making disparaging comments about patients on rounds.

This medical slang has infiltrated popular culture through television dramas like ER, House M.D., and Gray’s Anatomy. However, the reality of doctor slang extends far beyond what appears on screen. In fact, modern medical slang can be divided into two eras: “Before Shem and After Shem”, referring to the author whose work “The House of God” first exposed the underbelly of hospital life to the public, revealing the psychological toll on medical interns.

Hospital slang terms serve multiple functions in healthcare settings:

• Creating professional shorthand for efficient communication

• Building camaraderie among healthcare workers in high-stress environments

• Providing emotional distance from challenging clinical situations

• Establishing insider boundaries within medical culture

From terms like “GOMER” (Get Out of My Emergency Room) to documented cases where practitioners have written “TTFO” (Told To F*** Off) on patient charts, ER slang reflects both the pragmatic and problematic aspects of how healthcare professionals communicate when patients aren’t listening.

 

The Hidden Language of Hospitals

Within the sterile walls of medical facilities, a complex linguistic subculture thrives among healthcare professionals. This specialized vocabulary—often hidden from patients—serves multiple critical functions beyond mere communication efficiency.

Why slang exists in high-stress environments

Medical practitioners work in environments filled with pain, suffering, and death. Hospital slang primarily functions as a psychological defense mechanism against the emotional toll of these challenging realities. For doctors encountering strong emotional reactions daily, dark humor and specialized terminology provide essential psychological distance. This coping strategy helps physicians acknowledge and reflect upon patient mortality without becoming overwhelmed.

Medical argot typically begins during students’ third year of medical school when clinical rotations commence and peaks during internship before gradually declining throughout residency. This pattern coincides precisely with periods of maximum stress and responsibility.

How slang builds camaraderie among staff

Sharing slang creates powerful bonds between medical professionals. As one respirologist noted, “The inability to laugh on rounds in an environment like our ICU, where there’s very little to laugh about, is going to be tragic and injurious to safety and to the quality of care”.

Hospital slang strengthens team unity through:

• Creating a sense of belonging among practitioners facing similar challenges
• Establishing mutual trust between colleagues in high-pressure situations
• Facilitating non-verbal communication through shared understanding

Additionally, this linguistic phenomenon helps forge connections across hierarchies and generations, with experienced staff using it to mentor newer colleagues.

The role of ‘argot’ in medical culture

The formal term for medical slang—argot—derives from 17th century French, originally referring to the language of thieves. Beyond establishing professional shorthand, argot serves dual purposes: preventing outsiders from understanding conversations and creating bonds between colleagues.

Nevertheless, medical argot remains controversial. While it builds team cohesion, critics argue it potentially weakens physician-patient bonds and dehumanizes those under care. Furthermore, some terms carry pejorative undertones that may reflect inherent biases in medical culture.

 

From ‘GOMER’ to ‘Code Brown’: A Brief History of Medical Slang

Modern medical slang underwent a seismic shift in 1978, creating distinct eras that practitioners recognize as “Before Shem and After Shem”. This pivotal moment fundamentally altered how healthcare professionals communicated within hospital walls.

The influence of ‘The House of God’

Samuel Shem’s groundbreaking novel The House of God shattered the silence surrounding hospital culture, exposing the psychological toll of medical training and introducing readers to an entirely new lexicon. Written by psychiatrist Dr. Stephen Bergman under a pen name, the book revealed the “hazing, abuse and psychological damage inflicted on medical interns” while codifying slang terms that would influence generations of physicians.

The novel initially scandalized senior physicians who couldn’t comprehend why a book that seemingly “glamorized an unprofessional, dehumanizing attitude toward patients” resonated so powerfully with house staff. Yet its cultural impact became undeniable as medical students absorbed its terminology.

Slang terms that shaped hospital culture

Shem’s most enduring contribution was popularizing “GOMER,” an acronym for “Get Out of My Emergency Room” describing patients frequently admitted with “complicated but uninspiring and incurable conditions”. Though Bergman didn’t invent the term—it was already circulating during his 1973 internship at Beth Israel Hospital in Boston—he standardized its usage.

Other influential terms introduced or formalized in the novel include:

• Turf: Finding excuses to refer patients to different departments
• Buff: Sorting medical problems before attempting to transfer patients
• Bounce: When a “turfed” patient returns to the original department

How slang evolved across specialties

Following Shem’s influence, medical slang diversified across specialties, developing unique terminologies based on particular challenges. Rather than remaining static, hospital slang evolved to address emerging medical scenarios.

For instance, specialized terms developed for specific patient populations, with “walkers” describing elderly dementia patients and “dyscopia” referring to visual difficulties in the elderly. Likewise, terms like “fluffy” and “Milwaukee goiter” emerged specifically regarding obese patients.

Although many practitioners claim not to use slang daily, most acknowledge its continued presence in hospital discourse. Thereafter, medical slang research documented its peak usage during first postgraduate year—precisely when new physicians face maximum stress.

 

8 Hospital Slang Terms Doctors Rarely Explain

Behind closed doors, healthcare professionals employ coded language that patients seldom hear explained. These insider terms reveal the complex realities of hospital practice.

1. GOMER – ‘Get Out of My Emergency Room’

GOMER refers pejoratively to patients perceived as untreatable or undesirable. Originally popularized by Samuel Shem’s novel “The House of God,” this acronym typically describes chronically ill patients or those suspected of seeking pain medication. Medical students even created elaborate point systems—150 points earning the title “super gomer”.

2. Turfing – Passing the patient to another department

Turfing occurs when physicians transfer patients for non-medical reasons. Studies show residents label transfers as “turfs” when receiving physicians cannot provide more effective treatment than transferring physicians. Essentially, turfing happens when patient care feels “more trouble than it is worth”. Moreover, one study estimated turfing occurred in 17.34% of patients.

3. Bounceback – A patient who returns shortly after discharge

Bouncebacks represent patients returning unscheduled to emergency departments within 2-30 days post-discharge. Often used as quality indicators, studies show only 5-20% of return visits relate to inadequate medical care. Notably, patients with chronic pain were 2.5 times more likely to “bounce back”.

4. Code Brown – Fecal incontinence incident

Unlike official hospital emergency codes, “Code Brown” serves dual purposes. Officially, it refers to chemical spills or toxic fumes, yet among staff, it commonly indicates a fecal incontinence incident requiring cleanup.

5. FLK – ‘Funny Looking Kid’

This controversial term describes children with unusual facial appearances, particularly those with suspected genetic syndromes. Many physicians consider it demeaning and insensitive, preferring alternatives like “distinctive looking kid” (DLK).

6. Walkers – Elderly patients with dementia

“Walkers” ironically describes bedridden elderly patients with dementia and poor quality of life, despite their inability to walk.

7. Selfie – Self-inflicted injury patient

This recent addition to medical slang describes patients who harmed themselves intentionally.

8. Milwaukee Goiter – Slang for abdominal obesity

Named after Milwaukee’s beer-brewing reputation, this term refers to protruding abdominal fat, particularly when related to excessive alcohol consumption.

 

The Ethics of Slang: Harmless Humor or Hidden Harm?

Ethical questions surrounding hospital slang persist in medical institutions, prompting crucial conversations about professional boundaries. Studies reveal concerning patterns: 40.3% of hospitalists admitted to making fun of other physicians, 35.1% confessed to mocking attending physicians, and 29.8% acknowledged making disparaging comments about patients during rounds.

When slang crosses the line into disrespect

Medical slang crosses ethical boundaries primarily through dehumanizing language. Terms like “fluffy,” “Milwaukee goiter,” “dyscopia,” and “walkers” cast vulnerable patients—especially those with obesity or dementia—in a disparaging light. Consequently, patients who overhear such terminology experience genuine distress, as evidenced by a case where a patient overhead staff referring to her “morbid obesity” and misinterpreted discussions about “terminal cancer”.

Impact on patient care and perception

Derogatory language substantially influences treatment decisions:

• Providers prescribed fewer medications when using non-neutral terms implying patient responsibility
• Healthcare workers were more likely to believe patients deserved punishment when labeled “substance abusers” versus “having substance use disorder”

Why banning slang may not be the solution

Simply prohibiting slang might drive it underground. As noted in the Journal of Ethics, “the tactic of monitoring and prohibiting disrespectful speech could have the unintended effect of driving the use of such language underground”. Ironically, institutional policies condemning unprofessional language often fail to address underlying frustrations.

Using slang as a teaching moment

Educators increasingly recognize that slang usage presents valuable educational opportunities. Instead of mere condemnation, instructors can use derogatory language as an entry point to “confront the issues it points to”. This non-punitive approach encourages reflection on attitudes toward challenging patients, acknowledging genuine clinical difficulties without resorting to dehumanizing language.

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Conclusion

Hospital slang remains an integral yet contentious aspect of medical culture. Medical professionals must therefore balance the psychological benefits of insider terminology against potential dehumanization of patients. Though some terms like “GOMER” and “Code Brown” serve practical purposes, their usage demands careful consideration of ethical boundaries and patient dignity.

Medical argot clearly serves multiple functions within healthcare settings:

• Creating efficient communication shortcuts among overwhelmed practitioners

• Establishing psychological distance from traumatic clinical experiences

• Building essential camaraderie in high-stress environments

• Expressing frustration with systemic healthcare challenges

Nevertheless, this linguistic phenomenon carries real consequences. Patients who inadvertently overhear such terminology may experience lasting damage to their trust in medical professionals. Furthermore, research demonstrates that derogatory language influences clinical decision-making, potentially compromising care quality for vulnerable populations.

Rather than attempting to eliminate medical slang entirely, healthcare institutions might adopt more nuanced approaches. Educational interventions can transform problematic terminology into valuable teaching opportunities about professional boundaries. Medical educators specifically could address underlying frustrations that drive slang creation while promoting more humanistic alternatives.

Samuel Shem’s pivotal work undoubtedly changed medical communication forever, bringing previously hidden linguistic practices into public awareness. Since then, hospital slang has evolved alongside changing healthcare landscapes, developing specialized terms for new clinical challenges while maintaining its core psychological functions.

Healthcare professionals ultimately face a delicate balancing act. Medical slang provides necessary emotional release and team cohesion during immensely stressful situations. Still, practitioners must remain vigilant about how their words—even those never intended for patient ears—shape attitudes toward those under their care. This hidden hospital language, despite its utility, demands ongoing ethical examination as medicine continues its journey toward more compassionate, respectful patient care.

 

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