Answer: "Hospital" and "Surgery" in American/British English

[chomiji]

debirlfan asked us "What are the rules for American versus British usage for 'hospital' and 'surgery'?

It's true that British usage on these common medical terms differs from what's encountered in the United States. We'll take a closer look at how these words work.

Comments

[debirlfan]

"In hospital" seems to be becoming more common here in the US (at least in southern New England). I'm hearing it locally more and more often. I'm also hearing operations referred to as "surgeries" on a fairly regular basis. Maybe related to the popularity of British tv in the US these days?

[chomiji]

Yes, operations can be called "surgeries," but it's also a general category of procedure - he had plastic surgery or she's recovering from surgery. In the United States, it's not a place where medical procedures are performed.

There are still regional variations in U.S. speech, although they have become less distinct as more people watch the same TV shows and talk together online with others from different areas. Here in the Washington, DC area, I haven't heard "in hospital" myself outside of a British context, but the influence of popular TV shows and even books can turn up in all sorts of places.

[donutsweeper]

Thanks for this, BrE vs AmE will always befuddle me.

[chomiji]

Certainly I don't always get right myself! But I know how jarring it can be to see errors the other way 'round - when an author from another country gets U.S. expressions wrong - so it's always a topic of interest to me.

[sosaith]

Well done. I've never seen this explained quite so clearly before.

[chomiji]

I'm glad it worked for you!

[pepper_field]

FWIW, in the UK, it tends to differ between hospitals vs. general practice (i.e. your local doctor, within the community - are they called GPs in the US?). If you work in a hospital and are trying to track down a consultant, you often get told "They're in clinic", or "They've got clinic on Mondays". This is the session when their patients come in to discuss their illness and the treatment options, some minor treatments are given, etc - basically, the thing that House is avoiding when he says "This is Vicodin. It's mine. You can't have any. And no, I do not have a pain management problem, I have a pain problem. But who knows? Maybe I'm wrong. Maybe I'm too stoned to tell. So, who wants me? [nobody moves] And who would rather wait for one of the other two guys? [Everybody raises their hands] Okay. Well, I'll be in Exam Room One if you change your mind

[chomiji]

All this terminology is constantly evolving.   :-)

In the U.S., a "clinic" is a much smaller sort of business than a hospital. It may be a regular, free-standing operation. For example, the "Health Unit" at my workplace could be called a "clinic": it provides 'flu shots, allergy shots, dietary counseling, weigh-ins for those trying to lose weight, and even has an actual doctor a couple of afternoons a week; otherwise, the services are provided by Registered Nurses.

A "clinic" can also be a one-time or periodic temporary event: "The Health Unit will be holding a Glaucoma Screening Clinic next week," for example.

I see that you use "clinic" the way that I expect a person from the U.K. to use "hospital." In the U.S., I'd expect "a clinic" or "the clinic": "That's a nasty cough. Better run down to the clinic and see whether they'll prescribe something."

Although it's certainly possible that some U.S. hospitals refer to the time when the doctors will see walk-in patients as "clinic," I'm much more accustomed to hearing that as "

[azure_chaos]

With regards: I see that you use "clinic" the way that I expect a person from the U.K. to use "hospital."Clinics are held in a hospital by specialist departments (they're never walk-ins always by appointment/referral only - the only exception to this is the audiologist who will take walk-ins for people needing batteries changed in hearing aids lol

[chomiji]

:D

I expect that there are lots of specialty uses like that. In the U.S., the sub-unit of a hospital that specializes is almost always called the [Specialty] Department (for example, the Radiology Department) or, if it involves inpatients, the [Specialty] Unit (foe example, the Cardiology Unit ... I guess that would be the Cardiology Ward on your side of the pond?). And as you said for the U.K., it can also just be called by the name of the specialty: "You'll find her up in Oncology."

In the U.S., the term "clinic" now sometimes extends to other opportunities to consult with experts and maybe get things repaired: a "sewing machine clinic," for example, or a "computer clinic."

[sg_wonderland]

For one American view of the 'clinic', I tend to think of that more as a place where one would see any one of a number of doctors or maybe just a nurse. Most clinics come with a rotating staff of doctors, especially rural clinics. You might also see a nurse who can administer some shots, but could not write a prescription for, say, antibiotics; that would have to entail a doctor's examination

[chomiji]

Yes, that's the usual U.S. definition of a clinic; see my response to pepper_field.

From the U.S viewpoint, the U.K. use of "surgery" to mean the facility in which a doctor provides an examination is distinctive and can be startling.

Doctors in the U.S. who perform operations of some sort typically have an office facility in which they provide examinations and perhaps a few other services, as well as "hospital privileges" at one or more hospitals or other larger medical facilities. An obvious example is the usual obstetrics/gynecology set up: you see the doctor(s) for your checkups in the office, but when you deliver the baby or need a D&C, you need to go to a larger facility such as a hospital, although you will be attended primarily by your own doctor(s) - the same one(s) who examined you in the office - while you are there.

The plurals in the preceding paragraph are because in more populous U.S. cities, group practices are very common.

[sg_wonderland]

Group practices are rare in my rural area; I'm guessing that's basically a city/country type of thing.

I really love it when folks offer this kind of advice for non-American writers trying to write American characters. For me, nothing takes me out of a story faster than hearing an American character using a British-ism or vice versa.

I spent a ton of time the other day (Downton Abbey fic) trying to discover if Carson would carry in the tea tray or if that would be some other servant. I still don't know definitively. I suppose I will actually have to watch an episode to find out. What a sacrifice!

[chomiji]

I think the group practice idea is definitely driven by population. When you have more people, they need more doctors, and when you have a certain number of doctors in similar areas of practice in close geographic proximity, it makes sense to practice as a group: you can split overhead costs (such as running the waiting room and ordering supplies) and back each other up, so no one has to be on call every weekend or evening.

>> What a sacrifice! <<

XD

There's also a marvelous book called Ager's Way to Easy Elegance (1980), written by an old-school butler, that covers a lot of the details of who used to do what. The book is aimed at encouraging modern folks without servants to take proper care of their clothes etc., but a lot of the author's actual experiences come out in his discussion of the various topics. (You would likely have to buy a used copy.)