Words have meaning. Books are published by various learned people in order to solidify the meaning and spelling of words and establish general agreement among our countrymen. These dictionaries are important because without them people or governments may try to arbitrarily change the meaning of words for their own advantage. A common language with general agreement about the meaning of words is one of the pillars of civilized society.

Aside from the wide-ranging cultural and societal implications of precise common language, there is a certain practicality to a uniform understanding of what words mean.

If for some strange reason the government decides to make the words trousers and eyeglasses synonymous, the request for patients to remove their eyeglasses and read the top line of the eye chart suddenly becomes problematic.

This, of course, is an absurd example. It seems less absurd, however, when one considers the recent actions of CMS to require precise government-approved language in order to be paid for reading a radiograph. It seems that the bureaucratic geniuses in our nation’s capital have deemed that the word reviewed no longer means what all the dictionaries say it means. If one enters into the medical record, “I have reviewed PA and lateral radiographs of the chest and find a normal cardiac silhouette and no infiltrates”, no payment will be forthcoming. If, however, reviewed is substituted with interpreted, payment will flow, much to the consternation of your local radiology group.

While these two words are not synonymous, reviewed, by definition, is actually closer to what we do than interpret. Review means to make a general survey or a critical evaluation. Interpret means to explain or tell the meaning of something. So, why is our government splitting semantic hairs? Always follow the money when things don’t make sense. They don’t really care what word is used. They care that emergency physicians usually say reviewed, and if they deem that word to be unacceptable, payment can be withheld.

This behavior is troublesome for two reasons. First, withholding payment over the choice of two generally acceptable terms is disingenuous and makes me feel even more cynical (I did not believe that was possible) about our federal government. Second, manipulation of our language is a particularly Orwellian act and should make every citizen open their eyes to the truly objectionable actions of our government.

Government manipulation of words is not new and has been used to advantage by both Republicans and Democrats. The Democrats do seem to have more of a knack for it, however. In Washington, a cut is not really a cut. It is a reduction in the rate of growth. The president has not proposed a tax but a revenue enhancement. The service members initially sent to Viet Nam were only advisers. Before a grand jury, Bill Clinton said that to answer a question it would depend on what the meaning of is is. In Korea there was no war, just a conflict. More recently in Egypt, a coup is not really a coup if our government wants to continue sending aid to a country without tossing federal law out with the cat litter.

So who cares if we have to adjust our verbiage to satisfy paper pushers? Everyone should care because this is the symptom of a much larger problem. Eliminating a word from our vocabulary is the group of petechiae hiding under the shirt of the guy with fever and a headache. Manipulation of the language is the sign of a government that looks down upon its citizens with a snobbish paternal smile and a heart filled with contempt.

Philip Dick, science fiction writer from the last century, put it well when he said, “The basic tool for the manipulation of reality is the manipulation of words. If you can control the meaning of words, you can control the people who must use the words.”

If the federal government was not poised to afflict every hospital and physician’s office from Albuquerque to Zebulon, this would be drivel and my time would be better spent drinking a Yuengling Lager and watching the Tigers beat the Indians. But our government is, in fact, preparing to release upon our land the most onerous and repugnant collection of regulations ever designed by man.

This recent little foray into word control will seem like a lazy fly one might catch with chop sticks after the swarm of locusts descends and decimates every last stalk of corn in our fields. And there we will stand with a pitchfork in one hand and a computer mouse in the other wondering how such a disaster could happen. The government will have taken control of our professional language.

You may use the word obese but it will be at the expense of revenue. To remain in favor, the proper phrase will be satiety deficiency. There will be no chronic pain because of the negative implications associated with the words. Opioid receptor malfunction will please those in control.

Many of you, by now, think I have stopped taking my medication. But ask yourself these questions. Ten years ago would you have believed that the government would have warrantless access to our voice and electronic communications? Would you have believed that we would kill an American citizen, without trial, using an unmanned aircraft? Would you have believed that the IRS would put groups of Americans on a watch list and systematically prevent the granting of a tax status made easily available to others?

I was going to pay my income taxes this year but have decided that income is no longer an acceptable term at my house. If the IRS wants my money they will need to use the proper language. Personal remuneration is the acceptable term for 2013. They have plenty of time to change their forms.

Be happy.

Dr. Baehren lives in Ottawa Hills, Ohio. He practices emergency medicine at Wood County Hospital. Your feedback is welcome at DBaehren@premierdocs.com.