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January 13, 1984

Nouns on Nouns

Author Affiliations

La Jolla, Calif

JAMA. 1984;251(2):217-218. doi:10.1001/jama.1984.03340260025017

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To the Editor.—  Maybe I am a word freak, but isn't there something we can do about that bloated verbal monstrosity the health care delivery system?It's not that I am against health care. But why mess with that word delivery? It adds nothing to the meaning and it saps attention that the reader can ill afford to waste. Just put these two concepts side by side: the health care system (or simply health care) and the health care delivery system. Does delivery add anything?I have never known a physician to say that he was delivering health care. Dispense, maybe. Deliver? Ouch.Grammatically, the health care delivery system is a multiple-noun abomination. Some writers call this "the noun plague." The noun plague is born when a groggy writer piles noun on noun until he is way over his head, eg, the garbage disposal (good example) unit assembly instruction booklet