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doctors and bad handwriting

Discussion in 'Medical Students - MD' started by IdoDrugs, Mar 26, 2007.

  1. Hello. I figure this is the group of people closest to actual doctors here. I am a junior in undergrad (but will graduate as a fith year undergrad due to depression issues/changing majors). As a freshman and sophmore I worked (minimal...two days a week) in a pharmacy and now just do it during breaks.

    Why do many doctors have bad handwriting?

    It is very dangerous.
     
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  3. Jasoos

    Jasoos Speculumating

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    it would be a very good subject for investigation, that is all I can say
     
  4. OncoCaP

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    Here you go (let's use electronic prescriptions instead ;) ):

    BMJ 1996;313:1657-1658 (21 December)
    Abstract

    Objective: To determine whether doctors have worse handwriting than other health professionals.
    Design: Comparison of handwriting samples collected prospectively in a standardised 10 seconds' task.
    Setting: Courses on quality improvement.
    Subjects: 209 health care professionals attending the courses, including 82 doctors.
    Main outcome measures: Legibility rated on a four-point scale by four raters.
    Results: The handwriting of doctors was no less legible than that of non-doctors. Significantly lower legibility than average was associated with being an executive and being male. Overall legibility scores were normally distributed, with median legibility equivalent to a rating between "fair" and "good."
    Conclusion: This study fails to support the conventional wisdom that doctors' handwriting is worse than others'. Illegible writing is, however, an important cause of waste and hazard in medical care, but efforts to improve the safety and efficiency of written communication must approach the problem systemically--and assume that the problems are in inherent in average human writing--rather than treating doctors as if they were a special subpopulation.


    Introduction

    The assertion that doctors have bad handwriting holds an honoured place in traditional lore. According to conventional wisdom, doctors write in a code--a self righteous chicken scratch that is decipherable only by experienced pharmacists and, with luck, by each other. The question of doctors' handwriting, of course, has a serious side with far reaching implications concerning the quality and safety of health care. Some studies have found doctors' medical records and prescriptions illegible, wasteful, and dangerous,1 2 3 4 5 6 7 but we found no evidence on whether poor handwriting is indeed more of a problem among doctors than among other adults. We gathered data on handwriting under controlled circumstances to determine if, among professionals in health care, being a doctor is associated with poorer handwriting.
     
  5. tacrum43

    tacrum43 Behold the mighty echidna

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    I think it's just because you find yourself, as a med student, writing so much more than you're used to. Practicing physicians have to document a lot of information in writing for each patient too, so I can see where it comes from.

    I agree that it could be dangerous if the hand-writing is illegible. I would think that the new trend towards electronic records will help in this area (as well as portability and quick access).
     
  6. med_heidelberg

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    Ive found that my handwriting has declined since I entered med school. I write things out to memorize them and I write really fast and its often unreadable. So that might contribute to the problem.
     
  7. Law2Doc

    Law2Doc 5K+ Member
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    Agree with OncoCaP, it is a myth. I suppose being hurried in this profession may contribute more than any inherent lack of neatness.

    But FYI there are boards on SDN with actual doctors (ie residency forums) so this isn't the closest group you could find.
     
  8. lil pook

    lil pook Senior Member

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    i never had bad handwriting until i started med school. i have 2 theories:

    1) we are in such a rush all the time

    2) i have noticed when i don't get enough sleep (like right before exams) i can't even read my own writing. i believe our fine motor functions suffer when sleep deprived, and is most evident when doing things like writing
     
  9. Ashers

    Ashers Bacteria? Don't exist.
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    I've had bad handwriting my entire life, and it really hasn't changed since getting to med school. People used to ask me in junior high and high school if I was going to be a doctor because my handwriting was so bad.
     
  10. njbmd

    njbmd Guest
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    Most of the time, handwriting goes illegible because of hurry, when one can actually save more time by taking the time to be sure that what is written is clearly understandable by anyone who picks up the chart/script. If you print or write clearly, you can avoid those extra pages and phone calls as you orders will be carried out that much faster.

    Patients, pharmacy staff and nursing staff and medical staff are not happy with order delays because of poor handwriting. When the patient has to wait for the pharmacist to decipher scrawl, it reflects poorly on the physician and not the pharmacist.

    Electronic medical records are becoming more commonplace and will help to alleviate this problem. Physicians (including myself) can make sure that handwriting is legible at all times. Most of the time, one has to slow down and take the time to print or make letters clear.

    My script pads are large (twice the size of most) with plenty of room for my large block letters. Though I would never say that my handwriting is beautiful, it is legible. Many of my scripts are pre-printed too with name of medication and reason for prescribing. This helps the patient as well as the pharmacist.
     
  11. hameed kashif

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    i think its true that mojority of da doctors ve very bad hand writting:oops: its because during their medical college life they had to write much much more than stu.dents in other fields n they write with a faster speedi
     
  12. naegleria brain

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    1) we're always rushed
    2) we're always writing
    3) we've got nurses to sift though our chickenscratch for us
    4) we're always sleep deprived
    5) we're always stressed

    don't do drugs...it'll destroy your handwriting
     
  13. Law2Doc

    Law2Doc 5K+ Member
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    No way. Folks in med school and premeds write far less than nonsci majors, lawyers, teachers, writers and other more "wordy" professions. Based on my prior career, I can assure you that physicians are fairly low down on the writing intensive food chain. I would actually say that medicine seems to be full of people who avoided writing intensive courses like the plague.

    The hurried-ness is the most likely reason, if it is not just a myth.
     
  14. Critical Mass

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    It is necessary that we have our handwritiing graded by third grade teachers during USMLE II CS. Any rating of satisfactory or better is regarded as an automatic fail.
     
  15. Strongbow

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    I definitely avoided them.

    I have worked very hard at developing poor chicken scratch handwriting so I'd be a better applicant to medical school. I made sure to send an undecipherable note to every school.
     
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  17. 45408

    45408 aw buddy

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    All the people I knew in writing-intensive majors did a lot of typing, not handwriting though.

    Anyways, I have fairly neat and very distinctive handwriting. I think a lot of chicken scratch stems from being in a hurry, but I hope they switch to more electronic/computerized stuff, because I can type an incredible amount faster than I can write. My handwriting is always neat and always slow - trust me, I've tried to speed it up. I watch my wife write and I'm just amazed at how fast her pen moves. But I can type like a maniac if I want.
     
  18. Bevo

    Bevo Radiology, R1

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    LoL same here. I get it sometimes when I sign my name anywhere.

    I had this one english teacher who had been teaching for like 40 years and she once told me that she had never seen hand writing as bad as mine ever before.
     
  19. Droopy Snoopy

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    A lot of what a layman sees on a scrip and attribute to bad handwriting is actually Latin or abbreviations that are standard medical terminology. It's fully understandable by the pharmacist and attempts to prevent people from frauding up their valium dose (as easily).

    Plus when you're getting sued for something it's easier to make it up as you go if the actual orders are illegible to the lawyers ;) .
     
  20. Law2Doc

    Law2Doc 5K+ Member
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    Maybe lately (although I doubt it). But at least up until a few years back, in law it was essay test after essay test (including the non-multistate portion of the bar exam). Same with the undergrad history, english, lit, etc exams.
     
  21. danielmd06

    danielmd06 Neurosomnologist
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    Hee hee hee.

    As regards to the original post...my handwriting suffers because I'm always in such a blasted hurry...
     
  22. Law2Doc

    Law2Doc 5K+ Member
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    The reverse it actually true -- you need to be able to point to something unequivocal if you want it to be a useful defense. A clear medical record showing that you followed the standard of care, and kept good clear notes not subject to interpretation, is generally your best friend. If you leave stuff up to the experts to speculate on, you are often screwed.
     
  23. Disinence2

    Disinence2 Emergency Medicine
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    I can write neatly when i want! Its just when im in a hurry its fastest to scribble.

    In elementary school my teacher thought I had some sort of motor skills issue due to my messy handwriting that resulted in a very traumatic parent teacher conference where she attempted to place me in special education classes! (Imagine now life changing that could have been), anyways ill always remember proving her wrong by writing flawlessly saying i was just too lazy to write that way all the time.
     
  24. 45408

    45408 aw buddy

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    well, essay tests are handwritten, but no professor I ever met would take a handwritten term paper.
     
  25. 45408

    45408 aw buddy

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    ever hear about the guy who jacked an Rx pad and handed in his own scrip to a pharmacy?

    it said "1 pound mofeen"

    The scrip went unfilled.
     
  26. Law2Doc

    Law2Doc 5K+ Member
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    True, but I suspect I've written as many words in essay questions over the years as I have typed in term papers. Filled many a blue-book in my day. Few science majors/med students can make that claim. But many nonsci folks can. That's all I'm saying.
     
  27. Critical Mass

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    Do all residents write their SOAP notes by hand? Are there places where they use electronic charting?
     
  28. Law2Doc

    Law2Doc 5K+ Member
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    LOL - a google search suggests that this story is urban legend, but I suspect something similar probably occurred once upon a time.
     
  29. alwaysaangel

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    I work at a free clinic and a woman who was in a car accident was given a prescription for 20 Vicodin. She then proceeded to add a zero so it read 200 Vicodin (at the time we weren't using tamper proof forms like they do now - we just faxed copies of narcotic prescriptions directly to the pharmacy). When the pharmacy refused to fill it, they also contacted us and sent us a copy of the altered prescription so we knew what happened. Then she showed up at the clinic wanting a new prescription. It was kind of funny how offended she was when we informed her we would not be writing another prescription because of drug seeking behavior.

    So stuff like that definitely does happen.
     
  30. Law2Doc

    Law2Doc 5K+ Member
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    No doubt, but the web consensus seems to be that the "one pound of mofeen" incident didn't.:)
     
  31. Tired

    Tired Fading away

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    Depends on the program you're at. Many places are switching to electronic SOAP notes every day, with lots of bitching and moaning by the physician staff. Apparently many older docs (and nurses, to be fair) are under the impression that we can continue using paper charting indefinetely until the entire Amazon rain forest has been converted to medical records. Fortunately no one listens to doctors anymore, and the changeover continues unabated.
     
  32. 45408

    45408 aw buddy

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    Party pooper.

    alwaysangel, my mother-in-law just witnessed an incident at the Walgreen's she works at, where the pharmacist refused a narcotics prescription to a woman because the same prescription had just been filled the day before for someone else who picked it up. The woman threw a sh.t fit because she couldn't get her drugs, but the pharmacist wouldn't budge. Like the insurance is gonna pay for two of the same $500 prescription.
     
  33. 45408

    45408 aw buddy

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    Oh, I'd love that. My write-ups are 10x better if I can type it.
     
  34. MattD

    MattD Curmudgeon

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    At my school, we have a class. Our final exam is to submit a writing sample for review. If an expert in ancient handwriting analysis cannot read it, but a pharmacist can JUST make it out, we get an A. If a pre-med can read it, we get an F. It's pretty hardcore, there's a fine line between illegibility and random doodling. By far the hardest class of first year!
     
  35. alwaysaangel

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    Yeah I saw something similar to that - a woman had filled her vicodin prescription from her dentist the day before and was now trying to fill one from the doctor. But the pharmacist had caught the double prescription and cancelled one. The woman THREW A FIT! In that case its really not the price since vicodin generics are pretty cheap. But the pharmacist stood strong despite all the screaming.
     

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