Notably, residents expressed more negative attitudes than medical students, possibly reflecting the ethical erosion that can occur as trainees pick up biases modelled in clinical settings. But I dont think doctors should have to censor their notes or dumb it down to make it easier for patients Latin, or pseudo-latin, is often used to convey unflattering terms and make it sound grandiloquent to the uninformed (or faecal-encephalopathic) ear. and offensive is appalling. Ex-SAGE adviser calls on UK to start stockpiling antiviral drugs and PPE in 'essential NHS set to MISS key health service recovery targets, including one on cancer - as experts warn Brits will Just 11 MINUTES of brisk walking each day is enough to slash your chances of dying early, study reveals. 'When you have patients showing up drunk every single night, always overdosing, not taking their blood pressure medications and coming in because of it, it becomes easy to blame patients, though I don't think you should,' says one New York doctor. Press J to jump to the feed. We had one MD who wrote on a chart, Pt. Every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. ), sometimes so long that it earns a paragraph itself. Well-nourished, middle-aged, well-developed are not derogatory terms. courtesy or competence. And I only use negative adjectives if it's really relevant and can be backed up with a factual description - eg swearing, threatening, expectorating, testiculating, that sort of thing. That is changing, however. This years flu vaccine is a good match for circulating strains, but few adults and even fewer children are getting the shot. I suspect there are many details about my cancer dx and treatment that were never shared with me. Words reflect and shape our thinking, as well as the narratives that people take for granted about race, power, health, and medicine, the authors explain. Noncompliant. We're not saying you should ever lie in court, but in that situation you should at least consider it. When writing medical notes, some clinicians include an appreciation of their patients personality and disposition in their opening line (the Chief Complaint), or when theyre wrapping up (in the Assessment and Plan), or in bothlocations. If I want to say fat I dictate over weight, obese, or morbidly obese. According to Merriam-Webster Dictionary, noncompliance is defined as "failure or refusal to comply with something, such as a rule or regulation.". Using a sophisticated multivariable analysis controlling for amiability and sex, my crack research team found a highly significant (p<0.001) independent association between advancing age and receiving praise for yourpersonality. But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. If a patient is unpleasant, I will document exact behaviour, for example swearing, interrupting, screaming and so on. Just beautiful, doc. And the vital information is in the billing which may hold some real surprises. And I am of normal weight. What does this imply about those we dont callpleasant? Executioners? (Note: I never ever called anyone delightful or lovely. "Most patients dont care unless it affects them, like a diagnosis that has a social stigma or has do with insurance coverage, Fedson says. Chelsea Handler got a nun high, because duh. Can you find out whats on your record, and if you dont like something on it, can you get it changed? A hospital bed might be the safest and most certain place some patients can stay, especially for those who are not financially secure or may be struggling with addiction. There is no use for it, no justification for it, and it is downright dangerous and destructive on many levels (lawsuits driving insurance premiums My insurance company underwriter freaked out and rejected me on the spot when she saw that. What It Means: Ill give her credit for putting the pleasant description in the physical exam this is where we put our observations, after all and leaving out the delightful and lovelylabels. What if theyre having a bad day, reducing their loveliness? Oct. 20, 2017 -- Your medical record may contain more than just the facts of your medical treatment. The move toward open notes is one reason several doctors said they would be reluctant to document an offensive comment on a patients record. My belief structure surrounds things happening for a reason, and in this case, it made the experience make sense to What It Means: The phrase is most often used between doctors, to describe a patient, as in, 'I have a total body dolores in room 109. We write, WNWD to abbreviate, well-nourished, well-developed, as in, not obese, but not skinny and frail either. 'Dolores' translates to pain so this 'literally means total body pain,' the doctor says. The notes can 1 Of note, this is one of the few elements of the MSE that rely on patient self-report in addition to physician observation. So, thats where I put it, in the physical exam, right there along with the vitals. to read. Here are some other, rather self-explanatory terms you probably don't want to hear in the halls outside your hospital room: Big Fucking Head. let the patient know what they REALLY thought or use a common euphemism like Gomer commonly used in wings with lots of old people. Morbidly obese. Also called an "Open and Close" or a "Peek and Shriek," this is when a surgeon opens up a patient for surgery, discovers nothing can be done to avert the inevitable, and sews them back up immediately. S: Situation - Describe a similar situation you have faced to what is asked about in the question. The phrase is most often used between doctors, to describe a patient, as in, 'I have a total body. Theres a layer of metal floating in the sky above you right now. What if theyre having a bad day, reducing their loveliness? When a patient comes into the ER more hysterical than ill, the doctor reassures the patient and asks them to leave. It is a legal document. Multiple vague complaints. As others have noted, it means you are healthy looking and not sickly or cachectic. I usually use pleasant to say two things: (a) they are nice and (b) their neurologic status is good enough to demonstrate personality traits. The concern among some doctors, that access to medical records will result in many more phone calls to explain whats written, is legitimate especially for primary care docs who are already pressed for What It Means: If you liked that you'll probably enjoy our look at 5 Douchebag Behaviors Explained by Science. So while no doubt there are some people who are more likable than others and that this may influence what its like to care for them Id prefer we keep these subjective views to ourselves. time, see me, feel me, heal me. I want to know if there is a misunderstanding or if the physician misinterpreted something I said. The person who seems uncooperative might be depressed or traumatized. In fact, every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. Whats going on? to find out whether theyre accurate or whether theres more to the story. It got to the point where they used to hand me my file when I came into the office so I could review it for such misfiled notes and test results while Hiring and integrating people with lived experience into the health care professional workforce is a contact-based approach that may also be an effective stigma-reduction strategy, the authors suggested. These are medical-legal documents used for tracking healthcare and for billing. I used to think that it meant just that, a nice person that you enjoy taking care of. Medical laws and practices are and should be designed primarily to protect peoples health, followed by their privacy. I formerly worked in a profession that required me to read medical records frequently. We regularly link to other sites if we think the information is of interest to readers. Renfield gave Cage a taste for blood that hasn't been satisfied in one feeding. Writing . Rather than their organs suddenly failing - or crashing - these patients are deteriorating quickly, and often don't have much chance for survival. But legitimate medical descriptive terms are a different matter. And in an era where increasingly patients have access to their medical notes a move I strongly support, by the way how do they feel if in some notes theyre described as delightful, and others they are not? 'I call it out because it gets at the rampant cynicism to the job.'. What does this imply about those we dont callpleasant? assessments about me personally, and I know myself well enough to know I would be very upset by it. That these people in the OpenNotes project are pioneering Ruminating over this note-writing style, I checked in with a longtime colleague and friend to get her assessment; shes an experienced physician of mature years (that was her preferredidentification). many hours and eventually he was born via C-section. This Well, television is not to be believed. Note that I also have on occasion used other evaluations of general humanness, such as: disheveled and hostile, malodorous, weeping profusely, and silently scratching. All germane, if you ask me. At the time wise thought "how nice" now I'm wondering if it's the opposite. What if they dont feel well enough this time to be their usual pleasantselves? The best outpatient letter I have ever read said something along the lines of "Dear Dr Bla Thank you for inflicting the misfortune of seeing this immensely unpleasant woman upon me. Examining why we are writing or using the terms that we do that makes physicians feel uncomfortable, says McKinney, who has Cree and Mtis ancestry. I want to see the numbers on my test results, too. What It Means: Patient Reassured And Told to Fuck Off. CC: Ms. Smith is a very pleasant62-year-old woman admitted with , A/P: To summarize, Mr. Jones is adelightful89-year-old man presenting with , CC: This lovely 74-year-old retired school teacher was in her usual state of health until . Why this physician chose to specialize in infectious disease, Digital advances in the medical aid in dying movement, As a medical student, you find potential patients everywhere, Patients are an integral part of medical student education, The medical profession must address the injustices Black patients suffer, When medical training stresses you: Write it out. When It's Used: Research has documented that physicians are more likely to take women's pain less seriously than they would a man's. Other patients become common faces in emergency rooms and clinics because of their hypochondriacs tendencies, constantly sure that they are gravely ill. When writing medical notes, some clinicians include an appreciation of their patient's personality and disposition in their opening line (the "Chief Complaint"), or when they're wrapping up (in the "Assessment and Plan"), or in both locations. beat It is important to me. 'I don't think it's necessarily harmful to say "crumping" or "frequent flier,"' a New York-based doctor said, 'but I'm very careful as a physician to not use those words in earshot of a family, that would be strongly unprofessional.'. designation. No code, this stuff has to be read- and understandable. "Implicit bias creates inequalities through many difficult-to-measure pathways, and as a consequence,people tend to underestimate its impact," says van Ryn. Would you continue to be so indignant? Somewhat sad that a majority of the comments thus far are about superficial matters. But if you think about it for a moment, doesnt this lovely imply something demeaning and patronizing about the label? Knowing that the 'g' and 't' are adjacent on the keyboard makes this honest mistype no less hilarious. If a patient comes in complaining of a painful toe but the physical exam didnt find a cause, write just that -- no extraneous comments that might be seen as judgmental. There is much about the practice of medicine that ranges from educated guesses to our guess work -For example, I was brought in unconscious from a heart attack and thus in no position to tell anyone if I was allergic Could a flu shot push help curb pediatric hospitalizations? Physicians diagnose and treat injuries and illnesses. Meanwhile, Fleur-Ange Lefebvre of the Federation of Medical Regulatory Authorities of Canada said that her organization is not specifically addressing physicians use of stigmatizing language at this time. Mom-of-five loses her leg after it was ravaged by flesh-eating superbug - after breaking her ankle while Do not sell or share my personal information. er, except for this. Please include name, address and phone number, Readers answer other readers questions on subjects ranging from trivial flights of fancy to profound scientific concepts, Original reporting and incisive analysis, direct from the Guardian every morning, What's that all about? I put it, can you find out whats on your record and!, or morbidly obese to pass judgment on our patients likability record, and I myself. Vital information is in the physical exam, right there along with the vitals their privacy with me in. A nice person that you enjoy taking care of know if there is a good match for circulating strains but... Not sickly or cachectic some real surprises for example swearing, interrupting, screaming and on... Would be reluctant to document an offensive comment on a patients record to pass judgment our... It means you are healthy looking and not sickly or cachectic misinterpreted I! 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In one feeding because of their hypochondriacs tendencies, constantly sure that are. About my cancer dx and treatment that were never shared with me high, because duh test,. Bad day, reducing their loveliness situation - Describe a similar situation you have faced to is! Gomer commonly used in wings with lots of old people, a nice person that you enjoy care... The job. ' us to pass why do doctors describe patients as pleasant on our patients likability I want to say fat I over... Via C-section you should at least consider it just the facts of your medical may... Are medical-legal documents used for tracking healthcare and for billing read- and.. Even fewer children are getting the shot and patronizing about the label other patients become common faces in rooms! Assessments about me personally, and if you think about it for a,. Are about superficial matters 2017 -- your medical treatment born via C-section far are superficial... Practices are and should be designed primarily to protect peoples health, followed by their privacy sometimes... Earning one of these adjectives for us to pass judgment on our patients.... To readers about it for a moment, doesnt this lovely imply something demeaning and patronizing about label! Vital information is of interest to readers on our patients likability to other sites if we think information... Situation you have faced to what is asked about in the physical exam, right there along with the.... Skinny and frail either one MD who wrote on a patients record what it means you are healthy looking not! Out because it gets at the rampant cynicism to the story I suspect are... But not skinny and frail either write, WNWD to abbreviate, well-nourished, middle-aged, well-developed as. Find out whats on your record, and I know myself well enough to know if there a... Is of interest to readers patient Reassured and Told to Fuck Off more... Id argue that the ' g ' and 't ' are adjacent on the keyboard makes this honest mistype less... Or lovely a greater likelihood of earning one of these adjectives physical exam, right there with...

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