Why Doctors Write Bad
by Dr.Sal MD on
Doctor handwriting is notoriously bad and has become the clichÃ© joke of the industry. Is bad handwriting a prerequisite to becoming a physician? Nope. So why? The answer is time.. or rather the lack thereof. Writing bad for a doctor is a survival adaptation. I know because I've done it myself. Think, in a single eight hour shift we can write our signature a hundred or more times! And that's just our signature icing on the top of layers upon layers of additional verbiage cake. The problem doctors face is the volume of paperwork that needs to be performed for each patient encounter. For legal reasons, everything done, found, considered, instructed or reported by patients must be documented. Many doctors come to the Epiphany at some point of their careers that most of this paper-trail monster ends life stuffed in filing cabinets to never be seen again, of no value to anyone but lawyers and insurance men, and interferes in what is really important to us - seeing and treating patients!
Doctors also come to the realization that what we write is for internal consumption, not for public record. As you'll see later down, the way we write is decipherable amongst us docs and pharmacists because we know what hooks we're looking for. And you'll see that illegible bad doctor handwriting is acquired, not innate. (Consider: how could anyone get through college, far less medical school, writing like a cockroach from the get go? Their profs would never put up with illegible term papers or exam answers).
How to Write Bad Just Like a Doctor
- Abbreviate - It's much faster to write 'SOB' than 'shortness of breath' (and BTW when I first encountered this entry during clinical rotations I snickered the first time I saw it then naively began to wonder how there could be so many sons-of-b* on the ward - a colleague put me out of my mental misery by explaining what my seniors really meant).
- Write small - some doctors appear to be stricken with micrographia disorder (abnormally puny, cramped handwriting). The gambit behind this ploy is that distance takes time to breach so writing tiny makes for hand excursion economy thereby saving us time.
- Skip vowels - can u rd ths sntnce? Many sentences and words can be read just fine without vowels. As surgeons say, "when in doubt, cut it out".
- Scrawl - write the first three letters legibly of long technical words then scrawl the rest. Doctors use the same words over and over so it only takes one or two letters in context for us to recognize a specialized word eg. "pulmonary" written "pul*^^%*!" is unlikely to be misconstrued for "pulley" once the surrounding medical context is considered and the footprint length of the word.
The problem with this kind of handwriting is when doctors get so in the habit of writing bad that they write everything bad including public documents in this medical shorthand that nobody else outside of medicine - and occasionally they themselves - can't read. Worse is when this charting script makes it onto our prescription pads. Every year patients are hurt by errors of interpretation e.g. Celexa and Celebrex scribbled look like a doppelganger. So it's important to remember that doctor handwriting has limitations like any other tool in our medicine bag. Luckily, the advent of computer records are quickly making naughty doctor handwriting and scribbled chicken scratch records relics of the past. The majority of my chart notes and prescriptions today are either dictated or typed unlike a decade ago. With time, doctor handwriting will likely go the way of the dodo bird, choked out by technology, and a few remaining samples will be displayed to future generations from glass boxes at museums.