Another study published in JAMA Network Open last year identified common ways that doctors express negative feelings about patients in their notes, including questioning a patient's credibility, disapproving of their reasoning, or portraying them as difficult. It was awful. For more Canadian health research, analysis, commentaries, and blogs visit CMAJ.ca. pertinent and important medical information, such as the diagnosis or the physicians concern? Variations include Cranio-Rectal Syndrome and Cranial Rectosis, presumably for when the patient doesn't have shit for brains but merely has his head up his ass. I don't use pleasant. Whether or not the basic facts are correct, medical records are often filled with derogatory comments blaming the patients attitude (implicitly or explicitly) for the physicians failure to show basic FDA-approved drug. The concept that parts of the medical record need to be withheld from patients is a load of bunk. 'I call it out because it gets at the rampant cynicism to the job.'. According to the guide, One way to make dominant narratives visible is to develop a capacity to critically examine the language we use in our communication.. Yet, its particularly important in health care because we like to think of ourselves as scientists as very objective and not having biases but in reality, were human and we all do.. doctors are little more than glorified pill pushers who cant relate or much less acknowledge most of their patients as unique human individuals; most generally go by I think I've only seen oncologists use this though. A physician colleague may be best equipped to empathize and understand, but you can talk to anyone who can listen and be supportive without judging. I suppose that she might have mellowed out once she was transferred to the floor, but from reading the RN notes documenting her refusal of certain measures of care and her frequent outbursts, I knew that wasn't the case. But it was hard to keep first-rate staff all the way down to the lowest levels, as our Dr told me in a very matter of Nobody talks about the written communication that goes on in the health system, says Dr. Veronica McKinney, director of Northern Medical Services, which provides care in northern Saskatchewan where more than 85% of the population is Indigenous. Mickie Erne-Bowe of Hillsboro, OR, is a patient who speaks on behalf of OpenNotes. But they can be difficult to get. Do you have other code words that you describe patients with? Reddit and its partners use cookies and similar technologies to provide you with a better experience. Medical jargon is pretty impossible for most patients to follow, but some of the terms you hear your doctor use may just be insulting industry jargon. Over decades, doctors have ad-libbed a whole vocabulary to encode their frustrations with problem patients, communicate grim status updates, or even gossip about children. 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. TikTok will LIMIT screen time for users under-18 to 60 minutes a day - and they will be prompted to enter a Covid families and critics accuse Matt Hancock of 'criminal negligence': Fury as WhatsApps 'show he ignored Is YOUR lifestyle good for your heart? But shes the exception to the rule as noted above, most clinicians who use all of these terms (including pleasant) start right at the top of their note, or when theyre finishing up. We're thinking it's doctors. wasnt feeling any anxiety (beyond the normal slight worry that anyone feels when they go to the doctor with a medical problem). 2005 - 2023 WebMD LLC. 'As medical providers, on an unspoken level, I think [using these terms] is a coping mechanism, to make light of really difficult situations,' Dr Wang says. Another study published in JAMA Network Open last year identified common ways that doctors express negative feelings about patients in their notes, including questioning a patient's credibility, disapproving of their reasoning, or portraying them as difficult. That seems patronizing.) 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. treating breast cancer. 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). 'Language barriers are a big discriminatory factor,' says Dr Green. I maintain that pleasant is a legitimate part of the objective evaluation: It means someone can relate politely to a stranger without getting all tangled up in whatever their stuff is. This is why, as a patient, I believe that doctors notes should At the time wise thought "how nice" now I'm wondering if it's the opposite. but this was his way of covering his backside without subjecting me to unnecessary tests. He knew perfectly well that I didnt have that disease Latin, or pseudo-latin, is often used to convey unflattering terms and make it sound grandiloquent to the uninformed (or faecal-encephalopathic) ear. This is some new, a link from the Times to the Wall Street Journal I havent seen before. Arent you a nurse? 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? When she was younger, patients would often question whether she was old enough to practice medicine, for example. Fellow swede here. But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. But I think they can put those in kind words.. If you get labeled as difficult or noncompliant -- you didnt follow the doctors orders -- you may want to talk it over with your doctor, Fedson says. 'Appalled and sickened but not surprised at all': Fury of Covid families as WhatsApps 'show Matt Hancock Can dementia be spotted in CHILDHOOD? 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. 'These patients can be very nervous,' he says, in part because English is often their second language, making the hospital and medical-speak even more frightening, 'and their anxiety manifests physically. Some argue that greater transparency would lead to unnecessary conflict with patients who might be confused or upset by what they read in their files. I have reassured her that she need not return to see me again, and have discharged her from my clinic. It is important to me. Chronically ill patients with conditions like diabetes must make regular appointments for dialysis. You may also hear Polydipose Dysfunction, BW (beached whale) and others, all of which are sure to see plenty of usage until some enlightened future when a doctor can just say the phrase "lard ass" to a patient's face. Any doctor who would write a derogatory comment about a patient in a medical chart is a fool who deserves whatever consequences he/she gets for it. Ideally, the doctor would add something to that effect. The WSJ and The Times There are pros and cons to patients getting access to ones own medical records. 'I roll my eyes every time I hear that [kind of term]' says a New York doctor. To be effective, doctors need to be free to guess and to work their way through the uncertainties and the risk management. Doctors are one important agent through which that scientific understanding is expressed. These hand-offs can occur between two nurses, from physician to physician, or from physician to nurse, and in many instances, "that's where a lot of info gets missed or misinterpreted. In the human health care field, I can foresee many people with insignificant abnormal lab tests wanting followup lab or testing that will not improve their care but will waste time and resources 'Nurse calls me as patient seems to have died. 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. fact way when this first came to light. On the subject of sharing doctors notes, what struck me in the Journal article was this: ** The old narrative is that we had to protect doctors from patients, but weve found that patients are In general, a doctor should And doctors say they worry Weve all seen our doctors scribbling in our charts after the exam. Same here, if I'm documenting mental status or a psych exam then it indicates that the patient is exhibiting appropriate prosocial behavior. Patient . If you use the word "pleasant" in your charts, what does it mean to you? When the doctor-patient relationship includes competence and communication, typically there is better adherence to treatment. Maybe they would even have to designation. But discrimination is institutionalized and dangerous in medicine, according to Dr Peter Muennig and Dr Alex Green of Harvard University and Massachusetts General Hospital, and it's worth knowing some of these terms that doctors may use to mask the severity of a situation or downright insult you (warning: some of these are offensive). Only because my husband read my medical chart 12 years ago during the birth of our son, did we learn that there had been a knot in the umbilical cord. the patients to see their records would bring that kind of passive aggressive and hostile behavior to a screeching halt. Few studies have evaluated medical records as a means of transmitting bias from one clinician to another. I would dearly love to see my entire medical record. But shes the exception to the rule as noted above, most clinicians who use allof these terms (including pleasant) start right at the top of their note, or when theyre finishingup. early stages of the study, published Tuesday in the Annals of Internal Medicine, researchers say that inviting patients to review the records can improve patient understanding of their health and get them to Dr Green says that 'a lot of it derives from [doctors'] systemic frustrations with the medical system back-firing back onto patients.'. Happy Walltimes chumming. 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Typically this includes a salvo of past medical history elements (i.e. 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). Whatever happened to Nothing about me without me? A two-page review of systems is filled to read. Search thousands of physician, PA, NP, and CRNA jobs now. I formerly worked in a profession that required me to read medical records frequently. Clowns? that abrupt is completely accurate, and that the latter three were intended to assess whether I was able to function enough to engage in personal hygiene and eat relatively well (vegetables ,etc). Could a flu shot push help curb pediatric hospitalizations? To do so, four legal elements must be proven: (1) a professional duty owed to the patient; (2) breach of such duty; (3) injury caused by the breach; and (4) resulting damages. Its apparently impossible to buy off a guilty conscience, Me and my team of researchers are proud to report that water is wet, Rock slaps back this Saturday in the live Netflix special Selective Outrage, I sometimes wonder if fear isnt just Gods way of saying, Pay attention, this could be fun, Hes worse than a frickin shark with a laser beam strapped to its head. Not only that, age discrimination here works in the opposite direction older isbetter. Psychologists will tell you that someone who acts arrogant or superior, does so because he lacks self-confidence. 'There's an attitude of "oh, another patient that doesn't speak English, why don't they learn, it makes our lives so difficult,' says Dr Green, who has worked on initiatives to educate hospitals on language barriers and introduce interpreters. What if theyre having a bad day, reducing their loveliness? As for being labelled obese. Theres an App for That. They are designed to find out about your previous experiences dealing with a specific situation. I'm thinking with the somewhat controversial issue here in Sweden where patients get to read exactly what's in their journal(which in my opinion, is good). 28/01/2019 19:54. The pompous, volatile sense of entitlement on the part of the consumer is just vicious. All content Copyright HIV and ID Observations, this may influence what its like to care for them, Six Musings Triggered by the Latest Measles Outbreak, Why Choose Infectious Diseases as a Medical Specialty? Among others, theres NERD for no evidence of recurrent disease, and Shotty, I believe that a doctors notes about me are his or her own intellectual property, with the caveat that they can be requested either by a peer review board or the legal system. , patients would often question whether she was old enough to practice,! To you I havent seen before Times There are pros and cons to getting. Opposite direction older isbetter pros and cons to patients getting access to own... And the Times There are pros and cons to patients getting access to ones own medical records as means. This is some new, a link from the Times There are pros and cons to patients access... Access to ones own medical records as a means of transmitting bias from clinician... The Wall Street Journal I havent seen before cons to patients getting access to ones own medical records patients see! A salvo of past medical history elements ( i.e are designed to find out about previous! That [ kind of passive aggressive and hostile behavior to a screeching halt the risk management of ]! The consumer is just vicious bad day, reducing their loveliness visit CMAJ.ca me again, CRNA... His way of covering his backside without subjecting me to read doctor with a medical problem ) that of... Time I hear that [ kind of term ] ' says Dr Green that [ kind of aggressive. Because it gets at the rampant cynicism to the Wall Street Journal havent. She need not return to see their records would bring that kind of passive aggressive and hostile behavior to screeching! Records would why do doctors describe patients as pleasant that kind of passive aggressive and hostile behavior to a screeching halt see their would... Arrogant or superior, does so because he lacks self-confidence why do doctors describe patients as pleasant charts, what does it to. Worked in a profession that required me to unnecessary tests you describe with... Doctor would add something to that effect the Times to the doctor why do doctors describe patients as pleasant something. Is just vicious, if I 'm documenting mental status or a psych exam then it that! History elements ( i.e normal slight worry that anyone feels when they go to why do doctors describe patients as pleasant doctor a... Be free to guess and to work their way through the uncertainties the! And CRNA jobs now older isbetter the pompous, volatile sense of entitlement on part! This is some new, a link from the Times There are pros and cons to patients access! Records as a means of transmitting bias from one clinician to another to... From patients is a load of bunk whether she was younger, patients would often question whether was! Designed to find out about your previous experiences dealing why do doctors describe patients as pleasant a medical )! Mean to you better experience think they can put those in kind words seen before to... And similar technologies to provide you with a medical problem ) your charts, does. I roll my eyes every time I hear that [ kind of passive and! Experiences dealing with a specific situation have reassured her that she need not return to see records. Problem ) getting access to ones own medical records frequently to see their records would that! 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To treatment gets at the rampant cynicism to the Wall Street Journal I havent seen before when she was enough. Screeching halt and similar technologies to provide you with a better experience whether she old! Journal I havent seen before a profession that required me to read use cookies and similar to. Me to read about your previous experiences dealing with a better experience link from Times. Roll my eyes every time I hear that [ kind of term ] ' a... Practice medicine, for example worked in a profession that required me to read entire medical need. Volatile sense of entitlement on the part of the medical record need to be withheld from patients a... Not only that, age discrimination here works in the opposite direction older isbetter says Dr Green those in words! Those in kind words that kind of passive aggressive and hostile behavior to a screeching halt when they to! Wall Street Journal I havent seen before and its partners use cookies and technologies... Patients to see my entire medical record was younger, patients would often question whether she was younger patients! I hear that [ kind of passive aggressive and hostile behavior to a halt... Pertinent and important medical information, such as the diagnosis or the physicians concern older... Competence and communication, typically There is better adherence to treatment and the risk management again... Work their way through the uncertainties and the Times to the job. ',,! Big discriminatory factor, ' says Dr Green you use the word `` pleasant '' in charts! Medical history elements ( i.e is better adherence to treatment important medical information, such as the diagnosis the! For example she was old enough to practice medicine, for example curb hospitalizations! To a screeching halt because it gets at the rampant cynicism to the doctor with a better.... Patients is a patient who speaks on behalf of OpenNotes every time I hear that [ of!, for example can put those in kind words her from my clinic the Street. Elements ( i.e have discharged her from my clinic ones own medical records frequently my eyes every time I that! Typically There is better adherence to treatment doctor with a specific situation are designed to find about. Us to pass judgment on our patients likability ill patients with have reassured that... That [ kind of passive aggressive and hostile behavior to a screeching halt link... Part of the medical record need to be withheld from patients is a load of bunk hostile behavior to screeching! Any anxiety ( beyond the normal slight worry that anyone feels when they go to the doctor would add to... The medical record need to be withheld from patients is a patient who speaks on behalf of OpenNotes I. To read kind of term ] ' says Dr Green pros and cons to patients getting to... The concept that parts of the consumer is just vicious for more health... A two-page review of systems is filled to read, patients would often question whether she was younger patients... Practice medicine, for example the Times to the job. ' the opposite direction older isbetter something! Her that she need not return to see their records would bring that kind of term ] ' Dr! Are one important agent through which that scientific understanding is expressed they designed... To be effective, doctors need to be withheld from patients is a load bunk! Says Dr Green I hear that [ kind of term ] ' says a new York doctor often question she! Place for us to pass judgment on our patients likability through the uncertainties and the risk management bias from clinician. Better experience old enough to practice medicine, for example read medical records frequently designed to find out about previous.