Is there any particular reason that my prescriptions are ALWAYS illegible? My SO got three prescriptions yesterday and I could not make out two words on any of them–appearantly she has been prescribed a Birth Control pill called “Yummy”. Surely, with so many medications that have similar names you’d think the Medics would take great care to be sure that what they write could not reasonably be interpreted as something else.
Why can’t I read it?
Take it from a doctor’s son: doctors are usually rushed for time, and have to do a lot of handwriting as it is on medical charts. The more writing you do, the more your handwriting degenerates.
There is a movement afoot to prevent miscommunicated prescritions by having the Rx entered electronically.
Dr. Smock (the title character of a comic strip years ago) was asked once about doctors’ handwriting. His response: “our penmanship instructor in medical school was a nearsighted chicken who drank a lot.”
[rim shot]
Seriously, I must second Walloon’s reply. I happened across some of the notes that my father (on whom be peace) made in medical school while helping to clear out the house, and found myself surprised–actually, shocked–at how legible his handwriting was at the time. Nothing like it was later. Something happened to it along the way, and the combination of lack of time and volume of writing makes more sense than just about anything else.
(Not that I have any say in the matter, but I also support electronic Rx entry. In the second place, it might reduce prescription fraud; in the first place, it might have prevented the incident several years ago where a pharmacist misfilled a prescription–and a father ended up poisoning his own child.)
What’s scary is the fact that I’ve seen so many prescriptions from my wife’s doctor that I’m starting to be able to read them myself.
As a paramedic, I find that written information regarding patients is a vital part of my business. Generally I find that nursing staff and other allied health professionals have legible writing, which makes my job easier when assuming responsibility for patients in transit.
What I find totally arrogant is the general illegibility of handwriting from doctos. It really is the height of rudeness!!!
As others above have also pointed out, it is also potentially dangerous, given that the reader often cannot understand what has been written. In my experience, many patients do not have any insight into their illness, making accompanying info vital for accurate care.
What amazes me is that a litigation-mad society like the US hasn’t outlawed illegible handwriting from doctors, on the basis that is a potentially fatal danger.
Here’s a study published in the British Medical Journal that found no difference in handwriting legibility between doctors and non-doctors:
The reason that the prescription looks illegible is that doctors take for granted that the pharmacist is familiar with the medication and can correctly decipher even the most illegible script. And that is not quite untrue. If you are an emergency room doc who has to write out a hundred scripts a week for kids with otitis media, you are pretty sure that the pharmacist will understand that “Amox 250/5 150ml 1 t po tid” means “Dispense 150 milliliters of amoxicillin 250 milligrams/per 5 milliliters. Tell the patient (or patients guardian) to take/give 1 teaspoonful by mouth three times a day for 10 days.” And I don’t fault them for it. Prescriptions are not meant for the lay public to understand. It is basically a time saver - you can sit there and write out a beautifully calligraphed piece of work and make sure that everyone who sees it is impressed with your penmanship, or you can just write down in shorthand what the most important info is and get on with it. On the other hand, I have heard and seen some MDs who take it too far and and write for things that even the pharmacist can’t possibly decipher. A few months ago, there was an article in Drug Topics journal that chronicled the story of a physician who wrote a script for “Z-liquid”. He meant to prescribe Zithromax, an antibiotic, but the pharmacist, who was unsure of what medication to dispense (because Zithromax is not usually known by that designation and there are other liquid meds that start with Z, namely Zantac) called and tried to verify the med and was treated belligerently. Meh
My step father is a Dr, and does indeed have awful hand writing (on 'scripts, and everywhere else). He has an amusing annecdote where the first ever 'script he wrote, his patient brought it back to him, saying the chemist thought it was faked, cos it was so neat.
abby
I know a pharmacist. It’s not often, but sometimes a call has to be made on the order of “What the hell IS this?”
BTW, my doctor’s handwriting is better than mine. You have to know what the abbreviations mean.
I think some doctors think its tradition or their right to scribble. My father is a doc and he writes illegibly. His signature has degenerated into a fancy looking, symmetrical design bearing no resemblance to any human language.
Well, DrJ’s handwriting was always atrocious, but while in medical school he actively worked at getting his signature down to 1 second ( to save time, you know). Of course, by the time he got it that fast, you couldn’t even make out his initials, but he was rather pleased with himself.
The implication being that the bad handwriting is related to one’s profession, that doctors have bad handwriting because they are doctors.
An alternate theory – could it actually be gender related? Nurses and nurses’ aides are predominately women, doctors are still predominately men. Women on the whole have better handwriting than men.
The problem with the “so much to write” argument is that the people who write the shortest notes–surgeons–always have the worst handwriting. I can count three times this week when I’ve had to page a surgeon to find out what the hell his note said. (They’re always grumpy about it, too.)
I’m an internist, which means two-page progress notes, and mine are among the most legible you’re likely to find, primarily because I resigned myself to printing long ago. My signature, as my beloved CCL pointed out earlier, is not quite legible, but it is distinctive, and I have a little stamp that I always use underneath it. It would be really tough to reproduce my signature, since you’d have to not only reproduce my actual John Hancock, but you’d also have to buy an identical little stamp.
Seriously, I think the whole bad doctor handwriting thing comes from the fact that we don’t see the handwriting of most people very often. I’d say that if you took a cross section of anyone in any technical field and got a handwriting sample from each of them, the doctors wouldn’t be worse than most as a group.
Dr. J
For the most part, those of us who have to deal with doctors’ handwriting generally deal with a fairly limited vocabulary to start with, and most abbreviations are standardized.
And when I’m staring and squinting and still can’t read the stupid request, I just make a phone call to confirm what was done.
Don’t wanna bill the patient for open-heart surgery by mistake, y’know. 
Robin
I actually print all my notes to make them more legible. But it’s still tough, given the sheer volume of stuff I have to write, and the limited time to get it all documented. 30 patient encounters a day (and no, we don’t have dictation), dozens of drug refills, dozens of labs to be checked, a handful of old records to be reviewed and make notes on, all done in between patient care and phone calls and other interruptions. I do my damnedest, but if it ain’t legible, call and ask me what I meant. I don’t mind. Sometimes I can’t even read my own writing. But not very often. And I work with the same team of pharmacists, so they’ve gotten used to my style, for the most part.
QtM, MD
PS. Dr. J, let’s see your handwriting after more than a decade of doing it. If you’re still writing your notes, they’ll be a whole lot shorter than what you’re doing now as an intern!
Count me in as one of the people who think its not just doctors - even just at a summer job waitressing, my handwritting degenerated to a bunch of squiggles (although with a limited menu, it was easy for me to know that a V with a squiggle was vichyssoise and a C with a squiggle was consomme 
). But I KNOW that no one else I worked with could read that very well, much in the same way that I can’t read doctor’s scripts. I think it has to do with time and volume. If you’re talking to other people, or have to take care of something else, but still have to jot down a note, you’re going to write the bare minimum required to make it understandable.
My Dr. has prescription pads that are divided up into sections - quantity, drug name, dose, how often to take the drug, and so on. That way each part is easy to read. His handwriting is fine too.
I bet pharmacists wish other doctors would use his type of pads.
Just my $0.02:
A lot of prescriptions are written with latin abbreviations ie., BID for twice a day, or QAC for before each meal, so laypeople may have trouble reading them even if the handwriting is good.
I write A LOT every day and when I have a patient with 15 prescriptions to write in a 15 minute appointment I sometimes get rushed.
One of the worst prescription errors I ever saw was on an electronic prescription where the ER doctor accidentally clicked on penicillamine instead of penicillin and printed it out without noticing (because it was printed the pharmacist didn’t catch it but luckily the patient read the enclosed instructions and called to ask why he was put on a chelating agent for a sore throat).
I always assumed that I got into medical school because the admission committee couldn’t read my (handwritten) essay and just assumed I was brilliant 
.
Poor handwriting is a real danger in the medical profession. I just took a 3 1/2 hour CME handwriting course-my writing was better for 2 days but I intend to go back to working on it. Unfortunately, the doctors who really needed to be there weren’t at the course.
Which, of course, loses back a lot of the time that was supposedly saved by scribbling in the first place.