Anybody know why doctors’ handwriting is so illegible? I know this is a cliche, but it’s one of those generalizations I’ve yet to find the exception to. I’ve asked a few of them myself, and was tols something about having to learn to write fast to take notes in med school, but this doesn’t wash with me. I had to learn to eat fast in basic training in the army, but I don’t continue to swallow chunks of meat whole. Any M.D.'s or families/acquaintances of M.D.'s out there who can give me some insight? Thanks.
It’s to help prevent layman patients from reading the prescriptions, or so I’ve always figured.
I think there was an entry about this question in one of the Imponderable books.
It’s called lack of professional attitude*. In the working world only slobs have illegible handwriting. I have had to repeat weeks of vacuum metallurgy experiments because someone left behind a scrawled lab journal.
- People have been given the wrong medication because of illegible handwriting.
I’ve done a lot of chart reading a writing. By and large doctor’s writing isn’t that bad. You get used to it. Especially with the recent spate of confused prescriptions (lots of new drug trade names sound the same), I think doctors are making an effort to get better.
To explain why doctor’s writing is bad, you have to understand that they need to write a lot of stuff down for a history and physical exam. Even daily progress notes can go for pages in complicated patients. Add this to the fact that you have to talk while you write, that you are usually in a huge rush, and you are usually abbreviating every other word. I have written statements in charts that look like
Pt is 55 yo AAM c h/o CAD x 3 yrs, HTN x 3 yrs, (up arrow)chol x 3 yrs, MI c 3 c vessel CABG p 2 yrs, c/o 2d (up arrow)CP c exertion.
Any medical professional would know exactly what this means. When the layman sees something like
ECASA 65 mg PO qd qHS
it looks like gibberish. A medical professional knows it as “take a baby buffered aspirin every night before you go to bed.”
My SO is a doctor, & he has horrible handwriting, looks like sanskrit. But if he writes anything that’s meant to be read by anyone other than himself, he prints so it’s more legible.
Could be just habit. Alot of people have sort of illegible handwriting, and don’t make an effort to be legible when writing something routine. I think my handwriting is pretty good, but sometimes I can’t quite make out something I’ve written.
Doctors have to write an awful lot, often under pressure of time and while they are doing other things such as examining the patient and talking with colleagues. Add to that the fact that it is more difficult to decipher less-than-perfect handwriting if it contains a lot of unfamiliar terms and abbreviations, as edwino pointed out. It doesn’t matter so much whether the average person can understand it, but whether other doctors, nurses, pahrmacists, etc. can.
If he was sepnding 80 hours a week in the lab without proper breaks (for meals or anything else), being called out in the middle of the night to work on the experiments with only a couple of hours’ sleep, then he might have had some excuse for his bad handwriting.
I suggest to everyone that they speak to their doctor regarding the medication he prescribes for you, especially the name and dosage. Make sure to tell the pharmacist what your condition is (unless it is particularly embarrassing). Make sure you are leaving with the right medication. Read the information that comes with your medication to make sure it treats your condition.
Today many drugs sound similar and can easily be misread. I remember working for an insurance company and a pharmacist screwed up and gave mental medication to someone with a heart condition. Of course the pharmacist blames the physician’s poor handwriting.
If you find out you have been taking the wrong medication, DO NOT give the bottle to the pharmacist (they should have records of what they gave you). If the pharmacist gets the bottle, they will destroy it and make deny they gave you wrong medication. When you realize problems later, good luck suing the pharmacist without the bottle.
Good tip about keeping the bottle, RainbowDragon. Everyone should look up their medication in a drug book (such as the PDR) to make sure it treats what they have. You can even look up medications online. People who want to go the extra mile will check interactions with other drugs, and the dosage 
Arjuna34
OK. Here’s a real life example. What do you think it says? In a while, I will post another link with the answer and outcome!
I can’t decipher the handwriting in the prescription linked above, but I do remember the case being reported in the BMJ.
The prescription clearly says 20 mg. The maximum dose of the drug the pharmacist actually dispensed was, IIRC, 10 mg. The pharmacist should have realised that he was dispensing double the maximum dose of the drug and checked the prescription with the doctor. That is, after all, why we have pharmacists. Any idiot can put pills in a bottle but a pharmacist is supposed to know about dosages, interactions, etc. and check anything dodgy.
I’m not saying that the doctor wasn’t at fault, but poor handwriting is rarely, if ever, sufficient to lead to a drug error.
When I first saw the Rx in question, I wondered whether it said Zestril, Plendil, or Isordil. Each of these is a relatively common heart medicine, with similar a dosage range.
Well, here is the answer and the outcome.
Although the MD was clearly foolish, I agree with TomH that the pharmacist should bear some responsibility too.
getting back to the original question (why is doctors’ handwriting illegible?) I think that the answer is power.
Doctors have a lot of status and power, and people with status and power don’t have to make the effort to write legibly. It saves them a little effort (which is probably more than balanced by the effort of others trying to decipher their handwriting).
I like to think of myself as a pretty even-handed person, but if you compare my handwriting on (1) a note to my secretary to (2) a note to the senior guy, I have to admit that you’ll see a difference.
I suppose this is another one of the petty tyrannies that we all suffer in a world of rampant inequality. Perhaps one day, computers will help solve such problems, but I digress.
P.S. Thanks for the good tips about checking the prescription, saving the bottle, etc. I’m surprised that prescriptions aren’t logged.
Which is why judges, politicians, CEOs and all those other powerful people are notorious for having crappy handwriting, right? It’s only the one group of people who can be sued, prosecuted and lose their livelihoods as a result of poor handwriting who choose to abuse their position in this way.
“Which is why judges, politicians, CEOs and all those other powerful people are notorious for having crappy handwriting, right?”
In the jurisdiction where I live, lawyers have to submit a proposed order along with motion papers. Of course, everything is carefully typed, proofread, etc. And what happens if the judge wants to modify the order before signing it? Nine times out of ten, he (or she) will scrawl a few changes down, make a few cross-outs, and sign it. Now that’s power! (And yes, it’s often barely legible)
It would be interesting to see how often doctors get in trouble for their poor penmanship. I bet that a lot of the time, the pharmacist or nurses or whoever was reading it get the blame for any mishaps.
My SO’s handwriting on her prescriptions is so clear and perfectly nice you could read it from 10 feet away. Also:
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it takes her a minute to write a script, and
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I have even heard pharmacists comment on how they recognized her as the “one with the beautiful handwriting”.
Having worked in a couple of pharmacies and having a dad who is a PharmD, I know that MOST Pharmacists will NOT hesitate to call the physician on any ambiguity. In fact, I have never encountered one that didn’t.
I can’t tell you how many times I’ve pissed off customers by telling them that we’re not filling their prescription until their doctor calls back. Usually it was for illegible handwriting but it was not unusual for the doctors to prescribe the wrong dosage, interacting drugs, or even something that the patient was allergic to.
I’ve seen eye drops prescribed for the wrong eye, ear drops for the wrong ear, chewable antibiotics for infants w/o teeth, and physicians who feed their patients prescription drug habits without remorse.
I’ve also encountered Doctors who call for prices on different drugs for their patients w/o insurance coverage, doctors with perfect handwriting and doctors who try to do the right thing only to have their patients undermine them.
I’ve seen forged prescriptions, stolen scrips, people who take half their dosages because they want to “save money” and people who take double their dosages because “two must be twice as good.”
My point: There are bads seeds in every profession but there are just as many (and more) who take their professions seriously and try to do the right thing.
Be an educated consumer. It’s your life (and health) and it’s ultimately YOUR responsibility to make sure you’re protected and well taken care of.
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Slight tangent: CNN had an article a few weeks ago about errors in prescriptions due to hard-to-read handwriting. According to the article, the Institute for Safe Medicine Practices wants to phase out handwritten prescriptions.
Here’s the article: http://www.cnn.com/2000/HEALTH/10/04/doctors.handwriting.02/
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If there is one item that is lacking more than anything, it is the educated patient or client.
In other threads I have often marveled at how medicine and law affect our lives more than just about any other branches of professional practice. Yet, people are consistently so blazingly ignorant in both areas as to astound me. Whenever I’m given a prescription I always inquire as to what specific action the drug will have. More often than not, it is my vetrinarian that I am talking to, but that’s another matter. My vet knows the keen interest that I take in my animals and even reviews the x-rays with me.
I own a recent copy of the PDR and receive legal updates in my email. I try to stay abreast of current events in both professions. People who rely entirely upon someone else’s judgement when their life or liberty hangs in the balance are asking for trouble.
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Frankly, except for schoolteachers and cartoonists, I can’t think of any occupation other than doctors where lay people frequently see the person’s handwriting. Almost everything is typed. Hence, docs get the bad rap, when handwriting is often bad in many occupations (and yes, I agree that power=the ability to not give a damn about how illegible one’s handwriting is).