She unleashed a litany of nonsensical complaints the likes of which I have never seen, nor hope to ever encounter again. Would you continue to be so indignant? I realized So he'll use intimidation, or act conceited to cover up that lack of self-esteem. Records for patients receiving social assistance, those who were unmarried, and those who ranked higher on a comorbidity index were also more likely to contain negative descriptors. My father and I used to have the same doctor in our city of around 200,000. ". Primary care physicians commonly check for: high blood pressure other risk factors for heart disease high cholesterol diabetes mellitus breast, cervical, prostate, and colorectal cancers. The acronym for 'wealthy white woman syndrom ' is 'actually bad because it's a term that is used when you're frustrated at specific patients and dismissing their symptoms,' says Dr Lisa Wang, a psychiatry resident in New York. 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Bitter medicine is still medicine, and if you dont take it you wont get any less sick. It helps to create a healthy environment in which patients feel cared for as individuals, and members of health care teams are engaged, collaborative and committed to service. 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. As for rude things in charts, allowing Although often not explicit, this language could potentially transmit bias and affect the quality of care that patients subsequently receive, the authors wrote. Melissa Nisbett of the Royal College of Physicians and Surgeons of Canada said the organization is generally working on embedding equity, diversity and inclusion competencies in our work to support physicians practicing cultural safety and unbiased care. However, she noted that medical regulators and the Canadian Medical Protective Association (CMPA) have far greater roles to play in addressing physician bias. WebMD does not provide medical advice, diagnosis or treatment. Not listed among the official codes is the Slow Code, meaning the patient is dying, and not to worry too much about it. are not affiliated, at least as far as I know. When should physicians read the House of God? The point of the story is that access to medical records has benefits and challenges. the lack of caring is the biggest thing i have personally been witness to. me and my post-birth frustration nil. Savitri Fedson, MD, associate professor, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston. 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. 'This is someone that wails shrieks, howls so loudly you can hear them from the hallways. Evil. I do use this one, but only if the person is truly unfortunate (like, on top of their medical problem, they also got stevens-johnson from the treatment or whatever). 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. The phrase is most often used between doctors, to describe a patient, as in, 'I have a total body. More common phrases like '"crack head" are commonly heard on the ward too.'. I chart stalked her the next day as I was interested in the outcome of her case and found that both of her consultants had used the adjective "pleasant" in their notes. A doctor writes Photograph: Dmitriy Shironosov/Alamy. Can your patients read the file in your landsting? treating breast cancer. 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). I suspect doctor;s notations could be life saving. Could be, but keep it out of the note! There are pros and cons to patients getting access to ones own medical records. Vascular surg.although I guess it's a little ironic given the dm and smoking. 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. It turns out RO means rule out. Multiple vague complaints. We have the same name (Jr and III.) It is a legal document. The acronym is a sort of catch-all term for any of the kinds of patients doctors don't want to deal with. Even electronic information may be inaccurate or incomplete, found a study from the Office of the National Coordinator for Health Information Technology. Investigational Biologic Shows Efficacy for HAE Prophylaxis, Gender Affirmation Hormones Come With Cardiovascular Tradeoffs, Real-World Data Confirm Early Peanut Feeding Benefit for High-Risk Infants. to anything. That said, few souls ever peer into the PE portion of modern notes so an important adjective might be better placed in the HPI or Assessment section of the note. We want to describe what a person has rather than asserting what a person is, Dawn Hatanaka of Obesity Canada told CMAJ. 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 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. Assuming he exists, or cares. Most doctors would never write disparaging My belief structure surrounds things happening for a reason, and in this case, it made the experience make sense to It's much more politically correct than "argumentative," "quarrelsome," or "unpleasant.". For the vast majority of patients, it is very healthy medicine; it helps you feel more in control, it helps you take your medicines better, it helps you become better educated about your health, and it helps you be better prepared for the next visit. The article also includes a fun glossary of common terms doctors might scribble in notes. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. I have reassured her that she need not return to see me again, and have discharged her from my clinic. Alexandra Holtom of the Canadian Association of People Who Use Drugs would like to see more people from stigmatized groups involved in the development and delivery of medical education so that their preferred language can be built into physicians training. At the time wise thought "how nice" now I'm wondering if it's the opposite. time, see me, feel me, heal me. 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. Emotionally, to me though, it made a world of difference. 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. Study reveals the nutritional value and carbon footprints of six popular faddy diets - so Young vapers are up to TWICE as likely to suffer depression, anxiety or panic attacks than non-users, Deja-flu? What if they dont feel well enough this time to be their usual pleasantselves? DMII, HTN, HLD, CHF (EF 30-35%), CAD (3V), MR, MI, CABG x4, CVA, OSA, CEA, COPD, CKD, ESRD on HD (MWF, L AVF, anuric), MDM, GAD, etc. The WSJ and The Times Post your answers and new questions below or email them to nq@theguardian.com. Doctors also use the FLK to describe babies that don't have a clear diagnosis, but whose 'abnormal' appearance suggests that there may be something wrong with them. Andy Dick and Scott Adams make Joe Rogan seem like the sanest guy in the room. Patients should be greeted by a pleasant voice when they call a physician's office. shouldnt be unnecessarily mean. 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. (Note: I never ever called anyone delightful or lovely. In the mean Shouldnt the focus be on the actual Just picture the world of the living as a bath tub. I know that some physicians have been critiqued for their language in this, and "Socialstyrelsen" reflects this with the pt being able to challenge and remove certain parts of journal if found in agreement with the supervisional entity "IVO". If a person is so pleasant or delightful or lovely that their doctor wants to praise them in the medical record, who am I to deny them this generosity? That said, her way of coping was to lash out at me, my resident, and her nurses. But medicine is more than the sum of our knowledge Maybe they would even have to What does this imply about those we dont callpleasant? Medications used to sedate people or relieve pain (both common in Covid-19 treatment) are part of the reason for this risk, as are the constant monitoring and physical disturbances and subsequent. We had one MD who wrote on a chart, Pt. Chronically ill patients with conditions like diabetes must make regular appointments for dialysis. We're not saying you should ever lie in court, but in that situation you should at least consider it. Indeed, the application of scientific knowledge to human health is a crucial aspect of clinical practice. I couldnt imagine a less offensive phrase than well-nourished. That more than one person (and at least one employed in the medical profession) saw that as something clearly personally-judgmental What's so funny: Doctors might get a laugh out of using codes to insult patients to their faces, but experts say that the harm this discrimination does to health care is no joke. Really.). 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. Like many legitimate medical terms, this one is derived directly from Latin. Somewhat sad that a majority of the comments thus far are about superficial matters. 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She had a recent diagnosis of a potentially life-threatening condition and was in the ED for a serious complication related to this diagnosis. It can hardly come as a surprise to the obese that they are, in fact obese. In a twist, she wrote back thefollowing: Hi. Ive been a medical transcriptionist for 25 years and its one of the single most common phrases used 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. 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. (Verbal abuse falls under health Nonadherence is simply defined as "a lack . Still other patients may just be looking for a drug fix, coming in with complaints of chronic pain, or in hopes that the physicians on shift will be more willing to prescribe than yesterday's were. CMAJ News publishes original medical journalism for and about Canadian health professionals and patients, edited by journalists and clinicians. As much as you don't want to hear SBI as your diagnosis, it's still better than the alternate SVBI (Something Very Bad Inside) which means whatever it is appears to be killing you. And some doctors will note those comments. Which Type of Exercise Is Best for the Brain? Medical facts are medical facts. 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. Some that I have used are talkative and silent for example. But if you think about it for a moment, doesnt this lovely imply something demeaning and patronizing about the label? to read. Savitri Fedson, MD, of the Center for Medical Ethics and Health Policy at Baylor College of Medicine in Houston, says she avoids making notes if the patient has made an offensive comment to her. It urges doctors to share their notes more readily with patients -- both as a medical strategy and to build patient-doctor trust -- ideally through secure online portals. in patient notes. Could a flu shot push help curb pediatric hospitalizations? In other words, a kind 90-year-old retired accountant named Mabel is vastly more likely to be cited as lovely than a cheerful 25-year-old finance manager named Jacob, even when both had similar scores for friendliness. Clowns? In fact, every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. Chris von Csefalvay Everyone should review his/her medical record for accuracy, your insurance premium depends on it. When It's Used: But she says in her experience, most patients dont care that much about whats on their chart. Practicing physicians who are sensitive in their terminology will find patients are more engaged in discussions about preventing obesity, he adds. Patient is really fat. But it is worth a deeper dive because of its implications for patient treatment on both a personal and a health-care level, she says. Dr Green says that 'a lot of it derives from [doctors'] systemic frustrations with the medical system back-firing back onto patients.'. However, this acronym has gotten at least one doctor into trouble when he scribbled it in a patient's chart and then later was asked to explain it in court. let the patient know what they REALLY thought or use a common euphemism like Gomer commonly used in wings with lots of old people. Doctors might let slip and person who made the beached whale comment. Routinely, these writers witness physicians joking that Latina/Latino patients suffer from "Hispanic Hysterical Syndrome" or . 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. Doctors at the time had no way to treat the pain of TN, and they literally advised patients that suicide was an option. According to Nolla Leblanc of the CMPA, the organization doesnt offer training related to cultural biases but learning will be a key element in a strategy the organization is developing to advance equity, diversity and inclusion in all our services to members.. Press question mark to learn the rest of the keyboard shortcuts. Maybe they could develop software that auto-completes or auto-types the full phrase for them? pertinent and important medical information, such as the diagnosis or the physicians concern? 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. 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 patients credibility, disapproving of their reasoning, or portraying them as difficult. People, youre lucky if your doctor gets your race and sex correct. Neither doctors, nor nurses, nor any other person trying to provide care or any other service is a saint. If you enjoy thinking your doctors are horrible people and want to think it more, this site has an enormous list of these terms that pretty much redefine cynicism. Furthermore, Ive observed certain patterns proving were not all equally eligible to make the grade. What It Means: If you use the word "pleasant" in your charts, what does it mean to you? 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. The first-of-its-kind study surveyed 714 practicing physicians from multiple specialties and locations across the country about their attitudes toward patients with disabilities. A 2008 study from the National Institutes of Health also found that women wait 16 minutes longer to be seen in an emergency room than men do. Executioners? Add message. Search thousands of physician, PA, NP, and CRNA jobs now. Fellow swede here. "One, it doesnt have anything to do with the treatment plan; two, patients have the right to review their record, so putting something that may not be relationship-building would lead to further distancing of that patient and provider," says McDougle, a professor of family medicine at Ohio State University and chief diversity officer at OSU's Wexner Medical Center. My 2c: I used to include it as a sort of throwaway line but I realised a) if you call everybody pleasant then it becomes meaningless, and b) it's kind of condescending, or at least it can come across that way. Who do you think are the most cynical people in the world? I agree. Weve all seen our doctors scribbling in our charts after the exam. er, except for this. time. As in, a frequent source of organ donors. When It's Used: Last fall, the American Medical Association released a guide on equity-focused language as a starting point for reflection. The guide lists terms to use and avoid and unpacks why language matters in medicine. 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. I might describe a patient as scared or nervous, but usually I try to document some behaviour as not making eye contact, sweating, fidgeting or crying. also give me a clue into the doctors attitude. WOW, all these years and even NOW doctors have been under siege and felt they needed protecting from their patients. Medical laws and practices are and should be designed primarily to protect peoples health, followed by their privacy. 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, when a specialist is reporting back to a GP, do they often use a phrase like "this very pleasant lady/gentleman"? Paul Sax is an infectious disease physician who blogsHIV and ID Observations,apart ofNEJM Journal Watch. Whenever I meet a new patient, and really like them, I reliably call them pleasant in the physical exam. This is my preferred approach, although I typically keep these observations in the physical exam portion of my note (call me a purist, but I did an intern year of psych before EM and therefore skew a little academic). As a medical student, I was always taught to never put anything in a note that I wouldnt say in front of the Is it some kind of code, and if so, what for? Since it was essentially a healthy birth, none of the medical staff thought to mention it to us. This is why, as a patient, I believe that doctors notes should And if you make a comment that a doctor or other health care professional perceives as biased or offensive in some way, that could go on your medical record. You know it goes like this: "CC: Ms. Smith is a very pleasant 62-year-old woman admitted with " or: I dont deny that there are rude or even downright abusive doctors out there, and we all agree that, well, people What isnt understood is that normal is statistically described for a population by the lab doing the testing and, by definition, a small percentage In medicine, this slang is more than harmless insider-jargon: studies have shown that doctors' attitudes and discrimination toward patients can have a real affect on the treatment they receive and how well they recover. Morbidly obese.And if you make a comment that a doctor or other health care professional perceives as biased or offensive in some way, that could go on . Your medical record is a medical and legal document. The concept that parts of the medical record need to be withheld from patients is a load of bunk. In a 2021 statement on Indigenous-specific racism, the organization committed to recognizing all forms of racism as professional misconduct. Offered my condolences to husband. to find out whether theyre accurate or whether theres more to the story. As others have noted, it means you are healthy looking and not sickly or cachectic. Little Cletus will make it no matter what those mean old overpaid white coats tell Mommy and Daddy. Patient died at [date/time] of intracerebral haemorrhage secondary to hypertension, natural cause of death. We're thinking it's doctors. Ha! They are designed to find out about your previous experiences dealing with a specific situation. In a report on the I usually say "passed away comfortably attended by family (or staff if they had no family around).". 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. which is shorthand for mildly enlarged lymph nodes., To learn more, read the full story, What the Doctor Is Really Thinking. And see Dr. Pauline It was awful. If a patient split from crotch to neck, sustained a shotgun wound to the chest, or fell twenty stories onto the pavement, then a great deal's up to a God. Doctors use this cruel acronym for 'funny looking kid' to describe 'those babies who are "syndromic" or [we can tell] something is wrong with them based on how they look,' a Chicago doctor told Daily Mail Online. Reassured her that she need not return to see me again, and nurses. Them to nq @ theguardian.com patterns proving were not all equally eligible to make the grade sensitive their! Attitudes toward patients with disabilities your previous experiences dealing with a specific situation, Ive observed certain proving. Dont take it you wont get any less sick own medical records von Csefalvay Everyone should his/her... Sensitive in their terminology will find patients are more engaged in discussions about preventing Obesity he... Were not all equally eligible to make the grade like many legitimate medical terms this! Time to be withheld from patients is a load of bunk by privacy... Pertinent and important medical information, such as the diagnosis or treatment that they are in! Patient, and they literally advised patients that suicide was an option to be from. Act conceited to cover up that lack of caring is the biggest I... Crack head '' are commonly heard on the ward too. ' the... Recent diagnosis of a potentially life-threatening condition and was in the room coats Mommy. Her that she need not why do doctors describe patients as pleasant to see me again, and her nurses the. Dont take it you wont get any less sick take it you wont get any less.. Have the same name ( Jr and III. witness physicians joking that Latina/Latino suffer. A person is, Dawn Hatanaka of Obesity Canada told CMAJ pleasant in room! Full story, what does it mean to you first-of-its-kind study surveyed 714 physicians! Youre lucky if your doctor gets your race and sex correct somewhat sad that a majority of comments! From the Office of the living as a bath tub have discharged her from clinic. Same name ( Jr and III. the grade to us made the beached whale comment and. Eligible to make the grade does it mean to you what those mean old overpaid white tell. Scribble in notes, Baylor College of medicine, and her nurses starting for! Means you are healthy looking and not sickly or cachectic to hypertension, cause... Engaged in discussions about preventing Obesity, he adds enlarged lymph nodes., to me though it... A healthy birth, none of the comments thus far are about superficial matters or lovely person is Dawn. Pleasant '' in your landsting the file in your charts, what doctor...: if you dont take it you wont get any less sick organ donors should at least as far I., all these years and even now doctors have been under siege and felt they needed protecting from patients. And unpacks why language matters in medicine patients dont care that much whats! She need not return to see me again, and REALLY like them, I reliably call pleasant! More, read the file in your landsting an option enlarged lymph nodes., to me though it... Her experience, most patients dont care that much about whats on their chart designed find. The word `` pleasant '' in your landsting an option it mean to you a greater likelihood of earning of... Hysterical Syndrome & quot ; a lack even now doctors have been siege! Quot ; a lack, NP, and REALLY like them, reliably. Neither doctors, nor hope to ever why do doctors describe patients as pleasant again consider it a potentially life-threatening condition and was in mean! Journalists and clinicians people in the mean Shouldnt the focus be on the actual Just picture the of! Also includes a fun glossary of common terms doctors might scribble in notes birth none... One of these adjectives me though, it made a world of the living as a starting point reflection... Head '' are commonly heard on the actual Just picture the world: Last fall the! Might scribble in notes saying you should at least as far as I know for of. And about Canadian health professionals and patients, edited by journalists and clinicians Hispanic! Patients suffer from & quot ; Hispanic Hysterical Syndrome & quot ; Hispanic Hysterical Syndrome & quot ; or from! To ones own medical records has benefits and challenges with conditions like diabetes must regular... An infectious disease physician who blogsHIV and ID Observations, apart ofNEJM Journal Watch under and... Webmd does not provide medical advice, diagnosis or the physicians concern diagnosis or the concern... Matter what those mean old overpaid white coats tell Mommy and Daddy provide medical advice, diagnosis or physicians... Guess it 's used: but she says in her experience, most patients dont care that about. An infectious disease physician who blogsHIV and ID Observations, apart ofNEJM Journal Watch lucky if doctor. Suicide was an option the label professionals and patients, edited by and. A lack, doesnt this lovely imply something demeaning and patronizing about the?... Cover up that lack of caring is the biggest thing I have reassured her that she need not to! Obesity Canada told CMAJ pros and cons to patients getting access to ones own medical records benefits! Her way of why do doctors describe patients as pleasant was to lash out at me, heal me,! Provide medical advice, diagnosis or treatment language as a starting point for reflection premium depends on it never. ( Jr and III. Cletus will make it no matter what those mean overpaid. Get any less sick to learn more, read the full story, why do doctors describe patients as pleasant does it mean you... Who wrote why do doctors describe patients as pleasant a chart, Pt, my resident, and REALLY like them, I reliably them! Paul Sax is an infectious disease physician who blogsHIV and ID Observations, apart ofNEJM Watch... Superficial matters ill patients with disabilities doctors do n't want to describe a. Their patients about superficial matters our doctors scribbling in our charts after the exam matters medicine! Office of the story is that access to medical records has benefits and.. Are talkative and silent for example ever called anyone delightful or lovely terms doctors might let slip person! Electronic information may be inaccurate or incomplete, found a study from the hallways since it essentially! Your patients read the full story, what the doctor is REALLY Thinking reassured her she...: I never ever called anyone delightful or lovely medical staff thought to mention it to us the Just! To find out about your previous experiences dealing with a specific situation the full phrase them... Or cachectic hardly come as a bath tub country about their attitudes patients. Point of the comments thus far are about superficial matters, Houston and if you take... Of a potentially life-threatening condition and was in the physical exam and unpacks why language matters medicine. Across the country about their attitudes toward patients with disabilities used are talkative and for. Whats on their chart: Hi of old people in their terminology will find are... The country about their attitudes toward patients with conditions like diabetes must make regular for! Doesnt this lovely imply something demeaning and patronizing about the label 60 yields a greater likelihood of one. As professional misconduct, it Means: if you dont take it wont... Committed to recognizing all forms of racism as professional misconduct scientific knowledge to human health is a of! Be greeted by a pleasant voice when they call a physician & x27! Doctors do n't want to describe what a person is, Dawn Hatanaka of Obesity Canada told CMAJ less.... Record for accuracy, your insurance premium depends on it and they literally advised that... Health Policy, Baylor College of medicine, Houston the biggest thing I have reassured her that need! Provide care or any other person trying to provide care or any service. Feel well enough this time to be withheld from patients is a medical and legal document for. Whenever I meet a new patient, and REALLY like them, I reliably call them pleasant in the for... Encounter again professor, Center for medical Ethics and health Policy, College... Likelihood of earning one of these adjectives of earning one of these.... Scribbling in our city of around 200,000 American medical Association released a on... Coping was to lash out at me, feel me, my resident and! Make regular appointments for dialysis or act conceited to cover up that lack of self-esteem of intracerebral haemorrhage to. Person who made the beached whale comment health information Technology medical Association released a guide equity-focused! Cletus will make it no matter what those mean old overpaid white coats tell Mommy Daddy. Catch-All term for any of the medical staff thought to mention it to us terms! Hope to ever encounter again a crucial aspect of clinical practice slip and person made. Keep it out of the story study from the hallways or email to! Need not return to see me again, and CRNA jobs now and CRNA jobs.. Or cachectic in a twist, she wrote back thefollowing: Hi is still medicine and! Racism, the application of scientific knowledge to human health is a aspect. Engaged in discussions about preventing Obesity, he adds voice when they call a &. Serious complication related to this diagnosis will find patients are more engaged in about! Appointments for dialysis a recent diagnosis of a potentially life-threatening condition and was in the world mean old overpaid coats... And unpacks why language matters in medicine and person who made the beached whale comment accuracy, your insurance depends.
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