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Why are doctors known for bad handwriting? A Memoir

This is Why Many Doctors Have Sloppy Handwriting…

Both the issue of bad penmanship and its traditional explanation are no longer issues in the modern world.

The common explanation I have always heard is – that while rapidly taking notes in college and medical school, a doctor’s penmanship deteriorated over time. By the time they got out into practice, those writing habits could not be “unlearned”. In reality, even when I was in school in the seventies, one class member was charged with taking comprehensive notes for each class lecture, typing them and then distributing them to all the other members of the class. So at most, we only had to take hand-written notes once every 170 lectures. Today, students start using computers for note taking at an early age. They don’t even teach cursive in many grade schools anymore.

Today, I don’t write anything. All orders and notes must be entered electronically. I don’t even sign my name – I put in my password and an electronic signature is generated.

I’ve found that one can still hand-write a prescription in a pinch, but legally, they are all supposed to be transmitted electronically. Even calling the pharmacy to prescribe a drug has gotten so user-UNfriendly that it’s quicker to log into the system to order it instead.

Although electronic records are more common now, if you saw your doctor’s handwriting, there’s a good chance it’s chicken scratch. Here’s why.
If you’ve ever taken a handwritten prescription from a doctor or looked at the notes from your visit, it seems like no amount of squinting could help the letters get clearer. Bad handwriting almost seems like a requirement for graduating from med school. Although most doctors use electronic medical records today, you might still come across handwriting from your doctor—and have trouble deciphering it.

It’s not like only people with bad handwriting are attracted to the medical field. Ruth Brocato, MD, primary care doctor with Mercy Medical Center in Baltimore, Maryland says she went from winning a penmanship award in grade school to having a totally illegible script now. “I know other people have trouble deciphering my notes,” says Dr. Brocato, who adds that she can usually read her own writing.

Doctors take lots of notes:
For one thing, doctors have to write more than just about any other job. “In the medical field, if it’s not documented, it didn’t happen,” says Celine Thum, MD, medical director at ParaDocs Worldwide. Anything you talk about behind closed doors needs written evidence for your medical history.

Long days plus tons of writing equals a very tired hand. “If you’re writing literally for 10 to 12 hours a day and you’re handwriting, your hand just can’t do it,” says Dr. Brocato. Most doctors’ handwriting gets worse over the course of the day as those small hand muscles get overworked, says Asher Goldstein, MD, pain management doctor with Genesis Pain Centers in the tri-state area. Communication between doctors is important, too.

Rushing takes a toll:
If doctors could spend an hour with every patient, they might be able to slow down and give their hands a rest. But the fact is, most physicians are rushing around to the next patient. For instance, one patient might have just 15 minutes to discuss eight medical issues and ask important questions about prescriptions, says Dr. Brocato. With so many patients to see in a limited time, doctors are more concerned with getting the information down than perfecting their handwriting.

The jargon that doctors deal with also lends itself to bad handwriting. Case in point: imagine trying to write “epididymitis” without your computer’s handy spellcheck. “We have so many technical terms that are impossible to write,” says Dr. Thum. “You sometimes scribble to cover the error.”

Plus, some terms that are totally clear to medical experts might leave you scratching your head. For instance, QD is shorthand for a Latin phrase meaning “one a day” and TID means “three times a day.” Your pharmacist would know exactly what your doctor meant, but you’d probably just write it off as chicken scratch.

Poor handwriting is less of an issue today,
Now, many doctors are moving toward electronic medical records to cut down on lost-in-translation errors, even for prescriptions. Some states even legally require doctors to send in prescriptions electronically instead of passing over handwritten slips. Doctors agree there’s now less chance for error. “Things are much more legible than they have been in the past,” says Dr. Goldstein.

Of course, typing everything isn’t perfect either. There’s still the possibility of entering, say, 30 instead of 300, and the process is slower than just scrawling out a prescription.

Doctors know perfectly well that theses paper trails end in filing cabinets, never to be seen again, and that paperwork interferes with what’s really important – seeing and treating patients

Doctors also realise that what they write is intended to be seen solely by themselves and their peers, and not the public.

Their handwriting is mostly decipherable among themselves because they know what to look for, which proves that doctors’ handwriting is made and not born. (How could anyone get through university writing so illegibly?)

The consequences

According to the website Faculty of Medicine for Doctors and Medical Students, doctors’ sloppy handwriting kills thousands of patients every year.

“It could be that the doctor is focusing on the diagnosis and medication more than on writing the prescription,”

As patients, we have all been puzzled by what doctors have scribbled on prescriptions. Hardly a word can be recognised, often not even a single letter.

However, the resulting medication will find its way into our bodies, and we trust in the ability of pharmacists to decipher what the doctors have written. This could be one of the toughest jobs on the planet

Enter E-Prescribing…

Addressing the problem of bad handwriting – and advancing the case for electronic medical records – cms.gov describes E-Prescribing as “a prescriber’s ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care”.

The widespread use of E-Prescribing would help to improve the quality of patient care by decreasing the unacceptable number of deaths each year due to sloppy handwriting.

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