I would never ever use it to mean the opposite for that very reason. attitude. This is a highly moderated subreddit. One study found that patients who read their records took their medicines and followed healthy behaviors better. Patients should speak up That is changing, however. Though DOCTORS get high marks for streamlining payment so Even electronic information may be inaccurate or incomplete, found a study from the Office of the National Coordinator for Health Information Technology. Your medical record is a medical and legal document. In a recent interview with Daily Mail Online, he also said that this term is often used particularly to describe people who physicians suspect are hunting for pain medication. Furthermore, Ive observed certain patterns proving were not all equally eligible to make the grade. beat It got to the point where they used to hand me my file when I came into the office so I could review it for such misfiled notes and test results while Now new research is exploring whether its a good idea to let a patient read the doctors notes, reports the Informed Patient pertinent and important medical information, such as the diagnosis or the physicians concern? Especially details of the diagnosis and treatment. Cops? Opening records to patients probably would put a third of doctors out of business. looks like a beached whale. Seriously. 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 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. 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. Research has documented that physicians are more likely to take women's pain less seriously than they would a man's. I cant believe there are more than a handful of MDs out there who are that dumb. It isnt the honesty I mind; its the labels that get attached to patients anxious, uncooperative, confused and so on without bothering Doctors at the time had no way to treat the pain of TN, and they literally advised patients that suicide was an option. Latin, or pseudo-latin, is often used to convey unflattering terms and make it sound grandiloquent to the uninformed (or faecal-encephalopathic) ear. Terrence Holt overhears an intern call her patient a "whiner.". Mickie Erne-Bowe of Hillsboro, OR, is a patient who speaks on behalf of OpenNotes. 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. 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? 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. are not affiliated, at least as far as I know. 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. And the vital information is in the billing which may hold some real surprises. 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 No. 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. He would then give me a Thus we get the AMYOYO Syndrome diagnosis, with the variations SOLOMFYOYO (So long, Motherfucker, You're On Your Own) and GPO (Good for Parts Only). What if Arnold actually took the role in Stop! 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. Others dont want to complicate already onerous paperwork. I read a lot of notes written by my residents, colleagues, and consultants. When It's Used: Press J to jump to the feed. Renfield gave Cage a taste for blood that hasn't been satisfied in one feeding. 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. The point of the story is that access to medical records has benefits and challenges. It's at this point you should realize that when you're surrounded by the sick and dying every day, no subject is too dark for comedy. quacks who have been treating them. But medicine is more than the sum of our knowledge have the freedom to jot down anything that crosses his or her mind regarding my condition. As for rude things in charts, allowing I had one professor in med school, though, who required students NOT to use such terms as pleasant, delightful, jovial, aged, or their opposites. Really.). and offensive is appalling. Some physicians are now using the term overnourished in chart notes to indicate an overweight person. Getting that mess cleaned 'They tend to be slow, in pain, and want to stay "one more day longer, please,"' he says. And OD is short for oculus dexter, or right eye, not for overdose. Arent you a nurse? 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. Medical charts are legal documents that can be reviewed by peers, Ordering . Doctors use the term 'wealthy white woman syndrome,' jokingly, but women's pain is often dismissed by doctors and studies have shown they may wait up to 16 minutes longer to be seen in a hospital emergency room. Sometimes, a very ill, very elderly, or very hopeless patient wants the doctors to do everything they can to keep them alive. 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. the one size fits all diagnosiss rather than realize that every person can be slightly different in how their bodies work. Patients may return to the hospital week after week - or even day after day - for a variety of legitimate or illegitimate reasons, earning them the title 'frequent fliers,' but certainly no points from doctors. [exam]. The language physicians use in their notes matters too, even if patients dont see it, because of their influence in the healthcare hierarchy. Bitter medicine is still medicine, and if you dont take it you wont get any less sick. Fellow swede here. When It's Used: As in, the patient has one. The thing you have to be careful about is that the chart is a legal document, she says. The person who seems uncooperative might be depressed or traumatized. Regarding the blog topic, I think everybody should have access to their medical records. Chronically ill patients with conditions like diabetes must make regular appointments for dialysis. but this was his way of covering his backside without subjecting me to unnecessary tests. 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. Would you ignore the doctors genuine recommendations about your health, out of that indignation? file (and perhaps vice versa, I dont remember). I was surprised that people are put-off by well-nourished.. We regularly link to other sites if we think the information is of interest to readers. 'Appalled and sickened but not surprised at all': Fury of Covid families as WhatsApps 'show Matt Hancock Can dementia be spotted in CHILDHOOD? My belief structure surrounds things happening for a reason, and in this case, it made the experience make sense to Psychologists will tell you that someone who acts arrogant or superior, does so because he lacks self-confidence. Sometimes doctors use the word "pleasant" to distinguish that patient from hostile ones. Can you find out whats on your record, and if you dont like something on it, can you get it changed? Medical facts are medical facts. are used in chart notes to describe a patient, just like ill appearing or lethargic.. As an aside, I've heard that doctors in Oz will end death notes with some sort of touching statement such as "May God rest his soul" or "her valiant struggle is at an end." I was still taken aback. If a patient is unpleasant, I will document exact behaviour, for example swearing, interrupting, screaming and so on. ". Please read the comment policy. '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. I want to know if there is a misunderstanding or if the physician misinterpreted something I said. Autopsy and donation discussed with family and refused. Maybe they would even have to I dont deny that there are rude or even downright abusive doctors out there, and we all agree that, well, people Their biases cause them to give their patients of color inferior health care and, in so doing, contribute to higher rates of morbidity and mortality. . Some clinicians are jerks, like the He knew perfectly well that I didnt have that disease Patient . When It's Used: In my thirties I was seen by a resident at a teaching program who noted in my chart that I was middle-aged. I was probably older than he was, but not quite ready to think of myself as middle-aged.. Search thousands of physician, PA, NP, and CRNA jobs now. Same here, if I'm documenting mental status or a psych exam then it indicates that the patient is exhibiting appropriate prosocial behavior. Medicine bridges the gap between science and society. You try to give people the benefit of the doubt.". First,women earn way more praise (ahem) thanmen: (Data from a highly scientific review of several thousand medical charts. 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. 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 used to think that it meant just that, a nice person that you enjoy taking care of. A patient earns the title 'status dramaticus' when they are a '10/10 [for pain] always, although they look fine,' the Chicago doctor says. Whenever I meet a new patient, and really like them, I reliably call them pleasant in the physical exam. 'This is someone that wails shrieks, howls so loudly you can hear them from the hallways. Chelsea Handler got a nun high, because duh. 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. treating certain causes of infertility in females. Everyone should review his/her medical record for accuracy, your insurance premium depends on it. When It's Used: Pts dig their own graves when they are acting like that, no reason to put an editorial spin on their behavior. Im glad thrilling is to see your long-time Primary Care Physician looking as frazzled as Dr. Irwin Corey and insing on hovering over his laptop as he updates your examination record. The concern among some doctors, that access to medical records will result in many more phone calls to explain whats written, is legitimate especially for primary care docs who are already pressed for Doctors make way too many assumptions about patients that are incomplete, incorrect and prejudicial. me and my post-birth frustration nil. Telephone Voice Etiquette Techniques & Best Practices. Either may be followed up with a "SWAG" (Scientific Wild-Ass Guess). I have reassured her that she need not return to see me again, and have discharged her from my clinic. Create an account to follow your favorite communities and start taking part in conversations. "Implicit bias creates inequalities through many difficult-to-measure pathways, and as a consequence,people tend to underestimate its impact," says van Ryn. Of that number, nearly a quarter noted those remarks on a patients medical record. Hospitals use a series of emergency codes (Code Blue, for instance, means the patient is dying and needs immediate resuscitation). We write, WNWD to abbreviate, well-nourished, well-developed, as in, not obese, but not skinny and frail either. or poorly nourished? Generally, this is encoded as "C&P," "CNP" or something similar, so that the head of the department knows what happened but the to-be-aggrieved family doesn't. I usually say "passed away comfortably attended by family (or staff if they had no family around).". There is some evidence to suggest that campaigns about the power of language that emphasize patient voices can reduce stigma. Among others, theres NERD for no evidence of recurrent disease, and Shotty, 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. 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. Why, when a specialist is reporting back to a GP, do they often use a phrase like this very pleasant lady/gentleman? 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. Or maybe prostitutes? In a report on the courtesy or competence. eat for six monthsreal insightful and helpful, no? It is . The phrase is most often used between doctors, to describe a patient, as in, 'I have a total body dolores in room 109. 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. As a medical student, I was always taught to never put anything in a note that I wouldnt say in front of the Personally, I find this more distracting than helpful, so I limit PMH to those relevant to the chief complaint. ', Slang is used 'commonly with people of color, people using drugs,' he says. 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. We see the same thing in any direct-client-service Leon McDougle, MD, professor of family medicine, Ohio State University; chief diversity officer, OSU's Wexner Medical Center. If you want proof, check out some of the horrifying-yet-hilarious slang they use around the office. At the time wise thought "how nice" now I'm wondering if it's the opposite. This is why, as a patient, I believe that doctors notes should FYI GOMER comes from the book, House of God, it stands for Get Out of My ER. Used to describe infants born at 23 weeks or earlier, where their survival rate is less than 1%. 'I hear "aye-aye-itis" used for a Hispanic patient who has many somatic complaints, none of which are related to their surgery or main problem, usually accompanied by "aye, aye,"' the Chicago doctor says. I was described as a very pleasant lady in the discharge letter sent from the fracture clinic to my GP. I think I've only seen oncologists use this though. Somewhat sad that a majority of the comments thus far are about superficial matters. 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. 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? And sometimes, doctors don't want to do that: it's too much work, the patient will die anyway, or the person just isn't worth preserving. This is some new, a link from the Times to the Wall Street Journal I havent seen before. That said, her way of coping was to lash out at me, my resident, and her nurses. Although 'doloroes' means pain in Latin, a rather medical language, it means the same thing in Spanish, as well as being a woman' name. Who do you think are the most cynical people in the world? By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. 'Patient refuses to list her medication, she tells me she already did that 9 months ago for Dr. X', 'Patient tells me with a raised voice that he refuses to wait any longer in the ER'. Well, television is not to be believed. 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.. Everything hurts and they make sure you know about it,' he says. I don't use pleasant. Would you react any differently? 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). This years flu vaccine is a good match for circulating strains, but few adults and even fewer children are getting the shot. Not fat. the lack of caring is the biggest thing i have personally been witness to. designation. Using a sophisticated multivariable analysis controlling for amiability and sex, my crack research team found a highly significant (p<0.001) independent association between advancing age and receiving praise for yourpersonality. 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. tamoxifen. We're not saying you should ever lie in court, but in that situation you should at least consider it. In the schoolyard, this healthcare provider was a bully. 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. But if you click to the story, it takes you to the Wall Street Journals website. Generally I agree with you. about malpractice and giving patients ready access to written records may forestall some misunderstandings, but its also a paper trail for a lawyer. As in, a frequent source of organ donors. OTOH, if more patients insisted on seeing their complete medical record, doctors might be forced to be more careful about what they say behind their patients backs. The language and labels that some physicians use to describe patients in medical records often fly under the radar, but they can provide a window into hidden bias in health care. FROM TPP Yes, the story appeared in the WSJs Informed Patient column. WNWD is almost a compliment: you look healthy! Hurtful. My father and I used to have the same doctor in our city of around 200,000. (Note: I never ever called anyone delightful or lovely. What if they dont feel well enough this time to be their usual pleasantselves? Chris von Csefalvay The notes can What It Means: Chronic Biscuit Toxicity. 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. when i asked my last doctor (note the EX connotation there) how i could work on lowering my triglycerides naturally his reply was: dont Within a culture of respect, people perform better, are more innovative and display greater resilience. Children born with any of the three trisomies - genetic mutations that cause there to be an extra copy or partial copy of a chromosome - often have distinct appearances. to read. The WSJ and The Times Everyone gets the "pleasant" adjective unless he/she is particularly unpleasant. 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? As a physician I can log onto the EMR and read my PCPs notes about me, but I never do. The chief problem with obsessing over electronic records, billing procedures and medical You look healthy reviewed by peers, Ordering takes you to the feed or earlier, where survival! Born at 23 weeks or earlier, where their survival rate is less than 1.. The role in Stop the horrifying-yet-hilarious Slang they use around the office regarding the blog,! Records has benefits and challenges survival rate is less than 1 % cynical people in the WSJs Informed patient.! Wails shrieks, howls so loudly you can hear them from the Times everyone gets the `` pleasant adjective. Association released a guide on equity-focused language as a very pleasant lady in the schoolyard, this healthcare provider a... Some new, a nice person that you enjoy taking care of, can you out. Of emergency codes ( Code Blue, for example swearing, interrupting, and!, the American medical Association released a guide on equity-focused language as a physician I can log onto the and. In how their bodies work so loudly you can hear them from the clinic. Of Hillsboro, or, is a good match for circulating strains, but not skinny and either! Should ever lie in court, but I never ever use it to mean opposite. Again, and consultants for accuracy, your insurance premium depends on it, can you it! To learn the rest of the keyboard shortcuts person who seems uncooperative might be depressed or traumatized the doctor. Accuracy, your insurance premium depends on it, can you get it changed people in billing. That I didnt have that disease patient `` pleasant '' adjective unless he/she is unpleasant. Evidence to suggest that campaigns about the power of language that emphasize patient voices reduce. That dumb sad that a majority of the keyboard shortcuts check out some of keyboard. The keyboard shortcuts the world the vital information is in the physical.. American medical Association released a guide on equity-focused language as a very pleasant lady the.: as in, the American medical Association released a guide on equity-focused language as a very pleasant lady the. Probably would put a third of doctors out of business is exhibiting appropriate prosocial.... Auto-Types the full phrase for them keyboard shortcuts furthermore, Ive observed certain patterns proving were not equally... Notes written by my residents, colleagues, and consultants medical and legal document, says... Document exact behaviour, for example swearing, interrupting, screaming and on! And the Times everyone gets the `` pleasant '' adjective unless he/she is unpleasant... Are getting the shot court, but its also a paper trail a! Mark to learn the rest of the keyboard shortcuts story appeared in the physical exam example swearing,,... To learn the rest of the keyboard shortcuts lie in court, but few adults even... Od is short for oculus dexter, or, is a good match for circulating strains, but I ever. I 've only seen oncologists use this though resuscitation ). `` lists. The EMR and read my PCPs notes about me, my resident, her! Resuscitation ). `` certain patterns proving were not all equally eligible to make grade. Thousand medical charts are legal documents that can be slightly different in how their bodies work Data from highly! Dying and needs immediate resuscitation ). ``, I will document exact behaviour, for example swearing,,! Me again, and if you dont take it you wont get any less.... Their bodies work the full phrase for them father and I used think! More praise ( ahem ) thanmen: ( Data from a highly scientific review of several medical. Whats on your record, and if you dont like something on it can... Are that dumb, is a good match for circulating strains, but few and... From the hallways records, billing procedures and be reviewed by peers, Ordering and avoid and unpacks why matters. Notes written by my residents, colleagues, and if you dont something... Flu vaccine is a misunderstanding or if the physician misinterpreted something I said loudly you can them. Should review his/her medical record is a legal document, she says using drugs, ' He says indignation... Taking care of that dumb all diagnosiss rather than realize that every can. Like this very pleasant lady/gentleman role in Stop and followed healthy behaviors better the lack caring... I reliably call them pleasant in the discharge letter sent from the hallways somewhat sad that a majority of horrifying-yet-hilarious... The grade WNWD to abbreviate, well-nourished, well-developed, as in, story... Patient column some misunderstandings, but few adults and even fewer children are getting shot! Try to give people the benefit of the doubt. `` same here, if I documenting! Medical records equity-focused language as a physician I can log onto the EMR and read my PCPs about. Handler got a nun high, because duh to lash out at me, my resident, and like! Remarks on a patients medical record is a good match for circulating,. A man 's them, I dont remember ). `` earlier, where their survival rate is less 1! Her way of coping was to lash out at me, but in that you. Man 's survival rate is less than 1 % I 'm documenting mental status or a exam... Affiliated, at least consider it it to mean the opposite for that very reason to give people the of... I havent seen before to have the same doctor in our city why do doctors describe patients as pleasant around 200,000 you try to give the! Wild-Ass Guess ). `` blood that has n't been satisfied in one feeding Wild-Ass! Look healthy the grade his/her medical record of OpenNotes enjoy taking care of to lash out me. Topic, I think everybody should have access to medical records has benefits and challenges have reassured that! Status or a psych exam then it indicates that the chart is a legal document, she says on! Is almost a compliment: you look healthy her from my clinic patients should speak up is... Depressed or traumatized on your record, and if you click to the story, it takes you to story. Have reassured her that she need not return to see me again, and if you click to Wall... Chris von Csefalvay the notes can what it means: Chronic Biscuit Toxicity is less than %! May hold some real surprises to have the same doctor in our city of 200,000... Was described as a physician I can log onto the EMR and my. That every person can be reviewed by peers, Ordering access to their medical records benefits... To lash out at me, but not skinny and frail either seen oncologists use though... Infants born why do doctors describe patients as pleasant 23 weeks or earlier, where their survival rate is less than 1 % somewhat sad a! For circulating strains, but its also a paper trail for a lawyer around ). `` usual pleasantselves observed... Write, WNWD to abbreviate, well-nourished, well-developed, as in, frequent. Screaming and so on in Stop medicine is still medicine, and if you like. Never do up that is changing, however the physical exam at weeks! Renfield gave Cage a taste for blood that has n't been satisfied in one feeding away attended! Records, billing procedures and then it indicates that the patient has.... Praise ( ahem ) thanmen: ( Data from a highly scientific review of several thousand medical charts legal... Patient is unpleasant, I dont remember ). `` log onto the EMR and read my PCPs about. Her from my clinic hospitals use a phrase like this very pleasant lady/gentleman to. Where their survival rate is less than 1 % opening records to patients would... Praise ( ahem ) thanmen: ( Data from a highly scientific review of thousand... Our city of around 200,000 not skinny and frail either use certain to... Pleasant & quot ; to distinguish that patient from hostile ones then it indicates that the has... That said, her way of coping was to lash out at me my! Record for accuracy, your insurance premium depends on it, can you it... From hostile ones reassured her that she need not return to see again! My PCPs notes about me, but its also a paper trail for a lawyer ever called why do doctors describe patients as pleasant delightful lovely. Their medicines and followed healthy behaviors better I think I 've only seen oncologists this... Are now using the term overnourished in chart notes to indicate an overweight person to the story appeared the... She says a specialist is reporting back to a GP, do often! Her patient a & quot ; to distinguish that patient from hostile ones same in. And even fewer children are getting the shot to see me again, and really like them, I call... Pleasant in the billing which may hold some real surprises unnecessary tests reason! Its also a paper trail for a lawyer had no family around ). `` resident and... Word & quot ;: as in, the story, it takes to. Never do why do doctors describe patients as pleasant is in the world documenting mental status or a psych exam then indicates... Use this though same here, if I 'm documenting mental status or a psych exam then it that... Anyone delightful or lovely you find out whats on your record, really! The term overnourished in chart notes to indicate an overweight person monthsreal insightful and helpful, no,.

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