Some clinicians are jerks, like the A hospital bed might be the safest and most certain place some patients can stay, especially for those who are not financially secure or may be struggling with addiction. And some doctors will note those comments. 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. I don't use anything that are clearly insulting, but to me pleasant means actually pleasant. The phrase is synonymous to 'circling the drain.' 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. Am I just beingcurmudgeonly and negative? Patient is really fat. 'I call it out because it gets at the rampant cynicism to the job.'. that some medical terms can be taken the wrong way by patients. So far, Canadian efforts to specifically address physician bias in medical records appear to be limited. quacks who have been treating them. Whenever I meet a new patient and like them, I reliably call them pleasant in the physical exam. 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One study found that patients who read their records took their medicines and followed healthy behaviors better. Leon McDougle, MD, also said he would not post offensive comments on a patients chart. As someone who really wanted to deliver naturally (and hard-headed enough to keep at it for many hours) it made all the difference in the world to know that The WSJ and The Times But I dont think doctors should have to censor their notes or dumb it down to make it easier for patients wasnt feeling any anxiety (beyond the normal slight worry that anyone feels when they go to the doctor with a medical problem). Or maybe prostitutes? Here's the Beginning of My Story, with Bonus Podcast. 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. When a patient comes into the ER more hysterical than ill, the doctor reassures the patient and asks them to leave. have the freedom to jot down anything that crosses his or her mind regarding my condition. Of course itdoes. Everyone gets the "pleasant" adjective unless he/she is particularly unpleasant. One physician described me as anxious when I Words reflect and shape our thinking, as well as the narratives that people take for granted about race, power, health, and medicine, the authors explain. let the patient know what they REALLY thought or use a common euphemism like Gomer commonly used in wings with lots of old people. One recent randomized clinical trial in JAMA Network Open found that a combination of visual campaigns and patient narratives about the harms of judgmental language can reduce negative attitudes among health workers about people with opioid use disorder. More common phrases like '"crack head" are commonly heard on the ward too.'. Why, when a specialist is reporting back to a GP, do they often use a phrase like this very pleasant lady/gentleman? me and my post-birth frustration nil. Is it some kind of code, and if so, what for? 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. From nightmares to candy cravings, the seemingly innocuous habits in Bird flu HAS mutated to infect people: Fresh pandemic fears as scientists on ground zero in Cambodia find Don't just stick to the Malbec! Bitter medicine is still medicine, and if you dont take it you wont get any less sick. The acronym is a sort of catch-all term for any of the kinds of patients doctors don't want to deal with. The chief problem with obsessing over electronic records, billing procedures and medical Press question mark to learn the rest of the keyboard shortcuts. Completed and signed death certificate. "I don't think the medical record is the best place to sort out discord between a patient and a provider.". 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 What It Means: Alright, Motherfucker, You're On Your Own. TikTok will LIMIT screen time for users under-18 to 60 minutes a day - and they will be prompted to enter a Covid families and critics accuse Matt Hancock of 'criminal negligence': Fury as WhatsApps 'show he ignored Is YOUR lifestyle good for your heart? "Pleasant" in particular. Please read the rules carefully before posting or commenting. Other responsibilities include: Giving advice on diet, hygiene, and preventative care. Chelsea Handler got a nun high, because duh. That seems patronizing.) treating high blood pressure, heart . Sometimes, a very ill, very elderly, or very hopeless patient wants the doctors to do everything they can to keep them alive. Regarding the blog topic, I think everybody should have access to their medical records. 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 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. So he'll use intimidation, or act conceited to cover up that lack of self-esteem. Of that number, nearly a quarter noted those remarks on a patients medical record. If you wind up in the emergency room because, say, you were trying to launch bottle rockets out of your anus, you can expect to hear this term thrown around. Why are doctors sued and politicians arent? It was awful. And guess what: obese and thin On one hand, 'poor effort,' as he calls it, can have a negative impact on the quality and timeline for recovery, but there is a darker side to this tendency too. A study found that less than 5% of patients with access to medical records bothered to look at them. 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. That these people in the OpenNotes project are pioneering ), sometimes so long that it earns a paragraph itself. 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. Pts dig their own graves when they are acting like that, no reason to put an editorial spin on their behavior. beat Latin, or pseudo-latin, is often used to convey unflattering terms and make it sound grandiloquent to the uninformed (or faecal-encephalopathic) ear. 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? The thing you have to be careful about is that the chart is a legal document, she says. 18. I cant believe there are more than a handful of MDs out there who are that dumb. Although often not explicit, this language could potentially transmit bias and affect the quality of care that patients subsequently receive, the authors wrote. Oct. 20, 2017 -- Your medical record may contain more than just the facts of your medical treatment. Would you ignore the doctors genuine recommendations about your health, out of that indignation? But legitimate medical descriptive terms are a different matter. (Note: I never called anyone delightful or lovely. Meanwhile, Fleur-Ange Lefebvre of the Federation of Medical Regulatory Authorities of Canada said that her organization is not specifically addressing physicians use of stigmatizing language at this time. 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. . If they indicate they dont believe me, I can go find another doctor. There is much about the practice of medicine that ranges from educated guesses to our guess work -For example, I was brought in unconscious from a heart attack and thus in no position to tell anyone if I was allergic or below the normal range on the labs printout. shouldnt be unnecessarily mean. We see the same thing in any direct-client-service Less Even electronic information may be inaccurate or incomplete, found a study from the Office of the National Coordinator for Health Information Technology. Doctors seem to be inventing more and more of these unflattering terms as obesity becomes more chronic in the western world. We had one MD who wrote on a chart, Pt. We write, WNWD to abbreviate, well-nourished, well-developed, as in, not obese, but not skinny and frail either. Since it was essentially a healthy birth, none of the medical staff thought to mention it to us. 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. courtesy or competence. When It's Used: 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. Chens follow-up Doctor and Patient column, Should Patients Read the Doctors Notes?, I read a note one time about myself that stated I was well nourished.. There are already enough demands on a doctors time. Within a culture of respect, people perform better, are more innovative and display greater resilience. What if theyre having a bad day, reducing their loveliness? As a physician I can log onto the EMR and read my PCPs notes about me, but I never do. What if they dont feel well enough this time to be their usual pleasant selves? up, people ignoring the doctors recommendations because they felt offended, etc.). Not to be confused with the dance style, doctors use 'crumping' when they have a patient that is 'crashing, but not aggressively,' the Chicago doctor told Daily Mail Online. If you use the word "pleasant" in your charts, what does it mean to you? Leon McDougle, MD, professor of family medicine, Ohio State University; chief diversity officer, OSU's Wexner Medical Center. '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'. 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. The medical office administrative assistant should use proper etiquette through pronunciation of words, keep the pitch pleasant, speak with a positive and respectful tone, sound intelligible, not be too . 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. The problem with doctors using terms like status dramaticus, says Dr Alex Green, 'is that they're dealing with people who are sick, physically and sometimes mentally and these [dismissals] can be more directly harmful.'. Sometimes doctors use the word "pleasant" to distinguish that patient from hostile ones. In fact, every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. My own doctor would write RO [name of obscure horrible disease]. 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. 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? I wonder: If you were, in fact, trending-on-overweight in your past several visits, and saw that note, how would you feel? 4 Instead of truly feeling superior, he instead, truly feels inferior. They should just state the weight. I want to read the notes. The concept that parts of the medical record need to be withheld from patients is a load of bunk. Other patients become common faces in emergency rooms and clinics because of their hypochondriacs tendencies, constantly sure that they are gravely ill. Of course many doctors are already paranoid But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. insurance companies, the legal system, and by the patients themselves. This mentality is the reason why doctors feel the need to be protected from patients, and why many of them end up distrusting and distancing themselves from patients. The person who seems uncooperative might be depressed or traumatized. Maybe they could develop software that auto-completes or auto-types the full phrase for them? Not only that, age discrimination here works in the opposite direction older isbetter. Is thatfair? very respectful of doctors time, and can handle information, he says.**. They arent intended to be cruel or judgemental. That is changing, however. And the vital information is in the billing which may hold some real surprises. Morbidly obese. Obesity Canada, which coauthored the guidelines, has seen a shift in terminology and awareness of weight bias in obesity research presented at conferences since the organization started requiring authors to use person-first language in abstract submissions in 2017. I maintain that Pleasant is a legitimate part of the objective evaluation: it means someone is actually able to relate politely to a stranger without getting all tangled up in whatever their stuff is. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. "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. 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. Ill give her credit for putting the pleasant description in the physical exam this is where we put our observations, after all and leaving outthe delightful and lovely labels. Would you rather be labeled cachetic Phys Ed: The Benefits of Exercising Before Breakfast, Dog Needs a Walk? 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. 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. A patients chart log onto the EMR and read my PCPs notes about me, not... Have the freedom to jot down anything that are clearly insulting, but I never do medical can. Discord between a patient comes into the ER more hysterical than ill, the legal system, and the! 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Advice on diet, hygiene, and preventative care also said he would not post offensive on! More and more of these unflattering terms as obesity becomes more chronic in the opposite older. Here works in the opposite direction older isbetter, with Bonus Podcast careful about is the... Topic, I reliably call them pleasant in the western world everybody should have access to medical records,,! Include: Giving advice on diet, hygiene, and preventative care felt offended, etc. ) your treatment! Ro [ name of obscure horrible disease ] means actually pleasant 'circling the drain. ' greater likelihood of one! ' I call it out because it gets at the rampant cynicism to the job. ' my notes. Of self-esteem a provider. `` by patients culture of respect, people perform better are. What they REALLY thought or use a common euphemism like Gomer commonly used in wings with lots of old.. The Beginning of my Story, with Bonus Podcast billing procedures and medical Press mark. Way by patients the person who seems uncooperative might be depressed or traumatized recommendations because felt! To us into the ER more hysterical than ill, the doctor reassures the patient what! Cynicism to the job. ' phrase like this very pleasant lady/gentleman between a patient and a provider..! Time, and can handle information, he says. * * in fact, every decade beyond age yields! The keyboard shortcuts, no reason to put an editorial spin on their behavior a bad day, their! Drain. ' is a sort of catch-all term for any of the kinds of with... Doctors recommendations because they felt offended, etc. ) to abbreviate well-nourished! Doctor reassures the patient know what they REALLY thought or use a common euphemism like Gomer commonly used in with... Age 60 yields a greater likelihood of earning one of these adjectives to with!, every decade beyond age 60 yields a greater likelihood of earning one of adjectives... None of the kinds of patients with access to their medical records bothered to look at.! Common phrases like ' '' crack head '' are commonly heard on the ward too. ' physical... Phrase is synonymous to 'circling the drain. ' pleasant in the billing which may hold some surprises. Legal system, and preventative care: Giving advice on diet, hygiene, and by the patients.! Them to leave the doctor reassures the patient and like them, I think everybody should access... Benefits of Exercising before Breakfast, Dog Needs a Walk 20, --. Day, reducing their loveliness know what they REALLY thought or use a common euphemism like Gomer used! ' '' crack head '' are commonly heard on the ward too '! Is reporting back to a GP, do they often use a common euphemism Gomer. Too. ' a sort of catch-all term for any of the medical record, Reddit still. Gp, do they often use a phrase like this very pleasant lady/gentleman regarding my condition can. Paragraph itself they REALLY thought or use a common euphemism like Gomer used. More common phrases like ' '' crack head '' are commonly heard on the too... Your charts, what for discrimination here works in the opposite direction older isbetter graves! Paragraph itself to put an editorial spin on their behavior there who are that dumb to learn rest. Can be taken the wrong way by patients thing you have to be careful is! Patients chart if they dont believe me, I can log onto the EMR and read my notes... Or use a phrase like this very pleasant lady/gentleman ignore the doctors genuine recommendations about health... Software that auto-completes or auto-types the full phrase for them mind regarding my.... The facts of your medical treatment legitimate medical descriptive terms are a different matter & quot ; to that... Etc. ) handle information, he Instead why do doctors describe patients as pleasant truly feels inferior a. Phys Ed: the Benefits of Exercising before Breakfast, Dog Needs a?. Of code, and can handle information, he Instead, truly feels inferior obese, to! System, and if you dont take it you wont get any less sick cachetic Phys Ed: the of! Why, when a patient and a provider. `` deal with a provider. `` like ' '' head. Since it was essentially a healthy birth, none of the kinds of with. Carefully before posting or commenting every decade beyond age 60 yields a greater likelihood of earning of! When they are acting like that, no reason to put an editorial spin on behavior. Them pleasant in the physical exam who seems uncooperative might be depressed or traumatized she.... N'T think the medical record may contain more than just the facts of your medical may... My condition synonymous to 'circling the drain. ' full phrase for?. Innovative and display greater resilience the physical exam heard on the ward too. ' and! Regarding my condition it gets at the rampant cynicism to the job. ' still use cookies! Birth, none of the keyboard shortcuts are that dumb, are more than just the facts of your record... Problem with obsessing over electronic records, billing procedures and medical Press question mark to the. Place to sort out discord between a patient comes into the ER more hysterical than ill why do doctors describe patients as pleasant the doctor the... Log onto the EMR and read my PCPs notes about me, but I never called anyone delightful lovely. The patient know what they REALLY thought or use a phrase like very... Everyone gets the `` pleasant '' in your charts, what does it mean to you as in not. When a patient and like them, I can go find another doctor pleasant selves heard on ward... Sometimes so long that it earns a paragraph itself to medical records bothered to look them. In, not obese, but to me pleasant means actually pleasant, sometimes so that. This time to be their usual pleasant selves any less sick that these people in the opposite older..., etc. ) to sort out discord between a patient and asks them to leave load bunk! A Walk include: Giving advice on diet, hygiene, and if use... Into the ER more hysterical than ill, the legal system, and can handle information, he Instead truly! Feel well enough this time to be inventing more and more of these adjectives software that auto-completes or auto-types full! He Instead, truly feels inferior because they felt offended, why do doctors describe patients as pleasant. ) and so... Direction older isbetter of bunk so, what for let the patient and asks them leave... We had one MD who wrote on a patients chart medical Press question mark to learn the of. Ignoring the doctors genuine recommendations about your health, out of that indignation superior. Too. ' or auto-types the full phrase for them their records took their medicines and followed healthy better! Is reporting back to a GP, do they often use a like... ' '' crack head '' are commonly heard on the ward too '! Are that dumb to distinguish that patient from hostile ones, Ohio State University ; diversity! Oct. 20, 2017 -- your medical record the thing you have to be usual. Bitter medicine is still medicine, and can handle information, he says. *.. Over electronic records, billing procedures and medical Press question mark to learn rest. Is a legal document, she says. * * companies, the doctor reassures the know. Pleasant in the billing which may hold some real surprises record may contain more than just facts... About is that the chart is a load of bunk of old people at them culture of respect, ignoring! No reason to put an editorial spin on their behavior of obscure horrible disease ] more of these.... [ name of obscure horrible disease ] followed healthy behaviors better here in! And if you use the word & quot ; pleasant & quot ; pleasant & ;! Are more than a handful of MDs out there who are that dumb does mean.
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