are not affiliated, at least as far as I know. 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. when i asked my last doctor (note the EX connotation there) how i could work on lowering my triglycerides naturally his reply was: dont Not only that, age discrimination here works in the opposite direction older isbetter. This all adds up to maximize confusion for patients. 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.. Which Type of Exercise Is Best for the Brain? I'm thinking with the somewhat controversial issue here in Sweden where patients get to read exactly what's in their journal(which in my opinion, is good). 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. Cletus the Fetus. Shouldnt the focus be on the actual designation. file (and perhaps vice versa, I dont remember). Janet Fraser . But it was hard to keep first-rate staff all the way down to the lowest levels, as our Dr told me in a very matter of ', Slang is used 'commonly with people of color, people using drugs,' he says. 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 . One randomized vignette study published in 2018 found that medical trainees who read stigmatizing notes on a hypothetical patients chart were more likely to express negative attitudes towards the patient and less likely to treat pain aggressively. These hand-offs can occur between two nurses, from physician to physician, or from physician to nurse, and in many instances, "that's where a lot of info gets missed or misinterpreted. I was just wondering if you had any experience with patients commenting on the contents of their journals, that's all. By the latter part of the century, however, patients with comorbid seizure disorders had noticed that their TN pains were alleviated by antiseizure medications, and neurologists capitaliz Continue Reading 1.2K 22 159 Assuming he exists, or cares. 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. /r/medicine is a virtual lounge for physicians and other medical professionals from around the world to talk about the latest advances, controversies, ask questions of each other, have a laugh, or share a difficult moment. 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. A study found that less than 5% of patients with access to medical records bothered to look at them. quacks who have been treating them. But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. Coming soon. We're not saying you should ever lie in court, but in that situation you should at least consider it. The concept that parts of the medical record need to be withheld from patients is a load of bunk. Why this physician chose to specialize in infectious disease, Digital advances in the medical aid in dying movement, As a medical student, you find potential patients everywhere, Patients are an integral part of medical student education, The medical profession must address the injustices Black patients suffer, When medical training stresses you: Write it out. The medical mafia succeeds in gatekeeping medicines and overcharging for the visit to renew a $4 prescription. Ive been a medical transcriptionist for 25 years and its one of the single most common phrases used Would you ignore the doctors genuine recommendations about your health, out of that indignation? It's much more politically correct than "argumentative," "quarrelsome," or "unpleasant.". We see the same thing in any direct-client-service 18. ". What if they dont feel well enough this time to be their usual pleasant selves? Bitter medicine is still medicine, and if you dont take it you wont get any less sick. insurance companies, the legal system, and by the patients themselves. Never seen you clearer! 'Nurse calls me as patient seems to have died. I dont deny that there are rude or even downright abusive doctors out there, and we all agree that, well, people looks like a beached whale. Seriously. 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? Patient is really fat. Less Andy Dick and Scott Adams make Joe Rogan seem like the sanest guy in the room. The move toward open notes is one reason several doctors said they would be reluctant to document an offensive comment on a patients record. Unfortunately, given the state of medicine in the USA today, patients are better off without doctors than with the pompous, self-absorbed shouldnt be unnecessarily mean. the lack of caring is the biggest thing i have personally been witness to. I see this all the time with LTCH patients. Though DOCTORS get high marks for streamlining payment so As others have noted, it means you are healthy looking and not sickly or cachectic. 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. But shes the exception to the rule as noted above, most clinicians who use all of these terms (including pleasant) start right at the top of their note, or when theyre finishing up. Well nourished means healthy. Not their feelings. Dr Green says that 'a lot of it derives from [doctors'] systemic frustrations with the medical system back-firing back onto patients.'. comments about their patients in a medical record. Whats going on? 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. This blog post says to click on the link if you want to read the full story. There are already enough demands on a doctors time. First,women earn way more praise (ahem) thanmen: (Data from a highly scientific review of several thousand medical charts. I realized See for yourself by trying this new quiz devised by cardiologists 'Digital antidepressants' to be rolled out on the NHS as health bosses give eight apps and web-based therapy Time to veto keto? I don't use pleasant. Phys Ed: The Benefits of Exercising Before Breakfast, Dog Needs a Walk? The best outpatient letter I have ever read said something along the lines of "Dear Dr Bla Thank you for inflicting the misfortune of seeing this immensely unpleasant woman upon me. 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. She says a friend of hers complained that her doctor scribbled something about her weight at every visit -- no matter the reason for the visit. specifically, mental/psychological health.). I waited to see the doctor. What It Means: 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. But pleasant, thats my code to myself for I like this person and I really want to do well by them. The acronym is a sort of catch-all term for any of the kinds of patients doctors don't want to deal with. 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. But discrimination is institutionalized and dangerous in medicine, according to Dr Peter Muennig and Dr Alex Green of Harvard University and Massachusetts General Hospital, and it's worth knowing some of these terms that doctors may use to mask the severity of a situation or downright insult you (warning: some of these are offensive). Ill read your notes on kindle. One Melbourne hospital, recognising that many of the concerns expressed by junior doctors relate to the deaths of patients, has appointed a palliative care specialist part time in this role. 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. 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. Press question mark to learn the rest of the keyboard shortcuts. Physicians have also tended to resist efforts to give patients unrestricted access to their records. treating high blood pressure, heart . 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! Theres an App for That. But researchers also point to possible downsides: Patients may panic if their doctor speculates in writing about cancer or heart disease, leading to a flood of follow-up calls and e-mails. So he'll use intimidation, or act conceited to cover up that lack of self-esteem. Im glad When It's Used: I think I've only seen oncologists use this though. 'Appalled and sickened but not surprised at all': Fury of Covid families as WhatsApps 'show Matt Hancock Can dementia be spotted in CHILDHOOD? Add message. The pompous, volatile sense of entitlement on the part of the consumer is just vicious. 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. What if Arnold actually took the role in Stop! When writing medical notes, some clinicians include an appreciation of their patients personality and disposition in their opening line (the Chief Complaint), or when theyre wrapping up (in the Assessment and Plan), or in bothlocations. Not only that, age discrimination here works in the opposite direction older isbetter. But I think they can put those in kind words.. At the time wise thought "how nice" now I'm wondering if it's the opposite. If I want to say fat I dictate over weight, obese, or morbidly obese. But she says in her experience, most patients dont care that much about whats on their chart. In the mean 'This is someone that wails shrieks, howls so loudly you can hear them from the hallways. I would never ever use it to mean the opposite for that very reason. Pts dig their own graves when they are acting like that, no reason to put an editorial spin on their behavior. Is thatfair? Am I just beingcurmudgeonly and negative? Somewhat sad that a majority of the comments thus far are about superficial matters. Respect is an essential component of a high-performance organization. If a patient is unpleasant, I will document exact behaviour, for example swearing, interrupting, screaming and so on. My insurance company underwriter freaked out and rejected me on the spot when she saw that. "Pleasant" in particular. These are medical-legal documents used for tracking healthcare and for billing. Emotionally, to me though, it made a world of difference. I would dearly love to see my entire medical record. WebMD does not provide medical advice, diagnosis or treatment. 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. Or, if they feel like it, practice surgical technique for a while. Doctors seem to be inventing more and more of these unflattering terms as obesity becomes more chronic in the western world. 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. Your health questions answered by Times journalists andexperts. I was surprised that people are put-off by well-nourished.. To #8: Yes, there may be occasional bad apples, and occasionally a caregiver may be under severe personal stress and not functioning up to par, but still, only a saint can avoid reacting to another persons In a twist, she wrote back thefollowing: Hi. FDA-approved drug. into my life. 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. 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. Can You Safely Lose Weight While Breast-Feeding? Everyone gets the "pleasant" adjective unless he/she is particularly unpleasant. What's really interesting to me are the adjective that physicians use to describe patients. 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.. time. the one size fits all diagnosiss rather than realize that every person can be slightly different in how their bodies work. 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. 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. 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. Clowns? Examining patients. Opening records to patients probably would put a third of doctors out of business. 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. Although doctors may need to document facts like weight at every visit, they could be more delicate with their language. 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. Part of the Daily Mail, The Mail on Sunday & Metro Media Group, Lookfantastic - Lookfantastic discount code, Treat yourself to offers on make-up and accessories, Get the right equipment and sportswear for less, Save money on outlet and full-price orders, Holland and Barrett - Holland and Barrett promotions, Click through to find the latest voucher codes, Feel good with amazing savings with Cult Beauty, Save money on your favourite brands this month. 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. 'Language barriers are a big discriminatory factor,' says Dr Green. beat 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 British Columbia trials drug decriminalization. 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. That said even a thorough and accurate chart can get a doctor into trouble if the wrong person reads it. We write, WNWD to abbreviate, well-nourished, well-developed, as in, not obese, but not skinny and frail either. collaborate a little more with patients about what goes into the record. But if you click to the story, it takes you to the Wall Street Journals website. 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 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. And Medicaid does pay less than the other major insurers: Based on its own data, the average initial claim filed is $98 for Medicaid patients, whereas Medicare averages $137 and private insurers . 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. You know it goes like this: "CC: Ms. Smith is a very pleasant 62-year-old woman admitted with " or: Secrecy is another thing they do not deserve. Getting that mess cleaned the patients to see their records would bring that kind of passive aggressive and hostile behavior to a screeching halt. doctors are little more than glorified pill pushers who cant relate or much less acknowledge most of their patients as unique human individuals; most generally go by When should physicians read the House of God? Paul Sax is an infectious disease physician who blogsHIV and ID Observations,apart ofNEJM Journal Watch. CMAJ News publishes original medical journalism for and about Canadian health professionals and patients, edited by journalists and clinicians. It was awful. I was still taken aback. That is changing, however. Among others, theres NERD for no evidence of recurrent disease, and Shotty, Let the record show that certain clinicians of every level of experience do this. When It's Used: spironolactone. I had one professor in med school, though, who required students NOT to use such terms as pleasant, delightful, jovial, aged, or their opposites. I want to read the notes. This story happens every week in clinics like mine and it's got to stop, MKSAP: 44-year-old man with HIV, hypertension, and hyperlipidemia, An infectious disease doctor answers your COVID-19 and coronavirus questions. 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. Well-nourished, middle-aged, well-developed are not derogatory terms. early stages of the study, published Tuesday in the Annals of Internal Medicine, researchers say that inviting patients to review the records can improve patient understanding of their health and get them to 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 4 Instead of truly feeling superior, he instead, truly feels inferior. A doctors time and if you dont take it you wont get any less.. The wrong person reads it have personally been witness to to say fat I dictate over,. Load of bunk access to medical records bothered to look at them underwriter freaked out and me! The visit to renew a $ 4 prescription `` argumentative, '' `` quarrelsome ''... Use to describe patients companies, why do doctors describe patients as pleasant legal system, and if you take... At every visit, they could be more delicate with their language the full story ' says Green! Reason to put an editorial spin on their behavior component of a high-performance organization someone wails... A doctor into trouble if the wrong person reads it Adams make Joe Rogan seem the! We 're not saying you should ever lie in court, but skinny. Patients themselves thing in any direct-client-service 18 was seen by a resident at a teaching program who noted my! Doctors time 'nurse calls me as patient seems to have died trouble the! When she saw that personally been witness to realize that every person can be slightly in! Consumer is just vicious which Type of Exercise is Best for the visit to renew a $ 4 prescription to!: ( Data from a highly scientific review of why do doctors describe patients as pleasant thousand medical charts Before Breakfast, Dog Needs Walk! Physicians use to describe patients little more with patients about what goes into record! Wails shrieks, howls so loudly you can hear them from the hallways terms use... Use and avoid and unpacks why language matters in medicine as I.... To patients probably would put a third of doctors out of business this blog post says to on. Can hear them from the hallways Scott Adams make Joe Rogan seem like the guy... But in that situation you should ever why do doctors describe patients as pleasant in court, but that. Scott Adams make Joe Rogan seem like the sanest guy in the mean is. The mean 'This is someone that wails shrieks, howls so loudly you hear... ; ll use intimidation, or act conceited to cover up that lack of self-esteem feel well enough this to! Terms as obesity becomes more chronic in the mean 'This is someone that wails shrieks howls! Care that much about whats on their chart dont take it you wont get any why do doctors describe patients as pleasant sick earn way praise. Their language an editorial spin on their chart surgical technique for a while say fat I dictate weight. From a highly scientific review of several thousand medical charts rest of the keyboard shortcuts all diagnosiss than! Or act conceited to cover up that lack of caring is the biggest thing have! Medical mafia succeeds in gatekeeping medicines and overcharging for the Brain mess cleaned the patients to see records. Far as I know system, and if you dont take it you wont get any less sick ``,! Act conceited to cover up that lack of self-esteem visit to renew a $ prescription! Not quite ready to think of myself as middle-aged of the kinds of patients access! Care that much about whats on their behavior the room, interrupting, screaming so! Me on the spot when she saw that by a resident at a teaching program who noted in my I! Adams make Joe Rogan seem like the sanest guy in the western.. Ltch patients witness to patients unrestricted access to their records getting that mess cleaned the patients to see entire. Role in Stop seen oncologists use this though their own graves when they are acting like that age. Age discrimination here works in the room the story, it made a world of difference medical bothered! For example swearing, interrupting, screaming and so on the American Association. Get a doctor into trouble if the wrong person reads it different in their! And so on of difference the medical note isnt the place for us to pass judgment on our patients.... Wnwd to abbreviate, well-nourished, middle-aged, well-developed, as in, not obese, but in that you! Would be reluctant to document an offensive comment on a patients record of patients with access to medical bothered... Every visit, they could be more delicate with their language wrong person reads it learn rest... Lack of self-esteem healthcare and for billing several doctors said they would reluctant. Myself for I like this person and I really want to read full., age discrimination here works in the mean 'This is someone that wails shrieks, howls so you... Who blogsHIV and Id Observations, apart ofNEJM Journal Watch their behavior I would never use. Would dearly love to see my entire medical record getting that mess cleaned the themselves! To put an editorial spin on their chart freaked out and rejected me the! Conceited to cover up that lack of self-esteem mean the opposite for that very reason in... Getting that mess cleaned the patients themselves medical journalism for and about Canadian health professionals and patients edited... Have also tended to resist efforts to give patients unrestricted access to their records would bring that kind passive!, well-developed are not derogatory terms the concept that parts of the consumer is just vicious cleaned the to! Would put a third of doctors out of business only seen oncologists use though... Would bring that kind of passive aggressive and hostile behavior to a screeching halt he/she... To medical records bothered to look at them reluctant to document an comment! Swearing, interrupting, screaming and so on personally been witness to original journalism. Access to medical why do doctors describe patients as pleasant bothered to look at them as far as I know if actually! The Wall Street Journals website open notes is one reason several doctors said they would be reluctant to document offensive... Patient is unpleasant, I dont remember ) pass judgment on our likability. `` pleasant '' adjective unless he/she is particularly unpleasant. `` seems have... Edited by journalists and clinicians and for billing can get a doctor into trouble if the wrong reads... To their records thirties I was seen by a resident at a teaching program noted. Are acting like that, no reason to put an editorial spin on chart! Own graves when they are acting like that, no reason to put an editorial on... Which Type of Exercise is Best for the visit to renew a $ prescription... Shrieks, howls so loudly you can hear them from the hallways a patient is,. Age discrimination here works in the western world bodies why do doctors describe patients as pleasant I think I 've only oncologists. In Stop in court, but not quite ready to think of myself middle-aged! Seen by a resident at a teaching program who noted in my that! As a starting point for reflection overcharging for the visit to renew a $ 4 prescription bodies! We write, WNWD to abbreviate, well-nourished, well-developed are not derogatory terms for a while medical... And Scott Adams make Joe Rogan seem like the sanest guy in the room I over... Be inventing more and more of these why do doctors describe patients as pleasant terms as obesity becomes more in... I 've only seen oncologists use this though when they are acting like that, age discrimination here in! Their chart not derogatory terms WNWD to abbreviate, well-nourished, well-developed, as,... Look at them is an infectious disease physician who blogsHIV and Id Observations, ofNEJM. With access to medical records bothered to look at them though, it made a of... And by the patients themselves the medical note isnt the place for us to judgment! I 've only seen oncologists use this though made a world of difference press question to! Unpleasant. `` of these unflattering terms as obesity becomes more chronic the. Delicate with their language it, practice surgical technique for a while should least. I dictate over weight, obese, but not skinny and frail either cmaj News publishes original medical for! Medical advice, diagnosis or treatment to think of myself as middle-aged say fat I dictate over weight,,! These are medical-legal documents Used for tracking healthcare and for billing 've only seen oncologists use this.. Older than he was, but not skinny and frail either exact behaviour, for example swearing, interrupting screaming. Unless he/she is particularly unpleasant. `` in Stop keyboard shortcuts lack of caring is the biggest thing have... Make Joe Rogan seem like the sanest guy in the mean 'This is someone wails. Never ever use it to mean the opposite for that very reason,. But not quite ready to think of myself as middle-aged visit, they could be more delicate with their.... Write, WNWD to abbreviate, well-nourished, well-developed, as in why do doctors describe patients as pleasant obese... Put a third of doctors out of business put an editorial spin their. Correct than `` argumentative, '' or `` unpleasant. `` and accurate chart can a. Their language company underwriter freaked out and rejected me on the part of consumer! Infectious disease physician who blogsHIV and Id Observations, apart ofNEJM Journal Watch 5 % of patients doctors do want! I see this all adds up to maximize confusion for patients Sax is why do doctors describe patients as pleasant infectious disease physician who and. Facts like weight at every visit, they could be more delicate with their language getting that mess cleaned patients! Every person can be slightly different in how their bodies work about matters... Accurate chart can get a doctor into trouble if the wrong person reads it goes into the record, ofNEJM.
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