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January 16, 2007 12:41 AM   Subscribe

Why do most doctors have sloppy handwriting?

I've lived in three different continents, and doctors illegibly scribbling away has been a constant...

Is it something they are taught in med school?
Is there an unwritten rule about this?
posted by lorbus to Health & Fitness (26 answers total) 2 users marked this as a favorite
 
Is it something they are taught in med school?
Is there an unwritten rule about this?


I'll just regard those as rhetorical and not meant seriously.

Why do most doctors have sloppy handwriting?


Because they have traditionally had too much work to do and writing fast leads to untidy writing. The other reason for this legend is that the writing by doctors has always been considered hugely important so that people tend to critically examine their writing more than other groups. All IMHO of course and I've known lots of doctors with beautiful handwriting by the by.
posted by peacay at 1:04 AM on January 16, 2007


The truth about doctors' handwriting
from the study outlined on the linked page:

Results--The handwriting of doctors was no less legible than that of non-doctors.
posted by bunglin jones at 1:07 AM on January 16, 2007


My guesses:

1. It is harder to write legibly when you are talking to somebody. Doctors are busy people who have only a limited time to see each patient. So they tend to talk and write at the same time.

2. At school doctors are the people who studied science and maths rather than shorthand and calligraphy.

3. The prescription that the doctor gives you is not for the patient- it is a shorthand message for the pharmacist, consultant, etc using professional jargon. So there are large, unusual words and tendency to dress up everyday expressions in Latin or Greek.

For an aural equivalent of this listen to what your dentist says to you next time she checks your teeth - and compare it with the language she uses to get the dental nurse to update your case notes.
posted by rongorongo at 1:43 AM on January 16, 2007


How many other people's handwriting do you see?

I'm trying to think of the last time someone I delt with, who was providing me with a service, wrote something by hand for me. I'm having trouble. I have a car service report that's been filled in by the mechanic, and I have trouble reading that. Maybe it's just me, but I'm tending to think that handwriting, in general situations where presentation isn't important, tends to be messy. I know mine is.
posted by Jimbob at 1:49 AM on January 16, 2007


they have a lot more years of university study, and with all the notes they take, their writing deteriorates accordingly.
posted by taff at 2:25 AM on January 16, 2007


I always thought that the sloppy prescriptions were a form of security by obscurity - a neatly written script would likely set off alarm bells at the pharmacy.
posted by Meatbomb at 2:33 AM on January 16, 2007


plausible denial
posted by telstar at 2:39 AM on January 16, 2007


Thanks for the great answers...

True, it is one of the last professions that still uses handwriting on a day to day basis.

Next time a non-doctor writes down something I'll keep sharper eye.
posted by lorbus at 2:52 AM on January 16, 2007


FWIW All the doctors at my local practice print off their prescriptions on computer.

So whatever the reason is for the sloppy handwriting - it can't be that important.
posted by TheOtherGuy at 3:10 AM on January 16, 2007


I worked for two different doctors. One had ridiculous handwriting that was particularly sloppy, while the other had very neat, fastidious writing. The messy doctor saw 3-4 times as many patients per day as the fastidious doctor, so I would imagine the sheer volume of writing required for the 70 or so patients he saw made a big impact. However, the messiness extended past his note taking. Fastidious doctor wore a suit and tie every day, handwrote all his patient notes and then transcribed them himself, kept a very tidy and organized office, etc, while messy doctor dictated his notes for transcription, relied heavily on office help to keep his office clean, and wore khakis and scrubs to work every day.
posted by santojulieta at 3:35 AM on January 16, 2007


This reminds me of an earlier question (I can't find right now) about why your boss sends you emails that are

written,,,abit like this, ok?thx

They are busy people who aren't afraid to prioritise. Expending minimal energy making their handwriting legibile allows them to concentrate on more important things - talking to you, diagnosing stuff, getting on to the next patient etc.
posted by fire&wings at 3:36 AM on January 16, 2007


Doctors also use a great deal of abbreviations which makes things harder to read, especially for those non-medically knowledgeable. For instance:

# means "fracture"
++ means "to a great degree"
1/24 means "one hour"
+VE means "positive"
-VE means "negative"
C/O means "complaining of"
CXR means "chest x-ray"
DX means "diagnosis"
D&V means "diarrhoea and vomiting"
HtR means "heart rate"
L1-L5 are the lumbar vertebrae
QOD means "every other day" (Latin)

I guess that with their hectic schedules and the fact that they can write in a form of shorthand, their writing can appear to be messier than others - especially if you're not medically knowledgeable and are trying to work out a slew of symbols and other squiggles.
posted by TheDonF at 4:32 AM on January 16, 2007 [1 favorite]


I do a bit of work for doctors that has me seeing a lot of Patient Files. I have never seen any of them with neat hand-writing (by doctors) in them.
And I second taff's answer. Can personally attest that the longer you spend and the more notes you take during university, the messier your handwriting becomes. But besides trying to write quicker (which becomes a must at intensive lectures), I think it's also because you learn to read your own writing as well, no matter how illegible it looks to other people - which just leads further sloppiness.

Just think of how much your signature has changed since high school. Any vowels left? Mine barely has the semblance of initials.
posted by kisch mokusch at 4:39 AM on January 16, 2007


As someone who has worked in medical records, all of the above are true. The screensaver on all the computers is a rotating display of abbreviations that are no longer acceptable d/t...er, due to being problematic - qod is one of them, what with qod and qd blending together in that fantastic handwriting.

I started making some statements about younger/older and the older docs being worse, and the ESL docs being slightly easier to read, but there's so many exceptions that I think it does come down to the general population's handwriting distribution, times the speed factor, and divided by the fact that I can't think of any docs that were trained as architects or engineers first and thus none of them developed an actual need for legible handwriting. Now that they're moving to the computers - thankfully, even for scripts - this is becoming slightly less of a problem.

Slightly.
posted by cobaltnine at 5:54 AM on January 16, 2007


My handwriting skims the bare margins of legibility, having taken a serious downturn since medical school. I think the reason is that when writing "creatively", e.g. handwritten university essays / love letters / complaints to your Member of Parliament, you need time to think of each sentence in advance, and consequently can spend the time making things legible. When you become an intern / houseman you get deluged in more menial writing tasks than you possibly have time for, and have to scrawl each prescription / investigation request / patient record as quick as humanly possible. My writing took a dive at this stage, including my signature which turned from a thing of beauty into a scribble. Once you become a grown up doctor, and have your own secretary, much of your hand written notes are backed up by dictated letters, and thus there's no impetus to improve your writing much. The study linked above compares only doctors and other healthcare professionals, whereas a fairer comparison would be with teachers or lawyers.
posted by roofus at 7:04 AM on January 16, 2007


Purely anecdotal personal experience: When I was in grade school and high school, my handwriting was very clear and legible. Then I joined the Army and at one point I spent six months as the platoon clerk, signing endless forms in triplicate on a daily basis. By the end of that six months, my handwriting had worsened dramatically and my signature had completely devolved into an illegible scribble. Two decades later, and it remains the same. I expect doctors go through a similar trajectory.
posted by Lokheed at 7:07 AM on January 16, 2007


I think roofus and Lokheed have the idea: when you don't have mych time to write a great deal of words, you learn to take shortcuts with your handwriting. Personally, I think it comes from university & med school, and here's my completely anecdotal proof:

My wife was a biology major and will be starting a masters in Physiotherapy soon -- the constant stream of notes she needs to take to keep up with the prof require her to
A) Write stuff down in a hurry, and
B) Write abbreviations and symbols to save time.

As a result, her writing is pretty messy. I always have a hard time reading her notes, but she has no trouble understanding what she's written. I'd wager that doctors-in-training experience a similar thing.
posted by Milkman Dan at 7:25 AM on January 16, 2007


(SIDEBAR: The absolute worst handwriting I've ever seen belonged to Norman Rockwell. I saw several pages of notes he wrote at a big exhibit once when he was still alive. Always struck me as odd, how someone with such spot-on compositional skills wrote like a three-fingered crack baby.)
posted by RavinDave at 7:50 AM on January 16, 2007


There's an article in Time, Cause of Death: Sloppy Doctors, that says "doctors' sloppy handwriting kills more than 7,000 people annually." FWIW: most places (in my area, at least) are moving towards computerized data entry and printouts to help prevent errors.
posted by Hankins at 8:02 AM on January 16, 2007


I can only remember once in 15 years of reading records where I can honestly say I could instantly read every word of a doctors handwriting. It was in the context of a court case for a post-partum dural patch. Every single word. 6 doctors had been involved in the case and that was the only series of entries I could read instantly. The other took a little bit of deciphering.
When I spoke to the doctor concerned I discovered that he was adamant that this was part of his duty of care to his patient. He also incidentally (or perhaps not) has Asperger's. He simply will not be hurried if he feels it is in the patients best interest. I have found as Santojulieta has noted that this approach extends to most areas of his practice. Unfortunately it drives his peers crazy. What can I say.
Poor handwriting alone will not kill patients. It's a swiss cheese situation. Several factors operating more or less independantly but unfortunately for patients somewhat simultaneously tend to be involved. And the more pressure on a health service to cut corners to more likley the situation is to occur
posted by Wilder at 8:55 AM on January 16, 2007


Doctors are obviously not writers and don't especially care about the awesomeness that words are. Thus they aren't especially concerned with it. Just as a lesser-paid individual, I'm not especially concerned with how important a pill my doctor thinks I need because I don't especially justify the funds required to actually go to paying for them. Perhaps if I were a bit more concerned with whether a band-aid pill that actually does no real healing but just dumbs me to the symtoms, I might justify buying the pill. Perhaps if the doctor was a bit more appreciative of the spiffendiffity of the terrifitacular way words appeal to me, then he'd write with a tad better handwriting, instead of scribbling it out like they're just words.
posted by Quarter Pincher at 9:41 AM on January 16, 2007


I'm not especially concerned with how important a pill my doctor thinks I need because I don't especially justify the funds required to actually go to paying for them. Perhaps if I were a bit more concerned with whether a band-aid pill that actually does no real healing but just dumbs me to the symtoms, I might justify buying the pill. Perhaps if the doctor was a bit more appreciative of the spiffendiffity of the terrifitacular way words appeal to me, then he'd write with a tad better handwriting, instead of scribbling it out like they're just words.

English is not your primary language, I assume?
posted by docpops at 11:09 AM on January 16, 2007


Doctors are obviously not writers and don't especially care about the awesomeness that words are.

William Carlos Williams, Perry Klass, Jerome Groopman, Chekov, Sir Arthur Conan Doyle and a bunch of others might disagree.
posted by docpops at 11:12 AM on January 16, 2007


By the by, attorneys' handwriting isn't much better. I speak from experience here. I'd say less than 1/3 of the 70 attorneys I work with has legible handwriting and that's only if they're taking their time. My handwriting is very legible but I used a laptop through law school. I think if I had handwritten my notes I would be in much worse shape.
posted by Not in my backyard at 11:24 AM on January 16, 2007


docpops, let's play nice.
posted by twistofrhyme at 5:50 PM on January 16, 2007


Many doctors suffer from an overblown sense of self-importance. Writing neatly is something you do as a matter of courtesy to those who will end up doing the reading. Nearly illegible handwriting says, rightly or wrongly, "my time is more important than yours."
Of course, doctors don't readily admit this, but I've gotten a doctor friend of mine to confess, although admittedly he was high at the time.
posted by king walnut at 7:46 PM on January 16, 2007


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