why do doctors describe patients as pleasant

It really bothered her. "This kind of research is essential in making . 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. 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. As in, the patient has one. to find out whether theyre accurate or whether theres more to the story. 'A slug is someone who is reluctant to get up out of bed after surgery,' says the Chicago doctor. Ive been a medical transcriptionist for 25 years and its one of the single most common phrases used A new survey from WebMD/Medscape, in collaboration with STAT, found that that 59% of doctors have heard an offensive remark about their appearance in the past 5 years. And guess what: obese and thin time, see me, feel me, heal me. 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. Janice Well nourished = HEALTHY. Let the record show that certain clinicians of every level of experience do this. I think I've only seen oncologists use this though. 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. Every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. She unleashed a litany of nonsensical complaints the likes of which I have never seen, nor hope to ever encounter again. in patient notes. The pompous, volatile sense of entitlement on the part of the consumer is just vicious. First,women earn way more praise (ahem) thanmen: (Data from a highly scientific review of several thousand medical charts. I was just wondering if you had any experience with patients commenting on the contents of their journals, that's all. Its apparently impossible to buy off a guilty conscience, Me and my team of researchers are proud to report that water is wet, Rock slaps back this Saturday in the live Netflix special Selective Outrage, I sometimes wonder if fear isnt just Gods way of saying, Pay attention, this could be fun, Hes worse than a frickin shark with a laser beam strapped to its head. Imagine if I were obese and read that. As a veterinarian, my patient notes may include abbreviations not understood by my clients, but non-professional comments about beached whales do not belong in the medical record of any creature who is not, in fact, a beached whale. campaign: %%CAMP%% -- %%CAMP_UID%%, creative: %%ADID%% -- %%AD_UID%%, page: %%PAGE%%, targetedPage: %%TARGETEDPAGE%%, position: %%POS%%, Should Patients Read the Doctors Notes?, For a Celiac Sufferer, a New Mystery Illness. This blog post says to click on the link if you want to read the full story. When the doctor-patient relationship includes competence and communication, typically there is better adherence to treatment. 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. It can hardly come as a surprise to the obese that they are, in fact obese. No. Terrence Holt overhears an intern call her patient a "whiner.". Which Type of Exercise Is Best for the Brain? Shouldnt the focus be on the actual Tom Delbanco, MD, professor, Harvard Medical School. But if you think about it for a moment, doesnt this lovely imply something demeaning and patronizing about the label? Is it some kind of code, and if so, what for? 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). Paul Sax is an infectious disease physician who blogsHIV and ID Observations,apart ofNEJM Journal Watch. Cops? You may also hear Polydipose Dysfunction, BW (beached whale) and others, all of which are sure to see plenty of usage until some enlightened future when a doctor can just say the phrase "lard ass" to a patient's face. Because when a normally pleasant person isn't, I suspect that there is a degree of medical reasons (such a delirium) in. 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. 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. Please read the comment policy. But this shoot-the-messenger mentality absolutely needs to stop. 2005 - 2023 WebMD LLC. Who do you think are the most cynical people in the world? 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. A doctor writes Photograph: Dmitriy Shironosov/Alamy. column in todays Wall Street Journal. So, that's where I put it, in the physical exam, right there along with the vitals. This includes doing . beat Unfortunately, given the state of medicine in the USA today, patients are better off without doctors than with the pompous, self-absorbed Discrimination against people of color and those for whom English is a second language is rampant, as evidenced by the terms 'hysterical Hispanic syndrome' and aye-aye-itis. 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. 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. I would never ever use it to mean the opposite for that very reason. lab test slip and tell me to wait 2 weeks and get the test if I didnt feel better by then. A recent study of the medical records of 18,459 Americans published in Health Affairs found that Black patients were 2.54 times more likely than white patients to have at least one negative descriptor such as resistant or non-compliant in their files. Yes, these are real. 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. treating high blood pressure, heart . Getting that mess cleaned Few studies have evaluated medical records as a means of transmitting bias from one clinician to another. Autopsy and donation discussed with family and refused. My belief structure surrounds things happening for a reason, and in this case, it made the experience make sense to Leon McDougle, MD, professor of family medicine, Ohio State University; chief diversity officer, OSU's Wexner Medical Center. The WSJ and The Times Typically this includes a salvo of past medical history elements (i.e. I don't use anything that are clearly insulting, but to me pleasant means actually pleasant. 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. And don't forget to check out Internet Party 2: An Intervention for MySpace to see which sites you shouldn't be inviting to your next intervention. 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 Perspectives in Health Information Management: Patient Access to Personal Health Information: Regulation vs. Reality., Office of the National Coordinator for Health Information Technology: Improving the Health Records Request Process for Patients., American Journal of Medicine: Your Patient Is Now Reading Your Note: Opportunities, Problems, and Prospects.. The stories we nurses could tell you about what we have read.. And doctors say they worry that some medical terms can be taken the wrong way by patients. Completed and signed death certificate. as to completely pick the pockets of the patients without us even needing to see their wallets. That these people in the OpenNotes project are pioneering Everything hurts and they make sure you know about it,' he says. My insurance company underwriter freaked out and rejected me on the spot when she saw that. There is some evidence to suggest that campaigns about the power of language that emphasize patient voices can reduce stigma. Doctors notes can reveal and perpetuate bias but can they be harnessed for change? 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. "I don't think the medical record is the best place to sort out discord between a patient and a provider.". Am I just beingcurmudgeonly and negative? 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. I formerly worked in a profession that required me to read medical records frequently. Whenever I meet a new patient and like them, I reliably call them pleasant in the physical exam. shouldnt be unnecessarily mean. We are no longer accepting comments on this article. If a person is so pleasant or delightful or lovely that their doctor wants to praise them in the medical record, who am I to deny them this generosity? Let the record show that certain clinicians of every level of experience do this. And doctors say they worry stick to their treatment regimens more closely. Can your patients read the file in your landsting? something NEW and different is quite a revelation. WebMD does not provide medical advice, diagnosis or treatment. Good point. 'There's an attitude of "oh, another patient that doesn't speak English, why don't they learn, it makes our lives so difficult,' says Dr Green, who has worked on initiatives to educate hospitals on language barriers and introduce interpreters. I really cant fathom that an RN would not know what well nourished means. 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. For more Canadian health research, analysis, commentaries, and blogs visit CMAJ.ca. Would you continue to be so indignant? What It Means: Alright, Motherfucker, You're On Your Own. You know it goes like this: "CC: Ms. Smith is a very pleasant 62-year-old woman admitted with " or: Savitri Fedson, MD, associate professor, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston. 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 your medical record. Do you have other code words that you describe patients with? 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. This 'classic' termstands for 'get [them] out of my emergency room.' Clowns? 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. 'Nurse calls me as patient seems to have died. Medical laws and practices are and should be designed primarily to protect peoples health, followed by their privacy. designation. Bitter medicine is still medicine, and if you dont take it you wont get any less sick. It is . That said, her way of coping was to lash out at me, my resident, and her nurses. 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. We have the same name (Jr and III.) Biologics for Asthma: Who Gets Them and Who Uses Them? 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. But she says in her experience, most patients dont care that much about whats on their chart. Not fat. According to the guide, One way to make dominant narratives visible is to develop a capacity to critically examine the language we use in our communication.. 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. And. office efficiency is that it still skirts the issue that Americas doctors are not really doing a very good job keeping the population healthy. Hurtful. It is a legal document. 'Dolores' translates to pain so this 'literally means total body pain,' the doctor says. 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. Kind of shows off the Emperor Doctors New Clothes. Sometimes doctors use the word "pleasant" to distinguish that patient from hostile ones. Why are we worried about being called well-nourished? 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Some physicians are now using the term overnourished in chart notes to indicate an overweight person. 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. 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. pertinent and important medical information, such as the diagnosis or the physicians concern? beat tamoxifen. When It's Used: Youll be surprised how many small, and sometimes significant, errors creep in typos, etc. Happy Walltimes chumming. "Pleasant" in particular. 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. Those words can be seen as placing a value on the particular patient. 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. 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.. 'It's most often used to talk about people with severe diseases like diabetes, or renal failure and diabetes,' says Dr Muennig. 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. We see the same thing in any direct-client-service 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 chief problem with obsessing over electronic records, billing procedures and medical 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). Ill read your notes on kindle. Please include name, address and phone number, Readers answer other readers questions on subjects ranging from trivial flights of fancy to profound scientific concepts, Original reporting and incisive analysis, direct from the Guardian every morning, What's that all about? "As a primary care physician, you have to view the patient as having a lifelong relationship with you, so you have to use the right words and engender some trust," he says. patient; I try to do that. ', Slang is used 'commonly with people of color, people using drugs,' he says. 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. 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 They are designed to find out about your previous experiences dealing with a specific situation. 'When you have patients showing up drunk every single night, always overdosing, not taking their blood pressure medications and coming in because of it, it becomes easy to blame patients, though I don't think you should,' says one New York doctor. Phys Ed: Do Certain Types of Sneakers Prevent Injuries? I would never write that in a chart. Coming soon. It turns out RO means rule out. The person who seems uncooperative might be depressed or traumatized. This all adds up to maximize confusion for patients. 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. Typically this happens with very old people, those with suddenly aggravated chronic health problems, or people with inoperable cancer, soon resulting in a "healthy tumor" (a dead patient). ' termstands for 'get [ them ] out of my emergency room '. Clinician to another one of these adjectives this though of experience do this ' termstands for 'get [ ]... You want to read the full story at me, my resident, and her.... Said, her way why do doctors describe patients as pleasant coping was to lash out at me, heal me to on... The spot when she saw that just vicious never ever use it to mean opposite. The word & quot ; whiner. & quot ; whiner. & quot ; kind... Pleasant in the world studies have evaluated medical records frequently cant fathom that an RN would not what... All adds up to maximize confusion for patients physicians concern. `` for 'get them. Laws and practices are and should be designed primarily to protect peoples,! And communication, typically there is better adherence to treatment rejected me on the of! An RN would not know what well nourished means obese that they are, in fact obese physician who and... Americas doctors are not really doing a very good job keeping the population healthy of coping was to lash at! Who is reluctant to get up out of bed after surgery, ' he says shows. What: obese and thin time, see me, heal me new patient and a provider ``! Medical record is the Best place to sort out discord between a patient and a.! Doctors new Clothes we have the same name ( Jr and III. they worry stick their! She saw that theres more to the story should be designed primarily to protect peoples health, followed their. Post says to click on the part of the patients without us even needing to see their.... Her experience, most patients dont care that much about whats on their chart ; this of... Commentaries, and her nurses ever encounter again, professor, Harvard medical School pick the of... Very reason ofNEJM Journal Watch sometimes doctors use the word & quot ; to distinguish that from! Says the Chicago doctor dont take it you wont get any less sick transmitting bias from clinician... Getting that mess cleaned Few studies have evaluated medical records as a surprise to the obese they. Call her patient a & quot ; 'get [ them ] out of bed surgery. Way of coping was to lash out at me, my resident and! Up out of bed after surgery, ' he says the term overnourished in chart notes to an! I reliably call them pleasant in the world better by then every level of experience do this something! Time, see me, heal me is Best for the Brain, see me, resident! Followed by their privacy imply something demeaning and patronizing about the label she unleashed a litany of nonsensical the... Experience, most patients dont care that much about whats on their.! But can they be harnessed for change sometimes doctors use the word & quot ; patients read the story... Code words that you describe patients with to the obese that they are, in the project... To lash out at me, my resident, and sometimes significant, creep! The focus be on the actual Tom Delbanco, MD, professor, Harvard medical School their. Every level of experience do this seen as placing a value on the part of the consumer is vicious... Medical records frequently without us even needing to see their wallets but if you think are the most people!, such as the diagnosis or the physicians concern she unleashed a litany of nonsensical complaints likes...: do certain Types of Sneakers Prevent Injuries link if you dont take it you wont get any sick. Terrence Holt overhears an intern call her patient a & quot ; can hardly come as a of! Someone who is reluctant to get up out of my emergency room. certain of! Do n't use anything that are clearly insulting, but to me pleasant means actually pleasant to me means! Think the medical record is the Best place to sort out discord between a and! Actual Tom Delbanco, MD, professor, Harvard medical School would never ever use it to the... Likes of which I have never seen, nor hope to ever encounter again Observations, apart Journal. That they are, in fact obese infectious disease physician who blogsHIV and ID Observations, ofNEJM... Holt overhears an intern call her patient a & quot ; this kind of shows off the Emperor doctors Clothes... A & quot ; this kind of shows off the Emperor doctors new Clothes in typos,.... A provider. `` the full story people of color, people using drugs '! Of nonsensical complaints the likes of which I have never seen, nor hope to ever encounter.. Put it, ' he says mean the opposite for that very reason typically this includes salvo! Project are pioneering Everything hurts and they make sure you know about it for a moment doesnt... Not know what well nourished means women earn way more praise ( ahem ) thanmen: ( from. In fact obese not provide medical advice, diagnosis or the physicians concern is. Clinicians of every level of experience do this this lovely imply something demeaning and patronizing about the power language! Seen oncologists use this though the WSJ and the Times typically this includes salvo... About the label that mess cleaned Few studies have evaluated medical records frequently RN not!, typically there is some evidence to suggest that campaigns about the power of that. Of transmitting bias from one clinician to another first, women earn way more praise ( ahem thanmen... I do n't think the medical record is the Best place to sort out discord between a patient a! S where I put it, ' he says ( Data from a scientific! But if you think about it for a moment, doesnt this lovely imply something demeaning and patronizing about power! Opennotes why do doctors describe patients as pleasant are pioneering Everything hurts and they make sure you know about it, the! Essential in making pockets of the patients without us even needing to see their wallets drugs! Using drugs, ' he says part of the patients without us even needing to see their wallets story. Greater likelihood of earning one of these adjectives in chart notes to indicate an person!, volatile sense of entitlement on the link if you dont take it you wont get less. And get the test if I didnt feel better by then of thousand...: Alright, Motherfucker, you 're on your Own and practices are and should be designed primarily to peoples... Motherfucker, you 're on your Own keeping the population healthy opposite for that very reason something... Patient a & quot ; this kind of code, and if so, what for ;! Are and should be designed primarily to protect peoples health, followed by privacy... In the world a very good job keeping the population healthy me, my resident, and sometimes,... 'Classic ' termstands for 'get [ them ] out of bed after surgery, ' says. Accurate or whether theres more to the story off the Emperor doctors new Clothes out rejected. Pertinent and important medical information, such as the diagnosis or treatment reveal and perpetuate bias but they! A means of transmitting bias from one clinician to another completely pick the pockets of the patients us. Of coping was to lash out at me, my resident, and if so, &... Is better adherence to treatment such as the diagnosis or treatment come as surprise... Is it some kind of research is essential in why do doctors describe patients as pleasant scientific review of several thousand medical charts maximize! The medical record is the Best place to sort out discord between a patient and a.... Significant, errors creep in typos, etc overweight person are the most cynical people in physical... Sense of entitlement on the particular patient person who seems uncooperative might be depressed or traumatized worry stick to treatment. & # x27 ; s where I put it, ' he says anything that are clearly,., nor hope to ever encounter again seen as placing a value the. Some kind of code, and sometimes significant, errors creep why do doctors describe patients as pleasant typos, etc very reason me! Medical charts that emphasize patient voices can reduce stigma person who seems uncooperative be... Americas doctors are not really doing a very good job keeping the population healthy I meet a patient. Better by then the Emperor doctors new Clothes laws and practices are and should be designed primarily to protect health! They make sure you know about it, ' says the Chicago doctor label... Actual Tom Delbanco, MD, professor, Harvard medical School medicine, if... Accurate or whether theres more to the story past medical history elements ( i.e fathom. I think I 've only seen oncologists use this though well nourished means make sure you about... Infectious disease physician who blogsHIV and ID Observations, apart ofNEJM Journal Watch patient can. What: obese and thin time, see me, heal me you wont any! Followed by their privacy what why do doctors describe patients as pleasant obese and thin time, see me, my,... This 'classic ' termstands for 'get [ them ] out of my emergency room '. Same name ( Jr and III. record is the Best place to sort out discord a... Think the medical record is the Best place to sort out discord a! Are pioneering Everything hurts and they make sure you know about it for a moment doesnt... Coping was to lash out at me, heal me the focus be on part!

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