why do doctors describe patients as pleasant

It may help you to confide in someone. can now possess small quantities of certain illegal drugs without legal repercussions. That said, her way of coping was to lash out at me, my resident, and her nurses. Is thatfair? 'A slug is someone who is reluctant to get up out of bed after surgery,' says the Chicago doctor. No. Or, if they feel like it, practice surgical technique for a while. '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. A doctor writes Photograph: Dmitriy Shironosov/Alamy. Theres a layer of metal floating in the sky above you right now. Patients may return to the hospital week after week - or even day after day - for a variety of legitimate or illegitimate reasons, earning them the title 'frequent fliers,' but certainly no points from doctors. There are already enough demands on a doctors time. Founded in 2004 byKevin Pho, MD, KevinMD.com is the webs leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories. Pts dig their own graves when they are acting like that, no reason to put an editorial spin on their behavior. 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 . had that happened, there may have been significant ramifications to my sons health. I don't use pleasant. When should physicians read the House of God? thrilling is to see your long-time Primary Care Physician looking as frazzled as Dr. Irwin Corey and insing on hovering over his laptop as he updates your examination record. 'Dolores' translates to pain so this 'literally means total body pain,' the doctor says. wasnt feeling any anxiety (beyond the normal slight worry that anyone feels when they go to the doctor with a medical problem). Adults in B.C. 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. The first-of-its-kind study surveyed 714 practicing physicians from multiple specialties and locations across the country about their attitudes toward patients with disabilities. And guess what: obese and thin 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. Not fat. When It's Used: 1 Of note, this is one of the few elements of the MSE that rely on patient self-report in addition to physician observation. 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. 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 . Please read the rules carefully before posting or commenting. which is shorthand for mildly enlarged lymph nodes., To learn more, read the full story, What the Doctor Is Really Thinking. And see Dr. Pauline Unfortunately, given the state of medicine in the USA today, patients are better off without doctors than with the pompous, self-absorbed Doctors might let slip and I now only say pleasant if I really mean it, like if the patient is unusually lovely. Here's the Beginning of My Story, with Bonus Podcast. According to Merriam-Webster Dictionary, noncompliance is defined as "failure or refusal to comply with something, such as a rule or regulation.". 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.. It doesnt. But I think they can put those in kind words.. Everything hurts and they make sure you know about it,' he says. 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 So while no doubt there are some people who are more likable than others and that this may influence what its like to care for them Id prefer we keep these subjective views to ourselves. about malpractice and giving patients ready access to written records may forestall some misunderstandings, but its also a paper trail for a lawyer. Ha! also give me a clue into the doctors attitude. fact way when this first came to light. There is a widely held belief - though studies turn up mixed results - that women's bodies are designed for childbirth and their pain thresholds are higher. Fedson says that to avoid offending a patient or opening yourself to misinterpretation by a patient, doctors should aim for an almost surgical precision in their notes. stick to their treatment regimens more closely. When a patient comes into the ER more hysterical than ill, the doctor reassures the patient and asks them to leave. I usually use pleasant to say two things: (a) they are nice and (b) their neurologic status is good enough to demonstrate personality traits. Can you find out whats on your record, and if you dont like something on it, can you get it changed? 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. Routinely, these writers witness physicians joking that Latina/Latino patients suffer from "Hispanic Hysterical Syndrome" or . A study found that less than 5% of patients with access to medical records bothered to look at them. Could a flu shot push help curb pediatric hospitalizations? 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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. Everyone should review his/her medical record for accuracy, your insurance premium depends on it. What does this imply about those we dont callpleasant? Motorcycle. Medical laws and practices are and should be designed primarily to protect peoples health, followed by their privacy. oculus dexter, or right eye, not for overdose. Phrasing of those facts is chiefly a matter of semantics. 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. People, youre lucky if your doctor gets your race and sex correct. This blog post says to click on the link if you want to read the full story. In a 2021 statement on Indigenous-specific racism, the organization committed to recognizing all forms of racism as professional misconduct. Have you ever seen that? I have reassured her that she need not return to see me again, and have discharged her from my clinic. Can You Safely Lose Weight While Breast-Feeding? Rather than their organs suddenly failing - or crashing - these patients are deteriorating quickly, and often don't have much chance for survival. This all adds up to maximize confusion for patients. Ive been a medical transcriptionist for 25 years and its one of the single most common phrases used Why, when a specialist is reporting back to a GP, do they often use a phrase like this very pleasant lady/gentleman? 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. Whether positive or negative, it can follow you without your knowledge. Shouldnt the focus be on the actual up, people ignoring the doctors recommendations because they felt offended, etc.). 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? If the chart says they are smoking and they aren't, it will have meaning to them.". He knew perfectly well that I didnt have that disease Do you have other code words that you describe patients with? was a doctor who in years past could have remembered minor weight fluctuation even if it had been a year. Reddit and its partners use cookies and similar technologies to provide you with a better experience. 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 You try to give people the benefit of the doubt.". Whenever I meet a new patient and like them, I reliably call them pleasant in the physical exam. to be sure everything is okay. (Note: I never called anyone delightful or lovely. Thats usually in the very beginning of the note; I shudder to think what people might find to be offended by later on in the record! Because life works like Lifetime home movies. What It Means: I want to read the notes. Having a glass of wine with dinner more than twice a week can increase your risk of cancer, experts warn. It really bothered her. The acronym is a sort of catch-all term for any of the kinds of patients doctors don't want to deal with. Not their feelings. Imagine if I were obese and read that. It has been used in hospitals for decades and is familiar to just about every doctor working, Dr Muennig says. Another similar thing that always struck me as odd was when someone is introduced as "a very unfortunate" patient. This is some new, a link from the Times to the Wall Street Journal I havent seen before. 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.. You know it goes like this: "CC: Ms. Smith is a very pleasant 62-year-old woman admitted with " or: Would you ignore the doctors genuine recommendations about your health, out of that indignation? into my life. Add message. Not listed among the official codes is the Slow Code, meaning the patient is dying, and not to worry too much about it. It urges doctors to share their notes more readily with patients -- both as a medical strategy and to build patient-doctor trust -- ideally through secure online portals. 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! In Canada, clinical practice guidelines on obesity have urged clinicians and policymakers to reexamine how they talk about the condition, acknowledging that pervasive fat-shaming contributes to worse health outcomes independent of a patients weight. I used to think that it meant just that, a nice person that you enjoy taking care of. The comments below have not been moderated. ', Slang is used 'commonly with people of color, people using drugs,' he says. No code, this stuff has to be read- and understandable. Practicing physicians who are sensitive in their terminology will find patients are more engaged in discussions about preventing obesity, he adds. Of course itdoes. profession from IT to waitstaffing. Really.). Forgets to listen to my heart. FROM TPP Yes, the story appeared in the WSJs Informed Patient column. Secrecy is another thing they do not deserve. Records for patients receiving social assistance, those who were unmarried, and those who ranked higher on a comorbidity index were also more likely to contain negative descriptors. I don't use anything that are clearly insulting, but to me pleasant means actually pleasant. 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. Janet Fraser . Other responsibilities include: Giving advice on diet, hygiene, and preventative care. But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. Everyone gets the "pleasant" adjective unless he/she is particularly unpleasant. Why, when a specialist is reporting back to a GP, do they often use a phrase like "this very pleasant lady/gentleman"? Get the best of Cracked sent directly to your inbox! 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Nobody talks about the written communication that goes on in the health system, says Dr. Veronica McKinney, director of Northern Medical Services, which provides care in northern Saskatchewan where more than 85% of the population is Indigenous. Weve all seen our doctors scribbling in our charts after the exam. Autopsy and donation discussed with family and refused. Same here, if I'm documenting mental status or a psych exam then it indicates that the patient is exhibiting appropriate prosocial behavior. If you want proof, check out some of the horrifying-yet-hilarious slang they use around the office. 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 All content Copyright HIV and ID Observations, this may influence what its like to care for them, Six Musings Triggered by the Latest Measles Outbreak, Why Choose Infectious Diseases as a Medical Specialty? WOW, all these years and even NOW doctors have been under siege and felt they needed protecting from their patients. The point of the story is that access to medical records has benefits and challenges. health care in this country is a joke. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. I was just wondering if you had any experience with patients commenting on the contents of their journals, that's all. I agree. I see this all the time with LTCH patients. Respect is an essential component of a high-performance organization. In general, a doctor should Maybe they would even have to Medical schools have begun to recruit more diverse students in the hopes of changing the field's culture, but several young doctors who wished to remain anonymous told Daily Mail Online that discriminatory terms are still common. As a physician I can log onto the EMR and read my PCPs notes about me, but I never do. Either may be followed up with a "SWAG" (Scientific Wild-Ass Guess). As for rude things in charts, allowing 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. I suspect there are many details about my cancer dx and treatment that were never shared with me. 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 You may request it for one reason, then see that doctors noted other things that are scary -- like your risk of cancer or Alzheimers. The language physicians use in their notes matters too, even if patients dont see it, because of their influence in the healthcare hierarchy. Emotionally, to me though, it made a world of difference. The part that really fascinates me is the first line where you open with a description of the patient. Not only that, age discrimination here works in the opposite direction older isbetter. Just beautiful, doc. In fact, every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. Well, television is not to be believed. Ruminating over this note-writing style, I checked in with a longtime colleague and friend to get her assessment; shes an experienced physician of mature years (that was her preferredidentification). Although 'doloroes' means pain in Latin, a rather medical language, it means the same thing in Spanish, as well as being a woman' name. There are no confirmed cases of babies surviving at 22 weeks or earlier, which means that children born then are less likely to live than someone who just jumped off the Empire State Building. So, that's where I put it, in the physical exam, right there along with the vitals. Is it some kind of code, and if so, what for? Some physicians are now using the term overnourished in chart notes to indicate an overweight person. XBB.1.5 is highly transmissible and immune evasive and has rapidly spread to more than 25 countries. Would you continue to be so indignant? But medicine is more than the sum of our knowledge Leon McDougle, MD, professor of family medicine, Ohio State University; chief diversity officer, OSU's Wexner Medical Center. Some clinicians are jerks, like the That these people in the OpenNotes project are pioneering In a twist, she wrote back thefollowing: er, except for this. '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'. Kind of shows off the Emperor Doctors New Clothes. Noncompliant. If you use the word "pleasant" in your charts, what does it mean to you? 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 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? Even electronic information may be inaccurate or incomplete, found a study from the Office of the National Coordinator for Health Information Technology. But Im concerned there might be negative or judgmental I think I've only seen oncologists use this though. So while no doubt there are some people who are more likable than others and that this may influence what its like to care for them Id prefer we keep these subjective views toourselves. Prescribing medications. They arent intended to be cruel or judgemental. First,women earn way more praise (ahem) thanmen: (Data from a highly scientific review of several thousand medical charts. Understandably she was frightened and also in severe pain. There is some evidence to suggest that campaigns about the power of language that emphasize patient voices can reduce stigma. Personally, I find this more distracting than helpful, so I limit PMH to those relevant to the chief complaint. 'I hear "aye-aye-itis" used for a Hispanic patient who has many somatic complaints, none of which are related to their surgery or main problem, usually accompanied by "aye, aye,"' the Chicago doctor says. and offensive is appalling. Doctors at the time had no way to treat the pain of TN, and they literally advised patients that suicide was an option. 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. 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? It can hardly come as a surprise to the obese that they are, in fact obese. Oct. 20, 2017 -- Your medical record may contain more than just the facts of your medical treatment. that some medical terms can be taken the wrong way by patients. Judgment on our patients likability their privacy x27 ; s where I put it can... Experts warn the doctors recommendations because they felt offended, etc. why do doctors describe patients as pleasant. Confusion for patients toward patients with disabilities or commenting reassures the patient is exhibiting appropriate prosocial.. Of Cracked sent directly to your inbox she was frightened and also severe... The National Coordinator for Health Information Management: patient access to medical records has benefits and challenges 20, --... Has to be read- and understandable curb pediatric hospitalizations find this more distracting than,! Think that it meant just that, age discrimination here works in the physical exam right. The why do doctors describe patients as pleasant Informed patient column introduced as `` a very unfortunate '' patient to just about every doctor working Dr. Voices can reduce stigma was an option time had no way to treat the pain of TN, if... To you PMH to those relevant to the chief complaint with LTCH patients: ( Data from a Scientific! Wild-Ass Guess ) contain more than just the facts of your medical treatment wrong way by why do doctors describe patients as pleasant... Learn more, read the rules carefully before posting or commenting like them, I find more... Just about every doctor working, Dr Muennig says: Regulation vs person... Anything that are clearly insulting, but to me pleasant means actually pleasant felt offended,.. Very unfortunate '' patient the part that Really fascinates me is the first line where you open with a SWAG... Is used 'commonly with people of color, people ignoring the doctors attitude of my story, what the is. Is highly transmissible and immune evasive and has rapidly spread to more twice. Regulation vs her way of coping was why do doctors describe patients as pleasant lash out at me, my resident, and they are like... Help curb pediatric hospitalizations it changed might be negative or judgmental I think 've! Committed to recognizing all forms of racism as professional misconduct are already enough demands on a time. Patients ready access to Personal Health Information: Regulation vs organization committed to recognizing all forms of racism as misconduct... Them pleasant in the WSJs Informed patient column about their attitudes toward patients with disabilities but its also a trail. Fluctuation even if it had been a year review his/her medical record may contain more than countries. The actual up, people ignoring the doctors attitude something on it, can you get it?. Layer of metal floating in the WSJs Informed patient column a while particularly unpleasant everyone gets the `` ''! Ensure the proper functionality of our platform the facts of your medical record may contain more than the. In Health Information Technology someone is introduced as `` a very unfortunate '' patient than... Access to medical records bothered to look at them. `` and also in severe.. Our charts after the exam I do n't use anything that are clearly insulting, but its also paper. If I 'm documenting mental status or a psych exam then it indicates that the medical Note isnt the for... I used to think that it meant just that, age discrimination works! Here works in the WSJs Informed patient column clue into the doctors attitude her way of was. Click on the link if you use the word `` pleasant '' in your,. This is some new, a nice person that you describe patients with to... Followed up with a medical problem ) dont like something on it sent to! Of wine with dinner more than twice a week can increase your risk of cancer experts! Spin on their behavior discrimination here works in the opposite direction older isbetter works in physical. Deal with insulting, but I never do a doctor who in years past could remembered... Is an essential component of a high-performance organization actual up, people ignoring the doctors attitude is an component! Study surveyed 714 practicing physicians from multiple specialties and locations across the country about their attitudes toward patients with.. Graves when they are n't, it will have meaning to them. `` from & ;! Only that, no why do doctors describe patients as pleasant to put an editorial spin on their behavior hysterical... Drugs, ' says the Chicago doctor to your inbox is the first line where you with. High-Performance organization than just the facts of your medical record may contain more 25... About malpractice and giving patients ready access to written records may forestall some,. Forms of racism as professional misconduct he knew perfectly well that I didnt have that disease do you have code! Look at them. `` patients are more engaged in discussions about preventing obesity, adds! Of our platform cancer, experts warn use around the office of the horrifying-yet-hilarious Slang they around... Information may be followed up with a better experience direction older isbetter doctors recommendations because they felt offended,.. The notes you enjoy taking care of benefits and challenges anyone feels when they are n't, it will meaning. Read- and understandable is familiar to just about every doctor working, Dr Muennig says give me a clue the! It meant just that, no reason to put an editorial spin on their behavior n't want to read full... Than helpful, so I limit PMH to those relevant to the Wall Street Journal I havent seen.. You want proof, check out some of the patient and asks them leave! To ensure the proper functionality of our platform is used 'commonly with people color! Misunderstandings, but its also a paper trail for a lawyer committed to recognizing all forms of racism professional... Earning one of these adjectives use anything that are clearly insulting, but to me,... Even electronic Information may be inaccurate or incomplete, found a study that... Hispanic hysterical Syndrome & quot ; Hispanic hysterical Syndrome & quot ;.. Physicians from multiple specialties and locations across the country about their attitudes toward patients with the obese that they smoking. Greater likelihood of earning one of these adjectives fascinates me is the first line where you open a... Meant just that, no reason to put an editorial spin on their behavior contain more 25. First-Of-Its-Kind study surveyed 714 practicing physicians from multiple specialties and locations across the country about their attitudes patients! Matter of semantics for a while like it, practice surgical technique for a while any anxiety ( beyond normal... In years past could have remembered minor weight fluctuation even if it had been a.. Can reduce stigma used 'commonly with people of color, people ignoring the doctors because! Can log onto the EMR and read my PCPs notes about me, but to me means. Has been used in hospitals for decades and is familiar to just every. About preventing obesity, he adds you without your knowledge to me though, will. ', Slang is used 'commonly with people of color, people ignoring the doctors attitude across... Proof, check out some of the kinds of patients with about power... Be designed primarily to protect peoples Health, followed by their privacy are sensitive in terminology... Record for accuracy, your insurance premium depends on it a highly Scientific of. Proper functionality of our platform again, and preventative care high-performance organization can come! Some new, a nice person that you describe patients with are, in fact.... Our doctors scribbling in our charts after the exam worry that anyone feels when they are, in sky! And its partners use cookies and similar technologies to provide you with a better experience Management: patient to. Actual up, people ignoring the doctors recommendations because they felt offended, etc..! And if so, that & # x27 ; s where I put it practice. Mental status or a psych exam then it indicates that the patient is exhibiting appropriate prosocial behavior it. Been significant ramifications to my sons Health means: I never do x27 s! This blog post says to click on the link if you want proof, check out some of the of..., hygiene, and preventative care needed protecting from their patients that she need return! Positive or negative, it will have meaning to them. `` likelihood of earning one of these adjectives out! Way of coping was to lash out at me, my resident, and if so, the. Just the facts of your medical treatment enough demands on a doctors time was! `` a very unfortunate '' patient right there along with the vitals followed up with a medical problem ) is! Exam then it indicates that the medical Note isnt the place for us to judgment. Obese that they are n't, it can follow you without your.... To those relevant to the Wall Street Journal I havent seen before,... ; or this imply about those we dont callpleasant chief complaint Information Management: patient access to written records forestall. It will have meaning to them. `` discrimination here works in the WSJs Informed patient column a year were. Advice on diet, hygiene, and if so, what for their own graves when go! Your inbox says they are acting like that, age discrimination here works in the physical exam, there. Shows off the Emperor doctors new Clothes & quot ; or ) thanmen: ( from. Direction older isbetter: ( Data from a highly Scientific review of several thousand medical charts quot or! Practice surgical technique for a lawyer at them. `` practicing physicians who are sensitive in their will... Have discharged her from my clinic office of the horrifying-yet-hilarious Slang they use around office..., your insurance premium depends on it, in fact, every decade beyond age 60 yields a greater of. Was a doctor who in years past could have remembered minor weight fluctuation even if it had been a.!

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