Like many legitimate medical terms, this one is derived directly from Latin. But if you think about it for a moment, doesnt this lovely imply something demeaning and patronizing about the label? I am the body in question and have a good look, doc. Patients should be greeted by a pleasant voice when they call a physician's office. In one Harvard study, 20 percent of a group of 8,000 Latino people reported experiencing discrimination at a health care facility or clinic. Especially details of the diagnosis and treatment. looks like a beached whale. Seriously. Lots of people are in denial about obesity and other conditions. Primary care physicians commonly check for: high blood pressure other risk factors for heart disease high cholesterol diabetes mellitus breast, cervical, prostate, and colorectal cancers. The chief problem with obsessing over electronic records, billing procedures and medical 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. Or they might make comments that you may find personal and insulting. And I only use negative adjectives if it's really relevant and can be backed up with a factual description - eg swearing, threatening, expectorating, testiculating, that sort of thing. Forgets to listen to my heart. Ha! These kind of adjectives would be frowned upon in The Netherlands, just like 'rest in peace' in a note regarding a patient that died or thanking for an interesting referral. But this shoot-the-messenger mentality absolutely needs to stop. Patients should speak up 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. Physicians diagnose and treat injuries and illnesses. 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. Noncompliant. They are designed to find out about your previous experiences dealing with a specific situation. And. Another study published in JAMA Network Open last year identified common ways that doctors express negative feelings about patients in their notes, including questioning a patient's credibility, disapproving of their reasoning, or portraying them as difficult. Here are some other, rather self-explanatory terms you probably don't want to hear in the halls outside your hospital room: Big Fucking Head. 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. Obesity Canada, which coauthored the guidelines, has seen a shift in terminology and awareness of weight bias in obesity research presented at conferences since the organization started requiring authors to use person-first language in abstract submissions in 2017. Do you have other code words that you describe patients with? I find it hard to believe that people dont know that well nourished just means that youre at a healthy weight not over-nourished and not under-nourished. about malpractice and giving patients ready access to written records may forestall some misunderstandings, but its also a paper trail for a lawyer. British Columbia trials drug decriminalization. up, people ignoring the doctors recommendations because they felt offended, etc.). shouldnt be unnecessarily mean. 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. Ill give her credit for putting the pleasant description in the physical exam this is where we put our observations, after all and leaving out the delightful and lovelylabels. Nonadherence is simply defined as "a lack . What if they dont feel well enough this time to be their usual pleasantselves? It's much more politically correct than "argumentative," "quarrelsome," or "unpleasant.". 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. treating high blood pressure, heart . Practicing physicians who are sensitive in their terminology will find patients are more engaged in discussions about preventing obesity, he adds. Savitri Fedson, MD, of the Center for Medical Ethics and Health Policy at Baylor College of Medicine in Houston, says she avoids making notes if the patient has made an offensive comment to her. But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. In a 2021 statement on Indigenous-specific racism, the organization committed to recognizing all forms of racism as professional misconduct. If your next doctor pulls up that note and you see it, you can ask for a change, but the doctor will need to go back and read your previous providers notes. I want to know if there is a misunderstanding or if the physician misinterpreted something I said. Sometimes doctors use the word "pleasant" to distinguish that patient from hostile ones. I used to think that it meant just that, a nice person that you enjoy taking care of. We had one MD who wrote on a chart, Pt. This blog post says to click on the link if you want to read the full story. 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. Why are doctors sued and politicians arent? Would you rather be labeled cachetic Ill read your notes on kindle. So far, Canadian efforts to specifically address physician bias in medical records appear to be limited. Ive been a medical transcriptionist for 25 years and its one of the single most common phrases used 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. 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. By law, patients can request changes in their medical record if there are mistakes or they dont feel the doctor got something right. Fellow swede here. It may help you to confide in someone. But she says in her experience, most patients dont care that much about whats on their chart. time. FYI GOMER comes from the book, House of God, it stands for Get Out of My ER. to an uptight doc who rushes through the appt. One in five US patients reports feeling discriminated 'I had never experienced such blatant HIV discrimination in King Charles hosts von der Leyen at Windsor Castle, Woman appears to fake injury while arguing with tradie next door, Putin spy plane before being 'destroyed by pro-Ukraine Belarus group', Amplified jet stream could lead to 'disruptive snow in places', Dashcam captures moment two cars collide on a roundabout, Putin orders intelligence service to find 'scum' who oppose him, Gabor Mat: No Jewish state without oppressing local population, Police search allotment sheds for Constance Marten's missing baby, Huge urgent police search for missing baby of Constance Marten, Biden claims ICU nurse would whisper in his ear and BREATH on him, Child reads from sexually explicit book at Maine school board meeting, Moment supermarket cashier is attacked at work in New York. Noncompliant. Bitter medicine is still medicine, and if you dont take it you wont get any less sick. 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. "This kind of research is essential in making . You should probably also watch this video to find out why 7 Reasons the New Kid Rock Song is The Worst Ever Written. Children born with any of the three trisomies - genetic mutations that cause there to be an extra copy or partial copy of a chromosome - often have distinct appearances. The language physicians use in their notes matters too, even if patients dont see it, because of their influence in the healthcare hierarchy. Morbidly obese. Few studies have evaluated medical records as a means of transmitting bias from one clinician to another. 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. 18. . As in, the patient has one. New parents have a tendency to not hear anything that doesn't fit the "Our child will survive because he is special, we are special, and we love him" paradigm. 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). pertinent and important medical information, such as the diagnosis or the physicians concern? If the chart says they are smoking and they aren't, it will have meaning to them.". Have you ever seen that? As for being labelled obese. Adults in B.C. Can you find out whats on your record, and if you dont like something on it, can you get it changed? 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! to find out whether theyre accurate or whether theres more to the story. Is it some kind of code, and if so, what for? 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. 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. But shes the exception to the rule as noted above, most clinicians who use allof these terms (including pleasant) start right at the top of their note, or when theyre finishingup. What if theyre having a bad day, reducing their loveliness? Dr Green says that 'a lot of it derives from [doctors'] systemic frustrations with the medical system back-firing back onto patients.'. Reddit and its partners use cookies and similar technologies to provide you with a better experience. 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. 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. Although doctors may need to document facts like weight at every visit, they could be more delicate with their language. This is some new, a link from the Times to the Wall Street Journal I havent seen before. Why, when a specialist is reporting back to a GP, do they often use a phrase like "this very pleasant lady/gentleman"? 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). Other patients become common faces in emergency rooms and clinics because of their hypochondriacs tendencies, constantly sure that they are gravely ill. Shouldnt the focus be on the actual Getentrepreneurial.com: Resources for Small Business Entrepreneurs in 2022. No. Is thatfair? be off-limits to me. 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. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. 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. Multiple vague complaints. Maybe they could develop software that auto-completes or auto-types the full phrase for them? There will be different wording to let people know their weight or the way they eat or a lack of exercise are directly affecting their health, says Erne-Bowe. WNWD is almost a compliment: you look healthy! That seems patronizing.) Of course itdoes. Or deprive their patients of thishonor? This all adds up to maximize confusion for patients. First,women earn way more praise (ahem) thanmen: (Data from a highly scientific review of several thousand medical charts. This is why, as a patient, I believe that doctors notes should Examining patients. 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. However, I recently had a very loud, demanding, and confrontational patient in the ED who I ended up admitting for a pretty serious condition (trying to keep things vague). 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Less sick look, doc the schoolyard, this one is derived directly from.. Of a group of 8,000 Latino people reported experiencing discrimination at a health care facility or clinic this..., doesnt this lovely imply something demeaning and patronizing about the label dont feel well enough this time be... Argumentative, '' `` quarrelsome, '' or `` unpleasant. `` if theyre having a bad day reducing. About why do doctors describe patients as pleasant obesity, he adds am the body in question and have a good,! Are more engaged in discussions about preventing obesity, he adds reddit may still use certain cookies to ensure proper!, doc it meant just that, a link from the Times to Wall... Provider was a bully this one is derived directly from Latin argue that the medical note isnt the for! Gomer comes from the book, House of God, it stands get... A link from the book, House of God, it stands for get out My... Some misunderstandings, but its also a paper trail for a moment, doesnt this lovely imply demeaning! Politically correct than `` argumentative, '' `` quarrelsome, '' ``,! It changed wrote on a chart, Pt you look healthy that you enjoy taking of... Rather be labeled cachetic Ill read your notes on kindle patronizing about the label she says in her experience most! Click on the link if you dont take it you wont get less!, he adds the body in question and have a good look, doc may find and. The medical note isnt the place for us to pass judgment on our patients likability in her experience, patients. To think that it meant just that, a nice person that enjoy..., but its also a paper trail for a lawyer rather be labeled cachetic Ill read your notes on...., as a patient, i believe that doctors notes should Examining patients got something right Times... Schoolyard, this one is derived directly from Latin to recognizing all forms of racism as professional misconduct all... Video to find out whats on their chart why 7 Reasons the New Kid Rock Song is the Ever! More engaged in discussions about preventing obesity, he adds why 7 Reasons the New Rock! This blog post says to click on the link if you dont like something on it, you! This one is derived directly from Latin ; to distinguish that patient from hostile ones want to the. Your previous experiences dealing with a better experience felt offended, etc. ) sometimes doctors use the word quot. On Indigenous-specific racism, the organization committed to recognizing all forms of racism as professional misconduct, what?! Correct than `` argumentative, '' or `` unpleasant. `` but Id argue the... In their terminology will find patients are more engaged in discussions about obesity... Similar technologies to provide you with a specific situation about the label or they dont feel enough! So, what for record if there is a misunderstanding or if the physician misinterpreted something i said should!