What does this imply about those we dont callpleasant? When It's Used: I had one professor in med school, though, who required students NOT to use such terms as pleasant, delightful, jovial, aged, or their opposites. Whenever I meet a new patient, and really like them, I reliably call them pleasant in the physical exam. 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. Taking Vitamin D each day could cut your chances of getting dementia, study claims. Why are we worried about being called well-nourished? Patients should speak up Im glad beat 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. Every decade beyond age 60 yields a greater likelihood of earning one of these adjectives. 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. I had tried, unsuccessfully, to give birth naturally for many, A doctor writes Photograph: Dmitriy Shironosov/Alamy. This is a highly moderated subreddit. oculus dexter, or right eye, not for overdose. Am I just beingcurmudgeonly and negative? 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. But if you click to the story, it takes you to the Wall Street Journals website. This is some new, a link from the Times to the Wall Street Journal I havent seen before. (Note: I never ever called anyone delightful or lovely. 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. Prescribing medications. They arent intended to be cruel or judgemental. Let the record show that certain clinicians of every level of experience do this. 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 My Mom Will Shoot like Sly thought he would? Efforts to use more sensitive language in encounters with patients rarely address medical records. 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. Patients should be greeted by a pleasant voice when they call a physician's office. My conclusion is that the word "pleasant" was used by these consult services to denote which of their patients are "trouble." Writing . And OD is short for oculus dexter, or right eye, not for overdose. S: Situation - Describe a similar situation you have faced to what is asked about in the question. 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. 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. out after a two-second visual examination, noting normal condition in body systems that the doctors never bothered to check. In a 2021 statement on Indigenous-specific racism, the organization committed to recognizing all forms of racism as professional misconduct. On the subject of sharing doctors notes, what struck me in the Journal article was this: ** The old narrative is that we had to protect doctors from patients, but weve found that patients are ', He says he's seen this term used commonly to describe Latino patients in particularly. What does this imply about those we dont callpleasant? 'They tend to be slow, in pain, and want to stay "one more day longer, please,"' he says. The concept that parts of the medical record need to be withheld from patients is a load of bunk. 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. Other patients become common faces in emergency rooms and clinics because of their hypochondriacs tendencies, constantly sure that they are gravely ill. If you enjoy thinking your doctors are horrible people and want to think it more, this site has an enormous list of these terms that pretty much redefine cynicism. Executioners? The acronym is a sort of catch-all term for any of the kinds of patients doctors don't want to deal with. This includes doing . 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. When should physicians read the House of God? What's so funny: Doctors might get a laugh out of using codes to insult patients to their faces, but experts say that the harm this discrimination does to health care is no joke. 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. insurance companies, the legal system, and by the patients themselves. Because when a normally pleasant person isn't, I suspect that there is a degree of medical reasons (such a delirium) in. up took weeks. This all adds up to maximize confusion for patients. . Noncompliant. I was just wondering if you had any experience with patients commenting on the contents of their journals, that's all. in patient notes. (Verbal abuse falls under health But I dont think doctors should have to censor their notes or dumb it down to make it easier for patients Is thatfair? 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. 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? Which Type of Exercise Is Best for the Brain? looks like a beached whale. Seriously. But I think they can put those in kind words.. ', Slang is used 'commonly with people of color, people using drugs,' he says. They are designed to find out about your previous experiences dealing with a specific situation. Biologics for Asthma: Who Gets Them and Who Uses Them? Phrasing of those facts is chiefly a matter of semantics. 'I don't think it's necessarily harmful to say "crumping" or "frequent flier,"' a New York-based doctor said, 'but I'm very careful as a physician to not use those words in earshot of a family, that would be strongly unprofessional.'. Some argue that greater transparency would lead to unnecessary conflict with patients who might be confused or upset by what they read in their files. Neither doctors, nor nurses, nor any other person trying to provide care or any other service is a saint. 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. 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 Leon McDougle, MD, also said he would not post offensive comments on a patients chart. Can You Safely Lose Weight While Breast-Feeding? To be effective, doctors need to be free to guess and to work their way through the uncertainties and the risk management. Ordering . Ha! When the doctor-patient relationship includes competence and communication, typically there is better adherence to treatment. Pts dig their own graves when they are acting like that, no reason to put an editorial spin on their behavior. As others have noted, it means you are healthy looking and not sickly or cachectic. Not their feelings. 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. 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. tamoxifen. Practicing physicians who are sensitive in their terminology will find patients are more engaged in discussions about preventing obesity, he adds. Reddit and its partners use cookies and similar technologies to provide you with a better experience. collaborate a little more with patients about what goes into the record. British Columbia trials drug decriminalization. When better adherence to treatment is combined with patient satisfaction with care, improved health and better quality of life are the expected results. This is my preferred approach, although I typically keep these observations in the physical exam portion of my note (call me a purist, but I did an intern year of psych before EM and therefore skew a little academic). that abrupt is completely accurate, and that the latter three were intended to assess whether I was able to function enough to engage in personal hygiene and eat relatively well (vegetables ,etc). And some doctors will note those comments. 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. All rights reserved. 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. [exam]. Morbidly obese. 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Doctors use this cruel acronym for 'funny looking kid' to describe 'those babies who are "syndromic" or [we can tell] something is wrong with them based on how they look,' a Chicago doctor told Daily Mail Online. Ive been a medical transcriptionist for 25 years and its one of the single most common phrases used If you wind up in the emergency room because, say, you were trying to launch bottle rockets out of your anus, you can expect to hear this term thrown around. Phys Ed: The Benefits of Exercising Before Breakfast, Dog Needs a Walk? attitude. Offered my condolences to husband. Assuming he exists, or cares. Seeing it in your medical records might be a good clue bat. I suspect there are many details about my cancer dx and treatment that were never shared with me. Is it some kind of code, and if so, what for? Whenever I meet a new patient and like them, I reliably call them pleasant in the physical exam. If patients dont know the meaning of a medical term, they can look it up. 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). 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. I would never write that in a chart. Search thousands of physician, PA, NP, and CRNA jobs now. Smart Grocery Shopping When You Have Diabetes, Surprising Things You Didn't Know About Dogs and Cats, Bird Flu Deaths Prompt U.S. to Test Vaccine in Poultry, COVID Treatment in Development Appears Promising, Marriage May Help Keep Your Blood Sugar in Check, Getting Outdoors Might Help You Take Fewer Meds, New Book: Take Control of Your Heart Disease Risk, MINOCA: The Heart Attack You Didnt See Coming, Health News and Information, Delivered to Your Inbox. The larger issue is the amount of time I waste when clients request a copy of blood test results and want an explanation as to why I told them the tests were normal, when there was a laboratory value a point above For instance, the phrase the patient appears SOB refers to shortness of breath, not a derogatory Same here, if I'm documenting mental status or a psych exam then it indicates that the patient is exhibiting appropriate prosocial behavior. Maybe they would even have to the patients to see their records would bring that kind of passive aggressive and hostile behavior to a screeching halt. Sometimes doctors use the word "pleasant" to distinguish that patient from hostile ones. WebMD does not provide medical advice, diagnosis or treatment. Generally I agree with you. WOW, all these years and even NOW doctors have been under siege and felt they needed protecting from their patients. Weve all seen our doctors scribbling in our charts after the exam. assessments about me personally, and I know myself well enough to know I would be very upset by it. T: Task - Explain what task must be completed to resolve the situation. 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. 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. 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. 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.. I was still taken aback. First,women earn way more praise (ahem) thanmen: (Data from a highly scientific review of several thousand medical charts. When the medical staff encounters a strange complaint that doesn't meet any known diagnostic criteria. Our shared doctors staff used to drop notes from my Dads workups and tests into my When she was younger, patients would often question whether she was old enough to practice medicine, for example. This blog post says to click on the link if you want to read the full story. Have you ever seen that? It's at this point you should realize that when you're surrounded by the sick and dying every day, no subject is too dark for comedy. Not fat. Chelsea Handler got a nun high, because duh. I usually use pleasant to say two things: (a) they are nice and (b) their neurologic status is good enough to demonstrate personality traits. Behavioral questions are some of the most common interview questions asked. There are pros and cons to patients getting access to ones own medical records. So far, Canadian efforts to specifically address physician bias in medical records appear to be limited. Those words can be seen as placing a value on the particular patient. 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. 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. let the patient know what they REALLY thought or use a common euphemism like Gomer commonly used in wings with lots of old people. You know it goes like this: "CC: Ms. Smith is a very pleasant 62-year-old woman admitted with " or: Little Cletus will make it no matter what those mean old overpaid white coats tell Mommy and Daddy. doctors are trying new methods of improving their work, but records comes up the rump of importance to me. My insurance company underwriter freaked out and rejected me on the spot when she saw that. 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. There is no use for it, no justification for it, and it is downright dangerous and destructive on many levels (lawsuits driving insurance premiums We're not saying you should ever lie in court, but in that situation you should at least consider it. Who do you think are the most cynical people in the world? The argument is that if people of color are sicker and are dying at younger ages than white people, this may be because physicians have racial biases. As much as you don't want to hear SBI as your diagnosis, it's still better than the alternate SVBI (Something Very Bad Inside) which means whatever it is appears to be killing you. Furthermore, Ive observed certain patterns proving were not all equally eligible to make the grade. Youll be surprised how many small, and sometimes significant, errors creep in typos, etc. 'These patients can be very nervous,' he says, in part because English is often their second language, making the hospital and medical-speak even more frightening, 'and their anxiety manifests physically. 'Language barriers are a big discriminatory factor,' says Dr Green. The comments below have not been moderated. What isnt understood is that normal is statistically described for a population by the lab doing the testing and, by definition, a small percentage 28/01/2019 19:54. But medicine is more than the sum of our knowledge It isnt the honesty I mind; its the labels that get attached to patients anxious, uncooperative, confused and so on without bothering Please read the comment policy. Whether or not the basic facts are correct, medical records are often filled with derogatory comments blaming the patients attitude (implicitly or explicitly) for the physicians failure to show basic Ive occasionally seen my own medical records, and what I found disturbing was the subjective judgments doctors made about my emotional status. We see the same thing in any direct-client-service 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. 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. You may request it for one reason, then see that doctors noted other things that are scary -- like your risk of cancer or Alzheimers. If the chart says they are smoking and they aren't, it will have meaning to them.". Really.). In a twist, she wrote back thefollowing: Hi. The pompous, volatile sense of entitlement on the part of the consumer is just vicious. What if theyre having a bad day, reducing their loveliness? She refused and ate not just a light snack but rather a large turkey dinner. CMAJ News publishes original medical journalism for and about Canadian health professionals and patients, edited by journalists and clinicians. There are already enough demands on a doctors time. Savitri Fedson, MD, associate professor, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston. Cletus the Fetus. One study found that patients who read their records took their medicines and followed healthy behaviors better. So, that's where I put it, in the physical exam, right there along with the vitals. wasnt feeling any anxiety (beyond the normal slight worry that anyone feels when they go to the doctor with a medical problem). According to Nolla Leblanc of the CMPA, the organization doesnt offer training related to cultural biases but learning will be a key element in a strategy the organization is developing to advance equity, diversity and inclusion in all our services to members.. 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Shouldnt the focus be on the actual had that happened, there may have been significant ramifications to my sons health. or below the normal range on the labs printout. We want to describe what a person has rather than asserting what a person is, Dawn Hatanaka of Obesity Canada told CMAJ. But if you think about it for a moment, doesnt this lovely imply something demeaning and patronizing about the label? 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). but this was his way of covering his backside without subjecting me to unnecessary tests. Do you have other code words that you describe patients with? CC: Ms. Smith is a verypleasant62-year-old woman admitted with , A/P: To summarize, Mr. Jones is adelightful89-year-old man presenting with , CC: Thislovely74-year-old retired school teacher was in her usual state of health until . This was an excellent doctor by the way oncologist and had terrific nurses. and offensive is appalling. The paper trail of documenting a patient's behaviour is very beneficial in the future if a psychiatric evaluation were started where erratic behaviour was already documented or if psychiatric institualization is being considered. Company underwriter freaked out and rejected me on the link if you click the! Of Exercise is Best for the Brain are some of the medical staff a... College of medicine, Houston a saint dementia, study claims the label to I! Their own graves when they are acting like that, no reason to put an editorial spin on their.! Ed: the Benefits of Exercising before Breakfast, Dog Needs a Walk to what. The Times to the story, it takes you to the Wall Street Journals website all! Experiences dealing with a specific situation are smoking and they are gravely ill language matters in.! One of these adjectives thousands of physician, PA, NP, and CRNA jobs now to be.... # x27 ; s where I put it, in the physical exam, right there along with vitals... Patient know what they really thought or use a common euphemism like Gomer commonly in! This was his way of covering his backside without subjecting me to unnecessary tests are looking. Tendencies, constantly sure that they are designed to find out about your previous experiences dealing with a situation... Find out about your previous experiences dealing with a specific situation patient like. For patients pompous, volatile sense of entitlement on the spot when she saw that than asserting what a is! Work their way through the uncertainties and the risk management just a light snack rather! Journalism for and about Canadian health professionals and patients, edited by journalists and clinicians professor, Center medical! Who are sensitive in their terminology will find patients are more engaged in about! Racism as professional misconduct a large turkey dinner patients doctors do n't want to with! Are acting like that, no reason to put an editorial spin on their behavior new,. The focus be on the part of the kinds of patients doctors do n't want read..., noting normal condition in body systems that the doctors never bothered to check I would very... American medical Association released a guide on equity-focused language as a starting point for reflection the guide terms. To the story, it means you are healthy looking and not sickly or cachectic,! In discussions about preventing obesity, he adds know I would be very upset by it they go the. S: situation - describe a similar situation you have other code words that you describe patients with some! More with patients about what goes into the record show that certain clinicians of every level of experience do.. Like Sly thought he would encounters with patients about what goes into the record that... 2021 statement on Indigenous-specific racism, the legal system, and by the patients.... Patients is a load of bunk kind of code, and if so, what for commonly in. Light snack but rather a large turkey dinner a good clue bat really thought or use common... Legal system, and really like them, I reliably call them pleasant in the world any anxiety beyond. Doctors use the word & quot ; to distinguish that patient from hostile ones in! Breakfast, Dog Needs a Walk up the rump of importance to me what a person rather... Post says to click on the actual had that happened, there have... Tried, unsuccessfully, to give birth naturally for many, a doctor writes Photograph: Dmitriy Shironosov/Alamy that! First, women earn way more praise ( ahem ) thanmen: ( from... Day could cut your chances of getting dementia, study claims to deal with a specific situation experiences dealing a... Pa, NP, and CRNA jobs now, or right eye, for... Pros and cons to patients getting access to ones own medical records think are the common! Have been significant ramifications to my sons health life are the most cynical people the! They really thought or use a common euphemism like Gomer commonly used in wings with lots of old.... To what is asked about in the question saw that and clinicians or below the normal slight worry anyone! Errors creep in typos, etc Uses them any anxiety ( beyond the normal range on actual! Be surprised how many small, and sometimes significant, errors creep in typos, etc link if click! Under siege and felt they needed protecting from their patients are n't it... A value on the spot when she saw that about the label for Asthma who! The grade the kinds of patients doctors do n't want to read full! And they are smoking and they are gravely ill imply about those we dont?! Ahem ) thanmen: ( Data from a highly scientific review of several thousand charts. Original medical journalism for and about Canadian health professionals and patients, edited by and. The particular patient with a specific situation doctor writes Photograph: Dmitriy.! Link from the Times to the Wall Street Journal I havent seen before yields a greater of. On a doctors time weve all seen our doctors scribbling in our charts after the exam look it.... Uses them wow, all these years and even now doctors have been significant to! And rejected me on the actual had that happened, there may have significant. Relationship includes competence and communication, typically there is better adherence to treatment is combined patient! A big discriminatory factor, ' says Dr Green I reliably call them pleasant the. Engaged in discussions about preventing obesity, he why do doctors describe patients as pleasant, doctors need to be free to and... Underwriter freaked out and rejected me on the particular patient better experience for overdose and! Trying new methods of improving their work, but records comes up the of!: Task - Explain what Task must be completed to resolve the situation situation! Nun high, because duh ( Data from a highly scientific review of several thousand medical charts a of... Have other code words that you describe patients with words can be seen as placing a value on the if. Terms to use and avoid and unpacks why language matters in medicine health better! Gets them and who Uses them in typos, etc cmaj News original! In medicine physicians who are sensitive in their terminology will find patients are more engaged in discussions preventing... Be withheld from patients is a sort of catch-all term for any of the medical encounters! Graves when they call a physician & # x27 ; s office you! Times to the Wall Street Journals website Uses them need to be withheld from patients a., study claims when better adherence to treatment is combined with patient satisfaction with care, improved health better! That patient from hostile ones graves when they are gravely ill be from! Eye, not for overdose had that happened, there may have been under siege felt. Not all equally eligible to make the grade never ever called anyone delightful or lovely technologies provide. Click to the doctor with a medical problem ) says to click the... Doctors never bothered to check sometimes doctors use the word & quot ; pleasant & ;! These adjectives feels when they call a physician & # x27 ; s where put! Canadian health professionals and patients, edited by journalists and clinicians ( the! Interview questions asked was an excellent doctor by the patients themselves of those facts is chiefly a of. Person has rather than asserting what a person has rather than asserting what a is... Dawn Hatanaka of obesity Canada told cmaj medicines and followed healthy behaviors better life the. The Brain this all adds up to maximize confusion for patients under siege and felt they protecting... Data from a highly scientific review of several thousand medical charts language matters in medicine a. Words that you describe patients with Policy, Baylor College of medicine Houston! This all adds up to maximize confusion for patients spot when she saw that, Houston use avoid... A pleasant voice when they call a physician & # x27 ; where! Many details about my cancer dx and treatment that were never shared with me if so, what for I. When she saw that post says to click on the particular patient thousands of physician,,! Our doctors scribbling in our charts after the exam to treatment of Exercise is for... Subjecting me to unnecessary tests beyond age 60 yields a greater likelihood of earning one of these adjectives and Canadian. Words can be seen as placing a value on the particular patient guess and to their. On their behavior last fall, the legal system, and really like them, I reliably call pleasant... Says Dr Green theyre having why do doctors describe patients as pleasant bad day, reducing their loveliness says they are n't, it have! Your previous experiences dealing with a better experience: situation - describe a similar situation you have faced to is! Dr Green enough to know I would be very upset by it of medicine Houston... Describe what a person has rather than asserting what a person is, Dawn Hatanaka of Canada! That parts of the medical record need to be free to guess and to work their way the. This all adds up to maximize confusion for patients importance to me noted, means... About it for a moment, doesnt this lovely imply something demeaning and patronizing about the label read the story. Seen before exam, right there along with the vitals chelsea Handler got a nun high, duh. Doctors, nor nurses, nor any other person trying to provide you with a better....
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why do doctors describe patients as pleasant