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Why Do Doctors Write So Messy?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

This article originally appeared on page 15 in the June 7-8, 2003 issue of The Mississauga News under the feature: Health & Wellness, Doctor's Corner.

Almost 20 years ago, computers revolutionized the world. A new age in information management had dawned. Not so in family practice! Record keeping by computer is a logical but a very expensive proposition in an environment where there is no capital available for innovative ideas. The efficiency of a paperless office and electronic information exchange is still a dream to the average family doctor. Most doctors utilize computers for OHIP billing only. All charting is still done by hand, and all results arrive on paper. The binders of paper although thick are still the quickest method of information retrieval available to us. We resort to numerous short hand scribbles and notations to keep track of things, often at break-neck speed. Latin short-forms are still abundantly found out of convenience. I also incorporate small sketches. All in all this makes for what appears to be a messy notation, but shrinks a page or two of neatly printed notes into a few lines. Time necessitates this. Surprisingly, I have little trouble reviewing the notes of other doctors, but I can see how a lay person would.

One tip that I do offer all snowbirds, travelers and persons with multiple health problems is this: take the time to summarize your own health on a sheet of paper or better yet put it on a diskette. Most doctors have blank pre-printed information sheets for the asking. Make notes of past and current medical problems, medications, doses, names of specialists and their phone numbers, past health, hospitalizations, allergies, past surgeries and important information such as health and hospital numbers. At one time, the province was toying with the idea of a "smart card." In essence, your OHIP card would track your health information. For various reasons, another great idea died in the water. Handing a diskette or paper summary over to an emergency doctor or clinic physician will ensure that you receive a better quality of medical care. Time does not allow the detailed extraction of information from each new patient. Doctors will appreciate your effort and will happily review the information giving them a better perspective on your health. Diskettes can even have results and notes downloaded onto them for communication back to your own doctor.

Related resources:

Medspeak Terms. Use the alphabetical index to look up a medical term, from Deciphering Medspeak, Medical Library Association (MLA).
Rx Riddles Solved! - Definitions and meanings of medical "shorthand", i.e. "scribbles", used by doctors, pharmacists, and other medical professionals.

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