Friday, September 24, 2021
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Understanding Doctor’s Prescription

Once I went to a pharmacy with a doctor’s prescription.  While I could not crack the doctor’s ‘calligraphy’, the pharmacist got the name of the medicine right and commented sarcastically that the particular doctor used to prescribe only “this” medicine for the past 10 years, and told me not to worry. The doctor confirmed the medicine when I went to cross check.  I wondered whom to trust – the doctor or the pharmacist?

We used to joke that every bad handwriting resembled doctors’ prescription.  I bet that doctors do not on an average have worse handwriting than other professions, where most communications are typed. Also, doctors, while prescribing the costlier version of the medicine, often do not disclose to patients that variants of the same medicine are available at less than half the price.

The Institute of Medicine (IOM), an American NGO, reported that the untidy handwriting of physicians is responsible for 7,000 deaths a year. A study in New York (2010) found an astonishing 37 errors for every 100 paper prescriptions. An illegible prescription requires time to sort out with the doctor. In the case of urgent medication, the delay can result in patient discomfort.

As e-mail and texting have become our favoured means of written communication, handwriting has almost disappeared.  Yet handwriting persists in medical prescriptions and that’s unfortunate. Since the advent of modern medicine, doctors have gained notoriety for messy penmanship.  One explanation for this is that they are pushed to see too many patients within the appointment slot, and are therefore rushed when writing prescriptions.  Also, there is no incentive for beautiful handwriting!

I hope illegible writing is not a chapter taught in medical college. I know Shorthand as part of stenography. Is there any medical shorthand? I bet that doctors do not on an average have worse handwriting than other professions, where most communications are typed.

A local pharmacist tells me, “I don’t think all doctors have terrible handwriting. I must admit though, if a prescription looked too neat, I would get suspicious!” with a mischievous smile, adding that “doctors are the only adults who are forced to write their prescriptions themselves”.

Perhaps, a doctor is not writing for you to understand, but writing for a pharmacist who will know what he means. If you don’t understand a certain letter or a word in an average text, you can always infer by its context.  The inherent ability doesn’t work for medical prescriptions and the like.

From the patient’s perspective, illegible handwriting can lead to inappropriate dosage and a misread prescription can lead to mistreatment. As the patient is often not familiar with the jargon that is scrabbled in the prescription, the onus is on the pharmacist, who is tasked with the challenge of deciphering the content. In some countries like US, doctors are fined for illegible prescriptions.

Some doctors write prescriptions in an illegible manner, but write medical certificates clearly.  The same doctors will have rock steady hands when making a surgical incision. Could it be a medical ego that doctors write illegibly as a kind of secret code, to keep patients in the dark? Reading prescriptions take practice.  It is not something you can learn in school, because each doctor writes differently. Or their handwriting should be seen as a factor of medical intelligence?

Technology can ease this burden, as computers sooner than later would relay e-prescriptions directly to the pharmacy. While in US alone, 100,000 prescription errors occur every year, India does not have any such data.  Hope this issue ceases its value in contemporary time and becomes a part of history.  By the way, do female physicians write legibly?

 

(The views expressed by the author in the article are his/her own.)

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