Tuesday, January 08, 2013

Annoying habits in the medical record

Here are some of Dr. Herb Fred's pet peeves. A couple of my favorites:

Many consultants from various disciplines routinely end their reports with, “Thank you for allowing me to participate in the care of this most interesting patient.” What is the difference between an uninteresting patient, an interesting patient, and a most interesting patient?7 The answer, like beauty, lies in the eyes of the beholder. In my eyes, all patients are interesting, but not all doctors are interested.8 A simple “Thank you” or “Thank you for this consultation” would be sufficient and devoid of insincerity and cliché.

Finally, “The patient is ‘satting’ at 88%.” This expression of the patient's oxygen saturation level crops up frequently, not only in hospital records, but also in Morning Report, teaching rounds, and doctors' lounges. Patients can sit or be sitting, but they can't sat or be satting. To sat is not a verb form. It's a neologism—arguably the most popular neologism in medicine today. House officers are particularly fond of it, uniformly include it in case presentations, and consider it the 5th vital sign.9 Unless teaching faculties consistently prohibit its use by all trainees, “satting” will continue to saturate the medical environment.

I would add that those fond of the term “satting” are not only grammatically incorrect but also tend to be confused about the physiology of oxygen transport.

Dr. Fred opens:

This editorial focuses on selected examples of bad habits that I have found repeatedly in traditional (paper) hospital records.

Well, Dr. Fred, it only gets worse in the electronic medical record.

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