Legible Physician Handwriting - An Advocacy - A Legacy
I have been an advocate of legible physician handwriting since I started teaching residents in surgery residency program and medical students in medical school (circa 1982).
Legible physician handwriting is important because it promotes better communication among physician-to-patient, physician-to-physician, and physician-to-other-health professional.
Legible physician handwriting is most important in promoting SAFE patient care.
Legible physician handwriting reflects personality (particularly in terms of professionalism and compassion) of the physicians. If a physician is professional and compassionate enough, he / she would ensure his / her handwriting will be legible so as to prevent any difficulty in deciphering what he / she writes by a reader; to avoid miscommunication; and to promote patient safety associated with his / her handwriting.
I have written blogs on legible physician handwriting. I have made it as one of the screening parameters for students of Zamboanga Medical School Foundation, the school that I helped establish in 1994.
I don't claim to have the most perfect and the most beautiful handwriting in the world (or in the Philippines or in the surgical field). But I ensure that whatever handwritten notes or documents I made, they are LEGIBLE. This is my advocacy and a legacy that I leave and will leave behind.
I repost what I wrote before. But before that, here are samples of my handwritings.
Posted on January 22, 2017by reyojoson
Handwriting up to now is an essential requirement of communication unless a person has not learned (newborn up to toddler years) or has been incapacitated to write with his / her hands.
Despite the presence of information technology, promoting and facilitating digital writing, handwriting is still needed. Thus, every person must learn and continue to learn how to handwrite except for the situations mentioned above and he/she must do it legibly to achieve the goals of communication.
There is a cliché – you are what you eat. Translating, you are what you handwrite.
Handwriting brings out the personality and values of handwriter.
It demonstrates whether the handwriter is a caring person or not. He / she cares if he /she writes legibly to promote understanding of what he / she wrote. He / she cares if he / she writes legibly to promote safety of what he wrote (e.g. instructions and medical prescription).
It demonstrates conscientiousness or diligence in making the reader understand what he / she wants to convey. As one writes, one has to make sure each letter of a word is legible. Legible letters contribute to legible words. Legible words contribute to legible handwriting.
As one writes each letter of a word, he / she has to look whether it is legible or not. If not, he / she has to go back to the letter to make the necessary corrections or adjustments to make sure it is legible.
Going back to correct or adjust to make a letter of a word legible consumes time, but doing do indicates the writer is conscientious. To save time from repeated corrections or adjustments, one has just to make effort to make sure each letter is legible from the very start by carefully crafting the round curves, dots, slashes, spaces, etc.
If need to do so for legibility sake, write letters and words in print form. However, just the same, make sure the printed letters are legible.
Handwriting skills and outcomes-based education
The Department of Education and the Commission of Higher Education are currently promoting outcomes-based education. One of the outcomes should be legible handwriting by all graduates. There must be course on handwriting and an effective assessment tool to make sure all Filipino graduates (starting at grade school) have acquired the competency of legible handwriting.
Physicians and writing
Physicians are known to have poor handwriting. They should take a course on handwriting. Their handwriting is particularly important on the safety of their patients, particularly in orders in the medical charts and prescription.
Some perceptions of patients on doctors’ handwriting
“I thought all the while you doctors are trained to do that kind of handwriting – illegible handwriting.”
“You write beautifully. You are not a doctor.”
Links to Previous Posts:
ROJ@17jan22
Posted on October 2, 2011by reyojoson
Physician’s Illegible Handwriting – An Acceptable Trademark or a Ban?
by Reynaldo O Joson on Friday, August 19, 2011 at 11:07am
In my practice of medicine, I often get comments and remarks from my patients on my handwriting in prescription pads; written explanations of their symptoms, diagnosis, and treatment; medical records; admitting orders; medical certificates; etc.
Latest was last August 16, 2011 by two patients and their relatives.
The comments and remarks usually consist of the following:
“Ang ganda ang sulat ninyo, doc.”(“You have beautiful handwriting, doc.”)
“Malinaw ang sulat ninyo, doc.” (“Your have clear and legible handwriting, doc.”)
“Hindi sulat doktor ang sulat ninyo, doc.” (“Yours is NOT the handwriting of a doctor.”)
“Bakit pangit ang sulat sa karaminahang doktor?” (“Why is it majority of the doctors have poor handwriting?”)
The newest comment that I got last August 16, 2011 was this and I was taken aback which prompted me to write this TPOR (thoughts, perceptions, opinions, and recommendations): “Akala namin sinasadya ng doktor ang pangit na sulat?” (“We thought the doctors intentionally come out with their kind of writing, poor handwriting.”)
Sad to say, the illegible handwriting of physicians has become a trademark for the medical profession and the Filipino community has come to accept this. A negative trademark at that!
Illegible handwriting of physicians is a RISK in patient management. It can lead to MEDICATION ERROR – wrong drugs being issued by the pharmacists because of illegible prescriptions; wrong drugs, dosage, and timing during administration by the nurses to patients as a result of doctors’ illegible orders in the medical charts; wrong dosage and timing by patients at home as a result of doctors’ illegible prescriptions and written instructions. It can lead to WRONG and DELAYED MANAGEMENT(outside medication errors) for patients admitted in the hospitals when the nurses are NOT able to interpret the doctors’ order correctly because of illegible handwriting.
Illegible handwriting of physicians is a TIME-WASTER for all concerned – patients, nurses, pharmacists, laboratory staff, etc. It is a time-waster as it will take more time to try to interpret the illegible writings as compared to legible ones. It is a time-waster because of the time consumed by the nurses, pharmacists, and other concerned persons to call up the physicians for clarification and verification because of illegible handwritten orders and instructions.
With just some potential risks mentioned above, physicians’ illegible handwriting is NOT an acceptable trademark. It should be a ban.
In 2004, when I was helping Zamboanga Medical School Foundation established a new medical school, I recommended that one of the criteria for admission to the school is competency to have legible handwriting. We used the handwritten essays accomplished by the applicants in the assessment of the said competency.
Opinions:
For me, physicians’ illegible handwriting should be a ban. The perception of it being a trademark should be erased.
Recommendations:
For the medical schools and other medical training programs, I recommend including competency to write legibly as one of the criteria in accepting applicants and to provide training for legible handwriting. The latter is part of the MEDICAL TRAINING INSTITUTION’s DUTIES AND RESPONSIBILITIES!!!
For the physicians, I recommend for the sake of the medical profession (to erase the negative trademark) and of the patients (to promote safety), to always write legibly their prescriptions and medical orders and instructions. I recommend printed writing if it is difficult to come out with legible long-hand writing. [If certified physicians cannot come out with legible handwriting, institute all possible measures to ensure the prescriptions and medical orders and instructions can clearly be read such as asking an assistant to write, using computers, etc.] This is part of PHYSICIAN’S DUTIES AND RESPONSIBILITIES!!!
For the patients, I recommend proactively requesting physicians to write legibly, particularly the prescriptions and the medical instructions, that they will be receiving from the latter. Always READ the prescriptions and the medical instructions given and ALWAYS ASK, if clarification and verification are needed. This is part of PATIENT’s RIGHTS!!!
Posted on July 19, 2015by reyojoson
Two Parameters for Legible Handwriting in the Medical Setting
Handwriting is a communication activity that we cannot escape doing unless our hands are crippled to the point that we cannot write.
Even with the presence of typewriters, computers and information technology, we cannot avoid doing handwriting. We hand write to issue checks. We hand write to send short messages. We hand write on the charts of patients. We hand write our records of surgical operations. We hand write on the outpatient records of our patients. We hand write our prescriptions. Handwriting is here to stay.
Handwriting is a communication activity. Thus, handwriting should be legible.
Legible handwriting is a handwriting with message or messages clear enough to be read and to be deciphered.
Before, I used only one parameter to determine legibility of handwriting, the formation of the letters. I tried to read and decipher the letters that comprise a word. If I can read and decipher all the letters that comprise all the words in the message, then I say the handwriting is legible.
Recently, I discovered another parameter for legible handwriting, the size of the letters and words. The size should be big enough that one can easily read and decipher all the letters that comprise all the words in the handwriting at a distance of one foot.
Below are examples of legible and illegible handwriting based on the two parameters,formation and size of letters and words.
Note the difference in handwriting legibility secondary to size of the letters and words.
Note the difference in handwriting legibility secondary to size of the letters and words.
Note the difference in handwriting legibility secondary to formation of letters and words.
Note the legibility of the handwriting because of proper size of letters and words.
Note the legibility of the handwriting because of proper formation of letters and words.
ROJ@15jul19
ROJ@18nov20