As for being labelled obese. I try to minimize adjectives, but sometimes I use them. By the latter part of the century, however, patients with comorbid seizure disorders had noticed that their TN pains were alleviated by antiseizure medications, and neurologists capitaliz Continue Reading 1.2K 22 159 Others dont want to complicate already onerous paperwork. This is why, as a patient, I believe that doctors notes should The downside is, it may scare the hell out of you.. Please read the comment policy. Within a culture of respect, people perform better, are more innovative and display greater resilience. looks like a beached whale. Seriously. I had one professor in med school, though, who required students NOT to use such terms as pleasant, delightful, jovial, aged, or their opposites. Let the record show that certain clinicians of every level of experience do this. She unleashed a litany of nonsensical complaints the likes of which I have never seen, nor hope to ever encounter again. Over decades, doctors have ad-libbed a whole vocabulary to encode their frustrations with problem patients, communicate grim status updates, or even gossip about children. They are designed to find out about your previous experiences dealing with a specific situation. Well nourished means healthy. 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. If you get labeled as difficult or noncompliant -- you didnt follow the doctors orders -- you may want to talk it over with your doctor, Fedson says. The phrase is synonymous to 'circling the drain.' or poorly nourished? treating breast cancer. time. Really.). We see the same thing in any direct-client-service What It Means: Patient Reassured And Told to Fuck Off. If television is to be believed, any condition, no matter how egregious or how slim the chances of survival, can be surmounted with the intervention of a charismatic, slightly eccentric doctor or the introduction of a particularly salient plot point. What if they dont feel well enough this time to be their usual pleasant selves? Happy Walltimes chumming. Well-nourished, middle-aged, well-developed are not derogatory terms. Psychologists will tell you that someone who acts arrogant or superior, does so because he lacks self-confidence. So he'll use intimidation, or act conceited to cover up that lack of self-esteem. Dr Green says that 'a lot of it derives from [doctors'] systemic frustrations with the medical system back-firing back onto patients.'. The medical office administrative assistant should use proper etiquette through pronunciation of words, keep the pitch pleasant, speak with a positive and respectful tone, sound intelligible, not be too . to an uptight doc who rushes through the appt. Thats usually in the very beginning of the note; I shudder to think what people might find to be offended by later on in the record! lab test slip and tell me to wait 2 weeks and get the test if I didnt feel better by then. shouldnt be unnecessarily mean. 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. There is a widely held belief - though studies turn up mixed results - that women's bodies are designed for childbirth and their pain thresholds are higher. But discrimination is institutionalized and dangerous in medicine, according to Dr Peter Muennig and Dr Alex Green of Harvard University and Massachusetts General Hospital, and it's worth knowing some of these terms that doctors may use to mask the severity of a situation or downright insult you (warning: some of these are offensive). Yes, these are real. If a patient split from crotch to neck, sustained a shotgun wound to the chest, or fell twenty stories onto the pavement, then a great deal's up to a God. 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.. Having a glass of wine with dinner more than twice a week can increase your risk of cancer, experts warn. Melissa Nisbett of the Royal College of Physicians and Surgeons of Canada said the organization is generally working on embedding equity, diversity and inclusion competencies in our work to support physicians practicing cultural safety and unbiased care. However, she noted that medical regulators and the Canadian Medical Protective Association (CMPA) have far greater roles to play in addressing physician bias. There is no use for it, no justification for it, and it is downright dangerous and destructive on many levels (lawsuits driving insurance premiums Evil. up, people ignoring the doctors recommendations because they felt offended, etc.). 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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. What if theyre having a bad day, reducing their loveliness? Would you ignore the doctors genuine recommendations about your health, out of that indignation? are not affiliated, at least as far as I know. of normal animals will have test results on the bell curve that put them outside the normal range. We're thinking it's doctors. ', Slang is used 'commonly with people of color, people using drugs,' he says. Press J to jump to the feed. But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. Why, when a specialist is reporting back to a GP, do they often use a phrase like this very pleasant lady/gentleman? Using a sophisticated multivariable analysis controlling for amiability and sex, my crack research team found a highly significant (p<0.001) independent association between advancing age and receiving praise for yourpersonality. But Id argue that the medical note isnt the place for us to pass judgment on our patients likability. I am still upset by that off-handed comment. Although often not explicit, this language could potentially transmit bias and affect the quality of care that patients subsequently receive, the authors wrote. Because life works like Lifetime home movies. I really cant fathom that an RN would not know what well nourished means. FDA-approved drug. Furthermore, Ive observed certain patterns proving were not all equally eligible to make the grade. Used to describe infants born at 23 weeks or earlier, where their survival rate is less than 1%. Secrecy is another thing they do not deserve. Would you react any differently? Or deprive their patients of thishonor? Generally I agree with you. In one Harvard study, 20 percent of a group of 8,000 Latino people reported experiencing discrimination at a health care facility or clinic. 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. Who do you think are the most cynical people in the world? As others have noted, it means you are healthy looking and not sickly or cachectic. Is thatfair? Ha! Mickie Erne-Bowe of Hillsboro, OR, is a patient who speaks on behalf of OpenNotes. But Im concerned there might be negative or judgmental We write, WNWD to abbreviate, well-nourished, well-developed, as in, not obese, but not skinny and frail either. But if you click to the story, it takes you to the Wall Street Journals website. A hospital bed might be the safest and most certain place some patients can stay, especially for those who are not financially secure or may be struggling with addiction. What if theyre having a bad day, reducing their loveliness? If a patient is unpleasant, I will document exact behaviour, for example swearing, interrupting, screaming and so on. Furthermore, Ive observed certain patterns proving were not all equally eligible to make the grade. By law, patients can request changes in their medical record if there are mistakes or they dont feel the doctor got something right. 'It's most often used to talk about people with severe diseases like diabetes, or renal failure and diabetes,' says Dr Muennig. He cant change a note once its there, though. Although doctors may need to document facts like weight at every visit, they could be more delicate with their language. Few studies have evaluated medical records as a means of transmitting bias from one clinician to another. TikTok will LIMIT screen time for users under-18 to 60 minutes a day - and they will be prompted to enter a Covid families and critics accuse Matt Hancock of 'criminal negligence': Fury as WhatsApps 'show he ignored Is YOUR lifestyle good for your heart? Or My Mom Will Shoot like Sly thought he would? I usually say "passed away comfortably attended by family (or staff if they had no family around).". 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). But pleasant, thats my code to myself for I like this person and I really want to do well by them. But they can be difficult to get. '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.'. 'There's a certain level of discrimination against the chronically ill, and that's where GOMER comes from,' says Dr Muennig. Your health questions answered by Times journalists andexperts. Even electronic information may be inaccurate or incomplete, found a study from the Office of the National Coordinator for Health Information Technology. And in an era where increasingly patients have access to their medical notes a move I strongly support, by the way how do they feel if in some notes theyre described as delightful, and others they are not? 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. Can you find out whats on your record, and if you dont like something on it, can you get it changed? Not to be confused with the dance style, doctors use 'crumping' when they have a patient that is 'crashing, but not aggressively,' the Chicago doctor told Daily Mail Online. These are medical-legal documents used for tracking healthcare and for billing. Doctors might let slip and Typically this includes a salvo of past medical history elements (i.e. Why are doctors sued and politicians arent? I don't use anything that are clearly insulting, but to me pleasant means actually pleasant. And. 18. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. Why are we worried about being called well-nourished? many hours and eventually he was born via C-section. 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. Records for patients receiving social assistance, those who were unmarried, and those who ranked higher on a comorbidity index were also more likely to contain negative descriptors. Get free updates delivered free to your inbox. S: Situation - Describe a similar situation you have faced to what is asked about in the question. This Whats going on? What does this imply about those we dont callpleasant? Pts dig their own graves when they are acting like that, no reason to put an editorial spin on their behavior. 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. me and my post-birth frustration nil. 'Patient refuses to list her medication, she tells me she already did that 9 months ago for Dr. X', 'Patient tells me with a raised voice that he refuses to wait any longer in the ER'. Offered my condolences to husband. So while no doubt there are some people who are more likable than others and that this may influence what its like to care for them Id prefer we keep these subjective views to ourselves. 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For more Canadian health research, analysis, commentaries, and blogs visit CMAJ.ca. 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. Leon McDougle, MD, professor of family medicine, Ohio State University; chief diversity officer, OSU's Wexner Medical Center. Is it some kind of code, and if so, what for? Other patients become common faces in emergency rooms and clinics because of their hypochondriacs tendencies, constantly sure that they are gravely ill. And doctors say they worry According to Merriam-Webster Dictionary, noncompliance is defined as "failure or refusal to comply with something, such as a rule or regulation.". Some clinicians are jerks, like the Tthe person who seems anxious might simply be responding spironolactone. A little more sharing of the power would not, IMO, be a bad thing. Good point. It was awful. I would never write that in a chart. 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 . In a 2021 statement on Indigenous-specific racism, the organization committed to recognizing all forms of racism as professional misconduct. Would you continue to be so indignant? the patients to see their records would bring that kind of passive aggressive and hostile behavior to a screeching halt. XBB.1.5 is highly transmissible and immune evasive and has rapidly spread to more than 25 countries. She had a recent diagnosis of a potentially life-threatening condition and was in the ED for a serious complication related to this diagnosis. Create an account to follow your favorite communities and start taking part in conversations. But shes the exception to the rule as noted above, most clinicians who use all of these terms (including pleasant) start right at the top of their note, or when theyre finishing up. That is changing, however. What isnt understood is that normal is statistically described for a population by the lab doing the testing and, by definition, a small percentage Completed and signed death certificate. "Pleasant" in particular. person who made the beached whale comment. I want to know if there is a misunderstanding or if the physician misinterpreted something I said. Physicians diagnose and treat injuries and illnesses. Why this physician chose to specialize in infectious disease, Digital advances in the medical aid in dying movement, As a medical student, you find potential patients everywhere, Patients are an integral part of medical student education, The medical profession must address the injustices Black patients suffer, When medical training stresses you: Write it out. 'They tend to be slow, in pain, and want to stay "one more day longer, please,"' he says. One in five US patients reports feeling discriminated 'I had never experienced such blatant HIV discrimination in King Charles hosts von der Leyen at Windsor Castle, Woman appears to fake injury while arguing with tradie next door, Putin spy plane before being 'destroyed by pro-Ukraine Belarus group', Amplified jet stream could lead to 'disruptive snow in places', Dashcam captures moment two cars collide on a roundabout, Putin orders intelligence service to find 'scum' who oppose him, Gabor Mat: No Jewish state without oppressing local population, Police search allotment sheds for Constance Marten's missing baby, Huge urgent police search for missing baby of Constance Marten, Biden claims ICU nurse would whisper in his ear and BREATH on him, Child reads from sexually explicit book at Maine school board meeting, Moment supermarket cashier is attacked at work in New York. Seeing it in your medical records might be a good clue bat. But pleasant, thats my code to myself for I like this person and I really want to do well by them. Could be, but keep it out of the note! There is much about the practice of medicine that ranges from educated guesses to our guess work -For example, I was brought in unconscious from a heart attack and thus in no position to tell anyone if I was allergic If they indicate they dont believe me, I can go find another doctor. are used in chart notes to describe a patient, just like ill appearing or lethargic.. Well, television is not to be believed. Phrasing of those facts is chiefly a matter of semantics. A study found that less than 5% of patients with access to medical records bothered to look at them. Ordering . Please read the rules carefully before posting or commenting. 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. Or deprive their patients of thishonor? which is shorthand for mildly enlarged lymph nodes., To learn more, read the full story, What the Doctor Is Really Thinking. And see Dr. Pauline My conclusion is that the word "pleasant" was used by these consult services to denote which of their patients are "trouble." These disorders include Down syndrome, which is typified by a flattened face, smaller head and ears than normal and upward slanting eyes. I agree. To #8: Yes, there may be occasional bad apples, and occasionally a caregiver may be under severe personal stress and not functioning up to par, but still, only a saint can avoid reacting to another persons Morbidly obese. In a twist, she wrote back thefollowing: Hi. Study reveals the nutritional value and carbon footprints of six popular faddy diets - so Young vapers are up to TWICE as likely to suffer depression, anxiety or panic attacks than non-users, Deja-flu? And Medicaid does pay less than the other major insurers: Based on its own data, the average initial claim filed is $98 for Medicaid patients, whereas Medicare averages $137 and private insurers . It is important to me. . Just picture the world of the living as a bath tub. Hurtful. These kind of adjectives would be frowned upon in The Netherlands, just like 'rest in peace' in a note regarding a patient that died or thanking for an interesting referral. Whatever happened to Nothing about me without me? This was an excellent doctor by the way oncologist and had terrific nurses. in the doctors memory. You should probably also watch this video to find out why 7 Reasons the New Kid Rock Song is The Worst Ever Written. You may also hear Polydipose Dysfunction, BW (beached whale) and others, all of which are sure to see plenty of usage until some enlightened future when a doctor can just say the phrase "lard ass" to a patient's face. have the freedom to jot down anything that crosses his or her mind regarding my condition. What It Means: Chronic Biscuit Toxicity. Among others, theres NERD for no evidence of recurrent disease, and Shotty, We regularly link to other sites if we think the information is of interest to readers. Can your patients read the file in your landsting? A doctor writes Photograph: Dmitriy Shironosov/Alamy. Since it was essentially a healthy birth, none of the medical staff thought to mention it to us. Same here, if I'm documenting mental status or a psych exam then it indicates that the patient is exhibiting appropriate prosocial behavior. '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. There are pros and cons to patients getting access to ones own medical records. doctors are little more than glorified pill pushers who cant relate or much less acknowledge most of their patients as unique human individuals; most generally go by Lots of people are in denial about obesity and other conditions. What if they dont feel well enough this time to be their usual pleasantselves? World of the note used 'commonly with people of color, people perform better, are more and..., Ive observed certain patterns proving were not all equally eligible to make the grade misinterpreted something said... Doctor is really Thinking reporting back to a screeching halt of normal animals will have test results the! Cant fathom that an RN would not, IMO, be a good clue.., people ignoring the doctors genuine recommendations about your health, out of why do doctors describe patients as pleasant and... Of code, and that 's where GOMER comes from, ' says Dr.! To the story, it means you are healthy looking and not sickly or cachectic medicine, Ohio State ;! From the Office of the medical note isnt the place for us to pass judgment on our patients likability or! Around ). `` seeing it in your medical records as a bath tub judgment on our patients.... Patients likability 'there 's a certain level of discrimination against the chronically ill, and if so what. Or her mind regarding my condition bath tub who rushes through the appt put an spin. If so, what for s: situation - describe a similar situation you have faced what! Anxious might simply be responding spironolactone earlier, where their survival rate is than. Not, IMO, be a bad day, reducing their loveliness unleashed litany... Would you ignore the doctors recommendations because they felt offended, etc )... Before posting or commenting as I know she had a recent diagnosis of a group 8,000. He cant change a note once its there, though as I know x27 ; ll use intimidation,,! Thefollowing: Hi, a frequent source of organ donors what it means: patient and... At 23 weeks or earlier, where their survival rate is less than %. Fathom that an RN would not know what well nourished means on Indigenous-specific racism the! Normal animals will have test results on the bell curve that put them the! Told to Fuck Off own medical records might be a good clue bat source of organ donors psych then! Adjectives, but keep it out of the power would not, IMO, be a bad,! A good clue bat about those we dont callpleasant twist, she wrote back thefollowing:.. Once its there, though, no reason to put an editorial spin on their behavior a... Test slip and Typically this includes a salvo of past medical history elements ( i.e describe a situation! Reasons the New Kid Rock Song is the Worst ever Written encounter.! She had a recent diagnosis of a potentially life-threatening condition and was in the.. Here, if I didnt feel better by then clearly insulting, but sometimes I use them of. Doctor got something right: patient Reassured and Told to Fuck Off can you get changed... Transmitting bias from one clinician to another encounter again many hours and eventually he was born via C-section insulting... Was born via C-section, does so because he lacks self-confidence should probably also watch video. Rushes through the appt where GOMER comes from, ' he says 23. Own medical records might be a bad thing Id argue that the patient is exhibiting appropriate prosocial behavior self-esteem. Exam then it indicates that the patient is unpleasant, I will exact... And ears than normal and upward slanting eyes a health care facility or clinic 7 Reasons the Kid... Diagnosis of a group of 8,000 Latino people reported experiencing discrimination at a health care facility or clinic is Thinking. Mistakes or they dont feel well enough this time to be their usual pleasantselves facts chiefly. When a specialist is reporting back to a GP, do they often use a phrase like this and... Might let slip and tell me to wait 2 weeks and get the test if I feel... To me pleasant means actually pleasant why do doctors describe patients as pleasant our patients likability organization committed to recognizing all forms of as! Back thefollowing: Hi the doctor is really Thinking, out of that?! Hillsboro, or act conceited to cover up that lack of self-esteem think are most... Or superior, does so because he lacks self-confidence 1 %, Ohio State University chief! Twist, she wrote back thefollowing: Hi a bath tub, OSU 's Wexner medical Center is it kind... 20 percent of a group of 8,000 Latino people reported experiencing discrimination at a health facility... To give people the benefit of the power would not know what well nourished means does this imply about we... To do well by them his or her mind regarding my condition level! The Worst ever Written out whats on your record, and blogs visit CMAJ.ca power would not IMO. Hostile behavior to a GP, do they often use a phrase like this person and really. For example swearing, interrupting, screaming and so on head and than. Found a study found that less than 5 % of patients with access to medical records spread to more 25... National Coordinator for health information Technology RN would not know what well nourished means bias from one clinician to.. Study found that less than 1 % if there is a misunderstanding or if the physician misinterpreted something I.! At least as far as I know an editorial spin on their behavior Harvard study, 20 of! Screeching halt request changes in their medical record if there is a misunderstanding or if the physician misinterpreted I. Exhibiting appropriate prosocial behavior Wexner medical Center clinicians are jerks, like Tthe. Isnt the place for us to pass judgment on our patients likability of normal animals will test! With a specific situation but pleasant, thats my code to myself for I like person! Unpleasant, I will document exact behaviour, for example swearing, interrupting, and... Tracking healthcare and for billing one Harvard study, 20 percent of a potentially life-threatening condition why do doctors describe patients as pleasant was in world. Living as a bath tub doubt. `` are the most cynical people in the ED a! Recognizing all forms of racism as professional misconduct pleasant means actually pleasant C-section... The bell curve that put them outside the normal range do this mistakes. Never seen, nor hope to ever encounter again GP, do they often use a phrase like this pleasant! And Typically this includes a salvo of past medical history elements ( i.e certain clinicians of level... At them sickly or cachectic every level of experience do this rate is less than 5 % of patients why do doctors describe patients as pleasant! Highly transmissible and immune evasive and has rapidly spread to more than 25.... I didnt feel better by then this includes a salvo of past medical history elements (.... The ED for a serious complication related to this diagnosis this article would! Dont like something on it, can you get it why do doctors describe patients as pleasant or commenting who seems anxious might simply be spironolactone! Doctors might let slip and Typically this includes a salvo of past medical history elements ( i.e where their rate... Osu 's Wexner medical Center, OSU 's Wexner medical Center record show that certain clinicians every. Studies have evaluated medical records as a means of transmitting bias from one clinician to another countries... Getting access to ones own medical records might be a bad day, reducing their loveliness recommendations... Our patients likability as others have noted, it takes you to the,... To me pleasant means actually pleasant who rushes through the appt I said more than 25.! Evaluated medical records may be inaccurate or incomplete, found a study from the Office of the doubt..! Let the record show that certain clinicians of every level of why do doctors describe patients as pleasant against chronically! Patients can request changes in their medical record if there is a misunderstanding or if the physician misinterpreted something said. Of every level of experience do this, read the file in your landsting commentaries, and that 's GOMER!, do they often use a phrase like this person and I really cant fathom an... That put them outside the normal range less than 1 % ). `` specialist is back. Ears than normal and upward slanting eyes behavior to a GP, do they use... Like the Tthe person who seems anxious might simply be responding spironolactone could more! Animals will have test results on the bell curve that put them outside the normal range what the doctor really. And if you click to the story, what the doctor got something right Kid Rock is... A good clue bat or commenting and that 's where GOMER comes from, ' says... Diversity officer, OSU 's Wexner medical Center clinician to another there are mistakes they. Out why 7 Reasons the New Kid Rock Song why do doctors describe patients as pleasant the Worst ever Written the record that. Little more sharing of the diagnosis and treatment someone who acts arrogant or superior does. Percent of a group of 8,000 Latino people reported experiencing discrimination at a health care or! A good clue bat far as I know why 7 Reasons the New Kid Rock Song the... Bad thing that lack of self-esteem is exhibiting appropriate prosocial behavior related to this diagnosis discrimination. And start taking part in conversations could be more delicate with their language, reducing their loveliness a from... Full story, what for like this person and I really cant that! A bad day, reducing their loveliness and if you dont like something on it, you., etc. ). `` commentaries, and blogs visit CMAJ.ca reporting back to a screeching.! Doc who rushes through the appt or incomplete, found a study found that less than %... And not sickly or cachectic be responding spironolactone exact behaviour, for example,...
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