It's "totally unacceptable" that Canadian medical professionals' garbled scribbles on prescriptions and hospital charts continue to put patients at risk, one of the country's leading doctors said on Thursday.
Dr. Louis Francescutti, the president of the Royal College of Physicians and Surgeons, made his comments following the case of a Nova Scotia nurse who was reprimanded for his illegible handwriting. Earlier this month, the College of Registered Nurses of Nova Scotia ordered Wilfred Douglas Gordon to complete a documentation course after finding his writing on nurses' notes and patients' charts was unintelligible.
"But in 2011 it's totally unacceptable that we're still handwriting — that's how the monks did it," Francescutti said. "Everything should be dictated or typed."
The Nova Scotia nurses' complaints committee found that Gordon's penmanship was poor enough to put his patients at risk.
"The committee found that Mr. Gordon's handwriting was so incomprehensible that it was ineffective as a communication tool and, even more concerning, potentially misleading to those reading it," the college's report said.
For the next six months Gordon's supervisor will review his handwriting on patients' charts on a monthly basis.
But Francescutti has a simple idea to rid hospitals of the sloppy script that has endured within the medical profession.
"If you pull out a physician's chart and you can't read what it says, they shouldn't get paid for that procedure," he said. "Patients' lives are actually in danger by misinterpretation of drug dosage or a procedure. It's totally inexcusable."
Unreadable handwriting on patients' charts and prescriptions has been an area of concern for regulatory boards before.
College of Physicians and Surgeons of Ontario spokeswoman Kathryn Clarke said that cases have occurred where illegible medical records have been a factor in disciplinary decisions. CPSO disciplinary committee records show cases in 2006 and 2007 where a physician's garbled record-keeping was noted in the college's findings.
Francescutti said that while the importance of legible writing is covered in medical schools, "the people that teach it are the ones that can't write either."
The University of Rochester Medical Center attempted to bring some clarity to its staff's writing by bringing in handwriting experts to lead a seminar in 2003.
Robert Panzer, the hospital's chief quality officer, said that the free course taught staff to write legibly at a speed suitable for a hospital's hectic pace.
"We all got better. There's absolutely no question," he said. "At the end of this course I was able to write a legible note, which I really struggled with before."
But outside of attempting to reform chronic scrawlers, Panzer agreed with Francescutti that the best solution is to eliminate handwriting altogether — something the University of Rochester hospital has done with the implementation of electronic records.
"The real answer is to get away from ink and pen to things that are legible and can be seen anywhere by anybody who needs to see it, without being stuck with the chart," he said.
The Capital District Health Authority — the Halifax-based health authority where the reprimanded nurse works — said it's working to institute electronic health records. A health authority spokesman said that technologies such as tablet computers are being considered to eliminate the need for handwriting.
Francescutti was blunt in his assessment of the enduring stereotype of doctors with sloppy writing.
"If you're smart enough to get into medical school, you should be smart enough to know how to write," he said.
Dr. Louis Francescutti, the president of the Royal College of Physicians and Surgeons, made his comments following the case of a Nova Scotia nurse who was reprimanded for his illegible handwriting. Earlier this month, the College of Registered Nurses of Nova Scotia ordered Wilfred Douglas Gordon to complete a documentation course after finding his writing on nurses' notes and patients' charts was unintelligible.
"But in 2011 it's totally unacceptable that we're still handwriting — that's how the monks did it," Francescutti said. "Everything should be dictated or typed."
The Nova Scotia nurses' complaints committee found that Gordon's penmanship was poor enough to put his patients at risk.
"The committee found that Mr. Gordon's handwriting was so incomprehensible that it was ineffective as a communication tool and, even more concerning, potentially misleading to those reading it," the college's report said.
For the next six months Gordon's supervisor will review his handwriting on patients' charts on a monthly basis.
But Francescutti has a simple idea to rid hospitals of the sloppy script that has endured within the medical profession.
"If you pull out a physician's chart and you can't read what it says, they shouldn't get paid for that procedure," he said. "Patients' lives are actually in danger by misinterpretation of drug dosage or a procedure. It's totally inexcusable."
Unreadable handwriting on patients' charts and prescriptions has been an area of concern for regulatory boards before.
College of Physicians and Surgeons of Ontario spokeswoman Kathryn Clarke said that cases have occurred where illegible medical records have been a factor in disciplinary decisions. CPSO disciplinary committee records show cases in 2006 and 2007 where a physician's garbled record-keeping was noted in the college's findings.
Francescutti said that while the importance of legible writing is covered in medical schools, "the people that teach it are the ones that can't write either."
The University of Rochester Medical Center attempted to bring some clarity to its staff's writing by bringing in handwriting experts to lead a seminar in 2003.
Robert Panzer, the hospital's chief quality officer, said that the free course taught staff to write legibly at a speed suitable for a hospital's hectic pace.
"We all got better. There's absolutely no question," he said. "At the end of this course I was able to write a legible note, which I really struggled with before."
But outside of attempting to reform chronic scrawlers, Panzer agreed with Francescutti that the best solution is to eliminate handwriting altogether — something the University of Rochester hospital has done with the implementation of electronic records.
"The real answer is to get away from ink and pen to things that are legible and can be seen anywhere by anybody who needs to see it, without being stuck with the chart," he said.
The Capital District Health Authority — the Halifax-based health authority where the reprimanded nurse works — said it's working to institute electronic health records. A health authority spokesman said that technologies such as tablet computers are being considered to eliminate the need for handwriting.
Francescutti was blunt in his assessment of the enduring stereotype of doctors with sloppy writing.
"If you're smart enough to get into medical school, you should be smart enough to know how to write," he said.
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