Why Doctors Have Bad Handwriting! - Real Doctor Explains

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How weird is it that Doctors go through so many years of study, but some still have such bad handwriting? And it’s not something to be proud of. We know that bad handwriting has led to harm like wrong medications being given to patients.

But how does this happen? Here’s my take on why doctors have such bad handwriting and what can be done about it.

The first thing to get out of the way is that even though there’s a stereotype that doctors have bad handwriting, I can tell you for a fact that not all doctors have bad handwriting. And I’m not talking about myself necessarily – there are many doctors who have very easy to read handwriting. I mean how would we get through so many years of schooling if no one could read our essays.

But it is true that there are some doctors who’s handwriting could be mistaken for hieroglyphics. My theory is that even doctors who have bad handwriting don’t necessarily start off that way.

As an example, my signature before I started work was carefully thought out and distinctive. But just at the end of my first year of internship, it had turned into something out of a two year old’s colouring book.

So here’s the first reason why that happened: Quantity.

On the wards there are hundreds of things to write out – discharge summaries, drug charts, referral forms, x-ray slips, pathology slips…I think you get the idea. On top of that you’re constantly under time pressure. The amount of work in a hospital is almost always more than you can handle. So you start taking short cuts. Why take 5 seconds to sign something when you can do it in 5 milliseconds?

The second stage is to use short form and contracted sentences.

For example when I was working as an intern, one of the senior doctors in the Emergency Department was looking at a patient. Here’s a demo of what I had to write down in the patient notes while the senior doctor dictated his findings.

So Ankit this is a 68 year old male who presented to the ED with 2 hours of central chest pain and shortness of breath on exertion. He does not have a history of previous Ischaemic Heart Disease or Type 2 Diabetes. On examination he is sitting out of bed but looks otherwise well. His vitals are within normal limits. He has dual heart sounds with no murmurs and his lungs are clear. There’s no pedal oedema. The ECG show a Left Bundle Branch Block but we don’t know if this is pre-existing. The Chest xray is clear. The plan is for telemetry and serial troponins.

Got it? Good.

There’s no time to faff around because as soon as that last word has been spoken, it’s time to move on to the next patient.

The last stage is a gradual deterioration of your handwriting too.

The time pressure and high volume slowly leads to your handwriting becoming a mangled version of its former self.

Now if you have bad handwriting to beginning with, then you’re in real trouble. You may end up with handwriting that looks like chicken scrawl.

But there is an even deeper reason for the stereotype that doctors have bad handwriting:

Medicine is one of the few professions where the quality of your handwriting matters to other people.

Think about it, how many times has someone else had to read your handwriting? My guess is that most of the time, you probably just handwrite the odd note to yourself or make edits to a shopping list. It’s not routine for your handwriting to end up in front of a pharmacist who needs to work out what medicines to give, or in front of a nurse who’s trying to work out the plan for the day. So even if you have bad handwriting, no one really knows about it.

Doctors’ handwriting is incredibly visible. Everybody can see it from patients to other doctors. So if a doctor has bad handwriting, people notice and they care because if you can’t read what a doctor has written, it has some real consequences. This then confirms the stereotype and the cycle continues.

But still the problem of bad handwriting needs a solution – the risks are just too big to ignore. For doctors, it means having a look at our handwriting and seeing how its mutated from its previous self. If we can’t read it, then something needs to be done about it. For example I’ve seen some doctors use capital letters to make their writing more legible.

Some clinics and hospitals are making changes at the system level to get rid of handwritten notes altogether – electronic prescribing and medical notes are becoming more common. Whatever the solution, we all benefit from more legible notes from doctors.

Another common stereotype, especially in medical dramas, is for doctors to wear a stethoscope around their neck. But do you know why doctors use a stethoscope in the first place? Are they actually useful or is just to look cool? Click on the video to you right to find out. Thanks for watching and I’ll see you in the next one.

Further reading:

Legibility of doctors' handwriting is as good (or bad) as everyone else's: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464897/

Video credits:

Certain illustrations adapted from https://www.svgrepo.com/ and https://www.freepik.com/ (Sapann-Design / Freepik)


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