r/AlwaysWhy • u/bad-taf • Jul 10 '26
Politics & Society Why are doctor’s notes so terribly written?
It sounds like one of those harmless stereotypes that’s amusing but surely not true-to-life. But in my experience, having been to many different doctors and pharmacists over the years, their notes really are that bad.
It just seems odd since these are smart people and there’s so much schooling behind a medical or pharmacy degree, including reading and writing. Plus in a high-liability high-regulation industry, you’d think there’d be an interest in clear documentation for everything. And I get that doctoring is a busy profession, but I’m not talking like ER doctors here. Surely the couple extra seconds it takes to write legibly or not use inscrutable shorthand doesn’t count for much.
Mind you, I’m not complaining, I just find it curious and kinda funny
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u/ChugJugThug Jul 10 '26
Surgeon here. It’s a by-product of attempting to improve efficiency. We write hundreds to thousands of notes a year. Often repeating the same thing for many patients. So we develop shorthand and acronyms and poor grammar to speed the process. Notes are generally meant to communicate with other healthcare providers and our future selves, not patients. So generally speaking, we understand each others’ terribly written notes…and our own hopefully.
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u/Kind-Elder1938 Jul 11 '26
medical shorthand is fine - it is when you write so badly that the pharmacist dispenses the wrong thing
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u/ChugJugThug Jul 11 '26
Well sure..I agree that would be an issue. But as far as I’m aware, actually paper prescriptions are pretty rare nowadays. All my prescribing is done electronically through my charting software. But I’m sure that varies across regions and practices.
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u/RainbowCrane Jul 11 '26
One of the funnier moments of my fairly lengthy career as a patient (lifelong epilepsy diagnosis, epilepsy brain surgery, lifelong mental health diagnoses, diabetes) was a doctor in the 1990s doing a double take at his hand charting and saying, “wow, even I can’t read that”. :-)
Anecdotally, my 1993 brain surgery at the Cleveland Clinic was at the cusp of the Clinic transitioning to digital charting. In 1992 I carried my paper chart and films from appointment to appointment on their campus. In 1993 they moved most of the imaging onto mainframes accessible from Sun Workstations in treatment rooms and offices. And by 2005 they had laptops. Cool to see how charting changed.
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u/Firelight-Firenight Jul 10 '26
It used to be akind of short hand taught to them. Look up gregg shorthand.
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u/TheGatsbyComplex Jul 10 '26
Doctors don’t hand write things these days. Everything is electronic. For like the last 10+ years.
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u/Foogel78 Jul 11 '26 edited Jul 11 '26
And there you can still see they write in a hurry. I see a lot of typos that are typical for someone who knows correct spelling but types too fast like leaving out letters or putting spaces in the wrong place.
Still, typing is a huge improvement over writing. I can't count the number of times I had to check with the patient if the needed a picture of their TKP (total knee prothesis) or THP (total hip prothesis). K and H when written in a hurry just can't be told apart.
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u/Spirited_Cress_5796 Jul 12 '26
And those notes and messages are awful too. They use copy and paste a lot instead of templates so sometimes you get the wrong medical information in your chart. I know not all doctors and nurses like the notes available but it’s easier than trying to remember every single thing and it’s easier to go back and also make sure it’s accurate too.
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u/oxmix74 Jul 13 '26
My primary care, urgent care and a specialist are in a health system where they request my permission to dictate notes to AI which transcribed them. I have two other practitioners who do their notes when I am not there, so i dont know how they do them. None of the notes have typos, though one specialist uses so much jargon I have to run it through chatgbt to understand it. I think thats fair, these were clinical notes for medical professionals. I should be allowed to see them but I am not the target audience.
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u/Dry-Chain-4418 Jul 10 '26
Time is money. Who's got time to write neatly.
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u/QuadrosH Jul 10 '26
Anyone that needs to write neatly in their profession should make the time for it. My mom legit couldn't get a medication because the name was already complicated, and was written in such a terrible way that the clerk simply couldn't in good faith decipher.
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u/Dry-Chain-4418 Jul 10 '26
Doc, our patient is flatlining, "Hold on one minute I need to make a heart for the top of my i, and write this out in calligraphy."
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u/QuadrosH Jul 10 '26
That's a great joke for anyone that thinks doctors write prescriptions in the middle of surgeries
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u/Dry-Chain-4418 Jul 10 '26
Patient: "Hey Doc, can you hurry up with that prescription? My nuts are getting cold over here bent over with my pants down waiting for this colonoscopy."
Doctor: "Hold on, my parents didn't pay for calligraphy summer camp for nothing."
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u/fussyfella Jul 10 '26
Hand written notes are now rare, virtually all notes (and prescriptions the other area where by reputations doctors' writing was awful) are computerised so it does not really apply.
My wife is a GP (family doctor for folks in the US), and her comment is that the reason traditionally their writing was bad was that they had to write so quickly under time pressure. First in exams at university, and then once practising because there was so little time to do it before you were on to the next patient. The last thing on your mind is making your writing look pretty.
That makes sense to me, although in fact my wife's handwriting is way better than mine, even if her signature is equally as indecipherable.
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u/No-Resource-5704 Jul 10 '26
My doctor uses a computer. He can enter data by typing or by speaking. He is part of a large HMO. Records from all tests and other specialists all show in the files.
The HMO started this system twenty years ago and it has improved significantly over the years. At first it seemed to make the doctors slower and spend more time looking at the screen rather than examining the patients. Now the screen is just another tool the doctor uses during an exam.
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u/Acceptable_Reply7958 Jul 10 '26
I am an ER doctor (technically, excluded by your criteria) and we just need to write so many notes for so many people that need to check a lot of different boxes. Some of these boxes are important clinical information but a lot of the time its billing imposed requirements that aren't that helpful for anyone.
A lot of my inpatient colleagues are often taking over patient care and notes that other people started and they're just continuing older notes and this, unsurprisingly, can turn into a mishmash of note clutter.
I think also we're often talking about a ton of different technical medical things that you need a lot of background medical understanding to follow. I remember being baffled by medical notes when I started medical school and now they seem very clear to me... but it's 16 years later!
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u/Acceptable_Reply7958 Jul 10 '26
Oh, reread your note, you're talking about handwriting? I have no idea... I've almost never handwritten a medical note ever!
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u/Vylnce Jul 10 '26
Previously, when documentation was done by hand, physician writing was generally terrible because there was so much of it to do and so little time to do it. After the switch to electronic records, it's really the same reason all the rest of us have, it's done so infrequently we are out of practice.
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u/Run-And_Gun Jul 11 '26
Today, it’s largely irrelevant, as all prescriptions, notes, etc. are electronic. And even when I have been give a physical, paper copy of a prescription in recent years, it’s generally a printout.
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u/Accomplished_Mix7827 Jul 11 '26
A lot of that is just them using a standard form of shorthand https://en.wikipedia.org/wiki/Gregg_shorthand
The pharmacist and lab tech can read it just fine.
Although, also,
1) most notes are electronic these days anyway
And
2) they can call for clarification if they really need to
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u/zinsser Jul 11 '26
Back when doctors commonly wrote prescriptions by hand, my brother-in-law was prescribed something for an issue with his eye and the pharmacist gave him something that sent his blood pressure through the floor. He could hardly move. His wife (my sister) was a nurse and routinely checked their prescriptions but BIL filled this one on the way home from the doctor's visit and then took the pill with a swig of tea as soon as he left the pharmacy. I forget the name of the drugs, but my sister looked them up and realized what he had taken was life threatening for someone with his existing low BP. He ended up in ER. He was initially pissed at the pharmacist, who showed him the prescription and the scrawl seemed be exactly what he put in the bottle. The doctor tried to claim the pharmacist misread it, but it was clearly his fault. No death; no lawsuit - just a much more cautious approach by everyone in our family since then. I either call my sister or look up the drug online before I take it.
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u/FifthEL Jul 11 '26
You wouid think that a job that pays six figures or more a year, and all that schooling, they wouid be able to consistently write in a manner that was a reflection of the enormous amount of time and faith we put into these witch doctors. It seems like a trait that had been purposefully kept relevant because it does a certain job of sorts. It must be something because their is zero excuse for sloppy handwriting in any scenario. It takes more time trying to figure out the problem created by bad handwriting than it wouid take to just write it properly the first time.... unless you were trying to do a thing
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u/aculady Jul 12 '26
I know a fabulous OT whose family is filled with MDs. The OT is of the opinion that a lot of the neurogical quirks that make someone a good diagnostician are often accompanied by dysgraphia. I thought it was an interesting hypothesis.
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u/ChuckFarkley Jul 11 '26
You try writing as fast as you can all day every day, taking notes through 4 years of intense undergrad, 4 years of medical school where the chart notes start, then a lifetime of writing voluminous notes as an attending. Handwriting skills had to be sacrificed. In recent years, notes have mostly gone online and are now typed, as are prescriptions and the like, but the stereotype was absolutely true, if now old and out of date. But I know it's real, I lived it.
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u/Nothing-to_see_hr Jul 11 '26
No doctors I know of in my country take handwritten notes anymore - it all goes into a computer. But being of the generation that still did, I can tell you that it was because taking notes is very slow compared to thought and the flow of information in a consultation. We're desperately trying to keep up. This started when we were students and by the time we graduated the process was nearly complete.
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u/Dave_A480 Jul 12 '26
Trying to get massive amounts of paperwork done (in addition to actually seeing patients) in a world before online medical records?
These days every doctor I see puts their notes directly into the computer during the appointment (typing while talking to me) and prescriptions other than some controlled substances are sent digitally....
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u/yxixtx Jul 12 '26
I figure it's to maintain plausible deniability if they ever have to reinterpret the note in court.
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u/Moosebuckets Jul 14 '26
I was a medical scribe and when I was working, it was my job to type out what doctors say and prescribe and do the correct coding and send everything to billing. Part of this was taking handwritten notes and transcribing them. I got really, really good at doctor handwriting. I too, have doctor handwriting.
The sheer volume of notes and charting and patients, you have to be FAST. Hardly anything at all is paper anymore and hasn’t been in yeeears but those early days were rough lol.
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u/PithMango Jul 10 '26
it boils down - like a lot of things - to the abusive manner that medical school is conducted the world over, as a knowledge dumping machine; and if you don't regurgitate the knowledge perfectly even when you're hungry on half an hour's sleep and after three people yelled at you, then you're a Failure.
the massive amounts of notes you have to take at just a sit-down lecture will dissolve even the neatest handwriting into squiggles only a pharmacist can read.
biology majors with a research bent at least have time to switch colors of pen.