On the medical record, why did the doctor write so 'scrawled'? How did the doctors understand each other?
There are several unsolved mysteries about the hospital:
First of all, go to the hospital to see a doctor, can you read the doctor's words?
For example, the doctor asked netizens to buy this medicine. I even wondered if the doctor just wanted to see if the ballpoint pen could be used.
Do their characters need a codebook to check against? It looks like a word blown by a strong wind, but in the eyes of the pharmacist, it is very clear.
For another example, why does the obstetrics and gynecology department in the hospital arrange for a male doctor? Can you understand?
1. Why can't I understand the doctor's words?
Every time I take the medical record and see the handwriting written by the doctor, I seem to be worried that the patient will recognize it.
The main reason for the sloppy word count of doctors is that there are too many patients!
Doctors need to diagnose a large number of patients every day. In order to take care of each patient, it is natural to write prescriptions to patients as quickly as possible.
Although it is a "book from the sky", it's just that we ordinary people can't distinguish one or two, but pharmacists can understand it.
In fact, there are a lot of abbreviations or mixed Chinese and English, and professional names in doctors' prescriptions, which cannot be understood by untrained laymen. Pharmacists deal with doctors and nurses every day and cooperate for a long time. Naturally, they are familiar with it.
In fact, this phenomenon is not unique to China. The Institute of Medicine of the National Academy of Sciences of the United States has conducted a report on "the number of accidental deaths in the United States each year". Among medical errors, medication errors ranked fourth in the incidence of all errors , and the main reason for medication errors was prescription errors and scribbled handwriting by doctors. It is one of the important reasons for mistakes.
In an effort to reduce medical errors, a 2003 article in the American Journal of Healthcare Administration conducted a correlational analysis of the factors that affect physician prescription scribbles. The results found that the patient's age, gender, place of residence, and the number of diagnoses were related to the doctor's scribbles. .
Internal medicine in China has relatively higher requirements for the records of medical history and examination, so the handwriting is relatively clear. In surgery, the analysis requirements are lower than that of internal medicine, and most of them focus on surgery, so the handwriting is more scribbled.
How to avoid these mistakes, the most direct is not to write. Today, many hospitals in China have begun to use electronic prescriptions and printed prescriptions instead. So don't worry too much about making a prescription error.
2. Why are male doctors arranged in the obstetrics and gynecology department?
According to relevant statistical surveys, in developed countries in Europe and the United States, the average proportion of male doctors in obstetrics and gynecology is 95%. In Hong Kong and Taiwan, male obstetrics and gynecology doctors account for 90%. In large domestic hospitals, the proportion of male doctors in obstetrics and gynecology accounts for 30-40%.
What do you do when you meet a male doctor in a gynecological clinic? According to statistics from a website, about 40% of the about 13,000 people who participated in the survey felt embarrassed and would refuse to see a doctor because of this, and 5.52% were willing to accept it.
Why does obstetrics and gynecology arrange male doctors?
On the one hand, it is a natural advantage . Obstetrics has the characteristics of great responsibility, many emergency departments, and many rescues. Compared with female doctors, male doctors have a great advantage in physical strength. In the face of high-intensity work, men will relatively recover their energy. faster. In addition, although the number of male obstetric doctors is not dominant, there are many famous doctors.
On the one hand, Reshma Jagsi, an associate professor of ray oncology at the University of Michigan School of Medicine, has publicly stated that the existence of different perspectives in a group is more conducive to solving complex problems. In obstetrics and gynecology, men and women are equally important , and diversity can improve the quality of medical care.
The existence of male doctors in obstetrics and gynecology is inevitable. Faced with the confusion of some patients' families, the hospital's unprofessional and non-standard handling can easily lead to tension in the doctor-patient relationship.
In fact , there are provisions to protect the privacy of patients in the Law of China's Licensed Physicians and the Measures for the Administration of Nurses . Physician Li Jiafu, director of the Obstetrics and Gynecology Department of Zhongnan Hospital of Wuhan University, also said that male obstetrics and gynecologists are easy to cause distrust of patients. Generally, male family members are not allowed to enter the obstetrics and gynecology clinic, and the ward has strict regulations on visiting time.
When a male doctor examines a female patient, a female doctor or a female nurse must be present. If the patient feels unwell and proposes to change the female doctor for the examination, the hospital will also consider the patient's opinion.
In the eyes of doctors, patients are not divided into men and women . In the face of the outdated and conservative concepts of some patients and their families, it is even more necessary to guide them to change to agree with the "level of a doctor".
3. Inventory those inspections that need to be "embarrassing"
What do you think is the most embarrassing thing about going to the hospital for a checkup?
Some people said that the obstetrics and gynecology department met a male doctor, and some people said that the male anorectal department encountered a female doctor.
I believe that many doctors have professional quality, but due to some inspections, it is difficult to distinguish whether it is an inspection behavior or an intentional violation, which also makes the doctor-patient relationship full of contradictions.
Xu Hao, an attending physician at the First Affiliated Hospital of the University of Science and Technology of China, reminded that if these behaviors occur, they are all irregular.
For example, during a breast examination, a large area is pressed and rubbed on the chest; private parts are examined without notice; private parts are not worn with gloves; Use non-medical terms to describe the patient's body; move fingers in and out of private parts during bimanual consultation; ask details such as postures in intimate life, etc. When these things are encountered, the patient should question them.
Some examinations, although embarrassing, should be performed regularly for the sake of good health:
1. Digital anal examination
Digital anus examination can directly touch the anus, rectum, etc., and directly identify whether there is an abnormality of the anorectum through the fingers. According to relevant statistics, about 75%-80% of rectal cancers can be found through digital examination.
2. Gynecological examination
Gynecological examination is the most important means to discover gynecological diseases. Routine gynecological examination, leucorrhea examination, TCT examination, and ultrasonography are recommended and must be done.
Doctors need to devote a lot of energy to save patients, with more trust and more understanding. However, you must also master some medical knowledge and protect your rights.
References:
[1] "Can I understand the prescription from the heavenly book written by the doctor? Pharmacist: I don't understand anyway". Nutshell. 2018-12-05
[2] "[Close-up] Duan Tao: Obstetrician male doctors should be good at turning the danger into the invisible". Medical Economic News. 2014-08-20
[3] "Should I Promote the Feminization of Obstetrics and Gynecologists? "Laughing to death, there are hospitals that do not accept female doctors at the obstetrics and gynecology department". Medical Obstetrics and Gynecology Channel. 2021-12-08
[4] "Going to see a doctor with abdominal pain, but the doctor sticks his finger into the vagina: Is it life-saving or a hotbed of sexual assault? 》.DrX said.2021-04-19
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