Doctors and and really ununderstandable handwriting

[JohnB]

"Why did you follow a drugs chart you couldn't read?".

Is a fair enough question, the nurse shouldn't have followed an illegible chart. The second example is way out of line though. The nurses are held responsible for the drs mistakes? By the AMAs own arguments, a nurse is not qualified to decide what is or is not an appropriate drug or dose.

 

Out of curiousity, how many patients is a doctor allowed to kill before your Health Dept. does something about him? In Queensland it seems 90 is a good round number. Then the govt pays for his one way fare out of the country.

[blike]

Pardon me, but it's not true, it's an excuse.

 

Many other people in many other professions are also pressed for time yet they seem to be able to write legibly. For doctors to use the "lack of time" bit is nothing more than a cop out and a lame one at that.

Right. They actually teach that copout in medical school. Why else would it be illegible? Being lazy? Is that what landed them in medical school? You don't understand pressed for time. Third and fourth year students are pushed very hard to meet time demands. In fact, the clinical portion of the USMLE Step 3 has very strict time constraints. A patient with a big mouth can put you in a bad position very fast. In a real setting, insurance companies don't like when you spend lots of time with patients. They start sending letters to you about the amount of time you spend if you go over their "allotted time".

 

Imagine the following clinical setting. Assume the insurance companies mandate that you see X patients per day in order to have their business. Let's assume a physician has a total of 35 patients he must see in a day. You're only allowed to spend 15 minutes with each patient (because the insurance company says so). From each patient you must review the patient's history (charts), do a complete oral examination, a complete physical examination, a localized physical examination, and then chart everything. You must also diagnose, refer, and/or prescribe. Then, post-examination you have to document everything that you did. 15 minutes of visitation is what you're paid for. Anything else you do is on your own time. You also have 34 other patients who are getting pissed off at how long they've had to wait in the lobby.

 

I take it that injury or death to a patient is not really a consideration to a doctor?

That must be it. "You know what? screw this patient, I'm not going to write legibly".

 

Is a fair enough question, the nurse shouldn't have followed an illegible chart. The second example is way out of line though. The nurses are held responsible for the drs mistakes? By the AMAs own arguments, a nurse is not qualified to decide what is or is not an appropriate drug or dose.

It happens all the time. "I couldn't read your writing, what did you order?"

 

Out of curiousity, how many patients is a doctor allowed to kill before your Health Dept. does something about him? In Queensland it seems 90 is a good round number. Then the govt pays for his one way fare out of the country.

Depends on whether or not the doctor is actually the reason for the death.

[Glider]

Is a fair enough question, the nurse shouldn't have followed an illegible chart. The second example is way out of line though. The nurses are held responsible for the drs mistakes? By the AMAs own arguments, a nurse is not qualified to decide what is or is not an appropriate drug or dose.

It is another layer of safety so that should a doctor make an error, the nurses don't just blindly follow incorrect instructions, but think for themselves and question them. Our nurses are qualified to know what is and what isn't an appropriate dose. They are just not allowed to presecribe.

 

Out of curiousity, how many patients is a doctor allowed to kill before your Health Dept. does something about him? In Queensland it seems 90 is a good round number. Then the govt pays for his one way fare out of the country.

As far as I know they are not allowed to kill any. Every time a patient dies, the cause must be established (although it's often known) and recent treatment is reviewed to ensure it was correct.

[husmusen]

It is another layer of safety so that should a doctor make an error, the nurses don't just blindly follow incorrect instructions, but think for themselves and question them. Our nurses are qualified to know what is and what isn't an appropriate dose. They are just not allowed to presecribe.

 

I agree in part with serious reservations.

 

I have seen "stupid doses" that are perscribed for good reason.

I'm mainly thinking of opiates and end stage cancer sufferers.

I have seen insane levels of morphine being given to someone,

with no ill effects, and I have seen people on a quarter that amount

go into serious difficulties.

 

Now if it's an oncology nurse with 40 years experience, sure they should

have realised or queried.

If it's a 18yo Div 2 on their first unsupervised day, then

no it was soley the doctors fault, the nurse could not have been

expected to know.

 

In either case the doctor should also be held equally at fault

for their incorrect written instructions as it is neither acceptable

or professional to overlook mistakes simply because their is a failsafe,

it defeats the purpose of having a failsafe.

 

Cheers.

[husmusen]

Out of curiousity, how many patients is a doctor allowed to kill before your Health Dept. does something about him? In Queensland it seems 90 is a good round number. Then the govt pays for his one way fare out of the country.

 

Don't get me started, my anger over this is immense.

 

I feel it is important to note that it wasn't the government

that shipped him out.

 

It was the private executives of "Queensland Health", they merely

charged it to the taxpayer, under a government scheme.

It was not a routine or scheduled flight, they flew him out when the

story hit the newsstands. Thus removing a key witness whose testimony

(if the cops plea bargained) could have seriously damaged them.

 

This stinks worse than a fishmarket on a hot and humid day.

Also if myself a humble nurse, needs a full criminal history check.

Why the **** doesn't a surgeon? (I'd always assumed they did).

 

Didn't England have some problem with a maniac doctor who offed a

couple of hundred patients? Did they ever figure out how he got

away with it, why the death ratio didn't get picked up or drop any

red flags?

[blike]

Every time a patient dies, the cause must be established (although it's often known) and recent treatment is reviewed to ensure it was correct.

In the states, following a hospital review, a lawyer will kindly review the chart too!

[Glider]

It's not quite that bad here yet. In the UK, they tend to allow only those qualified to make a valid assessment look at the notes. Lawyers, bless their li'l hearts, are not.

 

Neither (as far as I know) are they allowed to look at patients notes until or unless it's decided there is some questions concerning the death and/or treatment and the court has ordered the notes to be released, as that would be a breach of patient confidentiality (as, I have no doubt, the lawyer would be the first to point out )

[□h=-16πT]

Apparantly I have handwriting like a doctor's, I don't think it's quite bad as that though, personally.

[JohnB]

I feel it is important to note that it wasn't the government

that shipped him out.

 

It was the private executives of "Queensland Health", they merely

charged it to the taxpayer, under a government scheme.

Husmusen, I believe in the old concept of "Ministerial Responsibility", the Minister has the office, perks and salary, if his/her department screws up royally like has happened here, they should resign.

 

The enquiry is apparently looking into 8 other hospitals because of "irregularities". Those of us outside the hallowed halls of the medical fraternity are asking how this guy could kill so many patients (to the extent that his nickname of "Dr. Death" was awarded by the nurses, they have testified to hiding patients from him.) yet not one bloody doctor complained.

 

Told to turn off the life support to free up a bed? Sure, no problem, no complaints either.

 

As far as I know they are not allowed to kill any. Every time a patient dies, the cause must be established (although it's often known) and recent treatment is reviewed to ensure it was correct.

Nice theory. So how does this piece of human excrement manage to kill a patient or two per week and nobody but the nurses notice? How does he order the murder of a patient and his order is obeyed? Sorry mate, but doctors are not the most popular people in Queensland at the moment.

 

Blike and Glider, I realise Doctors are pressed for time, but so are many other professions. Illegible writing is not acceptable in other professions, why should it be acceptable in medicine? It's a simple question.

[Glider]

Nice theory. So how does this piece of human excrement manage to kill a patient or two per week and nobody but the nurses notice? How does he order the murder of a patient and his order is obeyed? Sorry mate, but doctors are not the most popular people in Queensland at the moment.

I can't answer that question. I know nothing about the case. I suspect that very few people apart from those directly involved do. Anyone else will have 'heard that...' and drawn their own conclusions, probably on minimal direct evidence.

 

I strongly doubt any doctor anywhere could order a patient to be murdered and have that order obeyed.

 

Blike and Glider, I realise Doctors are pressed for time, but so are many other professions. Illegible writing is not acceptable in other professions, why should it be acceptable in medicine? It's a simple question.

Nobody said illegible handwriting was acceptable. It happens.

[husmusen]

Husmusen, I believe in the old concept of "Ministerial Responsibility",

the Minister has the office, perks and salary, if his/her department

screws up royally like has happened here, they should resign.

 

JohnB, I do too, when I posted that I thought Qld. health was

a private company, like Mayne Health.

 

Now I have gained a better understanding, I withdraw the comment.

The minister should resign but Dr Keating should be serving time.

He gave that guy a "glowing" letter of reference?! WTF!!!

 

I'd like to reassure you that most medical professionals aren't maniacs.

 

Glider, I have been doing a bit of digging over the past few

days, so far I have found the commision transcripts to be quite

illuminating. Although a hard slog(I'm finished with day 1 and 1/4 way

through day 2) I'm not prepared to go slinging my mouth off yet, but

I am prepared to say that something stinks like crazy.

 

Dr Patel is a butcher, that much is beyond doubt, whether due to

reckless incompetence or evil malevolance I don't know.

Dr Keating(The director of health) to put the kindest of kindest

lights on it, seems to be a great believer in the class system, and

to have allowed his personal freindship with Dr Patel to utterly

compromise his already poor judgement.

 

However there are gaps and unexplained things, but perhaps some

of the hoarde of witnesses yet to give evidence will shed light on them.

 

Cheers

[husmusen]

JohnB and otehrs,

 

This is a link to the transcript pool of the inquiry.

You may have already found this by other means but if not,

I think you'll find it quite illuminating.

 

http://www.bhci.qld.gov.au/transcripts.htm

 

It's up to day four at present.

 

Day 1 is formalities and mainly Toni Hoffmans evidence.

 

Day 2 is legal argument and Toni Hoffmans evidence and I think

a little of the D of M. Dr Miach

 

Day 3 is Dr Miach

 

Day 4 is Dr Miach continued. and the beggining of

Dr Keatings evidence.

[blike]

Apparently he lied about his disciplinary history to Australia, and Australia didn't check with Oregon (the state which revoked his license) before allowing him to practice there.

[JohnB]

Nobody said illegible handwriting was acceptable. It happens.

Unfortunately, it happens so often that doctors illegible handwriting is a standing joke throughout the entire western world. Doesn't it worry you?

 

The simple fact that it is so common should ring loud alarm bells somewhere. Somehow I'm not really surprised that it doesn't.

[rajama]

Why do doctors always have to write in such a way that you can barely read what is written? Is there some particular reason?

 

*Off topic posts are not minded in this thread*

 

Okay if I 'but-in' here?

 

Here's another 'wrinkle': a few weeks ago I was given a hand written note by a specialist to pass to my GP suggesting I try a particular drug.

 

I could read the note' date=' but [b']not [/b] the drug name. Obviously, the scribble would have made sense to my GP within the context of the note.

 

This suggests that the specialist had prescribed the drug so often it had reduced to scrawl, but that his normal handwriting was acceptable.

 

Thankfully my GPs prescriptions are generated and printed by computer, so at least some progress is being made (here).

 

Is this a general move to printed prescriptions (UK)

[husmusen]

From what I've seen they are becomming increasingly common.

A good thing too.

 

Cheers.

[JohnB]

Husmusen, you're right, it stinks.

 

A patient goes back to theatre 3 times because his wounds have come open, concerns are raised by the nurses and nothing happens?

 

I'm also concerned that the RBH, Prince Charles and other hospitals didn't raise any real objections to what was going on.

 

A lot of people closed their eyes to Patel's incompetence.

[Glider]

Unfortunately' date=' it happens so often that doctors illegible handwriting is a standing joke throughout the entire western world. Doesn't it worry you?

 

The simple fact that it is so common should ring loud alarm bells somewhere. Somehow I'm not really surprised that it doesn't.[/quote']

Yes it does worry me. I wish I had more power to do something about it. I play my small part (when working in hospitals) by simply returning any path. request I can't read. It's a bummer for the patient who has been waiting for hours, but I remind them that it the medic's responsibility to make sure people can read the forms and that there is no point in my sticking a needle in them if nobody is going to know what to do wtih the blood.

 

However there are gaps and unexplained things, but perhaps some

of the hoarde of witnesses yet to give evidence will shed light on them.

I sincerely hope so!