Thursday, 10 May 2007

Typing

A few years ago I was the only GP in our practice to type his notes on the computer, the other doctors wrote on the continuation cards. Nowadays we all type and it is not so easy to tell at a glance who wrote what. However on closer inspection there are considerable differences in the authors' styles. One partner types clusters of words, terse ideas rather than complete sentences, mirroring their characteristic pithy thought. Another, who seems to see life in extremes, writes prose that is littered with words like “amazing”, “extraordinary”, “tremendous”, “shocking” and “outrageous”. The patients here seem to lurch from one catastrophe to another. Martha writes clear prose that is full of insight and sometimes contains deadpan humour. Today I came across one such entry which made me laugh out loud. We both clearly share a dislike of the box-ticking mentality of the Quality & Outcomes framework which inter alia requires us to ask two formal questions to screen patients with certain chronic diseases for depression. She had seen an elderly gentleman with cardiovascular disease:
“Been gardening recently, off to Australia soon. Positive and active, it seems ludicrous to ask him the depression screening questions, perhaps he will be more depressed when he has been on the the holiday of a lifetime.”
This demonstrates two essential rules of note-writing: never write anything you would not want the patient or their relatives to read, and you can laugh with but never laugh at the patient. I saw him again today: it had indeed been the holiday of a lifetime and he was still extremely positive.

As for me, although I like to think that my entries are succinct descriptive and witty it is not for me to say. Now there's a thought - perhaps I could get Martha to contribute to this blog? I'm sure we could do with a woman's touch around here. What about it, Martha?

Postscript: on my return from holiday today I found out what had happened to Susan. She was of course bounced straight back out of hospital, they felt her poor gait was due to a painful knee. The facial asymmetry remains unexplained, and one of my partners (the pithy thinker) is trying to convince the staff at her care home that masterly inactivity is best.

6 comments:

The Shrink said...

I trust that years of training and experience with a true perspective on what's vital in the true sense of the word would engender a healthy sense of mirth and common sense into managing the vagaries of the QoF malarky. All good to see! And, too, I'd agree wholly that laughing with (but never about) the patient's a grand way to practice.

Ms-Ellisa said...

Please Martha please..........
We read so much about her :-D

Cal said...

I love it! Martha's writing, that is...


Come on, Martha!! Contribute!!

Dr Andrew Brown said...

Thanks to all for your comments.

I will attempt to twist Martha's arm.

the little medic said...

HEHE! Each GP that i've been with in my time at medical school has moaned about how bad their typing is. In fact, the last one asked me to type up all his patient summaries when each patient had left (this was actually quite useful as it helped me to learn how to summarise)

Dr Andrew Brown said...

Little Medic: I bought a typewriter as a medical student and typed up my "long essay" myself. Later I got interested in computing before they invaded our consulting rooms. Now I would happily throw the damn things out!
Learning to summarise is a useful skill, so keep at it. :-)

P.S. I'm afraid that Martha is reluctant to contribute at present. Her modesty is charming but entirely unwarranted. I shall continue to cajole her, in the hope of gently wearing down her resistance, and to report her "bons mots" from time to time.