Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Wednesday, May 23, 2007

Prejudice

  1. Black people are lazy.
  2. Surgeons are assholes.
  3. Doctors have lousy handwriting.
What do those three statements have in common?
  • They are not true.
  • They are offensive.
Attributing a trait or quality indiscriminately to a group of people is prejudice, pure and simple, whatever the trait and whatever the group. Adding a modifier like "many" or "most" does nothing to mitigate the offense, and trying to downgrade it by inserting "some" results in meaningless assertions. "Some" members of any group are just about anything.

Now let's look at some of the differences among those three statements. In this day and age, no one but the most obnoxious racist would agree that the first statement has any degree of veracity whatsoever. The problem is that the second two sentiments are considered true by so many people that they are often considered "conventional wisdom."

Why is this so? Why do people feel justified in labeling an entire medical specialty emotionally dysfunctional and an entire profession legibility-impaired? Perhaps people believe that because they have had experiences demonstrating these qualities with multiple members of a group, their observations are therefore applicable to the entire group. Perhaps people may even feel they have never met a member of the group who does not possess the offending quality. Yet despite that reasoning, it is still not legitimate to conclude that all blacks are lazy based on personal experiences with a given number of unmotivated African Americans, or lack of experience with those who are studious and industrious.

There are people of every race and nationality who are lazy. Discussions of motivation need to be addressed to the individuals displaying the behavior instead of inappropriately criticizing a whole group of people. Surgeons who lack interpersonal skills should not be excused because, "That's the way surgeons are." Not only are they not "all" like that by any means, inappropriate behavior does not deserve to be tolerated under any circumstances.

What about handwriting?

First of all, how legible is the handwriting of the average adult in any profession today? Who knows? How much longhand writing does anyone do anymore anyway? Not much. Handwriting fatigues the more you write, so being expected to write the equivalent of up to 15 pages by hand daily (hospital notes and prescriptions, not to mention office notes for those of us without EMRs) might explain some diminished penmanship.

I was a calligrapher before I became a doctor. My handwriting is not just legible; it is lovely. Patients are often in awe of my prescriptions, instructions and Return to Work notes, usually accompanied by some crack about doctors and their handwriting.

I don't disagree that those physicians who do not pay attention to these matters can represent a danger to patients both in and out of the hospital, with illegible orders and prescriptions respectively. Those individuals need to be counseled about their unacceptable performance in this area. But I know for a fact that I am not the only doctor with legible handwriting, and I am sick of listening to assumptions about my penmanship based on the letters MD after my name.

So knock it off about docs and handwriting already, you lazy assholes.

23 Comments:

At Wed May 23, 05:59:00 PM, Blogger scalpel said...

Certainly expressions such as those can be hurtful, and I think it is good that society frowns on statements like that. However, stereotypes exist for a reason, and one would have to be utterly clueless to not notice that in a large population, certain stereotypes are typically present in a higher percentage among the labelled group than in other groups. Obviously "lazy" and "asshole" are subjective qualities, but certain others are not, and they are just as unmentionable, unless one is a bigoted asshole like me.

How many Caucasians do you see running the 100 yard dash in the Olympics? They are drastically underrepresented on NBA teams as well. Certain ethnic groups are overrepresented on high school honor rolls while others are underrepresented. Ask a waiter who the worst tippers are, and you might find some more stereotypes. Physical features are often more prevalent in certain groups than others. Grief reactions, early pregnancy, multiple pregnancies....the list goes on and on, but we'd better not talk about it or the PC police will call us names.

Should anyone be demonized for being observant and honest if the intent is not to harm? Why can't we talk about these things rationally? Using a generalization in order to be hurtful or deny someone equal opportunity is clearly unjust. Stating the obvious isn't.

As a group, doctors DO have lousy handwriting. And we tend not to be able to dunk a basketball either.

 
At Wed May 23, 08:03:00 PM, Blogger Rav said...

what was this post about I couldnt read your font....

 
At Wed May 23, 08:36:00 PM, Anonymous Anonymous said...

scalpel, of course you're right. You surgeons always are. I've noticed that about you people.

 
At Wed May 23, 08:52:00 PM, Blogger #1 Dinosaur said...

As a group, doctors DO have lousy handwriting.

How the hell do you -- or anyone -- know that, Scalpel? Has anyone ever taken an age-matched group of non-physician professionals, had them fill in an ER chart, and then get blinded readers to judge legibility? That would be an interesting study, but until it's done, statements like that are exactly the kind of prejudice I'm talking about.

Rav: cute

 
At Thu May 24, 12:04:00 AM, Blogger scalpel said...

Well, the difference didn't reach statistical significance in one study, and another study (footnote 2) supported the hypothesis.

Shall I look for studies on 100 meter dash times, SAT scores or teenage multigravidas next? I suspect those studies would be more convincing.

 
At Thu May 24, 12:37:00 AM, Blogger scalpel said...

Anonymous commenters are sissies.

LOL.

 
At Thu May 24, 02:44:00 AM, Blogger SeaSpray said...

I have been reading doctor scripts and ER charts for 20 years.

It was difficult to decipher their writing in the beginning but then you get familiar with their writing and it gets easier. The good penmanship docs were RARE.

One thing that amuses me is the signatures that some of them use.

One Doc makes a check mark and that is representative of no less then 5 letters - with no evidence of any letter in the straight lined check mark. I could go on with amusing descriptions but I am sure you have seen some or maybe you sign differently too. You should post one of your scripts. it would be so unusual to see an arty script like that. :)

Oh and I have terrible writing and I'm not a doc. :)

 
At Thu May 24, 10:50:00 AM, Blogger Lynn Price said...

What? You mean surgeons aren't assholes? Kidding...

Excellent post, Scalpel.

 
At Thu May 24, 11:20:00 AM, Blogger Zac said...

Normally I'd never spam my own blog in someone else's comments, but my last post was about stereotyping and how to use it effectively... of course, I'm a 2nd year med student about to take the USMLE so it's a slightly different story.

I think it's relevant to the discussion at hand.

 
At Thu May 24, 11:38:00 AM, Blogger Voter Mom said...

You forgot cops & doughnuts.
Stereotypes hurt -- the former INS is a great place for getting stereotyped, by the way.

 
At Thu May 24, 11:52:00 AM, Blogger Ivory Tower Lurker said...

I can report anecdotal information: I used to process physician's hand-written forms. Out of a sample of about 1,000 physicians, I'd say that 95% were legible, and 5% were tough, but could be figured out with minimal brain power. Maybe 2-3 individuals might be so bad that a phone call was required for clarification. At the other extreme, one physician was obviously a calligrapher. I loved getting his forms!

You're in rare company, Dr. D.

 
At Thu May 24, 12:01:00 PM, Anonymous HCN said...

My family doctor has the reputation of the worst handwriting at the hospital next door. The moment I hand over his paperwork to get what he ordered... they recognize it as "oh dear, it is Dr. X!" In his defense, he does spend his day writing, writing, and writing some more as he puts notes on the charts, writes prescriptions and signs typed letters.

Actually, the WORST handwriting I have ever tried to decipher belonged to the teaching assistant of a history class I took in college. I complained that I could not read his comments in my exam bluebook, only to be told I should go to his office to talk to him... I replied that it would be a better use of time if he learned to write clearly (and even suggested the engineering graphics class where precise lettering was taught).

Here is another stereotype I developed after dealing with several neurologists. Out of the four of them, only one was not a bit flaky. All very nice people, but somewhat quirky in behavior.

 
At Thu May 24, 12:59:00 PM, Blogger The Tundra PA said...

The patient charts in our hospital (which contain both inpatient admissions and outpatient clinic visits)are almost completely handwritten; only discharge summaries are dictated and typed. Any one chart may contain 20 years or more of a patient's life, medically speaking. I frequently peruse charts that contain clinic notes going back to the 1950s. It is interesting how much more detailed the notes are now compared to then, but overall legibility is generally at least decent. Of course there are a few that resemble hieroglyphics.

I didn't click on Scalpel's link, but I love the idea of a study comparing the handwriting of physicians with an age- and education-matched cohort of non-physicians. I agree with you, #1 Dino, I bet there is not much difference.

I, too, get comments about the legibility of my handwriting. They are usually along the line of "well, you'll clearly never be a doctor, your handwriting is too good." The comment I get almost daily is that my signature looks like an EKG. Actually, it does, kind of.

 
At Thu May 24, 01:56:00 PM, Anonymous BECKY said...

scalpel, I agree with you and call me a sissie? How rude! Oh, wait, isn't that another trait surgeons have in common? ;)

Oh, and don't all of you play golf, too?

 
At Thu May 24, 04:10:00 PM, Blogger #1 Dinosaur said...

Scalpel: I clicked on your link, and then went to the original sources. The prospective study -- the one that divided fewer than 100 people into doctors, nurses and other medical personnel, and "administrative staff" -- used a form where each participant was asked to write his/her name, each of the 26 letters of the alphabet and the numerals 0-9, evaluated with software intended to test character recognition and not overall quality of handwriting.

I'm not buying it. It's pretty easy to whip out a small study in support of what "everyone knows anyway." Everyone *knows* that stenting all vessels improves outcomes...until an actual, well-designed study disproves it.

Lynn: *pouting* Did you think Scalpel's comment was better than my post??

 
At Thu May 24, 04:46:00 PM, Blogger scalpel said...

Like you said, how can our handwriting NOT suffer? When we are increasingly pressed for time, trying our best to overdocument to cover our asses and crank more patients through the mill, we try to save a little time with our charting rather than short-changing our patients of precious seconds.

At least I do. My handwriting used to be good.

 
At Fri May 25, 12:49:00 PM, Blogger Lynn Price said...

"Lynn: *pouting* Did you think Scalpel's comment was better than my post??"

Weeelll, I think Scalpel made some very valid points about the genesis behind the big ticket stereotypes and how they don't appear out of thin air.

As big a social drain some of those stereotypes are, I'm not seeing the fire regarding docs' handwriting unless you're the one required to decipher the scrips. Why be upset about the stereotype? It's not going to change the way you, personally, do business and it's not like you're going to be shunned out of society and labeled a worm.

Heck, editors of publishing houses are stereotyped as bloodless creatures whose only desire is to crush the hearts of new writers. I've heard of editors being pissed off about it, but I find it pretty funny because it's so untrue. We're really a very nice lot...for the most part.

Anyway, you know I adore your blog. And, yes, I can attest that your handwriting is lovely!

 
At Sun May 27, 11:32:00 PM, Blogger Sid Schwab said...

Hate to be an asshole, but, much as I like him, scalpel is NOT a surgeon.

 
At Mon May 28, 10:11:00 AM, Blogger scalpel said...

I think my assholishness confused him. Understandable, really.

 
At Fri Jul 20, 09:28:00 PM, Anonymous Kate Gladstone said...

The world needs more calligrapher-doctors ... and some hospitals have noticed this. Since 1996, I've made a large part of my income by visiting hospitals (at their request) to give the MDs courses in Italic handwriting uunder the rubric "Handwriting Repair."

 
At Tue May 13, 08:35:00 PM, Anonymous Anonymous said...

I have learned, that "in general", bad handwriting is reflective of the brain thinking faster than the hand can write. This applies to all professions. Good topic.

 
At Wed Nov 12, 08:48:00 PM, Anonymous markm said...

Anonymous, that could explains why most school teachers have such good handwriting, except that I remember a few that were pretty intelligent and still had good handwriting.

Anyhow, I cannot think of any professions that still require handwriting much to be read by others except teaching and the medical professions. Obviously, pre-meds have quite a lot of things that are more important to learn than good handwriting.

 
At Mon Nov 09, 09:59:00 AM, Anonymous Anonymous said...

my very later comment is that most of the doctors where i am print out there scripts and everything like that nowadays mind you they are the doctors who put out 4 or 5 patients an hour and you dont really like them and only go to cause they are easy to get into

 

Post a Comment

<< Home