評論
打印
Doctors' notes
醫(yī)生的筆跡
Careful what you write
注意你筆下的字
More patients are getting to read their doctors' scribblings
越來越多的病人開始讀懂醫(yī)生的潦草字跡
A DOCTOR who sees a child with an odd appearance might write “FLK” in his notes. Short for “funny-looking kid”, it is meant not as an insult, but as a reminder to watch for slow growth and mental retardation, which can accompany physical abnormalities. Later he may add “FLD”: funny-looking dads tend to have funnylooking offspring. But such candour may become a thing of the past as more hospitals and clinics make doctors' notes available to patients and their guardians.
面對一個長相奇特的孩子，醫(yī)生會寫下“FLK”的字跡?！癋LK”是“長相滑稽的孩子”的意思，此意并非是一種人身攻擊，而是暗示身體生長緩慢或智力發(fā)育緩慢，也會伴隨生理異樣。之后他加上“FLD”：長相滑稽的父親更易育有長相滑稽的后代。但隨著醫(yī)院和診所要求醫(yī)生以病人和其監(jiān)護(hù)者能讀懂的方式書寫，這種直白會成為過去式。
The trailblazers see open notes as a way to engage patients in their treatment, and to keep their other carers informed. A study in 2012 in the Annals of Internal Medicine of 105 American doctors who shared their notes with 20,000 patients backs this position. Over four-fifths of the patients who visited their doctors in the following year had looked at their notes. In a survey, about three-quarters said they felt more in control of their care. Few said the notes were confusing, offensive or worrisome; nearly all wanted access to continue.
病人的首個醫(yī)生將病歷上的信息視為參與治療的一種方式，讓之后的醫(yī)生獲得信息。2012年，《內(nèi)科醫(yī)學(xué)年報》做了一項調(diào)查，105名美國醫(yī)生有這種行為，涉及20，000個患者。一年內(nèi)再次就診的患者中，超過五分之四看到了首位接待他的醫(yī)生寫下的信息。一項調(diào)查表明，約四分之三的患者稱，這種信息共享讓他們更感安心。很少有人認(rèn)為醫(yī)生的字跡難以辨認(rèn)、有冒犯性或是令人不安的。幾乎所有人都想繼續(xù)治療。
The doctors who took part reported little change in their behaviour and little extra work, though some did alter the way they wrote about charged topics such as cancer, mental health, substance abuse and obesity. As for FLK and other medics' slang, Tom Delbanco, one of the study's authors, says: “Good doctors don't label things; good doctors describe things.”
參與該調(diào)查的醫(yī)生，很少特意改變行為和畫蛇添足，雖然在涉及癌癥，精神病，藥物濫用和肥胖等問題時，確實有部分醫(yī)生會換個寫法。該調(diào)查的作者之一湯姆·德百考稱，對于FLK和另外的醫(yī)學(xué)俚語，“好醫(yī)生不是給事情定義，而是描述事情?！?/div>
Some 3m American patients now have easy access to their doctors' notes, including those at leading institutions such as the Cleveland and Mayo clinics, and 1m of those cared for by the Department of Veterans Affairs. This is good business as well as good medicine. Patients with Kaiser Permanente Northwest must register on its website in order to read their doctors' notes, which makes their care easier to manage and lowers the chance that they will switch to a competitor.
如今，300萬名美國病人能夠輕松讀懂醫(yī)生的字跡，其中包括像Cleveland 和 Mayo 診所這樣的領(lǐng)先診所的醫(yī)生的字跡。他們當(dāng)中，有100萬名病人由退伍軍人事務(wù)部照顧。這對商務(wù)和醫(yī)學(xué)都是好事。凱撒醫(yī)療機(jī)構(gòu)的病人需在網(wǎng)站注冊，才能讀醫(yī)生的字跡，這使得他們可以更輕松的掌控他們的治療，降低他們流失到競爭對手的醫(yī)院去的幾率。
Health administrators elsewhere are watching with interest. Some British doctors have already opened their notes and more are likely to follow suit if the National Health Service keeps its promise to give all patients online access to their records by next year. The next step, says Dr Delbanco, is getting patients to contribute to their records. Funny-looking doctors take note.
海外的醫(yī)療管理者頗有興趣的關(guān)注此事。一些英國醫(yī)生已開放他們的字跡，如果國家衛(wèi)生服務(wù)局明年承諾讓所有的病人看到他們的醫(yī)學(xué)記錄，那么更多的醫(yī)生將開放字跡。德百考說，下一步是讓更多的病人看到他們的醫(yī)學(xué)記錄。記錄長相滑稽的醫(yī)生可要注意了。
