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Eight unaccepable abbreviations/chart.pdf
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On Abbreviations
Bruce T. ADORNATO
* * *
Brevity, is the soul of wit, but it may also be the mother of misunderstanding.
As I recall the sacred rites of transitioning a first year medical student to a doctor (health care provider still doesn't sound right), I recall three signal events:
Buying the white coat
Getting the no-no
gratuity from Eli Lilly and Company - that black bag with your gold-embossed
name, punctuated with those two magic letters that surely give the gift
eternal value.
Learning the secret
script of handwriting prescriptions and orders.
The third signal event, a true initiation into the mysteries of medicine, had more perceived glamour and glow than what we really had to do: memorize the arcane system of medical abbreviations, of which there are many: qhs, qod, qid, qd, bid, tid, ac, etc denoting time of ingestion or delivery and frequency; route of administration: iv, im, sl, po, pr; which side and which body part: os, od, ou, as, ad, au; and thousands of others, some standardized, some personalized: ROM (range of motion), SLR (straight leg raising), WNL (we never looked).
Now, as the regulatory bodies that scrutinize medical care (JCAHO, CMA, AMA, ABMS, AHPR, CIA, Homeland Security, and others) examine the causes of medical error, we find that our brevity is sometimes our enemy. Compounding the problem is the inability of computerized order entry systems to understand abbreviations. Just as we make mistakes, so can the order entry system. And we have to deal with this imperfect physician/ machine interface now. Accompanying my column is a partial list of common abbreviations that are no longer allowed. Yes, there are many more, but this list, compiled by the hospital, includes several abbreviations which pose significant issues - whether by computer or human interpretation.
Take comfort in the fact that you are smarter than the computer which doesn't understand your brevity. Better yet, take comfort in knowing that help is on the way: The real solution will be sophisticated voice recognition systems which will allow us to real-time dictate H&P's (sorry, history and physicals), and orders. If you don't think this is coming, call up United Airlines and make a reservation using the company's automated voice recognition system. It really works. A chipper voice says "Sorry, I didn't understand you. Did you say Friday, Feb 12th?" Some day the cyber person will say, "Did you say 10 milligrams of morphine sulfate or magnesium sulfate?" They are here to help.
Many of you might feel a nostalgic twinge for some or many symbols on this list; most of us will require some assistance if we are to put these on the shelf forever. We will require some mental reorientation and reprogramming to navigate this sea change.
After all, we did learn the abbreviations, and we think of ourselves as doctors - even after the gold letters started to fade on that old black bag. We will have to get along without these shortcuts and hopefully cause fewer misunderstandings.
Last month I announced the first Annual Stanford Medical Staff Favorite Websites Contest. Entries are rolling in, but because some of you may not have had a chance to see our Contest Rules in January, I'm extending the deadline for entries until Monday, March 1. Here again is the coupon:
A. Best Patient Information Site:
______________________________
B. Best Physician Pharmaceutical Site:
______________________________
C. Best Drug Information Download Site:
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D. Best Anatomy Reference Site:
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E. Best Practice Management Site:
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The winners in each category will be placed in a hat and a Grand Winner will be drawn. The Grand Prize is dinner for two at my house, or dinner at the New Old Pro sports bar in Palo Alto. Winner's choice.
Don't send the coupon by mail. Entries by e-mail only:
