FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

DR.WOLF DECIPHERS THE HIEROGLYPHICS ON PRESCRIPTION LABELS

Question: I recently saw my doctor because of bronchitis, and he gave me a prescription for an antibiotic. I couldn't read anything on the prescription he wrote except the date. His penmanship is the source of my question. Do all medical schools require doctors to take a course in creating illegible handwriting?

Answer: It does seem that poor penmanship is ubiquitous among physicians, but this is not because of required medical school courses or standards set by the Medical Board. I think the problem arises because of time management issues. You see, it takes each of us a little longer to write legibly than it takes to make a semi-legible scribble. Doctors are constantly under pressure to write notes, prescriptions, insurance forms and other documents before moving on to the next person who is impatiently waiting down the hall. Therefore, we have a tendency to let our penmanship get sloppy.

In most jobs the boss would come rap your knuckles with a ruler, or utilize a similar punitive measure, if he or she couldn't clearly read your missives. But who is

going to offend the doctor by complaining about penmanship, while he or she is trying to help you get well? You guessed it almost no one. Hence, doctors have little pressure to make their correspondence any clearer than need dictates for the pharmacist or nurse to identify the prescribed treatment. And, as I'm sure you know, pharmacists and nurses are highly skilled at interpreting these cryptic notes and instructions.

There may, however, be reasons other than penmanship that kept you from reading your prescription. You see, prescriptions must contain several specific pieces of information. They are: The name of the individual who is to get the medication, the date the prescription is written, the name of the medication and its strength, the amount of medication the pharmacist is to dispense, the instructions for taking it, and whether there are any refills. This considerable amount of information is packed onto that small prescription blank in a relatively standard way. The standard abbreviations make deciphering it easier for medical personnel, but not necessarily easy for the uninitiated.

Long before my day, prescriptions were written in Latin because it was the universal language of scholars. Today, English is the language of choice, but remnants of Latin remain in the abbreviations used on prescriptions. Common examples are the abbreviations about how medications are to be taken. The following are examples of the more common ones you have probably seen on your prescriptions: bid = twice each day, tid = three times daily, qid = four times daily, po = by mouth, hs = at bedtime, pc = before meals, ac = after meals.

In addition to abbreviations, prescriptions may seem rather cryptic because of the name of the medicine itself. Whether brand name or generic, uncommon names are given to drugs with the hope of avoiding confusion with already existing products. This policy gives rise to names like chloramphenicol (a powerful antibiotic, especially good for typhoid and paratyphoid fevers), furazolidone (useful for bacterial dysentery and food poisonings), propranolol (used to treat irregular heartbeat and glaucoma) and Lanoxin (helpful in treating atrial fibrillation). When one sees these kinds of names in writing, they really aren't illegible, they just seem that way.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Notice: There was an error in the column numbered 2038, about Nutrasweet. The sentence that said "A most revealing finding was that BEFORE NutraSweet's introduction, 53 individuals out of every million developed tumors of the central nervous system compared to 48 per million beforehand" (emphasis added). The sentence should have read: "A most revealing finding was that AFTER NutraSweet's introduction, 53 individuals out of every million developed tumors of the central nervous system compared to 48 per million beforehand." We apologize for the error.