Death by prescription: Doctors' handwriting causes 7,000 deaths a year

The jokes about physicians and their sloppy handwriting are age-old and more or less contented among doctors themselves. But for some people it is not funny at all. A misread prescription can lead to mistreatment and cause death.

In several countries the printed doctor prescription is pushed forward by policy makers as the safer option, as it not only provides clarity but also constitutes a data base of medication that the patient has taken over the years.

"It could be that the doctor is focusing on the diagnosis and medication more than on writing the prescription," argues Keya Shivadey, specialist Gynecologist and Obstetrician at Aster Medical Center.

In the UAE patients can ask for a print out of their prescription to be more secure. "I do give medications on print sometimes. But for the insurance company I still need to provide a written prescription.”

Although Keya says to have a very neat handwriting she agrees that sloppiness is evident among many doctors around her. "Thank God we have computers now and some doctors are prescribing the medication in print."

More than 100 doctors gathered in the state of Maharashtra, India last month to make a statement; bad handwriting of a physician is harmful.

According to non-profit organization Medscape India, which spearheads a campaign to address the issue, the number of fatal incidents due to unreadable prescriptions is internationally on the rise.

In fact, the Institute of Medicine (IOM) reported that the sloppy handwriting of physicians is responsible for 7,000 deaths each year.

"I do have a bad handwriting, but it never resulted in any problems," tells Saleem Moopen, Ophthalmologist at Aster Medical Center. "I sometimes receive phone calls when patients are at the pharmacy, and they cannot read what I have written."

As the patient is often not familiar with the jargon that is scrabbled on his note the onus is on the pharmacist, who is tasked with the challenge of deciphering the order for a certain medication. This is not an easy task, tells Usha, who has been working as a pharmacist at Aster Pharmacy for the past 5 years.

"Experience is a must," she says. "It takes about 3-4 year. Trainees have a difficult time. We advise them always to ask the doctor."

As the experience of the pharmacist increases, the ability to decipher the physician's handwriting grows. But this is something only the pharmacist will be able to do, as it requires primary knowledge about the medical background of the patient too.

"An experienced pharmacist will know what medicine the physician wanted to prescribe based on the diagnosis and the symptoms.

"Also the period of medication and the costs of the medicine tell you what kind of medication is prescribed. I can now decipher a prescription if I can read 2 or 3 letters, but for the patient it will be very difficult to read the prescription."

It is often claimed that the prescription is only meant for peers, who are specialized in deciphering the scrabbling because they most probably produce similar notes. Another joke says that while doctors are trained to write unreadable notes, pharmacists are trained to decipher them.

But it is not a good practice, admits Saleem. "I think you cannot not generalize and say that all doctors have a bad handwriting. But I think the majority of medical prescriptions are difficult to read. And actually it is not good if it is very bad handwriting. It should be readable. This does not only protect the patient but also the doctor, who might be accused of malpractice in case of wrong medication."

According to Saleem sloppy handwriting is often caused by a rush. "I have about 20 patients a day, and for every patients I have to write 2 to 3 pages for the insurance company. I have to write many long stories, and I have to do it fast. Then it turns from bad to worse."

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