Dr. Nomal Chandra Borah
Chairman & Managing Director, Guwahati Neurological Research Centre
Recently, when attending to a patient referred to me, I had great difficulty in deciphering the prescription of the doctor who treated the patient earlier. This led me to conduct a search online, and the search-string I chose was: illegible handwriting of doctors caused death. The result was stunning: 9,08,000 items in 0.46 seconds. The most interesting aspect of this was the number of people affected by it. The report – 'To Err is Human' – by the Institute of Medicine (IoM) states that medical errors cause at least an estimated 44,000 preventable deaths annually in the United States of America alone, of which 7,000 deaths are attributable to sloppy handwriting. Anecdotal evidence and personal experience lead me to believe that the situation in India is far worse.
Let me elucidate how this happens. A few years ago, the daughter-in-law of the former editor of a leading publication in Assam was admitted to GNRC, suffering from convulsions. While the investigations could pinpoint no reason, a chance discovery by an attentive nurse revealed that a doctor in Delhi had prescribed her DUODIL – an analgesic, but what was bought and consumed was DAONIL – a medicine for diabetics. This was causing a sudden fall in her blood sugar levels, leading to the convulsions. Such a grave consequence, simply because of the illegible handwriting of the doctor who treated her in Delhi!
Recent guidelines from the Medical Council of India (MCI) mandate that doctors must write prescriptions legibly and in capital letters. They must also furnish a complete and detailed prescription to ensure that there is no chance of incorrect treatment. Although a good move from MCI, this protocol is hardly being adhered to by practitioners. There is no monitoring mechanism to ensure adherence. This is a grave cause of concern.
I recently watched a programme on BBC which concluded that in Tamil Nadu, only one in five doctors in rural areas writes legible prescriptions. Another study concludes that only half of Indian doctors actually sign their prescriptions at all.
Doctors' prescription isn't just a guide for patients but also an instruction manual for family members, documentation of drug requirement for chemists and track record of patients' past and present conditions for other doctors. When patients are referred to me, I go through all associated prescriptions. Yet, even after so many years of experience, I am unable to decipher 25% of the prescriptions written by other doctors.
Illegible handwriting causes loss of information and prevents better care for patients. As a doctor, I believe that Mahatma Gandhi's belief that 'good handwriting is an asset', is applicable to physicians perhaps more than most other professions. A doctor's handwriting can mean the difference between life and death for patients. Can there be any asset dearer than life, which doctors protect? And if the doctor's handwriting can strip the patient of that protection, isn't good handwriting an invaluable asset for doctors? Shouldn't all doctors then attempt to acquire such an asset? My answer is an unequivocal 'YES'.
About Dr. Nomal Chandra Borah
Dr. Nomal Chandra Borah is the Chairman and Managing Director at GNRC Ltd., which has evolved from a clinic in Guwahati, Assam to North East India's premier multi-specialty hospital chain. At present, it operates three hospitals - GNRC Dispur, GNRC Sixmile and GNRC Medical. World Bank Group awarded a grant of US$150,000 to help scale the ultra low-cost primary to tertiary healthcare service delivery model of GNRC Medical. Dr. Borah has published 15 papers in national and international journals, has attended 19 international conferences and has supervised DNB training programme in Neurology. He is a member of the Medical Ethics Committee of the Indian Medical Council, Assam State Branch..
Dr. Nomal Chandra Borah is the Chairman and Managing Director at GNRC Ltd., which has evolved from a clinic in Guwahati, Assam to North East India's premier multi-specialty hospital chain. At present, it operates three hospitals - GNRC Dispur, GNRC Sixmile and GNRC Medical. World Bank Group awarded a grant of US$150,000 to help scale the ultra low-cost primary to tertiary healthcare service delivery model of GNRC Medical. Dr. Borah has published 15 papers in national and international journals, has attended 19 international conferences and has supervised DNB training programme in Neurology. He is a member of the Medical Ethics Committee of the Indian Medical Council, Assam State Branch..
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