A scribbled prescription
First of all, the lack of medical investment and the environment of supporting doctors with medicine have led to doctors' prescriptions being scribbled.
Although Beijing has begun to pilot the medical reform measures of "separating medicine from medicine", in most hospitals in China, doctors' income still depends on how much business they have created for the hospital, and drug income accounts for half of hospital income or doctors' workload. If the prescription is written neatly and clearly, many patients may not choose to buy medicine in the hospital, but choose a pharmacy with much lower price outside. Under the medical background that the medical and health investment is seriously insufficient and the current medical expenses are seriously lower than the labor cost, half of the business income is gone. How can hospitals and doctors bear the huge economic pressure brought about by this? Therefore, the rule of supporting doctors with medicine may be the most fundamental reason for disorderly prescription.
Secondly, the tense doctor-patient relationship and the opportunity to avoid communication lead to doctors' prescriptions being scrawled.
At present, the phenomenon of doctors scribbling in the process of writing various medical documents is also a special product of the increasingly tense relationship between doctors and patients. For some doctors, not letting patients know what medicine they have prescribed may reduce a lot of trouble. Because some inappropriate drugs are used in reality, or for other reasons, the patient has physical problems after taking the medicine. As long as the patient doesn't know what medicine the doctor prescribed, it's hard to go to the doctor for a theory. With such luck, it is not surprising that doctors prescribe drugs at random. Doctors don't want patients to know the contents of prescriptions, that is, they don't want to satisfy their right to know, or they don't want to communicate with patients enough. It seems that the doctor has lightened the burden, which seems to be labor-saving and worry-free, but it is actually a double-edged sword. Doctors prescribe drugs indiscriminately, avoid communicating with patients, and even prescribe drugs hastily for a few minutes. Will patients be satisfied with such opaque medical services? This is very unfavorable for easing the current tense doctor-patient relationship.
Thirdly, the unreasonable allocation of medical resources and heavy work pressure lead to doctors' scribbling in prescribing.
Due to the unreasonable allocation of medical resources in China, many hospitals are overcrowded. The time pressure faced by doctors in their daily work is often more severe than the above-mentioned "writing a sentence in 10 second". Doctors receive a large number of patients every day, ranging from dozens to hundreds. Under the pressure of excessive medical treatment, in order to save time, those scribbled prescriptions are more likely to happen than usual. Secondly, in our country, the written work that doctors have to complete is endless, and most of them are a collection of proper nouns with certain routine characteristics, whether in outpatient or in hospital. After these proper nouns are written repeatedly, the glyph strokes will inevitably move towards the realm of "spirit likeness". Some scholars have found that in internal medicine, due to the diagnosis and treatment of diseases, the record requirements of medical history and examination are relatively high, and the handwriting is clearer; Surgery requires less discussion and analysis of illness than internal medicine, and most of the treatments are mainly surgery, so the handwriting is scrawled. The situation in foreign countries is similar to that in China: in a research report in Spain, the medical records of 1 18 are illegible and ambiguous, including surgical medical records of 16 and only two medical records of internal medicine.
Finally, the characteristics of medical profession and the particularity of medical documents lead to the scribbling of doctors' writing.
Because the medical literature written by doctors contains a large number of proper nouns and drug names, mixed with English, English abbreviations and even Latin, and many Chinese abbreviations, non-medical people will inevitably feel confused when reading. Even colleagues will encounter difficulties in reading medical literature in non-professional fields, especially those with elegant brushwork, who can only sigh at the paper. For pharmacists, it is not difficult to identify drug names because they have to face doctors' prescriptions every day, and the judgment of handwriting will become higher and higher with the passage of time. But even so, it is inevitable that a tragedy like that in the United States will happen. For doctors themselves, poor handwriting is not a good thing: first of all, it is easy to cause medical errors, and once medical errors occur, the consequences are often serious and harmful to others; Secondly, poor writing will also bring inconvenience to our doctors' clinical research. It is a pity that messy handwriting can only provide limited clues when it is necessary to review, collect and summarize cases, and the treatment experience can not be well preserved.
Handwriting is a characteristic with strong personal color. Doctors, like teachers, belong to a profession with a high degree of handwriting openness. Compared with teachers, doctors have greater writing responsibility and higher requirements, and the harm of scribbling is also greater. Although doctors have no tendency to scribble on the whole, because of the working environment, pressure and professional characteristics, doctors' handwriting is generally illegible to ordinary people. Of course, some doctors are used to flying dragons and dancing phoenix, but people with bad handwriting actually exist in all industries. It is a common problem all over the world to put an end to doctor's graffiti, especially prescription graffiti and reduce medical errors. There have been many researches and attempts abroad. An article published in Am J Manag Care in 2003 analyzed the influencing factors of doctors' scribbling, including patients' age, gender, residence, diagnosis times, visiting time and so on, which was considered to have a considerable relationship with doctors' scribbling. The similar spelling of some drug names also increases the risk of prescription errors to some extent. In view of the above situation, measures such as improving medical environment and improving drug names can reduce prescription errors to some extent.
To sum up, in any case, all kinds of public hazards caused by indiscriminate prescription should be paid attention to by the society. What government functional departments have to do is not only to introduce laws and regulations to manage prescription disorder. More crucially, we should accelerate the process of new medical reform as soon as possible, completely eradicate the trend of supporting doctors with medicine, realize the separation of medicine as soon as possible, and strengthen the management of pharmaceutical affairs in medical institutions. Only in this way can the problems related to prescription disorder be cured and the safe use of drugs be better promoted. Of course, the most direct way is to use electronic prescriptions and print prescriptions.