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Observations or Studies about Clinical Writing Practices

Locate an article–either from a mainstream news outlet or a more specialized one–about the contemporary writing practices of clinicians, particularly as they shape communication with patients. You can engage any aspect of the piece, but you might relate it to the findings from your interview of a medical/health professional or the training you might need for your targeted profession. Here are some examples of the types of articles you could respond to:

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7 Comments

  1. sarahmhudak says:

    http://www.psychologytoday.com/blog/psychology-writers/201112/what-should-i-write-about

    Psychology Today is a magazine written about all sorts of current psychological topics, but it is written for non-psychologists. Even though I am a Psychology major, I enjoy this magazine because its format allows for a quick understanding of complex topics. On their website, Psychology Today has a lot of helpful links and articles. The link I posted above is written by Carolyn Kaufman, who has her PsyD in psychology for writers, so I feel like her tips for writing a book are valid. Many clinical psychologists who have their Master’s, their PsyD, or are practicing counselors end up writing books for the public in a format similar to the one public health journalism entails. Using her three tips is a solid way to make sure your work gets read and used!
    Her first tip is writing about something you are passionate about. This will help you find ideas, and will also push you to complete the piece you are working on.
    Research truly begins after taking interesting ideas and looking for information gaps. Inside those holes is a study! Even while writing or conducting a study, more of these holes may appear. Kaufman’s second tip is to not be afraid of the research; she encourages writing out the questions and saving them for later potential studies or digging deeper.
    Her most important tip is to remember who you are writing to. The readers of your book, in this instance, will most likely not have an extensive training in psychology, but they are clearly still interested in your topic. Kaufman stresses the importance of helping your readers understand the information and apply it to their daily lives. This can be done by step-by-step guidelines, real-life examples, and providing a section at the end of each major topic for discussion and reflection.

  2. kgardner1130 says:

    In the first article, Doctors and Patients, Lost in Paperwork, I was interested in how the new resident work hour restrictions are affecting patient care in relation to patient notes and handoffs. This article pointed out how many residents spend just as much time working on documentation as they do seeing patients. It also explained how electronic medical records are helpful, but they also lend to more careless errors and bypassing important information. It seems that medical training may need to now include instruction on how to efficiently take patient history and write notes in addition to standard medical practice.
    Another article I read, Limits on residents’ work hours may adversely affect patient care, written by a correspondent from the Boston Globe, addressed how the resident work hour restrictions have affected patient hand-offs. Dr. Gupta explains how the restrictions have forced residents to be rushed out of the hospital to ensure that they leave on time. She also noted how the shorter shifts have resulted in more frequent shift changes and more doctors interacting with each patient for less time. This makes it clear that now more than ever before, the method doctors and residents use to track patient information will be vital. Residents will have to learn how to record information in a hurry so they do not leave late; however, this rush could lend itself to more sloppy note taking and more mistakes in the hand-offs. It will also be important that doctors are well trained to fully read and understand patient notes even when under a time crunch. In this new training environment, it will be important that writing and note taking are taught to new residents so that patient care does not suffer.

    http://www.boston.com/whitecoatnotes/2012/06/27/limits-residents-work-hours-may-adversely-affect-patient-care/wsxX6ujZCg3t2Db46WXHAK/story.html

  3. apectol91 says:

    The third article brings up the question of whether email communication should be used between doctors and their patients. There are both pros and cons to this. I feel that this is a very pertinent issue in todays society. No longer do we rely on USPS and landlines as means of communication, but rather text message and email. Just take a 5 minute walk around UCF campus and count how many people you cross paths with that are glued to their smart phone, unaware of their surroundings other than the 2 feet they can see in their peripheral vision.
    Email could be a valuable tool for doctors and patients to use as means of communication for many reasons. As the article points out, it increases the efficiency and accessibility of doctors. Doctors can give specific protocols and information on self home care or other such information which may be pertinent to the patient which may otherwise go in one ear and out the other were it to be communicated face to face. Doctors are notorious for having chicken scratch handwriting, so emails may also eliminate any issues of illegibility. Implementation of emails can also be beneficial by reducing wait times, as well as completely eliminating wait times for patients who may only have a trivial question which could just as easily be answered over email. Many patients may also have limited means of transportation to go physically see the doctor, so email communication would aid if that were the case. Email is also thought to increase the frequency of communication between doctor and patient, which can benefit the patients overall health by constantly keeping your provider updating on your well being.
    In contrast, email may not be a useful means of communication because it reduces the ability to build a personal relationship with your doctor. Patients tend to feel as if their doctor cares more for their well being when they physically sit and take the time to have a one on one conversation with them. Important physical attributes may also be missed through email communication, as pointed out in the article. These can include facial expressions, body language, tone/quality of voice, posturing, gait or any other such physical abnormality that may be a sign or symptom indicative of some pathology.
    The issue of privacy is brought up, however I feel this could go both ways. Yes it could foster a path for information to get into the wrong hands, but so could phone conversations or medical records. Encryption on emails could eliminate this risk, but is no guarantee.
    When I interviewed by cousin, he made mention of the use of text and email as means of communication between his colleagues, which I agree is a very useful source. As an athletic trainer, email may be useful in sending athletes rehab protocols for them to complete at home, or any other type of information or instruction. The main issue with using email would be not being able to see the patient, which is a crucial part in the recognition of injury, as it is imperative to observe every aspect of your patient/athlete.

  4. tamarabwi32 says:

    http://www.oregonlive.com/pets/index.ssf/2013/01/pet_talk_oregon_veterinarians.html

    The article above describes the difference in what veterinarians write down on the prescription pad and what owners buy at a pharmacy or pet store to treat their pet. People tend to be more flexible in terms of ignoring prescriptions or diagnosis from vets than they are from people doctors, so there is disaster waiting to happen between what is written out for them and what they do for their pet. I actually see this issue where I work, where people who are prescribed heart worm medication and they buy cattle or swine ivermectin and dose their pet from there. It can technically be a safe and less costly alternative, but if you slip up on the dose part you could kill your dog or cat.
    In the case of this article, a surprising number of pharmacies are simply blocking communication from their medical professionals by giving the wrong product, a potentially life-threatening choice for the animal.

  5. ryanmarracino says:

    The article “Make Sure Patient Portals Go Beyond Meaningful Use” discusses how many physicians would like there to be an online system called a portal that would allow patients to have access to their own medical information online, as well as have a secure way to communicate with their doctor any questions, and also provide a way for doctors to send reminders and suggestions to patients. The article states that the primary reason to have a patient portal is simply to create a third form of communication with patients outside of face-to-face and phone calls. It suggests a method for implementing the portal system saying that it doesn’t have to be an “all or nothing approach”, and the system can be put into place slowly over time as physicians find which features are useful, and where they feel the system is lacking.
    I think this would be a great way to increase the knowledge that patients have about themselves, and could be an effective way to increase the efficiency of treating patients. I know with the orthopedic doctor that I shadow, there are many patients who go through physical therapy, and have many exercises to remember, and the doctor only checks on their progress every 6-8 weeks. Possibly having a system that could allow the patient to tell the doctor their progress, and have the doctor or physical therapist possibly modify their exercises and monitor their progress it would make a more comprehensive treatment for the patient as well as a more efficient way for the doctor to help patients without unneeded visits.
    Incorporating a patient portal into a physician’s practice could be a revolution in patient communication, and could allow for much greater control for the patient by allowing them to make more informed decisions, and making them capable of seeing the importance of drugs they are taking or therapy they are doing.
    http://www.ama-assn.org/amednews/2013/01/28/bica0128.htm

  6. hgmohan says:

    The most interesting fact of note to me was in the third article, where it mentioned that if doctor-patient communication was done through just email, the doctor could miss out on key facial expressions and body language. We see it all the time on tv shows like “House” or “Lie to Me”–how a single stray expression can determine the difference between life and death. Of course, those are just tv shows, and it’s unlikely that patients in the real world would be willing to die to hide a symptom that could mess with their personal life (I’m sure some would, though). The doctor-patient relationship is already strained enough, as the first article notes that doctors are cutting back on time spent with patients to catch up with their paperwork. There’s a line in the show “Scrubs”, where one of the main characters, Dr Cox, says, “People think of us as pill-dispensing, walking lawsuits, who are in fact less informed than their internet phones.” Taking all of this into consideration, I don’t think using email, or other impersonal forms of communication, is a good idea. If doctors want patients to trust them, they need to be able to spend time with them. If they resort to using email for communication, then what’s the point? Anybody can pick up a phone, type in their symptoms, and get a rough diagnosis. Having a face to face meeting is vital, to not only get a correct diagnosis, but to keep the trust between patient and doctor strong.

  7. igoldfarb says:

    While reading the NY Times article there were many things that stood out to me as troubling. The first was the practice that many doctors notes are pieced together from previous doctors notes. It’s kind of like the game of telephone; one doctor could leave out an important fact about the patient which might be incredibly important for a treatment that a later doctor prescribes. With the ever prevalence of electronic health records, the amount of time that doctors as well as nurses have to spend on paperwork has diminished. Doctors can now dictate their notes over the telephone and have a program type them out in the patient’s records. The article stresses (and I couldn’t agree more) that still face to face contact between doctors and patients are the most important part of healthcare. Doctors MUST speak to patients while at the same time not seem rushed or distracted like many of them do. Patients need to be able to tell their doctors everything and feel that they truly care about their well being. If that exchange doesn’t occur then there is a good chance that the health of the patient will not be the doctors, nurses, and other health care providers first priority; but instead filling out paperwork and making sure that insurance forms are filled out properly are their top priority.

    http://www.nytimes.com/2010/04/08/health/08chen.html?_r=1&

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