This is my 100th blog posting, so it seemed like a good time to get a bit frivolous. The NY Times recently ran a front page story about websites that collect user-submitted triviata – such as “Pets Who Want to Kill Themselves” (pictures of bulldogs wearing bunny ears or cocker spaniels in Yoda costumes) – and are later repurposed into bestselling books. Just as I was thinking about that, I happened upon a medical chart with one of the funniest dictation snafus I’d ever seen, and I got to thinking…
Every doc knows that transcripts of medical dictations can be glitchy. After all, we do them in the car, or with Colbert on in the background, or frantically between patient encounters. We talk a mile-a-minute, and our word salad is chock-full of obscure medical terms. The transcriptionists charged with making sense of it all vary in skill and experience; these days, many are based in other countries. So it should not be surprising that little errors crop up all the time. But every now and then, we see a real doozy.
With that as background, here’s the deal: I’ll give you my two favorite medical transcription faux pas, and we’ll see if we can generate a boffo list of all-time favorites from all of you. Who knows, maybe there’s a book in it.
Here’s the one I just saw recently. A patient of Middle-Eastern descent suffered an acute respiratory deterioration. The covering physician came to see the patient stat, and later dictated that he found the patient in extremis (a fairly common medical term-of-art, it’s Latin for “at the point of death”).
Pretty scary situation, but not as scary as the transcriptionist made it out to be:
“…on my arrival to the ICU I found the patient to be an extremist.”
I kid you not.
As good as that one is, it doesn’t quite take the cake. That honor belongs to a dictation I did as a resident, of a hospitalization of a gay man suffering from AIDS and pneumocystis pneumonia. (Parenthetically, this area soon became my first research focus, such as here and here). The patient did reasonably well, but remained a bit hypoxic at the time of discharge. In describing the discharge plan, I mentioned that “The patient was discharged with home O2” – shorthand for home oxygen.
But the transcriptionist apparently thought I was commenting on the patient’s lifestyle and escort rather than his medical equipment. The final dictation read:
“The patient was discharged with Homo Two.”
OK, your turn. Any favorites out there?