CAPITAL punishment for doctors!

Doctors still scribble prescriptions despite HC order to write in capital letters

• A recent survey finds 59% prescriptions are not legible
• In 64% cases there are no mention of dosage; no duration in 55%

Earlier this year, the Medical Council of India (MCI) approved a draft notification that made it mandatory for doctors to write prescriptions in capital letters; this was after complaints that chemists sometimes gave wrong medicines because of similar sounding names of drugs. However, despite the notification, doctors continue to ‘scribble’ on prescriptions.

A pharmacist from Nalgonda approached the Hyderabad High Court on the matter and the court ordered the implementation of the MCI notification. “A legible prescription for careless doctors,” was the order of the court. It also wondered why anybody didn’t think of ditching the prescription pad and going digital.

Their hands may be blessed with cure, but not with good handwriting.

Prescriptions from doctors are often illegible, missing instructions on dosage and list unnecessarily a large number of expensive branded drugs.

A recent study published in the Journal of Medical Sciences reviewed 1,100 prescriptions in Hyderabad. The study revealed that 59 per cent of the prescriptions were barely legible, and many others offered incomplete directions about dosage and use. More importantly, certain expensive drugs were overprescribed even when generic cheaper versions were available in the market.

Some 89 per cent prescriptions did not bear names of the physician and 20 per cent lacked the physician’s signatures. In 64 per cent of the cases, the physician did not mention dosage and in 55 per cent of the cases, the duration of treatment was missing.

Bad handwriting has few serious consequences if you’re a baker, but for doctors, getting it right is not only critical, it can mean life or death. If the pharmacist can’t decipher what the doctor jotted down, you could end up with the wrong pill or dose. Keeping this kind of incidents in view the court has come out with a solution-- capital letters.

There have been long-standing concerns on doctors’ handwriting.

“We want prescriptions to be legible,” says Jayshreeben Mehta, president of the MCI.

“There have been numerous cases of pharmacists and patients straining their eyes to figure out the name of medicines prescribed by doctors. Sometimes drug names are misread, putting the safety of patients at risk. Non-pharmacists face problems in identifying the exact medicine in case of two or more similar sounding names,” says Retd IMA Chairman (Hyderabad) Dr Narsing Rao.

Doctors across India should write the names of medications they prescribe to their patients only in capital letters, the country’s apex medical regulators have said in a move intended to counter the legendary illegibility of prescriptions.

The Medical Council of India has approved a draft notification that directs doctors to write drug prescriptions in full capital letters. The notification will need the approval of the union health ministry before it slips into the rulebook for doctors nationwide.

Doctors like Khurana feel that if the doctor’s handwriting in capital letters is also illegible, the Supreme Court’s order will not serve the purpose. Rather, doctors should be advised to write the prescriptions legibly.

“Some pharmacy companies try to capitalise on a drug’s brand value by introducing another drug after making minor changes in the spelling,” says Gheesulal Jain, ex-president, pharma association. Some of the similar sounding medicines include Celin (vitamin C) and Celib (for arthritis) and many such names differ only by a letter and makes lot of difference in line of treatment and could lead to some reaction, anaphylaxis or death in some cases.