医生的笔迹

　　Careful what you write

　　注意你笔下的字

　　More patients are getting to read their doctors' scribblings

　　越来越多的病人开始读懂医生的潦草字迹

　　A DOCTOR who sees a child with an odd appearance might write “FLK” in his notes. Short for “funny-looking kid”, it is meant not as an insult, but as a reminder to watch for slow growth and mental retardation, which can accompany physical abnormalities. Later he may add “FLD”: funny-looking dads tend to have funnylooking offspring. But such candour may become a thing of the past as more hospitals and clinics make doctors' notes available to patients and their guardians.

　　面对一个长相奇特的孩子，医生会写下“FLK”的字迹。“FLK”是“长相滑稽的孩子”的意思，此意并非是一种人身攻击，而是暗示身体生长缓慢或智力发育缓慢，也会伴随生理异样。之后他加上“FLD”：长相滑稽的父亲更易育有长相滑稽的后代。但随着医院和诊所要求医生以病人和其监护者能读懂的方式书写，这种直白会成为过去式。

　　医生的笔迹.jpg

　　The trailblazers see open notes as a way to engage patients in their treatment, and to keep their other carers informed. A study in 2012 in the Annals of Internal Medicine of 105 American doctors who shared their notes with 20,000 patients backs this position. Over four-fifths of the patients who visited their doctors in the following year had looked at their notes. In a survey, about three-quarters said they felt more in control of their care. Few said the notes were confusing, offensive or worrisome; nearly all wanted access to continue.

　　病人的首个医生将病历上的信息视为参与治疗的一种方式，让之后的医生获得信息。2012年，《内科医学年报》做了一项调查，105名美国医生有这种行为，涉及20，000个患者。一年内再次就诊的患者中，超过五分之四看到了首位接待他的医生写下的信息。一项调查表明，约四分之三的患者称，这种信息共享让他们更感安心。很少有人认为医生的字迹难以辨认、有冒犯性或是令人不安的。几乎所有人都想继续治疗。

　　The doctors who took part reported little change in their behaviour and little extra work, though some did alter the way they wrote about charged topics such as cancer, mental health, substance abuse and obesity. As for FLK and other medics' slang, Tom Delbanco, one of the study's authors, says: “Good doctors don't label things; good doctors describe things.”

　　参与该调查的医生，很少特意改变行为和画蛇添足，虽然在涉及癌症，精神病，药物滥用和肥胖等问题时，确实有部分医生会换个写法。该调查的作者之一汤姆·德百考称，对于FLK和另外的医学俚语，“好医生不是给事情定义，而是描述事情。”

　　Some 3m American patients now have easy access to their doctors' notes, including those at leading institutions such as the Cleveland and Mayo clinics, and 1m of those cared for by the Department of Veterans Affairs. This is good business as well as good medicine. Patients with Kaiser Permanente Northwest must register on its website in order to read their doctors' notes, which makes their care easier to manage and lowers the chance that they will switch to a competitor.

　　如今，300万名美国病人能够轻松读懂医生的字迹，其中包括像Cleveland 和 Mayo 诊所这样的领先诊所的医生的字迹。他们当中，有100万名病人由退伍军人事务部照顾。这对商务和医学都是好事。凯撒医疗机构的病人需在网站注册，才能读医生的字迹，这使得他们可以更轻松的掌控他们的治疗，降低他们流失到竞争对手的医院去的几率。

　　Health administrators elsewhere are watching with interest. Some British doctors have already opened their notes and more are likely to follow suit if the National Health Service keeps its promise to give all patients online access to their records by next year. The next step, says Dr Delbanco, is getting patients to contribute to their records. Funny-looking doctors take note.

　　海外的医疗管理者颇有兴趣的关注此事。一些英国医生已开放他们的字迹，如果国家卫生服务局明年承诺让所有的病人看到他们的医学记录，那么更多的医生将开放字迹。德百考说，下一步是让更多的病人看到他们的医学记录。记录长相滑稽的医生可要注意了。