{"id":9094,"date":"2019-02-18T14:14:29","date_gmt":"2019-02-18T19:14:29","guid":{"rendered":"https:\/\/blogs.nejm.org\/hiv-id-observations\/?p=9094"},"modified":"2019-02-20T15:14:36","modified_gmt":"2019-02-20T20:14:36","slug":"yes-many-people-are-pleasant-or-delightful-even-lovely-but-should-that-be-in-the-medical-note","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/yes-many-people-are-pleasant-or-delightful-even-lovely-but-should-that-be-in-the-medical-note\/2019\/02\/18\/","title":{"rendered":"Yes, Many People Are “Pleasant” or “Delightful,” Even “Lovely” — But Should That Be in the Medical Note?"},"content":{"rendered":"
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Isn’t she “lovely”? Could be, but keep it out of the note!<\/p><\/div>\n

When writing medical notes, some clinicians include an appreciation of their patient’s personality and disposition in their opening line (the “Chief Complaint”), or when they’re wrapping up (in the “Assessment and Plan”), or in both locations.<\/p>\n

You know — it goes like this:<\/p>\n

“CC:\u00a0 Ms. Smith is a very pleasant<\/strong>\u00a062-year-old woman admitted with …”<\/p>\n

or:<\/p>\n

“A\/P:\u00a0 To summarize, Mr. Jones is a\u00a0delightful<\/strong>\u00a089-year-old man presenting with …”<\/p>\n

or:<\/p>\n

“CC:\u00a0 This lovely<\/strong> 74-year-old retired school teacher was in her usual state of health until …”<\/p>\n

Yikes, not a fan of this practice.<\/p>\n

Am I just being\u00a0curmudgeonly and negative? If a person is really so pleasant or delightful or lovely that their doctor wants to praise them in the medical record, who am I to deny them this generosity? Or deprive their patients of this honor?<\/p>\n

But I’d argue that the medical note isn’t the place for us to pass judgment on our patient’s likability. What does this imply about those we don’t<\/em> call pleasant?<\/p>\n

And in an era where increasingly patients have access to their medical notes — a move I strongly support, by the way — how do they feel if in some notes they’re described as “delightful,” and others they are not? What if they’re having a bad day, reducing their loveliness? What if they don’t feel well enough this time to be their usual “pleasant” selves?<\/p>\n

Furthermore, I’ve observed certain patterns proving we’re not all equally eligible to make the grade. First,\u00a0women earn way more “praise” (ahem) than men:<\/p>\n