Doctors' reports can look like spilt Alphabetti Spaghetti

Torbay Weekly

I once received a handwritten note from the hospital. The patient’s name was at the top and it just said 'MSU NAD FU IVU OPD'.

To any non-medic it could have been a bad hand in Scrabble. To most people the only intelligible letters would have been FU but not in a good way.

In fact, it made sense. Mid stream urine test (MSU), no abnormality detected (NAD) follow up (FU) for intravenous urogram (IVU - a kidney x ray) and OPD (outpatient department).

Why are doctors so keen on acronyms? They are a useful shorthand.

A busy junior doctor did not need to write everything out in full when writing to a colleague.

It would have taken too long and I knew exactly what they were saying.

Even when speaking it is easier to say DNA than deoxyribose nucleic acid.

Everyone now knows about the PCR test but are unlikely to know that it is polymerase chain reaction.

Even I have been confused now that LFTs are used for lateral flow tests.

Since I was a student, LFTs have been liver function tests.

When the MRI (Magnetic resonance imaging) scans were first used they were called NMR scans (Nuclear Magnetic Resonance) but there was concern that the word 'nuclear' would frighten people although it is nothing to do with nuclear power or even bombs.

It is not only diseases which have acronyms.

We have the NICE or National Institute of Clinical Excellence although the acronym is now ruined by changing 'clinical' to 'Health and Care Excellence'.

There is also the CQC - or Care Quality Commission - overseeing standards.

A few years ago it was decided to set up a committee to examine why Torbay had one on the highest rates of teenage pregnancy in the county.

At the first meeting it was suggested that they call the committee the Sexual Health Advisory Group until someone pointed out the acronym.

I always raise my eyebrows when companies talk about the importance of PR.

I understand PR to mean per rectum examination, now often called DRE or digital rectal examination.

I do not need to go into details except to comment that some company’s PR can feel like remarkably like the medical version.

The acronym epidemic (or AE) seems to be spreading.

People have started using them as a code. Someone recently talked about PD. It took me a while to realise they meant Parkinson’s disease.

We are not the only profession to use acronyms.

Anyone who has watched crime dramas, especially Line of Duty will be used to the fictional AC12.

When working with the police it took me a while to understand PNC (police national computer) which is also a bank but, hopefully, not known to the police.

In custody everyone is guided by PACE or the Police and Criminal Evidence Act 1984.

Crime scenes have SOCOs or scenes of crime officers.

Even I was an FME or forensic medical examiner.

No journalist would be allowed to use an acronym without an explanation.

If anyone only wrote the acronym the sub editors would add the full name unless it is so widely used that no explanation is needed.

I cannot imagine any paper writing BBC (British Broadcasting Corporation).

But there is another problem.

Now that most letters to GPs are copied to patients the message can be indecipherable.

And Google does not always help with acronyms.

NAD, no abnormality detected, is also an important coenzyme in biochemistry.

One cynic suggested that 'examination NAD' could mean 'not actually done'.

The important message for my former colleagues is to learn from journalists.

Copying a report to the patient which is full of acronyms can look as though you have spilt a tin of Alphabetti Spaghetti on the page.

The patient is entitled to reply, 'I N I W Y T A', or 'I’ve no idea what you’re talking about'.