Do Doctors Need Handwriting Classes Now?

Weird things happen in our country every day. We sometimes hear news of VAT on Education, we hear authorities say that 'tigers have gone on vacation' when we speak of their endangerment, we hear of an editor of a newspaper get 72 cases against him that amounts to more than the national budget, and more. In a land where, new laws are implemented on a daily basis, whether they make sense or not, whether they benefit the common people or not, the newest of these laws to be implemented has to do with doctors' handwriting.

For a long time now, doctors' handwritings have been scrutinised and criticised all over the country because they are illegible – to the point where pharmacists have reportedly given out the wrong medicines to patients. And while some cases may sound hilarious – like giving out Viagra instead of heart medication – the consequences for others can be dire, even deadly.

Some cases are so odd it makes us wonder what the doctor was thinking. Safinaz Homayara Himi regularly buys arthritis medication for her grandmother. "I took the prescription to the pharmacist, and he could not read what was written for the life of him. After several attempts, we were asked to get the prescription rewritten," she says. After they went back to the doctor and asked to write a new prescription, he began to write on the old one. "Since there was no space, he actually began to write vertically. We had to persist a lot to get him to write on a new piece of paper."

Cases like these, while mind-boggling, are still quite harmless compared to some of the horrendous things that happen. Sakib Rahman, director of Lazz Pharma, a popular drugstore in Dhaka's Kalabagan, is still haunted by the memory of selling the wrong drug due to unreadable handwriting. Instead of Anoxil, a multivitam, the pharmacist handed out the bleeding medication Anaroxil. "If we provided Anaroxil instead of Anoxil, the consequences could really have been fatal," says Sakib. Luckily for the patient and for the pharmacy, the patient realised the mistake himself and came back to have it fixed. 

To make matters even more complicated for pharmacists, around 150 drugs in Bangladesh have names that resemble each other, according to Professor ABM Faroque, Department of Pharmaceutical Technology of Dhaka University. "If the retailer provides, say, Incidal instead of Inderal, the high blood pressure will not normalize, which Inderal is supposed to do. This may lead to dangerous consequences," he says.

Since the prescriptions are written in pen and pad, the handwriting turns out to be sloppy in many cases. In Lazz Pharma, pharmacists, in some branches, choose not to hand out medication if they don't understand the handwriting, which is around 10-20 percent of the time, unless the doctor prescribing the medicine has been consulted. 

This issue was recently recognised by the Bangladesh High Court on January 9, 2017, when it ordered the Government to issue a circular in 30 days, asking doctors to write prescriptions 'clearly in capital letters or provide a print copy so that patients or dispensers have no trouble in understanding the names of the medicines.'

Basically, the doctors, like second grade students, have been asked to practice good handwriting. How exactly are they going to go about it? Through handwriting classes? Is this suggestion by any means offensive to them? 

"When you write the same thing a 100 times a day, all day, every day, your handwriting is bound to become a little sloppy," argues Dr Murtaza Zakiul Abrar, who runs his own practice."If you have five patients in a day, you can take your time to neatly write down the names. But that isn't the case, is it?" Dr. Abrar believes that the prescription should be whatever the patient takes from the visit in written version. "This includes diagnosis, advice and information for the next doctor. In which case, everything must be discussed before it is written down."

But do doctors have these comprehensive discussions their patients? "A prescription by all means is a legal document. It can be presented in court for multiple purposes. It is submitted in workplaces for sick leave, etc, so handwriting being illegible will likely cause a lot of problems. But is it common enough for a new law? For all doctors to be addressed?" asks Dr. Abrar. "It feels like a path to harass doctors more often than not. I agree with the intention of this law, but it leaves a large margin to be exploited. What is the definition of legible handwriting exactly? If I am sued for handwriting, I'm forced to cut a deal with the patient and pay him off. After that, I start printing prescriptions, which means I start charging more."

So, in the end, who wins? 

The new law has been implemented since yesterday, February 9, 2017. Whether the doctors have to face unnecessary harassment now, or the cases of wrong medication handed out decrease, is yet to be seen. We can, 

however, come to one conclusion…

Weird things happen in our country everyday.

Cartoon: Ehsanur Raza Ronny