Jokes around the notoriously bad handwriting of doctors are common worldwide, but the latest order emphasising the importance of clear handwriting was in India, when the Punjab and Haryana High Court declared that “legible medical prescription is a fundamental right” and can make a difference between life and death.
The BBC reports that the court order was related to a bail hearing involving a woman’s allegations that a man had taken money from her promising her a government job, after fake interviews and sexually exploiting her.
The man denied the charges, saying they had a consensual relationship and that the case was brought on because of a dispute over money.
But when the judge looked at the medico-legal report, written by a government doctor who had examined the woman, he found it incomprehensible and illegible.
“It shook the conscience of this court as not even a word or a letter was legible,” he wrote in the order.
“At a time when technology and computers are easily accessible, it is shocking that government doctors are still writing prescriptions by hand which cannot be read by anybody except perhaps some chemists,” he wrote.
The court asked the government to include handwriting lessons in the medical school curriculum, and set a two-year timeline for rolling out digitised prescriptions.
Until that happens, all doctors must write prescriptions clearly in capital letters, ordered the judge.
Dr Dilip Bhanushali, president of the Indian Medical Association that has more than 330 000 doctors as members, told the BBC that they were willing to help find a solution to the problem.
In cities and bigger towns, he said, doctors had moved to digital prescriptions, but it was very difficult in rural areas and small towns to get prescriptions that were clear.
“We have recommended to our members to follow the government guidelines and write prescriptions in bold letters that should be readable to both patients and chemists. A doctor who sees seven patients a day can do it, but if you see 70 patients a day, you can’t do it,” he added.
This is not the first time an Indian court has called out sloppy handwriting by doctors, with judges in Allahabad High Court once lamenting about “reports written in such shabby handwriting that they are not decipherable”.
Experts say emphasis on doctors’ handwriting is not about aesthetics or convenience, but a medical prescription that leaves room for ambiguity or misinterpretation can have serious, even tragic, consequences.
According to a 1999 report by the Institute of Medicine (IoM), medical errors caused at least an estimated 44 000 preventable deaths annually in the United States, 7 000 of which were attributable to sloppy handwriting.
More recently, in Scotland a woman suffered chemical injuries after she was mistakenly given erectile dysfunction cream for a dry eye condition.
Health authorities in the UK have admitted that drug errors have caused appalling levels of harm and deaths, and that roll out of electronic prescribing systems across more hospitals could reduce errors by 50%.
India does not have robust data on harm caused by poor handwriting, but in the world’s most populous country, misreading of prescriptions in the past has resulted in health emergencies and many deaths.
Chilukuri Paramathama, who runs a pharmacy in the Indian state of Telangana, told the BBC that in 2014, he filed a public interest petition in the High Court in Hyderabad after reading news reports about a three-year-old who had died after she was given a wrong injection for fever.
His campaign, seeking a complete ban on handwritten prescriptions, bore fruit when in 2016, the Medical Council of India ordered that “every physician should prescribe drugs with generic names legibly and preferably in capital letters”.
And in 2020, India’s Junior Health Minister Ashwini Kumar Choubey told Parliament that medical authorities across states “have been empowered to take disciplinary action against a doctor for violating the order”.
But nearly a decade later, Chilukuri and other pharmacists say that badly-written prescriptions continue to arrive.
BBC article – No more scribbling: Indian court tells doctors to fix their handwriting (Open access)