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Mind your x’s / z’s
September 21, 2007
We doctors are always looking for ways to do things faster. A prime example of this is our signatures. I once calculated that I sign my name a total of 200 times per day. Signing my name as a “squiggle” takes me a total of one second. If I sign my name neatly so it can be recognized, it take about 3 seconds. This means that I save 400 seconds per day, which is a total of 6.7 minutes. Then multiply this over the 18 days per month, you see I save 120 minutes per month, which is 2 hours, and it neatly works out to 24 hours per year saved per year. I gain an extra day by doing a squiggle instead of a signature! Now I just need to know how I am going to spend this “bonus day.”
So this gets me now looking for other ways to get bonus time. One way in which doctors save time is through the use of abbreviation. The rule of thumb is that you put an “x” or a “z” after a letter and you have an abbreviation. For example:
- Bx - Biopsy
- Cx - Culture
- Dx - Diagnosis
- Fx - Fracture
- Hx - History
- Rx - Prescription (see below)
- Sx - Symptom
- Tx - Treatment
- Dz - Disease
- Sz - Seizure
I think this came from the use of “Rx” which everyone knows as the symbol for prescription. Here is the possible origins of this per Yahoo Answers:
Version #1
Rx is an abbreviation for the Latin word “recipere” or “recipe,” which means “Take, thou.”
Version #2
the Rx symbol was a corruption of the ancient symbol for the Roman god Jupiter. If you’re an astrology fan, you know this symbol which has a very similar crossed leg at the bottom right.
Version #3
R probably came from “recipe” but the pharmaceutical symbol used to be an EYE with an “x” below it instead of the “R,” and was called the “Eye of Horus.” According to pharmacological authorities, the Egyptian god Horus was the “father of pharmacy.”
Well, I think it is just because we are lazy and wanted to get more “bonus time.” Another thing you can do is to put a “/” between to letters:
- b/w - between
- b/c - because
- d/o - disorder
- f/u - follow-up
- h/o - history of
- r/o - rule out
- w/u - work-up
Then there is the line over the letter trick :
- c - with
- s - without
- p - after
- q - every
I figure I will gain a year over the course of my life doing this stuff. I plan on taking up a hobby, like scrapbooking, macrame, or paintball.
So let’s see what you have learned:
B/W you and me, the prob c our Cx is that people are s understanding of hx. I get all w/u b/c p q encounter, I r/o common sense b/w their ears.
Signed:
Rob
(3 votes, average: 5 out of 5)
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September 21st, 2007 at 5:52 pm
Nice post Dr Rob.
September 21st, 2007 at 6:04 pm
Sometimes two worlds collide when we spend so much of our lives abbreviating meaningful information. For instance, and you may not know this, I met my wife through the use of a newspaper personal ad. Here is what I wrote:
I am a 25yo male looking for an ambulatory female who is A&O x3, NCAT, in NAD with PERRL, MMM, OC/OP clear, CTA B, RRR with Nl S1S2, Abd NTND with no HSM, pulses 2+, DTR 2+, and no obvious deformities ASAP.
I can honestly say that my wife fits that description almost perfectly.
September 21st, 2007 at 6:17 pm
You learn new things every day, for I certainly did not know some of them. The Dr Rob Dictionary of Timesaving Abbreviations, required for everyone’s reference library.
***** Five virtual stars.
regards
jmb (No 3)
September 21st, 2007 at 7:09 pm
Nice new digs and great post.
September 21st, 2007 at 7:55 pm
Yes, funny. Creative. Time-saving. BUT . . . (sorry to be such a nay-sayer) JCAHO will/has shut you down. Where I work, you cannot use any of them. There is actually a black-box warning at the bottom of each physician’s orders sheet (yes, this is one of the few handwritten items in a chart—all the rest is computer charting) reminding doctors of all the forbidden abbreviations.
You must have anticipated that someone would rain on your parade, Rob and Dr. C.
Chris and Vic
September 21st, 2007 at 8:52 pm
Chillin’ new pad! Not RX pad, I mean as in ‘online domicile.’ Speaking of RX pad, if the local Walgreens or CVS calls with an increase in opiate forgeries w/your name on it, you have nothing but this post and your “bunny rabbit” signature to blame. LOL!
September 21st, 2007 at 8:59 pm
Clark: AWESOME! Such delicious irony that what’s an otherwise uselessly general description (esp. for a personal) would snag the very person you’d be looking for.
September 21st, 2007 at 9:43 pm
So Clark, did your wife answer that ad?
Thanks for everyone visiting so quickly. This has been a major headache.
September 21st, 2007 at 10:18 pm
Dr. R,
Thanks for opening OU Qpost. And JCAHO can kx my ax.
Dr. S
September 22nd, 2007 at 1:28 am
Well done, Smak. I couldn’t have said it better myself.
September 22nd, 2007 at 4:46 am
Sorry to disappoint guys. All was in jest. I actually did write that in a medical school publication in a phony personals page. I met my wife around that same time period but it was my cool demeanor and mysterious aloofness that won her heart not my goofy sense of humor.
September 22nd, 2007 at 5:37 am
Okay, what is up here Dr. Rob? A math quiz before one can submit a comment? The sum of five + nine indeed! Er, and I mis-read that and was submitting five x nine… uh, my sin…
Whatever. Paintball. Most assuredly you are a paintball kind of fellow more than a macrame guy.
The rest is all Greek to me.
Luv,
tl
September 22nd, 2007 at 3:16 pm
There’s a whole host of abbreviations simply a set of initials, usually capitalized: PTA, OOB, CP, AMI, ASCVD, PVD, TIA, CVA, MS, TURP, BPH, UGI, BE, CABG, COPD (or COLD), DOE, UTI, URI, PE, DVT, ARF, and it goes on, some being esoteric to a given specialty. Some of these save a huge amount of writing, which would likely be illegible to boot. We used to use SOB (shortness of breath), though there was a campaign by do-gooders to change this to SOA (shortness of air) so we don’t offend anyone (ie, putting down, “Pt. c/o SOB….”).
Sometimes there’s a clash: Cx I have not seen as culture, but I have as denoting cervical, either uterine cervix or cervical as in neck. D/C is used a lot, most “correctly” I think for discontinue, but also less correctly for discharge (as in discharge from the hospital). Usually I see Rx referring to either prescription or treatment (as in a non-drug prescription).
Maybe you need to tweak you anti-spam thingy — seems to me the answer to one + five ought to be six, not 6.
September 22nd, 2007 at 3:19 pm
I wanted to add that every time I see someone write, “D/C O2″ I have this vision of the nurses going in a smothering the patient with a pillow.
September 22nd, 2007 at 3:25 pm
Nice site: clean, crisp, fast. Good post, too. (Trying to comment again, using Firefox. Wouldn’t buy my addition on Safari.)
September 23rd, 2007 at 3:10 am
Me likey the new looky. Here’s a question - what’s your abbreviation for “secondary to”? I use 2 with a little degree sign after it (which I can’t find on my keyboard), but lots of people ask me what that means. How hard is it? CAD 2-degree-sign daily double cheeseburgers? What’s the question?
September 23rd, 2007 at 3:17 am
FD - I do use the same sign as secondary. That is standard, meaning: “to the second degree.”
Greg - Very good on the O2. I never thought of that. Would be a bad idea to D/C the O2. I could have done a lot more abbreviations (TAH-BSO) and others, but I had to cut it off at some point.
TL - Just want to beat the spammers. Not real hard math.
September 23rd, 2007 at 4:42 am
Nice new blog Dr. Rob.
September 24th, 2007 at 3:02 am
Love the primer on abbreviations…they were a staple in med term courses for HIM & were totally familiar. (Though I knew the great majority of them before ever hitting a classroom…) The problem a commenter mentioned above is a common one, though: many places have a list of “prohibited abbreviations” that are either confusing, hard to read, or outdated, sometimes all three. Sometimes that list is three sheets long, as I saw during one of my internships.
As for JCAHO…they seem to be the bane of anyone even remotely connected to health care. The rules & regs can make the HIM people crazy too! Love Dr. Smak’s comment about that!
September 25th, 2007 at 2:21 am
Those are abbreviations I use too. However, I’m a lot careful with the U/A right now because even if in the hospital I practice it means urinalysis, some nurses still mistake it as uric acid test or testing for serum uric acid.
About the signature, I still prefer to sign my surname clearly, even if the order sheet had my name stamped on it. Just being extra careful because some still mistake my signature for somebody else’s though I don’t know why.
September 28th, 2007 at 5:51 am
alt 2 4 8 will give you the second degree sign. (Typed way too many grants!)
September 28th, 2007 at 5:52 am
alt 2 4 8 will give you the degree sign
October 3rd, 2007 at 11:21 pm
I love what I’ve been reading. I was a biology teacher and have a daughter who is a veterinarian ( have an abbr. for that besides vet). I enjoyed reading all of this and the page on Medscape. Sent it to my medical friends, MD. PhD, DDS, MD DDS, Rx, medical advertising, and of course my daughter the DVM.