Doctors’ handwriting: study finds 25% of all prescriptions to be poorly legible

One in four medical prescriptions analysed in study published in the Malta Medical Journal, are written in poorly legible handwriting.

Doctors’ reputation for poor handwriting has been officially confirmed by a study that found 25% of prescriptions written by 166 participants to be poorly legible.

Poor handwriting is a considered as a major problem in healthcare as these can endanger the health of patients while contributing to lawsuits in cases of negligence.

The Institute of Medicine in the United States (IoM) reported that 7,000 annual deaths are attributable to illegible handwriting by medical professionals.

In the Malta study, 137 medical students in the third to the fifth year of studies, and 29 doctors of varying grades from Foundation to consultant level, were asked to complete a pre-prepared prescription, including five medications onto a standard hospital prescription chart.

No significant differences were found between doctors and students when it came to hand writing quality.

Every participant’s handwriting was graded using a standard score, cross-checked by two researchers and a further 3 independent assessors.

25% of participants had print-quality handwriting and 50% had clearly legible handwriting. Only 3% had barely legible handwriting but 22% had “moderately legible” handwriting.

9% of the participants had actually declared having had handwriting training. 

Furthermore, participants were themselves asked to adjudicate their own handwriting and 23% admitted to having made an effort and filled in the study forms using handwriting that was superior to their norm, whereas 12% felt their writing was worse than usual.

The majority of participants reported being “very” (36%) or “quite bothered” (42%) by the legibility of colleagues’ handwriting, with 6% reporting that they were “hardly bothered” or “not bothered at all”.

On questioning, 78% admitted to being concerned with poor handwriting in the healthcare work environment. In the event that participants had difficulty reading a prescription due to poor handwriting, 88% of participants reported that they would ask colleagues for help.

Possible solutions to the problem mentioned in the article include penmanship classes, the use of self-inking stamps to heighten prescribers’ awareness and traceability, the use of computer-generated prescribing, voice activating systems and, routine training for medical students.

The study was authored by medical doctors Yimeng Zhang, Nicole Zerafa, and Simon Attard Montalto.