Professional Development for Healthcare Professions Blog

Style Over Substance - Making Ourselves Irrelevant

Posted by Chad Sines on Fri, May 17, 2013 @ 07:00 AM

GrammarI was reading a blog entry comparing large MTSOs to Wal-Mart. The author made some interesting points that inspired the reader to think; however, she had a few grammatical errors. What struck me as off was that the comments seemed to suggest that since this MT made “glaring” errors, the substance of the article was not worthy of reading. The author apparently was to be shamed and discarded as seemingly irrelevant simply because of “mute” versus “moot” and other simple oopsies. While reading the comments I was almost yelling “WHO CARES??? Get off your pedestal and listen to the message!!”

This left me scratching my head and wondering if MTs have lost touch with who they are and what their role is. Why do we as MTs feel that we are the gatekeepers of grammar? Isn’t that a faulty view of our role? I was taught that our main focus is on patient safety. We transcribe dictated material and alert the physician when we notice a potential safety issue.

A prime example occurred at a meeting I attended a few years ago where an auditor gave a presentation on what she did. She showed us a transcription and asked us to find the errors. We saw “tylenol” instead of “Tylenol” and declared it proudly. We saw “you’re” instead of “you are.” We even found some subject-verb agreement errors. The auditor kept track until we declared ourselves finished.  We were so proud. A group of 20ish MTs had ripped that document to pieces and proved our relevance in healthcare documentation…or did we… After ensuring we were finished the auditor thanked us for proving her point that we have forgotten what our role is truly about. None of us noticed that there were four separate doses of morphine in the record as active prescriptions scheduled at different times which constituted a very lethal dose had they been administered. (a result of the physician increasing the strength but failing to DC the previous dose) Oops. Result- Pretty words, dead patient.

So why did a group of about twenty people with 20+ years experience for many including several instructors miss something that should have been glaring like a neon sign?

I think the reason is that we have moved away from patient safety and into the world of grammar keepers. We are fighting a battle that no physician/facility really cares about. In every example above, patient safety was never a concern; however, the one issue that was a severe risk was completely missed. In practice we have allowed so many style variations in templates that our QA spends the majority of their time checking style instead of critical patient information.

With the push towards the mandatory EHR, the role of the MT is changing overnight. The grammar keepers are being pushed aside for those who can bring value to the table. It is a very different way of approaching healthcare documentation. It requires one to look at the substance and disregard what is meaningless to all but other grammar keepers.

Now I am not saying that grammar/style is irrelevant, but I am saying it MUST not be how we define ourselves. It should be secondary except in cases where it honestly affects patient safety…And no..Safety is not affected just because we feel we want to throw our hands in the air. "I told the patient to go their" is understandable despite being grammatically correct and do not even get me started on "your, you're" or the use of commas.

I think we need to get back to substance over style. We have to refocus and get back on task. What is said must be more important than how it is said. In a blog, the writer’s interesting points could be missed leading to a lack of enlightenment for the reader which only stifles knowledge. In the case of a patient record, it could end up harming the patient. Unless we can wrap our mind around our true purpose, we are going to have little success showing outsiders why we are relevant.

Topics: Industry Issues