Letters English as she is spoke and writ

Ambiguous or faulty medical communication is responsibility of doctors to put right

BMJ 2015; 350 doi: https://doi.org/10.1136/bmj.h310 (Published 20 January 2015) Cite this as: BMJ 2015;350:h310
  1. David B Menkes, academic psychiatrist1
  1. 1University of Auckland, Private Bag 3200, Hamilton 3240, New Zealand
  1. david.menkes{at}waikatodhb.health.nz

The comedic range of medical transcription errors is vast indeed.1 My personal favourite reflects, I fancy, healthy scepticism on the part of the typist who indicated a recalcitrant patient to be invested in “homeopathetic” remedies.

On a more serious note, we need to be wary of transcription capable of unleashing subtle chaos into the meaning of dictated letters. Some English words are sufficiently fragile that the intended meaning can be reversed with as little as a single space inserted between the first two letters of, for example, “atypical depression.” The risk of confusion (and worse) is compounded by words such as “atypical” and “asynchronous,” where an added space produces opposite meaning with little or no change in pronunciation.

Another source of confusion arises from us, not our secretaries, when we use words with very different meanings that are spelled identically—for example, my patient whose “invalid disability certificate” was due for review. Whatever its origin, ambiguous or faulty medical communication remains our responsibility to monitor and put right.


Cite this as: BMJ 2015;350:h310


  • Competing interests: None declared.


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