GP jargon buster: a guide

Medicine is one of
the most notorious culprits for the use of abbreviations, acronyms and jargon. One must know the difference between an ERCP and an ERPC. One is a gallbladder procedure, the other a procedure to deal with an incomplete miscarriage, respectively. Likewise, if a medicine is prescribed 'prn', it is given 'as and when required', whereas if prescribed as 'pr',
it is to be given rectally. Hopefully, most pharmacists pick up prescribing errors before it is too late.

Somewhat cynically
perhaps, I believe medical
terms are occasionally used to deliberately obscure meaning. The condition erythema ab
igne is a prime example. This translates as 'redness from fire', the technical dermatological term for a burn.

There are also many apocryphal jargon terms in medicine, most of which probably originate from junior hospital doctors, who make use of black humour to survive the brutal early years. These include UBI (unexplained beer injury), 'Eiffel syndrome' (I fell on it - the almost-universal explanation given by patients attending A&E with a rectal foreign body), and 'TF Bundy syndrome', which is perhaps too rude to translate here, but equates to 'really rather ill but not quite dead'.

Doctors frequently used slang for each other as well. Surgeons were known as 'slashers', psychiatrists as the 'Freud squad', and orthopaedic surgeons as 'knuckle-draggers' or 'human carpenters'. Anecdotally, doctors referred to someone suspected of malingering, or 'swinging the lead', as suffering from Plumbii pendulosis.

Happily, the use of such derogatory terms is disappearing, probably due to the gradual breaking down of barriers between doctors and patients, the increasing regulation of doctors, and openness of access to medical records.

In the area of clinical negligence, medical jargon can present a significant barrier to the understanding of a case by the non-medical people involved.
It is the duty of expert witnesses
such as myself to help explain the medical background of a case for the benefit of the court.

Most clinical negligence solicitors will probably pick up a good understanding of medical terms through dealing with medical records over time.

Many of the medical acronyms, abbreviations and eponymous syndromes are
very well known, and are easy
to find in the excellent medical dictionaries and websites available. However, there is no easy resource for the frequently impenetrable GP lingo. GPs often use their own personal acronyms and abbreviations, which sometimes even their colleagues don't understand. For example, I have seen the term 'P' used with five different meanings. When you combine individualised jargon with typos due to the time pressure facing GPs, as well
as their appalling typing skills,
you can end up with practically unintelligible records.

The best person to decode GP records is a GP, who uses such language on a daily basis.

A few examples of some of the common terms in use, many of which would be hard to find on any published resource, are listed to the right. This is not an exhaustive list and I am happy to help decode any unexplained terms you may come across. SJ

 

TERM: MEANING AB, ABx, Antibs: antibiotics Adv: advice BO: bowels open Body habitus: size of patient  Ca: cancer (occasionally also calcium) DNA: did not attend DNR/DNAR: do not resuscitate DSH: deliberate self harm ETOH: alcohol Functional: a condition with no obvious physical pathology to explain the symptoms GI: gastrointestinal inbow: if not better, or worse ini: if no improvement LN: lymph nodes (glands) Mets: metastases (spread of a cancer)  Mitotic: cancer (euphemism) NAD: no abnormality detected Neoplastic: cancer (euphemism) OOH/111: out of hours P: pulse, patient, plan, pupil, Paracetamol prn: pro re nata – as and when required/if needed R, Ref: refer R, RR: respiratory rate Rev, RV: review SOS: if needed  stat: immediately Supratentorial: implies a psychological disorder TATT: tired all the time T, Tmp, temp: temperature US, USS: ultrasound scan UWG: usual warning given (eg side effects of a medication) 2WW: two week wait (cancer referral) 1d, 1/52: 1 week 1m, 1/12: 1 month

Dr Nicholas Swale is an expert witness specialising in GP clinical negligence

www.drswale.com