We have an outpatient case paper for women attending antenatal clinic. It is something like a printed spreadsheet. All one has to do is to fill in the blanks under appropriate headings. It makes sense to do so, because one can always check what the previous readings were, and note if there is a trend, like weight gain or increase in fundal height. A sample of that case paper is reproduced below.
It did not work out as was intended by the civic body which gets these papers printed. So I gave strict instructions that all parameters should be checked and written in respective columns. It still would not work, so I kept giving the same instruction again and again. Still I find the following variations repeatedly, involving faculty and resident doctors equally. On a given case paper, when the patient has been seen by different doctors on different days, there is utter chaos.
- Some of them move the columns showing fetal size (by date, clinically and by USG) one column to the right. So the successive readings are not one below another.
- A few of them move the columns showing fetal size (by date, clinically and by USG) one column to the left. So the successive readings are not one below another.
- Some of them do not fill rows horizontally. They write the three parameters one below another in three paragraphs.
- One of them has a unique style. There are only two readings in place of three. One is written on the left half of the paper, the other on the right half, in a huge letter size. No one has any clue about the heading of either of them. It looks like the following. It does not serve the purpose it is supposed to serve, and wastes a lot of paper too.
All this stresses me out when the patient comes to me for a check-up the next time. The only solution to this problem is to stop going to the antenatal clinic, like a number of senior faculty in many hospitals did and do, or take voluntary retirement. At the moment I have chosen to take the stress and keep working, because working is what I got to do.
