I/M

Most SOAP notes start with: 55 yo gentleman.... or 40 yo female....19 yo patient....or 23 yo man....a way to convey an image in the reader's mind, a quick identity for the patient. Sometimes other descriptors are added to enhance the image: well-appearing....pleasant.....morbidly obese.....Hispanic......Caucasian......you name it.

In prison, the doctors simply write I/M .

Inmate. That is what they are. That is the only image that they wish to convey and the only identity that they permit them to have.

I refuse and still write "patient" (gender is assumed in an all-male facility). A subtle difference, perhaps. Maybe just a shortcut they use to save a few key strokes. Or with the first word of the entire assessment, are they are setting the tone early? Maybe with three key strokes: I/M buys them the excuse they were looking for. The excuse to blow off a nagging symptom, to refuse a CT scan, to withhold a new medication. Maybe it is a reminder to them, the first thing they and future readers will see when they open the chart: Inmate, Inmate, Inmate.

I can't be sure. But for now, I'm writing "patient" not I/M, because it feels like that's why I am here. To help a patient. To not harm a patient. To listen to a patient.

(((((((My next post could easily be a rant about how I think it is absurd that the 50 million people without health insurance (and without a prison sentence) don't have anywhere close to the access to health care that these inmates, er, patients have. So before you label me a complete Hug-a-Thug, know that I am conflicted to say the least.)))))))))))