MUMBAI: It turns out that all those jokes about doctors ’ scrawl are not funny at all.Doctors’ illegible handwriting causes 7,000 deaths in the US every year and another 1.5 million Americans report minor adverse reactions—be it diarrhoea or rashes—or even death.Now, a movement has begun in Mumbai asking the medical fraternity to write prescriptions in “separate, capital letters”. The brainchild of an NGO called the Forum for Enhancement of Quality in Healthcare ( FEQH ) and the Quality Council of India (a semi-government organization accrediting services), the first meeting on the issue held last week was attended by representatives of medical associations and NGOs. The campaign borrows from QCI’s hospital accreditation system called the National Accreditation Board for Hospitals (NABH) which requires prescriptions to be written in capital letters.“We don’t have an estimate of how many people suffer or die because prescriptions written by doctors couldn’t be deciphered by pharmacists. But going by the US estimates, we can be sure that India, where 40 lakh prescriptions are written every day, has a fair share of errors,” said FEQH chairperson Prakash Gadgil.Few cases of the tragedy that poor handwriting can wreak have made it to the annals of Indian medical history; in the most famous one, a three-year-old child died at the Spring Meadows Hospital in Noida a decade ago. The family was awarded Rs 17.5 lakh in compensation by the National Consumer Forum.Medico-legal expert Dr Lalit Kapoor from the Association of Medical Consultants AMC ) recalled that the pediatrician had diagnosed the child with typhoid fever and written out a prescription that included an injection of chloromycetin to be given intravenously. But the nurse read the medicine as chloroquine and the child died after suffering for a few days. “I always tell young doctors that their bad handwriting could cost them lakhs,” said Dr Kapoor.But will doctors accept the ‘write in capitals’ campaign? Dr Mukesh Gupta , who edits AMC’s medical journal Grasp, is positive. “There are always situations in which the nurse is not sure if 51U is ‘5 international units’ or ‘51 units’. It would be better to write medicines in capitals,” he said.The difficulty would be in changing decades of habit. “The habit (of writing in capitals) has to begin in medical schools for it to catch on,” said Kapoor. But as Gupta added: “We could write out 100 prescriptions in capitals the time we take to answer phone calls from patients needing to reconfirm the medicines they bought.”The prescription writing habit is changing worldwide. Almost a third of all the prescriptions in the US are electronic. The e-change occurred after a Cornell University study in 2010 showed that nearly two in five handwritten prescriptions had errors.Closer home, state government-run JJ Hospital in Byculla offers only computerized prescriptions. “We want to implement the computerized prescription plan in all our 14 medical colleges. While this wasn’t envisaged due to poor handwriting of doctors, there is no denying that it cuts down on prescription errors,” said JJ Hospital dean T P Lahane.But given the uneven computerization levels in India, Gadgil felt that writing in capital letters would be a better option, especially at stand-alone clinics. Dr Snehalate Deshmukh, former vice-chancellor of Bombay University and former dean of Sion Hospital, concurred, with a caveat: “Doctors shouldn’t forget their verbal communication and remember to brief the patient on how to take the medicines.”Mukesh Gupta said the idea would be best implemented by doctors themselves. “We could get doctors’ associations to put out statements in medical journals. We could have slides about it during continued medical education lectures, associations could send SMSes to their members, etc,” he said.