Chapter 44 Written Communications

1. Today's Medical Assistant Chapter 44 Written Communications

2. Introduction to Written Communication In the past, written communication was usually sent through the mail Today, written communication is also sent electronically Can be viewed or printed after transmission Must adhere to professional standards If written communication contains protected health information, a consent for its release must be obtained from the patient

3. Business Letters • Letters must be formatted correctly to maintain a professional image • May be dictated by the physician and prepared by the medical assistant (MA) • May be composed by the MA • Form letters or letters based on templates may be used for routine correspondence

4. Equipment and Supplies A computer and printer are usually used to create a letter Word processing software facilitates formatting and corrections Letterhead stationery is used with matching envelopes Letters are usually photocopied for the medical record and if copies are sent to other recipients

5. Heading • Return address is placed at the top of the letter, or letterhead stationery is used • Date line on second line below return address or two to three spaces below letterhead • Month is written out in full • Written as month, day, and year (e.g., January 5, 2009)

6. Inside Address • Includes the name and address of the party to whom the letter is being sent • Located just above the salutation • Placed on the paper so that the body of the letter is centered top to bottom • Inside address is single-spaced • If the letter will require 2 pages, inside address begins on the second or third line below the date line

7. Salutation or Greeting • Formal greeting uses “Dear” plus a title with the recipient’s surname • Use of the first name is informal and should be avoided • Not correct to use credentials • Example: Dear Dr. Taylor: • In a business letter, the salutation is punctuated with a colon • Salutation is followed by one blank line

8. Body of the Letter Contains the substance of the letter Each paragraph is single-spaced with a double space between paragraphs

9. Complimentary Closing Placed on the second line below the body of the letter First word is capitalized and closing is followed by a comma The standard complimentary close is “Sincerely,” or “Sincerely yours,” More formal closing is “Yours truly,” or “Very truly yours,” Example: “Sincerely yours,”

10. Signature, Printed Signature, and Title Four to five spaces are left after the closing for the handwritten signature The printed signature includes the full name of the individual sending the letter, including credentials

11. Signature, Printed Signature, and Title A title may be entered on the line below the printed signature If the MA composes the letter, he or she usually also signs the letter If the physician dictates the letter, the physician will proofread and sign the letter

12. End Notations • The order of information given below the signature may vary according to office policy • End notations include enclosures, copies, and initials of the individual who prepared the letter • The initials of the individual who dictated the letter are entered in upper case followed by a slash or colon and the initials of the individual who prepared the letter in lower case

13. End Notations • End notations include enclosures, copies, and initials of the individual who prepared the letter • Enclosure(s) may be written out or abbreviated “Enc.” • The number of enclosures is given so that the recipient can be sure everything was actually included with the letter • The copy notation indicates recipients of copies of the letter. The copy retained by the office is not included in the copy notation

14. Business Letters

15. Setting Up a Letter • Margins • Top margin should accommodate the letterhead • Side margins may be 1-2 inches • A short letter usually has wider side margins • Body of the letter should be centered top to bottom on the page

16. Setting Up a Letter • Font • Generally accepted font for business letters is Times or Times New Roman • Entire letter (except for letterhead) should be in the same font • A header should be placed at the top of a 2-page letter including recipient, page number, and date

17. Letter Styles • Full block style • All lines are left-justified, but letterhead may be centered • Left-justified means that the line begins at the left margin • A double space is used between the paragraphs of the body of the letter

18. Letter Styles Full block style

19. Letter Styles • Modified block style • All lines in the inside address, salutation, and body of the letter are left-justified • Date line, complimentary close, and printed signature are right-justified or set on a tab at the center or to the right of the center • Right-justified means ending at the right margin • A double space is used between the paragraphs of the body of the letter

20. Letter Styles Modified block style

21. Letter Styles • Semiblock style • All lines in the inside address, salutation, and body of the letter are left-justified • Date line, complimentary close, and printed signature are right-justified or set on a tab at the center or to the right of the center • All paragraphs are indented and a double space is used between paragraphs

22. Letter Styles Semiblock style

23. Letter Styles • Simplified style • All parts of the letter (except the letterhead) must be left-justified • The salutation is replaced by a subject line in all upper case letters • The complimentary close is not used, and the printed signature line is in all uppercase letters five lines below the written signature • A double space is used between the paragraphs of the body of the letter

24. Letter Styles Simplified style

25. Composing a Business Letter • Collect information and jot down important points • Be sure information is in logical order • Review old letters for wording • Enter the letter into the word processor and format • Have a draft letter proofread by the office manager and/or physician if necessary • Proofread for accuracy, grammar, and spelling

26. Responding to Written Communication • MA usually responds to correspondence or e-mails related to office management • Supply orders • Billing or insurance questions • Requests for information about the practice

27. Responding to Written Communication • Correspondence related to patient care is referred to the physician • If paper-based medical records are used, MA attaches letter to medical record • If physician dictates a reply to a letter related to patient care, MA transcribes the dictation

28. Grammar and Punctuation Grammar is a term meaning the accepted rules to create meaningful sentences MA must always use correct grammar and spelling Parts of speech are categories that describe how words are used

29. Parts of Speech • Nouns • A noun is the name of a person, place, or thing • Common nouns refer to general things or categories • Proper nouns refer to specific individuals or places and begin with an upper case letter • Examples of common nouns: baseball, rabbit, medical assistant • Examples of proper nouns: Dean Johnson, Bugs Bunny, New Orleans

30. Parts of Speech • Pronouns • A pronoun is used in place of a noun • Possessive pronouns show ownership • Examples of pronouns: he, she, you, I, them • Examples of possessive pronouns: mine, his, their, theirs

31. Parts of Speech • Verbs • A verb either shows action or a state of being • A verb that shows a state of being may also be called a linking verb • A sentence requires a subject (noun or pronoun) and a verb to be complete • Examples of action verbs: run, sing, dance • Examples of verbs that show a state of being: is, are, seems

32. Parts of Speech Adjectives and articles An adjective modifies a noun Two or more words used together as one modifier may be joined by a hyphen (e.g., 20-year-old) English has three articles: a, an, the

33. Parts of Speech • Adverbs • An adverb modifies a verb, adjective, or other adverb • Words that end in -ly are usually adverbs • Question words are also adverbs (e.g., who? where? why?) • Prepositions • A preposition shows the connection of a noun to some other word • Prepositions often show relationships of space, time, or possession • Examples of prepositions: to, on, above, of, in

34. Parts of Speech • Conjunctions • A conjunction joins words, phrases, or clauses in a sentence • Examples of conjunctions: and, but, or, because • Interjections • An interjection is a word that expresses feelings • Examples of interjections: oh! yeah! ouch!

35. Sentence Structure • Simple sentence • A simple sentence is composed of one independent clause • Example: The dog was very hungry. • Compound sentence • A compound sentence is composed of two independent clauses • A comma separates the two independent clauses in a compound sentence • Example: The dog returned from its walk, and it drank all the water in its bowl.

36. Sentence Structure • Complex sentence • A complex sentence consists of one independent clause and one or more dependent clauses • A dependent clause cannot stand alone • If a dependent clause begins a sentence, it is followed by a comma • If a dependent clause follows an independent clause, a comma is not used • Examples: • When it returned from its walk, the dog drank all the water in its bowl. • The dog drank all the water in its bowl when it returned from its walk.

37. Sentence Errors • Sentence fragment • A dependent clause is used to stand alone as a sentence • An additional independent clause is necessary for meaning • Example: When I arrive for my appointment.

38. Sentence Errors • Run-on sentence • It is a sentence in which two or more independent clauses are used without a conjunction • My appointment is on Thursday I will bring my insurance card. • Comma splice • It is the incorrect use of a comma to separate two sentences • Example: My appointment is on Thursday, I will bring my appointment card.

39. Comma Rules • When to Use a Comma • To separate the elements in a series of three or more things • Example: The patient complained of abdominal pain, difficulty breathing, and headache. • Before a conjunction that joins an independent clause • Example: The patient called an ambulance, and the ambulance brought her to Memorial Hospital.

40. Comma Rules • When to Use a Comma • To set off introductory elements like prepositional phrases or dependent clauses • Example: After the upper GI, the patient continued to experience abdominal pain. • To set off information that could be omitted or placed in parentheses without changing the meaning of the sentence • Example: The patient, who was referred by Dr. Johnson, had an appointment today.

41. Comma Rules • When to Use a Comma • Before quotation marks that open a quotation • Example: The patient said, “My incision burns like fire.” • To avoid confusion • Example: For most, the academic year is already finished.

42. Comma Rules • When to Use a Comma • Between the city and state, the day of the month and the year, a name and the title • Example: June 17, 1987 BUT June 1987 • With terms like not, however, and but to express contrast • Example: The wound was large, but it was healing well.

43. Comma Rules • When to Use a Comma • To separate appositives, nouns of direct address, titles that follow a person’s name, and introductory words from the rest of the sentence • Example: We will make an appointment with Dr. Cannon, a gynecologist. • To separate parenthetical expressions from the rest of the sentence • Example: The report, I hope, will give you more specific information

44. Spelling Proofread all documents for spelling Spell check is helpful but cannot verify that a word is correct in context Keep a list of difficult words and try to learn them A medical dictionary and computer program can be helpful

45. Proofreading Look up any unfamiliar words to verify spelling Write out abbreviations for medical conditions, but use standard abbreviations for medication times, measurements, and vital signs

46. Proofreading Personalize the spell check program by adding commonly used words Leave a space if there was an unintelligible word so that the physician can fill it in before signing

47. Preparing Memoranda A memo is used to communicate within a business Memo headings include the names of the individuals to whom it is sent, the name of the person sending the memo, the date, and the subject The message is informative and succinct The memo may be sent in hard copy or as an attachment to an e-mail

48. Electronic Transmission and Photocopying Documents Compare the use and style of business letters and electronic communication, such as e-mail or clinical messages. Explain how to use e-mail and attachments for business communication. Explain how to transmit information using a fax machine. Describe how to make copies of multiple-page documents. Lesson 42.3

49. E-mail • A method of exchanging information between individuals using a computer • Usually uses a format like a letter, but less formal • Usually not used with patients • Should contain a subject line • Use correct grammar and spelling • Subsequent e-mails usually created as a reply so that previous communication is included

50. E-mail Abbreviations, humor, and negative comments should be avoided in e-mails to business contacts Assume that e-mails are not private and do not include confidential information Be sure that e-mails are sent to the correct recipient Print e-mails that contain information related to orders or other business transactions