Rx for Understanding Visit Notes: A Dose of Sleuthing

I don’t, as a rule, read the notes from my doctors’ visits, but from time to time when I get an email saying, “You have received new test result information" or "an edit to an existing test result in Partners Patient Gateway,” I follow the breadcrumbs to see what it’s all about.

The results of 3 squamous cell cancers

When I did this recently, it led me to a visit note from my most recent dermatology visit, to the Mohs surgeon. I knew the results when I went in. Three squamous cell cancers, that had already been biopsied, were the cause of my visit. So the report was more of a summary than a reveal of test results.

Understanding my skin cancer visit notes

Some of the shorthand, and the abbreviations and the acronyms, sent me to the dictionary, er, um, I mean to the Google search bar. And some of it gave me pause.

If you have Patient Gateway or some other patient portal, it’s an interesting exercise, to some extent. But it can also be a little unsettling to see your diagnosis and evaluation in medical terms if you’re not used to that sort of language.

New medical history information

For starters, I learned something interesting, and learning something interesting is always a good thing. At the top of my medical history, it said, “Fitzpatrick skin type: III: Sometimes burns first but always tans with continued sun exposure.” I had never heard of Fitzpatrick skin types. It is a way to classify skin by its reaction to sunlight and is based on melanin pigment in the skin.¹ Mine is right in the middle. (Though it says sometimes burns first, I mostly burned first back in my sunbathing and lifeguarding days. Then the skin peeled and I turned brown, admiring the accomplishment which is partially to blame for the skin cancers I have now.)

What does RTC stand for?

I had expected to have Mohs surgery on three lesions but only ended up having it on one. The report detailed that I was to apply a combination of Efudex and Dovonex (calcipotriene) to the others. Then it said that I knew to "RTC" if anything unusual popped up. I didn’t know what RTC was and thought I should find out in case I had missed some instructions.

The hunt for a medical terminology definition

I looked up “What does RTC Stand For in Medical & Science?" On a site called Acronyms and Slang, I read, “For RTC we have found 470 definitions.” Great. They included Residential Treatment Center, Red Tail Catfish, Rapid Transit Category, Round the Clock, Required to Create, and Room Temperature Creep.²

I tried these on to see if they fit my situation. Go to a residential treatment center because the chronic skin cancers are getting me down? Catch a red tail catfish to get my mind off my troubles? Think of how my trips to Boston (90 miles from home) are fast and so are therefore in the Rapid Transit Category? Think of skin cancer round the clock? Required to create a plan of action? What about room temperature creep?

I can't fit it into the skin cancer scenario. Let’s say the creep is the one who won’t open the window at night and so the room temperature is too hot. As in, “Hey, you room temperature creep, I can’t sleep in a room that is hot.”

A likely 'Return to Clinic'

Another site, All Acronyms, had twenty-plus meanings. They included Road Traffic Collision (already had one of those on my way to a medical appointment), Report to Congress (wouldn’t want to put myself through that), and, drumroll...the one that I think fits the situation best: Return to Clinic.³

I already have three more dermatology appointments set up, with three separate specialists, so I’m sure that I will RTC in good time.