What's up doc? Am I a Tfbundy or just Fodttfo?

ARE you a Groli who got Pafo and was politely Ttfo in A&E? You might not know it, but there’s every chance you have fallen victim to medical slang.

Doctors have finally revealed the secret language they use to tell their colleagues exactly what they think of troublesome patients and to poke fun at them behind their backs.

The acronyms - which range from the bizarre to the downright offensive - include Grolies (Guardian readers of limited intelligence in ethnic skirts), patients who have had too much to drink - Pafo (P***** and fell over) and advice for chronic hypochondriacs - Ttfo (Tell Them to F*** Off).

Other choice examples include Sig (Stroppy ignorant girl), Oap (Over-anxious patient), Tatt (Talks all the time), Code Brown (Episode of faecal incontinence), Teeth (Tried everything else, try homeopathy) and the most shocking of all - Tfbundy (Totally f***ed but unfortunately not dead yet).

The ‘colourful’ terms are not only being used in the heat of the moment by stressed doctors on busy wards but are also being recorded for posterity in patients’ medical records.

Concern at the use of medical slang has led to warnings from medical unions that doctors could be sued or embarrassed in court if the slang is discovered on patients’ notes.

However, according to paediatrician Dr Adam Fox, who has exposed the secret language of doctors, the use of the abbreviations is still widespread on the wards.

Fox, who has spent six years collecting about 300 different examples of medical slang, said: "The largest group is simple obscenity and derogatory name calling. Everybody uses Tfbundy and there are loads of rude ones about patients, such as Pumpkin-positive if they are stupid, because if you shine a light in one ear their whole head lights up."

Some of the 200 examples collected by Fox include:

FLK - Funny Looking Kid

JLD - Just Like Dad. Used when the father of a FLK appears on the postnatal ward

NFN - Normal for Norfolk. Used as an explanation for the FLK with no other problems

Crackerjack Referral - The type of patient referral that doctors dread most. As in, It’s Friday, It’s Five O’Clock... It’s Crackerjack.

Fox, who is based at the Luton and Dunstable Hospital, north of London, explained that often the language was used as a "coping mechanism" by doctors who come face to face with death and suffering every day.

He said: "The use of medical slang helps to depersonalise the distress encountered in doctors’ everyday working lives.

"It is a way of detaching and distancing oneself from patients’ distress through loss, grief, disease, dying and death.

"Often an example of this would be dealing with the morbid practice of receiving payment from filling out cremation forms. ‘Ash cash’ is a universally recognised term. This should not be confused with ‘bash cash’ following claim forms from assault victims."

However, the use of medical slang in patients’ notes could land doctors in hot water. Aside from the offence the slang causes to patients, doctors are required by law to keep accurate and clear medical records.

The diagnosis GOK (God only knows) could be confused with GOR, gastro-oesophageal reflux, the most common cause of heartburn .

Fox said: "People are clamping down on the really offensive terms. They are frightened because patients can now ask to see their notes and could get upset. It is becoming very much a verbal rather than written form of communication."

The doctor, who has lifted the lid on medics’ secret language in a supplement to the British Medical Journal, added: "It is unethical, and while most people find it funny to hear these terms used about other people it would not go down very well if their dead grandmother had been referred to as a ‘crumble’ in her medical notes."

According to Fox, accident and emergency departments are the "epicentre of medical slang" and the source of the most colourful terms.

Yesterday, one Scottish A&E consultant said junior doctors, who pick up the expressions at medical school, were now being told never to use them on the wards or in patients’ notes.

The doctor, who asked not to be named, said: "There was a case a number of years ago when a A&E doctors had to stand up in court and explain the Fodttfo (Fell over drunk, told to f*** off) that had been written into a patient’s notes. They ended up in real trouble."

Last night the Medical and Dental Defence Union of Scotland (MDDUS), which provides legal advice and indemnity to doctors, warned against the use of medical slang.

Dr Bill Mathewson, deputy chief executive of the MDDUS, said: "Fortunately, these terms are disappearing - not only because of our efforts but also because patients’ records are no longer hidden away."