Thoughtful reporting

I just got a report from a neurologist at University of Missouri Health Care. It gave me delight! Why?

Here's the text:

This study shows evidence of severe carpal tunnel syndrome on the right side with ongoing denervation. There is no evidence of neurogenic thoracic outlet syndrome. Nerve conduction EMG does not rule out vascular thoracic outlet syndrome.

NCS= nerve conduction study
SNAP= sensory nerve action potential
CMAP= compound muscle action potential
MUP= motor unit potential
EMG= electromyogram
F IBS= fibrillations
PS W’s= positive sharp waves

Raghav Govindarajan, MD, (ABDA)

What's delightful about carpal tunnel syndrome?

Nothing really. Getting a report that clarifies the diagnosis is often a relief for my patient who has been wondering what is causing their weird symptoms that stumped me, the family physician. Knowing it's a treatable problem helps. Knowing what it's NOT is often a relief: "It's not a stroke. It's not cancer."


This report was delightful to me as a physician dedicated to clear communication. 

The diagnosis is clear, and written in plain language with the proper clinical terms (not just lay language). The list of abbreviations shows consideration for the reader. 

There's a warning about what has NOT been excluded diagnostically: "Nerve conduction EMG does not rule out vascular thoracic outlet syndrome." 

The whole "Conclusion" is a clear, tight, thoughtful package. 

Golden Apple

It might be no surprise to learn that this physician was also recently awarded the National Golden Apple Award for Teaching Excellence by the American Medical Student Association.