@drzackmd: When medical shorthand meets a courtroom cross-examination, standard clinical syntax can suddenly get put on trial. In clinical documentation, physicians frequently use wide-scope negation, where a leading negation applies across an entire series of findings (e.g., "no nausea, vomiting, fever, or chills") rather than repeating "no" before every single symptom (Chapman et al., 2001). During the Lindsay Clancy trial proceedings, cross-examination attempted to claim a psychiatrist documented pressured speech simply because the word "not" was not repeated directly before the phrase (Commonwealth v. Clancy, 2023). However, standard psychiatric review of systems charting and matching checkboxes confirm the intended clinical documentation (American Psychiatric Association, 2013). While clear documentation is essential in an era of open medical notes, understanding standard medical phrasing prevents legal mischaracterizations of accurate clinical charts. #DrZacharyMeade #MedicalDocumentation #Psychiatry #MedLegal #ClinicalPearls
Dr Zack, MD
Region: US
Monday 17 August 2026 15:00:00 GMT
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LUVPilot :
His job is to create doubt, she got flustered and he did his job.
2026-08-17 22:09:19
1328
Michele :
she lost credibility when she couldn't remain professional
2026-08-18 00:28:30
2201
Deckcrew11 :
All these doctors defending her … my god
2026-08-17 22:42:16
859
Shamrocks&Thistles :
The difference is you included the word "OR" in your list.
Grammar matters.
2026-08-17 17:28:21
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Latoya :
Why did she get hostile when she could have explained scope negations
2026-08-17 20:53:46
382
Kelli 🫶🏻💖✨ :
The fact that people are still arguing about what she meant is why the lawyer won that one. She left it open to interpretation
2026-08-18 00:02:22
162
Cory Kreder :
Why not explain that on the stand? Why take the defensive route instead of explaining common language practices in the field?
2026-08-17 18:51:01
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Apple User67645339 :
Her note was fine. Her response to the close questioning was abysmal. Her saying she didn’t care what she wrote is about as bad an answer that a witness can give. Whoever prepped her dropped the ball.
2026-08-17 15:58:09
833
Jen exer :
The defense did his job, he found documentation left up for interpretation.
2026-08-18 00:23:51
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Kristina Ballerina :
From what a lot of medical professionals are saying, notes need to be VERY precise and leave NO ROOM for interpretation. Her note left room for interpretation. And the response was defensive. She’s not likable, which works well for the defense. So it’s a combination of the two. 1) She left room for interpretation. 2) She’s not likable.
2026-08-17 16:05:28
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justliving :
dude please,it's basic English written in basic English that's why she said "I know what it says I know what I meant" doctors do not do this you are wrong
2026-08-17 17:51:44
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Lindsay :
It wasn’t a long list of negatives. She should have used “or” and her attitude makes it so much worse for her.
2026-08-18 07:20:38
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Charie St Claire :
But you said “or” chest pain. She did not. Your point is she was sloppy.
2026-08-17 22:41:56
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tristinsb :
we're passed that. it was the "I DONT CARE WHAT IT SAYS, I KNOW WHAT I MEANT" that completely stripped her of any professional credibility that she had. I would never ever trust someone with my mental health who loses their own composure so quickly and to that degree.
the lawyer knew exactly what he was doing.
2026-08-18 16:32:45
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Default.1234 :
Who writes not pressured speech, it’s normal speech
2026-09-07 20:41:25
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fee2.o :
It’s fine she should have said that . Getting defensive and attitude is out of line
2026-08-17 19:59:13
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Phoenixscribe :
Medical charts are legal documents, and should be written clearly.
There's a reason I include "Don't write so you can be understood, write so that you can't be misunderstood" in every training presentation.
Taking the extra time to edit to "not hyper, no pressured speech" is worth it, specifically for cases like this.
2026-08-18 05:29:20
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leo.the.lionesses :
Wait!! Hold up this is a medical documentation this should be accurate wording so everyone could understand what is being written
2026-08-18 12:46:03
26
Butter :
Just because "you all do it" doesn't make it right. This kind of mentality and poor documentation is what hurts patients. It shouldn't be "we could do better" but should be "we NEED to do better".
2026-08-18 02:43:31
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Julie Marie :
I read medical records every day and doctors in fact dont do that. They do that with “no”. THE WAY YOU KNOW THIS. Is “NOT pressured speech” makes NO SENSE. THAT SAID. It’s very clear this was a documentation error OR her check box of speech appropriate was a documentation error and all that means from a person who literally AUDITS MEDICAL RECORDS is: the note is useless regarding her speech
2026-08-17 17:45:47
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Yesenia @ Colores :
Who says Not pressured speech? It would be no pressured speech?
2026-08-18 01:33:21
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Dinochickens :
Doctors are expected to do their notes in precise language. So it is very clear to others what occurred. Not ambiguous. If you choose to shortcut, you’re not doing your notes correctly and you’re not a good doctor.
2026-08-17 22:33:44
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Valentina :
As medical professionals, we’re taught to document clearly and avoid ambiguous wording. In the phrase “not hyper, pressured speech,” the word “not” does not grammatically carry over to “pressured speech.” If the intention was to say that neither was present, it should have been written as “not hyper or experiencing pressured speech” or, more clearly, “no hyperactivity or pressured speech.” As written, “pressured speech” reads as a separate documented finding, so that interpretation is not unreasonable.
2026-08-18 12:14:16
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Geff Klein :
The lawyer knew damn well what it meant
2026-08-17 17:26:07
174
Collyolly :
For me it was that she couldn't recall anything except what she meant on that one note, 😳
2026-08-17 20:54:02
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