When I was in my clinical year in veterinary school and actually starting to see real clients and their animals, almost always at the top of the pet’s medical chart were the initials CC. CC = Chief Complaint. It’s the owner’s main complaint and the reason they’re bringing the animal into the veterinary hospital. Examples of a CC may be diarrhea, vomiting, lethargy, swollen left ear, or limping on right rear leg.
I went to the University of Tennessee College of Veterinary Medicine (UTCVM). At UT, we used the acronym ADR sometimes for the chief complaint. ADR = Ain’t Doin’ Right. I loved it because sometimes that was exactly the owner’s complaint.
Many times an owner would say, “Fluffy just isn’t herself and I can’t put my finger on anything in particular, but she’s definitely not herself.” Or sometimes an owner might say, “Bandit is just off. His appetite is not up to par and he’s just not acting right.” ADR was a perfect chief complaint in those types of situations. It’s not a diagnosis. It’s the reason the concerned owner is standing in front of you with their animal friend. There was hardly a day that went by in practice when I didn’t get an ADR animal.
Shortly after I graduated, I went to work for a veterinarian who was the sole owner of a house-turned-veterinary clinic. I had worked at this clinic while in undergraduate and prior to getting into veterinary school and when I had breaks during vet school. I knew this veterinarian and his family well and they were like family to me. He was my own veterinarian who I entrusted with the care of my own pets. He was like a second father to me and he even used to tell clients that I had grown up at his clinic. I was thrilled when upon graduation, he offered me a position. I knew him and the practice well and knew the clientele and couldn’t imagine a better place to work.
One day, not long after I had started to practice there, my boss approached me waving the medical record of one of my hospitalized patients and asked me, “What’s ADR?” This was before computerized records when we still actually wrote on hard copy medical records. I explained it was an abbreviation for the colloquial term, “Ain’t Doin’ Right” and it was used when an owner’s complaints about their animal’s health were very vague, when the animal just seemed “a little bit off” to them. I told him, you know, those clients who come in and say, “I just can’t put my finger on it and I don’t know what’s wrong with my dog/cat, but he’s just not acting right? My boss asked if this was a “UT term” and I explained, yes, that they use it on records in the veterinary teaching hospital (and therefore obviously teach it to their students).
After my explanation, my boss told me he didn’t want me to use ADR anymore on the medical records because “it wasn’t professional” in his opinion.
I couldn’t keep from laughing aloud and said, “Oh, and “PPP” that you write on the medical records is professional?” He got a sheepish grin on his face and then laughed. He had to admit, I had him there. You see, his PPP was an acronym for Piss Poor Prognosis (and I’m pretty sure he told me he had learned it at the veterinary school he had gone to). If he had a patient with a grave prognosis, he’d write PPP in giant letters (and usually in red ink) at the top of the medical chart. And I absolutely hated it. Because more than once when I was seeing one of his client’s animals, the client happened to look down at their pet’s chart as I stood at the work station close to the exam table, and they’d ask me, “What does PPP stand for?” Yeah, try explaining that one to an owner. Real professional.
But he was the boss and he made the rules and I respected those rules. So I stopped writing ADR as a chief complaint.
The practice grew and more veterinarians were hired over the years. One, like myself, was a UTCVM graduate. One of the first cases she saw on her first day happened to be an ADR dog. So she wrote on the medical record: CC- ADR. I laughed to myself when I saw it. I later pulled her aside and told her about his feelings on writing ADR on a record. She was puzzled and with furrowed brow said, “But why? It’s so perfect.” I smiled and shrugged my shoulders. And for the record, he never said one word to her.
I’ve been told that some medical doctors use it too but I think it’s more popular in the veterinary world. It’s also an acronym for Adverse Drug Reaction.
I’m curious (because I was having this conversation with my niece not long ago who is a first year veterinary student)– what are your thoughts? Is ADR unprofessional in your opinion?