Friday, March 1, 2013

Doctors Office

English: A typical examination room in a docto...
I took my family member to her first visit to Johns Hopkins Oncology, in the glistening, new, and impressive Sidney Kimmel Cancer Center. After completing the new patient registration, she was given an orange card to be used at all check-ins. We swiped the card, which has a bar code in the back, and poof, she was registered for her appointment with the doctors and with the lab.

The examination room that she was taken too had a computer terminal, which, I presume, was to be used to access an electronic health record. What happened during her intake was very instructive.

The oncology fellow, rather than typing into the computer, scribbled the history and physical information on unlined paper. Now, I am assuming that, later on, she was probably going to dictate her note. But, nevertheless, she obviously found it easier and more efficient to write the information down on pen and paper.

Now I know that we physicians have been castigated for being techno phobic dolts who are balking at using computerized health records. But here was a young physician, a top flight Johns Hopkins trainee appearing to be about 30 years of age, who chose to actually write things down. Now, either the Hopkins folks are dolts as well (doubtful), or this obsession with typed records is not well thought through.

It is more organic to write your personal notes down than to type them into the computer. It is freer flowing and unconstrained by the rigidity of the computer algorithms. We, alas, still think better in an analog than in a digital fashion. Certain things work beautifully by computer. Having laboratory and radiology results available on-line and on the computer are wonderful. Being able to look up current medical data on-line or on the PDA is great. Communicating with other physicians and with patients electronically can easily be seen as improving patient care. But I am yet to be convinced that we must discard the handwritten personal notes. Scan them in, or have them written on a tablet PC if need be. Let’s think long and hard, though, about writing our notes by some program-generated paradigm.

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