Lamenting the Loss of an Office Staple

MICHELE NORRIS, host:

Commentator Elissa Ely laments the loss of an office staple in the clinic where she works.

Dr. ELISSA ELY (Psychiatrist): The medical chart is becoming electronic. Rooms full of molding paper records are about to be liberated. Soon, charts will start to live in space and when they do, trees will breathe easier. The old world is ending.

In our clinic, each visit has always begun with an encounter form. This sounds like a moment of Far Eastern etiquette, some long-practiced bow with just the right amount of neck showing. Actually the encounter form is a piece of paper passed from patient to doctor, written on by hand, then placed in the chart. It's a cumbersome method of billing and note taking. It's also the finest kind of communication.

On their way to my office, patients stop at the encounter form window. A kindly woman sits behind a half door with no escape. She's been sitting there for years, generating the forms patients carry upstairs. She's never angry, never in a hurry, and never alarmed when someone is talking to himself. She delivers form after form with a peaceful expression. By the time the patient hands their encounter form to me, it's already full of personal information. Patients have written on it in a hundred ways, though not with pens. This one is covered with coffee stains. That one has been sitting in a back pocket with a moist pack of day-glow LifeSavers. Tears and sweat cover another. Corners have been folded and unfolded in the waiting room, anxiously, angrily in boredom and shame. Occasionally, a piece of origami emerges. It's a crime to use these pieces of art for recording purposes. I'd much rather hang them on my wall.

So much is gained by electronics, so much suddenly lost. Information will be easier to share. Physician thinking will finally be legible. The new world is coming. But the patients and I have been filling out encounter forms together for years. I'll miss the thousand cranes.

NORRIS: Commentator Elissa Ely is a psychiatrist in Boston. Transcript provided by NPR, Copyright NPR.