As I have said many times before, I am no Luddite. I neither hate nor fear technology. My longstanding aversion to the adoption of an electronic medical record was entirely rational, based on the reality that an EMR is a tool. Until I had need for it (at a price I was willing to pay), I had no reason to go electronic.

Circumstances have changed, as they are wont to do, and I have changed along with them. My office now sports an electronic medical record, internet-based practice management system, and document scanners. I continue to make do with my positively antediluvian two-year-old iPod touch and my dumb phone, but have made impressive headway against the paper tide.

One feature of my EMR is a secure patient portal, which enables patients to access portions of their medical record online. Everyone who signs up for it loves it. The enrollment process is electronic, of course, except for one last piece of paper: after the system sends the patient an email with instructions on how to log in, the patient is supposed to enter a unique temporary PIN code that I’ve generated for him in the office. This produces a document. Usually I print it out and hand it to the patient, acutely cognizant of the irony of creating paper to enable paperlessness. At times, I’ve been known to jot it down on a note pad or sticky note, at least cutting down the size of the paper involved. Once or twice, patients have asked me to print the document as a PDF and attach it to an email. I’m happy to do that, but I think part of the idea is to have verification separate from the email.

Last week, though, I came face-to-face with the face of the Uber-Tech.

A tech-savvy patient eagerly agreed to enroll in the portal. The system generated the PIN document as usual, complete with the little rectangular “Print” button sitting patiently there in the upper right hand corner of the screen.

“How would you like me to print this out for you?” I asked my patient.

“Oh, don’t bother,” he replied.

He got up, took his (smart) phone out of his pocket, turned it on, stepped over next to me, and used it to take a picture of the section of my computer screen that contained the required information.


Dinosaur, MD (aka, Lucy E. Hornstein, MD) is a solo-practitioner in Family Medicine. She is also a book author (Declarations of a Dinosaur) and posts frequently at her blog, Musings of a Dinosaur, where this post first appeared.

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