A Day of Practicing Medicine Without the Computer

It wasn’t even nine o’clock when the screen on my laptop suddenly froze. From that moment until my last patient left the building, my clinic had no Internet.

For my part, the day went pretty smoothly, mostly because of some of my own work habits. It also helped that it was a warm, sunny day and my schedule was on the light side. Others have frowned at my old-fashioned work habits, but this is what I do:


For all pre-booked visits, we print the last office note. We also print important lab results and outside reports. One reason is that I may give these to the patient. The other is that when you create an office note and need to incorporate what happened in the ER or hospital, what the MRI showed and so on, the EMRs I have worked with don’t easily allow me to read the source document and type/dictate my own note in a split screen. And since interoperability is just a theoretical concept most of the time, I cannot import or cut and paste from outside sources.

Having the last office note printout gives me a reminder of what happened, the medication and allergy lists, all kinds of information that helps me move quickly through an Internet blackout day.


I don’t know what life would be like without this paper, which has gone through a few renditions over the years. It lets me quickly jot down important parts of my patient’s history and exam, what tests I need to order, what referrals I need to make and all kinds of things which in theory would be super quick to do with a computer but unfortunately aren’t.

At the end of the day yesterday, I copied these sheets, left the originals with my medical assistant and brought the copies home, so that on my day off (who pays the price for a computer failure?) I can finally enter the lost visits into the system while the office schedules the followup appointments and things like that.

Ironically, I have been toying with the idea of making an update to my work sheet, inspired by old rheumatology notes I used to see; they had a drawing of a body with each joint made into a stylized box for notations about which joints were affected by disease.

My recent thought has been to put a picture of a body on my sheet with simple indicators for things like, how much edema, size of a lesion, grade of murmur and so on…

Here is my work sheet in its current form. It saved the day for me yesterday:

2 Responses to “A Day of Practicing Medicine Without the Computer”

  1. 1 Naomi August 10, 2019 at 9:26 pm

    All I have ever read that u write I can use in some way of my struggles thank you for that!

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Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.


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