Monday, November 16, 2009

Melissa Young, MD: Paperless office? Ha!

A paperless office? Wait, I can’t stop laughing.

So I am now about six weeks into my new practice. I had visions of being paperless when I started. I realize now that being paperless is as elusive to a physician’s office as being neat is to my house with two small children. You try to keep things neat and tidy, but the kids keep pulling more toys out of the toy box, and their well-meaning grandparents keep bringing them new things to strew upon your floor.
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Patients bring in stacks of lab results, old records, and lists of questions. Drug reps bring in their detail pieces. And the mailman drops off a new stack of junk mail, journals, and EOBs.

Yes, much of it gets scanned. And one day, my secretary and I will be comfortable and confident enough with our EMR that we can shred things as soon as they are scanned.

But for now, we scan, we save, and after the file folder gets full, we survey and we shred. Because I had planned on being paperless, there really isn’t room for paper to be stored. I have one four-drawer filing cabinet and three more file drawers spread around the receptionist’s area. I keep personnel files, instruction manuals (and there are many – one for every component of the computer network, not to mention the phone, the copier, and some of the medical equipment – ok I can probably throw out the one for the sphygmomanometer), and paid bills, but I suppose I could scan much of that too.

There is something to be said for having a tangible piece of paper in one’s hand, and filing it in a folder you can see and touch. And having lived a lifetime reading ink on paper, it is a tough transition. But being able to pull up any document from anywhere in the office, heck, from home even, will make the transition worth it. I’m pretty sure I could even find the sphygmo’s manual online if I tried.

Melissa G. Young, MD, FACE, FACP, is an endocrinologist in private practice, an assistant clinical professor at Robert Wood Johnson, and a working suburban mother of two in Freehold, N.J.


  1. When we opened our practice several years ago, I hired a computer phobic medical assistant. We worked together in getting her comfortable and now when the system goes down (and it will occasionally)she is the first one to complain that she can't live without it.

    I still do not understand why I order 2 cases of paper instead of one every month.

  2. We have successfully converted to a completelypaperless office using a generic document management product called Globodox ( We continue to dictate notes and letters using voice recognition, generate office reports digitally, and scan in whatever paper exists. All the documents are saved as non-editable tiff files and event logs for every document are generated. My staff fax our letters direct from globodox so we never have to print, stuff, or apply postage! We scanned in all our charts and shredded them all. The software is comparatively cheap ($4000), very easy and intuitive to use, and me and my staff love it. The efficiency is 100% better than when we had paper charts. We opened up lots of space that used to store charts. We even scan in all our EOB's so we don't have boxes of these stacked all over the place. This isn't going to get me the HITECH bonus, but I'm not sure I want to work toward that anyway. And if I do want to upgrade to a full EHR, my data is fully exportable with a few keystrokes!
    David E. Cohen,MD (Paramus NJ)