This site is intended for health professionals only

Diary of a practice manager: getting a battering from RAM

1 May 2007

Share this article

Edward Picot has been a practice manager for 16 years. His website,, features a collection of his writing, poetry, short stories and animations.

The three senior GPs in our practice can’t type very well, which means that our “paperless” environment can be a struggle for them. Their consultations are sometimes not written up as fully as they might be. Sometimes, let’s be honest, they’re not written up at all.

This is particularly true of home visits and consultations at the end of a busy evening surgery, when the GPs tend to think, “Oh, I’ll write that up later,” then never get round to it.

One possible solution would be voice-responsive software. We had a demonstration of this about eight years ago, but at the time it was horribly slow, inaccurate and expensive. Recently, though, the price has come down to about £60, and reviews have suggested that it’s become much quicker and more accurate. So we splashed out the money and bought a copy.

When I attempted to put it on one of the computers at the surgery, however, an alert appeared, informing me that it would only install on a machine with 1 GB of RAM or more. The computer in question only had 504 MB – as did all of the other computers in the surgery. The only machine with enough RAM was the server, but I didn’t have an administrative login for that.

I rang our clinical system supplier and described the situation. They told me I could have an administrative login if I wanted, but if I installed extra software on the server then I did so at my own risk. I brushed this aside, sent them the necessary written request, and got an administrative login back by email.

Yet, when I tried the installation on the server I hit another problem: on closer examination it turned out not to have a sound card, and the software wouldn’t install without this.

Ok, I thought, next idea: how much would it cost to upgrade the RAM on one of the rank-and-file computers? It turned out that an extra memory-card for the motherboard would cost £30, but if I put it in myself and it went wrong then our clinical suppliers would claim that we had broken our maintenance agreement. On the other hand, if we asked them to come out and do it for us they would charge a fortune, because it would mean sending an engineer from miles away.

So, I’ve had £60 worth of voice-responsive software for two weeks now, and haven’t been able to try it out yet. Sometimes working with computers can be like that. Every time you try something new you hit an unexpected snag, and have to spend several hours on the internet looking for a solution. You have to be patient and persistent.

Today, I ordered the memory cards to upgrade the RAM on one of our PCs. It may all go horribly wrong – but if it goes right, that’ll be another thing I’ve taught myself to do.