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Diary of a practice manager: technophobes and technophiles

1 March 2007

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

Almost every day, the Messages Book goes missing. Somebody rings with a message for one of the doctors – a request for a phone call, or a query about a prescription – and we reach for the Mess­ages Book to jot down the details, but it’s nowhere to be found.

No matter how many times this happens, it always bamboozles us. Only after hunting up and down for several minutes do we realise that one of the doctors has borrowed it in order to ring someone back in a quiet moment between consultations. Until the book is returned, we’re reduced to jotting things down on Post-it notes or bits of scrap paper.

Why don’t we record all our messages on our clinical system? Then they would always be accessible from all parts of the surgery: automatically dated, timed, and legible.

Only one problem. It isn’t just administrative staff who use the Messages Book. It’s the doctors too, and three of the four doctors on the premises can’t type. The one that can is the registrar, and he’ll be gone in six months. The others would much rather scribble on paper than pick their way slowly and painfully across a computer keyboard. The suggestion that we should handle our messages electronically was mooted at a practice meeting sometime last year, and the three senior doctors rejected it.

The registrar voted in favour, of course. Far from being a technophobe, he’s a rabid technophile, forever besieging me with questions about our clinical system. How soon will we be able to take appointment bookings online? What about patients collecting their test results via the internet? Can’t we display different doctors’ appointment schedules onscreen in different colours?

We often find this with registrars – they’ve heard all about the very latest developments in clinical technology, and they want to know why we’re not implementing all of them right now. The idea of taking things one step at a time is anathema to them. It wouldn’t be so bad if all the registrars badgered you about the same things, but they don’t – each one seems to be mad keen on a completely different set of innovations from the one before.

Recently, we had new printers installed, and our current registrar discovered that they were duplex-capable – they could print on both sides of a sheet of paper. We should put them all on the duplex setting straight away, he insisted. He didn’t even expect me to do it: he was perfectly happy to do it himself. Incautiously, I gave in, and he went round the entire surgery whistling and singing, his face a picture of contentment. Then, as it was his half-day, he went home.

Immediately after he left, the big problem with duplex printing became apparent. Every repeat prescription that ran to more than one page printed the second page on the reverse side of the first. I had to go around the whole surgery again, putting the printers back the way they had been.