Tools of the Trade


I have had some of you ask me what I use day-to-day to get my job done. In other words, what are the tools of the trade for a psychiatrist as he goes about the business of seeing patients in the clinic and the emergency room?

Although the personal interview and personal attention to patients is my stock-in-trade, I could not survive nowadays without technology.

I use a new twenty-one inch iMac in my home office, the machine I use to do most of these posts. I have two 4 TB hard drives attached to it for extra storage of music, video, and other items, as well as to back up my data. Everything is backed up three times, twice on my desktop on two different drives and once in a cloud service off site.

I have a set of harman-kardon speakers as well as a DVD drive attached to this machine for enjoyment of music, as well as for viewing videos, doing continuing medical education and the like.

There is a copier/scanner, a stand alone printer and a Fujitsu ScanSnap iX 500 on another desk adjacent to my main workspace. A shredder lets me securely get rid of paper that needs to be destroyed. I am transitioning to a completely paperless home office, so the last two remaining piles of charts and supporting documents on the floor will find their way into the ScanSnap and from there to my iMac as soon as time permits. 

My iPhone has been my primary go-to computing device on the road since 2007. When I leave home, the iPhone goes with me. Everywhere. Everything that I do on the iMac syncs wirelessly at home and through the cloud without me thinking about it. When I pick up the phone, I can get right back to a post, a project or anything else I was doing on the main machine at home before I walked out the door. Believe me, I have tried more configurations of more machines than you can shake a stick at, including desktops, laptops, phones and tablets. For me, having one main machine at home and one device to take with me just works better overall. 

Of course, you have seen me post about the setup at work, including the Polycom system, an HP laptop, a Dell desktop, fax machine, printers and the like. This is in my telepsychiatry office and is a static configuration that I leave on and operational all the time. As you know, I am an Apple guy, I use PCs and supporting peripherals to do my day job by default, trying not to whine too much about it! Another Dell desktop lives at the clinic office and is tied into the department network, so I can access all databases and notes for either job from either site. 

So tech is cool, but what about analog tools? Is there still a place for them in the twenty-first century? Of course there is! I also love paper, notebooks, pens and other analog tools almost as much as I do my tech toys. In the home office, I always have a couple of Field Notes notebooks and a large cup full of pens around for jotting down ideas as they come to me, later to be captured in my electronic devices for processing. I have a large whiteboard on an easel right behind my desk, so that I can stand up, think about projects on my feet and jot down outlines or notes as I go. On this board I also note books that I’m reading, places I want to visit, and a working budget for my daughter’s upcoming wedding! There’s something about having a large  white space like that that promotes brainstorming and planning for me, which can be very helpful in a way that a blinking cursor or mouse pointer cannot. 

When interviewing patients, especially new patients I meet for the first time, I’m still a clipboard and template sheet kind of dinosaur. I have an interview template that I’ve used on and off, with multiple modifications, for over twenty-five years. It keeps me on track, helps me to remember overall areas that I want to cover, and is sprinkled with mnemonics for various assessment tools that I might want to use. When I get to the bottom of the stack of papers on that clipboard, I make fifty more copies and keep going. 

I also have Field Notes notebooks in my bag for on the go, plus an assortment of charging cables, batteries, pens, paperwork and other goodies that I grab as I go out the door. I keep this bag stocked all the time, so that I never have to remember whether or not I have a USB cable or a uni ball Vision Elite pen or some other equipment that I might need when I’m away from home. 

Prescription pads, printed schedules, paper projects that need to be top-of-mind and various other stuff take up the remainder of the room in my bag. There is always something to send to someone, process, respond to or to read. 

I haven’t covered absolutely everything, but you get the gist of what I grab and go with almost every day as I go about the business of working, writing, reading, seeing patients and living. 

One day soon, I’ll share with you the applications that I use on my iPhone every day. That little device connects me with the world and keeps me organized and productive in ways that I would never have imagined even five years ago. 

What do you use as you go about your day? Are you a digital or analog person, or do you rely on both to keep you productive? 

I’d love to hear from you. 

Different Strokes



We sat there yesterday morning, all partaking of the proffered breakfast at the hotel that was being remodeled and so was a little more disorganized on this Sunday morning than would be expected. I sat at one end of the long straight row of wooden tables, sampling my oatmeal and fruit. They sat at the other, enjoying the eggs and muffins and coffee. I was headed out for a day of walking up and down grassy slopes and taking pictures. I’m not sure where they were going. 

I couldn’t help overhearing the conversation being lead by a fellow who looked to be in his mid sixties, maybe older. 

“Yeah, he told me he was getting one of those phones, you know, they call ’em smart phones or something like that.”

Murmurs of agreement, slurps of coffee, another bite of egg, another piece of muffin buttered and disposed of. 

“I don’t know why he would need that. I have a phone, and it works fine I guess. But you know,  he says it has this new virtual keyboard, I think he called it.”

Mumble mumble, virtual, mumble mumble, typing on a phone?, mumble mumble. 

“Yeah. Really. Blackberry or something like that. Yeah. Blackberry I think he called it.”

“I don’t know why they like those tiny little keyboards,” piped up another man around slurps of orange juice.

“Remember that Olivetti you used to type on?” brought up one man.

“And the IBM Selectric?” the woman asked, her first foray into the discussion.

They reminisced a minute about the old days of typewriters and correction fluid and ribbons and reams of paper. 

Then the conversation turned to Hawaii and which beaches were best and the last trip each of them had taken there.

We can’t assume that what gets us excited and drives our exploration and jump starts our curiosity does that for everyone else in the world around us. Those of us who love technology anxiously await the fall and the next release of the latest smart phone with near field communication (NFC), fingerprint recognition on the lock screen and multi-layered, parallax driven home screens that move as the viewing angle is changed. 

Others of us look forward to the next trip to beaches with black sand and sunsets that are to die for.

The take home for you on this Monday morning?

The next generation iPhone will have a gorgeous retina display, a virtual keyboard and do things that we never even thought about doing on a phone ten years ago.

If you want sun, fun, and gorgeous sunsets, and you don’t mind a significantly higher cost of living for a little while, head to Hawaii. Skip the big island. The smaller, out of the way places are best. 

Different strokes for different folks. 

I hope you all have an excellent week.