Our clinic recently moved to a new charting system whereby medical notes are no longer handwritten. Instead, doctors and therapists now type their notes into a, we are abundantly assured, very secure database. The idea is to make records more easily accessible to other providers and to help make one’s medical history more “portable.” Plus, doctors’ legendarily bad handwriting no longer need get in the way of understanding what they are actually writing. We are hardly the first institution to adopt electronic medical records, and it seems as though whatever reformed health care system eventually emerges, it is sure to require some form of electronic charting as a way to promote efficiency, save trees, and enhance portability.

A few weeks into this experiment, some interesting unintended consequences are becoming obvious. While a session used to involve paying close attention to the patient’s expressions, and looking him or her straight in the eye in a way that builds rapport and communicates empathy, many of us now have to stare at our computer screens, instead, fingers on the keyboard as we type the information we are receiving. (This is much worse if the doctor never learned how to type.) As a result, the patient can feel ignored or experience the therapist as uninterested or un-warm, and the therapist may miss important facial cues or other telling body language.