Wednesday, July 2, 2014

Cost-Effective Medical Exams Using Common Office Equipment

This study first appeared in The Placebo Journal, Idiopathic Wit & Wisdom, Vol 9 #2, Dec 2009

Donald B. Stewart, M.D.
Birmingham, Alabama

Dr. Stewart is currently Chief Visual Humorist at the DS Art Studio Gallery, where he limits his practice to endorphin management, and disorders of the funny bone.


The article summarizes the experience of the author and a non-representative, non-random sample of unmatched cohorts in an anecdotal study to measure the capability of readily available business office technology as a cost-effective aid in the screening and diagnosis of common proctological pathology. The practical application of office copying machines and scanners was examined, and compared empirically to standard examination methods.


This study was initiated as a result of a spell-check function in the Microsoft® Word  dictionary program, which automatically suggested that the term “proctoscopies” should be changed to “photocopies” in the text of a clinic memo. While this unanticipated verbal juxtaposition brought to mind any number of unsavory visual concepts (and at least one popular after-hours office diversion), it also suggested an alternative and potentially cost-effective clinical application of a common business technology.

To date, the use of photocopy equipment in medical practice has been limited to the reproduction of medical records and office documents. Widespread (sic) use of office copying machines for screening and diagnosing routine proctological maladies has been absent in the medical literature, and has appeared only sporadically in the popular and trade press. (1, 2)


Volunteers were solicited by general consensus at an annual clinic holiday celebration. Preparatory induction anesthesia was achieved using of a selection of popular OTC malt-based ethanol products, distributed prn until test subjects attained an acceptable level of behavioral malleability to complete the study. A sterile field was maintained before and after each procedure via the liberal application of various brands of EtOH (35-45% by volume) and absorptive office products, with the result that by the end of the study, the elusive IT goal of a truly paperless office was achieved.

Several brands of freestanding and desktop copiers (analog and digital) and digital scanners were compared for optical quality, ease of access, and overall patient comfort. Unfortunately, some lacked the structural integrity required to support patients with body mass exceeding 90 kg, +/- 5 kg.

Resulting images were distributed among the attendees for diagnostic evaluation, with a general cross-referencing of clinical opinions regarding the various electronically reproduced visual data. Many were secondarily scanned by personal cell phone and digital photographic devices, and distributed via internet to professional colleagues for second and third opinions.

Results were equivocal, with the notable exception of one unnamed partner in the group practice, who was diagnosed by every measure to be a pain in the ass. While test subjects were not routinely screened for demonstrable crack habits, consensus among all investigators confirmed the wisdom and clinical efficacy of just saying no.


In the end, it was determined that under ordinary circumstances, common office photocopy equipment does not provide sufficient light to penetrate the darkness. Furthermore, our data suggest that given the current level of technology, digital scanners on the desktop will not soon replace traditional digital examination in the medical office. Introduction of the most recent iPhone® photo application, the iRect (3), may offer more penetrating and enlightening data in the future.


  1. Plumpbottom, K.M., “My Boss Is An A**, And I Have Pictures To Prove It”, Secretarial Monthly, Volume 1, #2, 2001, pp 16-17.

  1. Bunz, Seymour, “From Xerox to Staff Directory – Guess Who? An interoffice matching game of coworker recognition.”  Medical Group Management Magazine, July 2007, pp 77-80

  1. Dover, Ben,  “iRect: The Light at the End of the Tunnel” Journal of American Scatology, Volume 6, #32, 2008, pp 29-33.

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