A cytological procedure providing useful supplementary information in the diagnosis of laryngeal malignancy is described. Of 51 patients, 22 had complete correlation with histological examination in confirming a benign condition. Twenty patients had complete correlation in confirming a malignant lesion. Five patients showed cellular atypia in the presence of benign conditions. Three showed atypia, of which 2 were malignant, 1 being unstable histologically but with no evidence of frank malignancy. Ten patients had been irradiated previously; in all cases the distinction between residual disease and no evident disease was correctly diagnosed with respect to the histological appearance.

The physician often spends far more time gazing at the screen than at the person who has made the appointment. The patient has booked with the expectation their illness or accident will receive undivided attention. Immediately there is a problem, both for the doctor and the patient. Careful medical record-keeping is one of the most important duties of a clinician. How else can a patient's history be documented, the clinical findings recorded, the provisional diagnosis entered, and the chosen treatment pathway defined? But how does the doctor maintain confidence-giving eye contact whilst doing all this? The 19th century physician, as exemplified by the famous painting of “The Doctor” by Luke Fildes in 1891, typifies the devotion to care exhibited by the committed physician. The actuality is that today's physicians display equal amounts of dedication to their work; the difference in 1891 was that there was very little available to treat the great majority of illnesses. EHR, if used to its potential, is the means of pulling all this data together and getting it right every time!