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Posted by on Aug 19, 2016 in Bioethics, CRPS / RSD | 2 comments

Where’s NCR paper still used? (19.08.2016)

Where’s NCR paper still used? (19.08.2016)

Every now and then it strikes me that although medical science is advancing at a rapid pace, and these advancements are often being provided in hospitals fairly soon after their development (and approval for use), the same just can’t be said of advances in administration. Not in my area, at any rate.

I was – finally! – diagnosed with a rare disease on May 27th, and had the first of many day-surgery procedures that same day. In each of these procedures, a neuro-anaesthesiologist used an ultrasound machine to find a specific cluster of nerves, and then injected medications directly into the nerve cluster. I’ll write later about these stellate ganglion blocks. (In the meantime, read 10 days & 6 day-surgery procedures)

The goal of the series of 6 stellate ganglion blocks, within 10 work days) was to try to stop the spread of Complex Regional Pain Syndrome (CRPS). This kind of treatment would, I think, have seemed like science-fiction just a decade or so ago. But now, in 2016, I underwent my first ‘stellate block’ within an hour of my diagnosis!

Instructions to fax a form to a hospital

Photo: Sandra Woods

But technological advances seem to have come to a standstill in many areas of hospital administration. Yesterday’s a good example.

I received a referral from my local community hospital to a large university hospital centre in the downtown, or city centre, area. This university has several large hospitals in the Montréal area.

The referral document, from the community hospital was a carbonless copy paper form; it was on 3-sheet NCR paper(1). You might remember these tear-away forms from the 1970s; the top page is white, then there are couple of other pages underneath – usually in different colours. Whatever’s written on the top form ‘magically’ appears on the underlying pages. My referral form had a white first page, then yellow and pink pages, followed by a green partial page (the top portion of the form only).

The time warp doesn’t end there, though! Guess: How did I have to send my NCR paper referral form to the large, world-class, university hospital to which my treatment was being referred? –>  By fax…  In 2016.

This isn’t a negative reflection on our hospitals, which generally try their best to care for patients, but rather on how healthcare administration is set up in Québec – and in much of Canada. We have world-class clinicians & researchers, often with world-class diagnostic & treatment tools, working within a larger system that’s reliant on technology from the 1970s and ’80s.


(1) PC Mag, “Definition of: NCR paper”, PCMag Digital Group, Ziff Davis, LLC:


  1. Great story. I like that you use humor even if you have pain. Sad that you still have those carbon-less forms ‘-(

  2. This was really funny. My hospital uses carbonless paper forms. And faxes. I thought big city hospitals would not anymore. Almost 2019, eh!

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