As part of my senior registrar training at St Mary's in the late 1960s I spent a year working on the cardiothoracic unit. It was while wrestling, both physically and mentally, with the two, three, or even four volumes of case notes of patients coming for cardiac surgery that I thought that there must be a better way of organising them.

Help was at hand. A film of one of Lawrence Weed's presentations was shown in the medical school. His vivid demonstration of what he thought of disorganised and confusing case notes caught my imagination. Why could doctors not use a scientific methodology when recording their clinical findings? I was seized with a missionary fervour and for 35 years used the principles of the problem oriented …