There is something about Dragon NaturallySpeaking that tends to make it collapse in front of spectators. I think we dictate louder and more carefully in front of people.
I don't use it in the room. I take notes in the room, then come out of the room and dictate. There is no space in my exam rooms for a computer.
I am toying with the idea of bringing a tablet in with me, but I am not paperless, and I don't know about juggling a tablet and a paper chart.
And, yes, the plan is to phase out the paper chart, but it will mean phasing into a new location as well.