|Dr. McGoff and Dr. Anderson listed the following pros and cons of using medical scribes.
- Better continuity of care
- More face-to-face time with the patient and increased patient satisfaction
- Better medical-legal documentation
- More accurate documentation that helps with proper coding
- Training time for scribes and physicians
- High turnover rate
Find more about Scribe America on their website.
The Joint Commission offers more information about the responsibilities of scribes here.
Read the Rand study on physician concerns about EHRs on their website.
If you use electronic health records (EHRs), you may agree with physicians surveyed in a Rand study published last fall. Their top concerns about EHRs were:
- Not enough face-to-face discussions with patients
- Too much clerical work
- Accuracy of medical records through template-generated notes
- Low productivity
According to the study’s authors, physicians see advantages of EHRs but complain that the systems are cumbersome to operate and contribute to their dissatisfaction. However, many physicians have found that employing medical scribes can help solve these problems.
Medical scribes are paraprofessionals trained to document patient information into an EHR as directed by a physician. Scribes can be pre-med or medical students, medical or physician assistants, nurses or nursing students. They follow a physician into the exam room and record the patient history, the examination and treatment plan, as dictated by the doctor.
For many physicians, the process is a win-win situation. By using scribes, they can interact more with the patient and save time entering information in the EHR.
Here, two ISMA physicians describe their experiences with scribes or team members.
John McGoff, M.D., Indianapolis
Emergency physician John McGoff, M.D., began using scribes soon after his practice implemented an EHR two years ago.
“We saw a sizable decrease in productivity when we started using EHRs,” he said. “Medical scribes have gotten us back to the same productivity level we had before the EHRs.”
He noted that scribes more accurately document patient history and medications. However, he double checks their work. “A good scribe will have minimal corrections,” he said.
Scribes in his practice are usually pre-med, nursing or physician assistant students.
|John McGoff, M.D., dictates patient information to his scribe, Caleb Larsen (at computer).
|Patrick Anderson, M.D., is joined by two of his care team members, Shayna Marshall (left) and Lori Dill (right).
Patrick Anderson, M.D., Richmond
Internist Patrick Anderson, M.D., uses a team care model that provides an expanded scope of practice. He uses two to three nurses to assist with patient care and data collection.
His model is based on Team Care Medicine developed by Peter B. Anderson, M.D. (not related)
With his approach, a nurse first obtains the preliminary medical information from the patient. When Dr. Anderson enters the room, he dictates information to the nurse for the medical record. At the end of the meeting, the nurse reviews instructions with the patient, discusses the patient plan and answers questions.
“For me, there is no more data entry at 11 p.m. My time in the office has been reduced,” said Dr. Anderson. “This system makes it fun to practice medicine because I get to talk more to my patients and see additional patients. Quality of care is improved and patient satisfaction is higher.”
However, Dr. Anderson advises you to carefully select team members.
Read more about the team care model here.
Perspective from a scribe
As a pre-med student, Caleb Larsen has worked for Dr. McGoff and his partners for about nine months. He is one of 20 scribes employed by their emergency medicine practice. He explained that scribes usually spend one week in the classroom and work one week under supervision as part of their training. However, the usual work life of a scribe is one to two years.
”The average income is around $8 to $12 an hour. It’s not a high wage, but the experience is invaluable,” he noted.
He went on to explain how his job gives him the opportunity to learn medical terminology and to work alongside physicians as they interact with patients.
Larsen heard about scribing as an undergraduate and applied through Scribe America, a training and management company that places scribes throughout the country.
“For physicians, using a scribe definitely helps increase productivity and quality of care,” commented Larsen. Doctors help patients and scribes help doctors.”