Medical scribes making a comeback
Assistants help doctors focus less on paperwork and more on patients.
Medical scribes are making a comeback as doctors look for help with the flood of information they have to enter into electronic health records.
Whether it’s a remote scribe listening in or a person taking notes quietly in the background of the office visit, these workers help get all the important information into the computer system while helping doctors make more patient eye contact and spend fewer late hours over a computer.
“There’s a lot of definite advantages of electronic medical records. Enhancing physician engagement with the patient is not one of them,” said Dr. Tom Greer, with PriMed Patterson Woods Family Practice, who works with a remote scribe service.
Every insurer and governmental agency wants to collect this big data, including for evaluating big picture outcomes and trying to improve care.
With scribes, there’s a person taking notes and putting these data points into the permanent computer record, and providers save hours of time when they switch to checking and approving instead of doing all the input.
Dr. Mark Couch, president of PriMed Physicians, said he has been working with a scribe for about four years now because with the increasing complexity of electronic records, there’s a need to document lots of data in the right place in the right way.
Use of scribes was associated with significant reductions in electronic health record documentation time and significant improvements in productivity and job satisfaction, according to a 2018 study of 18 primary care physicians published in JAMA Internal Medicine.
There are also some cons. Particularly, there’s a cost to the practice’s overhead, with an in-person scribe costing more than a scribe service that can listen and work remotely from a central hub.
Couch said having a scribe has been worth it and allows him to reach more patients as well.
Several job ads for scribes in the region advertised different wages between $10 to $15 an hour. These jobs are often filled by people who have medical school or other health career plans and want to learn more about the field.
Greer, who also previously worked with an in-person scribe, said one of the things a physician might wonder is what their patients are going to think.
Greer said every once in a while he’s had a patient who is hesitant about the scribe, and so if there was something a patient wanted to discuss very privately without the scribe that they could.
“I think for many people initially it’s like ‘Who is this third person?’ Yet on the other hand, we try to reassure them this person has a confidentiality agreement, are contracted with us and they are a part of the medical team,” Couch said.
The scribe also helps with the patient relationship, Greer said, because he can spend more time looking at the patient during their visit.
Because repeated studies have shown that lots of physicians are struggling with burnout. In a recent Medscape survey about the prevalence of physician burnout factors and how they affect doctors’ lives, different specialties reported anywhere from 29% to 54% physician burnout.
“A huge part of that is the paperwork,” Couch said. “Imagine if you could delegate that paperwork for someone else to complete? It allows many physicians to reduce their time on the thing that bothers them the most and helps get that work done.”