Medical Scribes – So What’s In It For Them?

Earlier this week I wrote a guest blog post on KevinMD entitled “Scribes Put Humanity Back into the Practice of Medicine.” This prompted several dozen comments and a lively back and forth about the merits and ethics of using medical scribes. But one strain of commentary in particular caught me by surprise, because it seemed premised on the idea that scribes are somehow taken advantage of. This suggests, I think, I fundamental misunderstanding of who medical scribes are and what they get out of the experience. I’d like to take a swing at clearing up that misunderstanding.

It’s important to know just who it is that typically becomes a medical scribe: for the most part, it’s college undergraduates with an interest in pursuing careers in medicine. I was one of those people. Granted that was a while ago, but the requirements for being accepted to medical school, and now to a Physicians’ Assistant or Nurse Practitioner program, remain fundamentally the same. So, my experience as an aspiring physician is still relevant, and a brief retelling of it should provide some insight into the question “Why Become a Medical Scribe?”

Once I’d decided I wanted to become a doctor I began doing some research into what, besides getting good grades, I would need to do to achieve that goal. In the U.C. Berkeley campus library I found a book outlining various career options and what one needed to do to pursue them. I turned to the “physician” section and began reading.

I soon discovered that good grades were insufficient. Anything less than an A- in a core subject was going to attract some unwanted attention. I then learned about the MCAT, the SAT for medical student wannabes. Again, a good score wasn’t going to cut it. I needed a great score. Lastly, I read the part about “volunteer work”. Apparently an A- GPA and a killer MCAT score were not necessarily enough. The people sitting on medical school admissions committees wanted to know if you had some idea what you were getting yourself into. One of the criteria they used to make this determination was whether or not you’d done any volunteer work. Had you spent any time working in a real medical environment, or were your romantic notions about medicine derived wholly from what you’d been watching on TV?

Up to that moment I was of the latter variety of applicant. There were no doctors in my family. It just seemed like a cool thing to do. So off I went to the University of California Medical Center in San Francisco. (I’d called first, and yes, they had a volunteer department.) Once there I met with a kindly old woman who asked about my interests: in which department would I like to do my volunteer work? I had no clue. None. “Uh, cancer research,” I said. (At that point, I should have considered a career in acting.) “Well,” she replied, “you’re in luck. It seems we have a volunteer position open in our oncology department.”

I hadn’t bothered to find out whether or not the hospital even had a cancer research center, and the word “oncology” was a bit unfamiliar, but I decided to go with it.

“Great!”

The following Tuesday I stopped at the volunteer office, picked up my short white volunteer lab jacket and name badge, then proceeded to the twelfth floor: Oncology. I introduced myself and was escorted to a desk where I was instructed in how to affix labels to test tubes.

Had it not been for a particular oncology fellow who found me somewhat amusing, that would have been the extent of my clinical experience. When I told him why I was there, and when he stopped laughing, he offered to let me shadow him. We went on rounds, he let me watch him do procedures, he explained, to the best of my understanding, what was going on with particular patients, and when my stint as a volunteer was nearing its end, he offered to write a letter of recommendation that I could include in my med school applications.

That ended up being a good experience for me. But being a medical scribe offers a great experience. A scribe is taught the fundamentals of an actual history and physical. This is a skill not generally acquired until sometime during the first two years of medical school. A scribe is able to participate in the evaluation, diagnosis and treatment of more patients in a single day than I was exposed to during my entire time as a volunteer. Scribes become experts on all electronic medical record formats, something that’s true of very few, if any, physicians. And to top it off, scribes get paid. Minimum wage, to be sure, but they get paid to do something they would gladly do for free (as I did back in the day).

A former medical scribe is a much better prepared medical student than someone without that background. He or she has a clearer view of what a life in healthcare means and a more refined sense of where in the field they are apt to find the most satisfaction. So when someone asks me what’s in it for the scribe, I can honestly say “plenty.” And when they ask if being a medical scribe helps someone get into medical school, I can honestly say “yes.”

I wouldn’t be in this business if I felt that medical scribes like ours were taken advantage of. Instead, I take pride in the fact we give the next generation of physicians, PAs, and NPs the opportunity to get real clinical experience that will help them get into professional school and jump start their careers.