Long before I began working as a physician I made my living playing the guitar. I still play and even do the occasional gig. While practicing the other day I realized that doctors and musicians have something in common—roadies! OK. I admit it. It sounds a little weird. What kind of doctor has his own roadie? Let me explain.
Imagine you found out your favorite band was coming to town for two nights. They are hugely popular and tickets are going to be hard to come by. But you are determined, and though you had to spend a little more than you had hoped, you manage to acquire two. Row ten. Near the center. Nice. Your significant other is impressed.
As the day of the concert approaches your excitement rises. It’s going to be great. Finally, the day arrives. You brave the traffic and the parking. You fight your way through the crowd and claim your seats. The lights go down, there’s a flash of light from the stage, and BAM! The first chords erupt from the amps and you are transported.
Midway through the third song, though, the guitar player, the one you really came to see, breaks a string and the band stops playing. The lights go back up, the guitar player rummages around for a few minutes to find the extra set of strings he always has on hand for this sort of emergency, then walks to the mic to apologize for the delay while he changes strings.
Have you ever seen something like this happen? Of course not. Sure, guitar players break strings all the time, but as soon as they do a roadie runs out with another guitar, all strung and tuned up. The show goes on uninterrupted. Rock stars understand that it’s a waste of their time, and poor showmanship, to fool around doing things their fans don’t care about. It’s their job to concentrate on the music, not the equipment.
Well, the practice of medicine is the same. It has just taken doctors a little longer to realize their value lies in doing what they do best—being doctors. There has always been a non-clinical aspect to medical practice. Time-consuming, but essential, chores that need to be done for quality care to be delivered, like documenting the doctor-patient encounter in the medical record. And until recently doctors have assumed this task was something only they could do. The introduction of the electronic medical record, though, has begun to change some minds.
The EMR provides clearly legible charting with easy access to essential information for all involved in an individual patient’s care. Orders are clear, lab and imaging results are easy to find, discharge instructions are detailed and understandable. But all this comes with a price. The EMR takes time to produce. A significant amount of time. Time the doctor could be spending with the patient instead of the computer. Wouldn’t it be great if the doctor had a roadie?
It would, and he does. But that person isn’t called a roadie, he or she is called a scribe. A well-trained scribe is the doctor’s personal assistant, an expert in computerized medical documentation, who can enter the pertinent elements of a patient’s visit in real time, while the history and exam are being performed, without the doctor having to split his attention between the patient and the EMR.
The doctor is free to concentrate on the patient, what is said, what is found on the exam. More time can be spent at the bedside, where the doctor’s special skills and knowledge are most useful. And it doesn’t matter if the doctor is an expert with computers or completely technophobic. In either case he will have more time to spend with his patient if he does not have to spend any doing data entry.
I don’t care if Eric Clapton is the fastest string-changer in the world. If I’m at one of his concerts I don’t want to spend a single minute watching him change strings. Same goes for the doctor. Let a scribe take care of the chart while the doctor takes care of the patient. That’s why the patient came in the first place, right?
Dr. Jim Pagano, MD, FACEP, is the chief medical officer of Precision Scribes and has over thirty years of emergency medicine experience. He’s seen everything an emergency physician can see, and more than a few things they should not.