Over the years that I’ve been a medical scribe, and now as the owner of a medical scribe company, I’ve always been struck by how impressed medical providers (physicians, nurse practitioners, and physician assistants) are with the productivity and quality-of-life gains they enjoy as a result of working with scribes. (“Why didn’t I use a scribe before?” is a common refrain.)
But I’ve also been struck by how many providers who haven’t ever worked with a scribe see them as unnecessary at best, or a distraction at worse. And unfortunately, this prejudice is often based on misconceptions about what scribes do and how they work.
So, in an attempt to clear this up (once and for all? a man can dream…), here’s my list of the top misconceptions about medical scribes and the truth that belies them. Let’s count them down.
Misconception #6: “I’m fast enough on my own.”
There aren’t many places where providers aren’t pressured to see more patients, nor do many providers like the fact that they often finish their charts at home after their shifts. So when someone tells me they are “fast enough,” I don’t hear they wouldn’t like to be faster.
What I hear instead is a fear that using a scribe will make them slower, and that would be a bad thing. But assuming for the moment that a scribe is well-trained (we’ll talk about training a little later), working with a scribe won’t slow you down, and will often be faster, if only because two things (exam and documentation) are done the same time rather than one after the other.
A recent study estimated that the average physician racks up 4,000 (mouse) clicks per shift. In the immortal words of Peter Drucker: “Do not believe that it is very much of an advance to do the unnecessary three times as fast.” To say “I click the mouse fast enough on my own” isn’t saying much when someone else could be doing the clicking for you.
Misconception #5: “I’ll have to teach the scribe how to do everything.”
Many providers assume they’ll have to instruct the scribe how to do everything, but this isn’t true. First, medical scribes are typically recruited from the pool of pre-medicine undergraduate students in the area. These students are smart, passionate about medicine, and eager to learn (because their future career depends on it). And second, before they ever work with a provider, scribes from any legitimate scribe company are put through extensive training on the structure and flow of a history and physical, an introduction to the various types of procedures they are likely to witness, and how to enter the pertinent information into the EMR in a way that makes sense and allows for maximal reimbursement.
So far from a blank slate who needs to be taught everything, providers will instead get a motivated member of medicine’s next generation who is knowledgeable about the EMR and eager and ready to adapt to how that individual provider likes their chart documented.
Misconception #4: “I will lose control of my chart.”
Not true. Providers maintain complete control of their chart and remain responsible for what goes into the medical record. And as always, the provider reviews and signs off on each chart before it’s final. The only thing a provider loses control of is the unpleasant and time-consuming chore of having to fill out the EMR herself.
(A quick aside: this does not mean a provider must dictate everything the scribe puts into the medical record. In fact, a truly great scribe (like ours!) will adapt to the style of each provider. So the scribe learns that when you say “normal ear exam,” you want “Ear canals clear with no cerumen. Tympanic membrane is normal with no erythema, bulging, or dullness” in the chart. Think of them as human macros.)
Misconception #3: Patients don’t like having a scribe in the room.
With very few exceptions, once a scribe is introduced and a brief explanation of his or her role is given, patients accept them and are grateful for having the doctor’s undivided attention. In my own personal experience as a scribe. I worked with hundreds of different providers and was in the room while they visited with thousands of patients. In all of that time, only twice did a patient ask me to leave the room, which I happily did. The provider filled me in on what to put in the chart after the exam was finished.
Misconception #2: Scribes are only there to help with documentation.
Because their most visible task is documenting patient encounters in the EMR, some people think that documentation is the only thing that scribes do. But in truth, a great scribe will do many things that belie the “scribe” title.
There are inefficiencies present at every medical facility. (We could call them “10 Ways You are Losing Money and Don’t Know It,” but maybe I’ll save that for another post.) Any time a provider has to step away from a patient—to page another doctor, to locate a replacement otoscope because the exam room’s is broken, to check on the status of a test—is time they aren’t practicing medicine. A well-trained scribe can easily address and eliminate these inefficiencies. Greater productivity and increased revenue are the result.
Great scribes are much more than limited “information managers.” We train our scribes to think of themselves as aides-de-camp. Their job is to do whatever is necessary to allow the provider to stay focused on their patient.
Which finally brings us to the biggest and most common misconception about medical scribes.
Misconception #1: “You’re giving me a scribe because you think I’m doing a bad job.”
No, they’re not. They’re giving you a scribe (or you’re giving yourself a scribe) because your time is too valuable to be wasted doing things an assistant can do for you. Your patient is depending on your training and experience for proper diagnosis and treatment. It makes complete sense for you to have a scribe who lifts the burden of distracting, non-medical tasks from your shoulders so you can stay focused on the medical tasks only you can do.
A great scribe makes this possible. And I’m happy to confirm that conception of medical scribes is absolutely true.
Garrett Lewis is the co-founder and EVP, Scribe Operations of Precision Scribes.