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…
A few years back Dr. Jim Pagano published a guest blog post on KevinMD.com about medical scribes that prompted quite a lot of discussion, suggesting that scribes are a hot button topic that piques the interest of many physicians. And indeed, when physicians are asked directly about scribes, this suggestion is borne out. Sermo.com, a large online community of physicians, on March 24, 2014 conducted a poll that asked…
Your ER may be seeing an increase in the daily census over the past several months. The reasons for this are several, but among them is the new class of under-insured patients created by the ACA. Those enrolled under the Medicaid expansion are often finding themselves unable to get a timely appointment with their primary care physician. The ER is available, capable, and now, for them, free of charge….
The decision to hire a medical scribe is usually based on three factors: 1) The type of medical practice in which the physician is involved, 2) The need to document specific bits of information on each patient in order to get paid for the work done, and 3) The introduction of an electronic medical record. Ophthalmologists were among the first to understand the value of scribes. They learned early…
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…
The journey of our Surviving the Emergency Room series has reached its end. You’ve arrived, been triaged, and have seen the doctor. Now, the grand finale, what everything has been building to: just what are we going to do to you? The Dispo Your disposition, that is, what we are going to do with you when we’re done with our evaluation, is something we’ve been thinking about since you…
The previous five parts of our Surviving the Emergency Room series have brought us to this: basic etiquette and standards of behavior. Or, put another way, The 7 Things That Drive ER Doctors Crazy. 1. Abusing the System First, don’t abuse the system. While it’s true that patients brought to the ER by paramedics get seen faster than those coming through the front door, especially when the department is…
When I’m not helping to run Precision Scribes, I am an emergency physician. Over 30 years of practice, I think I’ve seen everything that could possibly be seen in an emergency room. For me, a visit to the ER is routine; it’s my job. For you, it’s understandably a bit intimidating. And so I’ve penned this “user’s guide” to the ER that tells you how to survive a trip…
By now you have some idea of the best times to visit the ER and what to expect when you get there. Having demystified the notion of triage, the actual doctor visit, and, to some extent, the means by which it all gets paid for, it’s now time to address the topic of significant others. These are the friends and relatives who’ve accompanied you to the ER, usually for…
Last time, having made it to the actual exam room, or “Inner Sanctum,” you experienced first hand the excitement, fears, entertainments and humiliations the ER has to offer. Of course, all this comes at a price. In this installment we will explain the value of the insurance card, the importance of having it with you when you arrive, and what to do about the ridiculous bills you’ll get if…
