Imagin
e conducting an in-depth physical exam and history-taking with a patient in your office, while someone stands silently and expressionlessly in the background taking notes on a laptop about the interaction. That’s essentially what medical scribes do, and their services are in increasingly high demand as doctors and hospitals try to meet meaningful use guidelines with often-unwieldy EHR systems.
Physicians remain responsible for the content of every patient’s medical record, which requires a review of the scribe’s notes, but the scribe industry promises to save physicians hours of work each day. Most scribes are medical students or pre-med undergrads hoping to embellish their medical school applications with in-the-trenches experience—and make a few extra bucks ($8 to $16 an hour). The American College of Medical Scribe Specialists estimates that the number of medical scribes in the U.S. will jump five-fold in the next five years, from 20,000 currently to 100,000 by 2020.
OrthoBuzz recently spoke with one middle-aged orthopaedist whose practice experimented with medical scribes but who felt uncomfortable having a stranger listening in on the patient-physician interaction. In a recent “viewpoint” piece in JAMA, George Gellert, MD, posed another reason why medical scribes might not be a good idea: they could impede the needed innovations in EHRs that will be driven primarily by direct physician engagement with the technology and feedback on it.
OrthoBuzz would like to know about your experiences with medical scribes. Please tell us what’s working and what’s not by clicking on the “leave a comment” button in the box to the left.
This is “back to the future”. When I first started to practice in 1972, an older orthopedist wanted to work a few more years. He had a “girl” working for him in the exam room who took short hand (remember that?) and then went off and typed the report, He had it back within hours, checked it and filed it. Remember reports were not “sent” everywhere then. “there is nothing new under the sun”.
CAP
This has been a necessity to enter data in our current EMR. A colleague in a collaborating office has not only kept up with pre-EHR volume but has been able to increase quality care in both numbers and extent of procedures with the use of alternating scribes in his office.