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January 14, 2014

With scribes, doctors 'think medically instead of clerically'

Daily Briefing

    "Medical scribes"— employees who shadow physicians and input patient data into electronic health records (EHRs)—have become a common sight at hundreds of clinics and EDs across the country, helping doctors to focus on patients instead of paperwork, Katie Hafner writes in the New York Times.

    Although EHRs were widely expected to help manage the demands of hospitals and doctors' offices, they "have become a disease in need of a cure, as physicians do their best to diagnose and treat patients while continuously feeding the data-hungry computer," Hafner writes.

    Christine Sinsky—a primary care physician (PCP) at Medical Associates Clinic and Health Plans—notes that the clerical work turns "physicians into secretaries," which "is not a winning proposition." A recent study in Health Affairs found that PCPs spend up to two-thirds of their days on clerical work that could be completed by someone else. And research has shown that that clerical work is a major contributor to physician dissatisfaction.

    RAND: EHRs may be making some doctors miserable

    Doctor: Scribes are a 'triple win'

    Medical scribes offer "a triple win," Sinsky says, adding the "patients get undivided attention from the physicians, the scribes are continuously learning while making an important contribution, and the physician gets the satisfaction of doing the work they went into medicine for in the first place." In a study of more than 50 primary care practices, Sinsky found that physicians who use scribes are more satisfied with their work and choice of careers.

    Although companies typically charge $20 to $25 per hour for scribes, physicians say they come out even or ahead financially because they are able see up to four extra patients a day.

    ScribeAmerica CEO Michael Murphy estimates that there are 10,000 scribes working in hospitals and medical practices around the country and that demand is rising quickly. Training a scribe can take as little as 15 days, and some scribes use the job as training for another medical profession.

    Joint Commission releases guide for unlicensed scribes

    Still, "[n]ot everyone is sold," Hafner writes. Some physicians argue that scribes could compromise patient privacy. One study found that about 10% of patients are uncomfortable with having a scribe present (Hafner, Times, 1/12).

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