Practice Notes

A scribe for everyone?

by Cassie Dormond and Anita Joseph

Inc. Magazine recently named Medical Scribe Systems (MSS) one of America’s fastest growing companies—which isn’t surprising when we consider that the business has doubled its client base in the last year alone.

Does MSS’s rapid success indicate that when it comes to scribes, more is always better?

The answer to this question comes down the purpose of a scribe. Medical groups have historically had two objectives in hiring scribes.

One is to increase patient throughput. Spending time on documentation after each patient encounter slows physicians down. But with the addition of a scribe, physicians can complete each patient examination more rapidly and increase the total number of patients they see per day.

The second common objective is to increase physician engagement. Physicians across the country say that EMR documentation contributes heavily to job dissatisfaction. Interestingly, in speaking about his company’s success, the CEO of MSS does not explicitly call out physician engagement. He instead says that scribes "positively impact patient interaction[s], clinical efficiency, and the quality of documentation." While physician engagement may be an implicitly understood benefit of scribes, it is not necessarily what makes them strategically important.

EMRs: Expecting too much, too soon?

During our recent research cycle, we found that progressive groups are deploying scribes primarily to increase throughput and are including stronger financial guardrails to protect their investment. They are pulling away from the use of scribes as a tactic to improve provider engagement.

We spoke to progressive organizations that offer scribes to all physicians but set an elevated productivity threshold for those physicians that choose to work with a scribe. Physicians who don’t meet the productivity threshold are not eligible for a scribe the following year.

The EMR Optimization Toolkit

These organizations send the message that a scribe is a financial privilege that comes with a financial responsibility. This conditional offer ensures that scribes are an asset that improves physicians’ efficiency—and not another sunk cost shouldered by the medical group. (Admittedly, studies indicate that after an implementation period, physician productivity returns to normal and they spend the same amount of time per-patient as they did before introduction of the EMR, except in the case of new patients, where physicians continue to spend more time with them.)

To improve provider satisfaction with EMR, progressive groups offer training and support. While they do not ignore the problem of struggling physicians who are unable to document effectively, they acknowledge that training and support is a better, and more sustainable, cure for provider dissatisfaction with EMR.

Missing the mark on ambulatory EMR implementation?

Missing the mark

Discover 12 common mistakes medical groups make when implementing and using electronic medical records—and strategies to overcome each one.