Scribes: Key Practice Resource

by Kristin Seiberling, MD, AAOA Board of Directors

Electronic health record (EHR) has become an integral component of health care and is the crusade of the future. It has many positive attributes that promote a better health care system, but in itself it is seemingly cumbersome and redundant. Without supportive measures, we as physicians will be left with a significant increase in documentation time and frustration. Fortunately, or unfortunately, EHR is here to stay, and we as physicians need to embrace it and learn to navigate it in the most efficient manner. Scribes are a mechanism to help physicians navigate thru the EHR in the most time efficient manner.

In my experience, scribes have not only allowed for a significant reduction in my documentation time but have also allowed for an increase in productivity and more importantly more face-to-face time with the patient and job enjoyment. With a scribe, I can dedicate the whole visit to uninterrupted face-to-face interaction with the patient while the scribe dutifully types in the patient history.   During the patient encounter the scribe may also on demand search the chart for results, record visit diagnosis, pend requested orders and enter subsequent referrals.

By allowing myself to solely focus on the patient and not the charting during the actual visit work to me becomes more enjoyable and less hectic. Scribes allow me to become more time efficient and therefore more productive which is seen in my increase in patient volume for the same number of hours worked in the past. No longer am I staying late into the night finishing up charting.

That being said the physician is ultimately liable for what is put in the EHR so it is important to read and edit each individual chart. Scribes are not physicians and their documentation often needs to be rewritten in explicit words that can really only be determined by treating physician. However, with seasoned scribes the degree of editing lessens with time and a factor of trust ensues.

Turnover of scribes is therefore an inauspicious issue. Many scribes are aspiring medical professionals and using the year to enhance their knowledge and CV before applying for nursing school, medical school, etc. Nevertheless, I would rather retrain a scribe every year than give up the amenity that scribes bring to my practice.

Editor’s Note: Please keep in mind rules vary by jurisdiction. We recommend confirming what scribe certification allows in your practice area to help assure they can perform all the tasks, like pending orders, you will assign.