“Like some virulent bacteria doubling on the agar plate, the E.M.R. grows more gargantuan with each passing month, requiring ever more (and ever more arduous) documentation to feed the beast,” wrote Danielle Ofri, M.D., in this New York Times article.
She is not alone in her concerns about the runaway paperwork problem faced by doctors today. Some research has shown that documentation takes up more than half a physician’s time. Time on paperwork means time away from patients, and this has some asking themselves why they even went to medical school in the first place.
It is no surprise then that EMR demands are increasingly seen as a major contributor to the rising rates of burnout among physicians (neurologists in particular). The effort to address this issue has led to an increased use of a new category of medical assistant—medical scribes.
A medical scribe is someone (non-licensed) who accompanies a physician, taking notes during patient encounters, retrieving test results, and otherwise helping with workflow and documentation. At the recent meeting of the American Academy of Neurology, Jennifer W. McVige, MD, shared her experience using medical scribes at Dent Neurologic Institute.
“[Adding a scribe] saved my life. It saved my life in medicine because I probably would have figured something else out. I just could not balance it anymore,” said McVige, a pediatric neurologist with board certification in adult and pediatric headache as well as neuroimaging. McVige also reads MRIs on the side, directs Dent’s Concussion Center, and takes part in research.
Three years ago, after the birth of her third child, she reached a tipping point. “I was burnt out. I would come home. I was teary eyed. I’d have ten more notes to do. I would stay up till 3:00 in the morning.” She’d heard about medical scribes and spoke to Dent’s CEO Joseph V. Fritz, PhD, about bringing one on and he agreed. “I now have a wonderful scribe named Clayton. He is part of my practice. He is with me and part of everything I do.”
McVige and Fritz say medical scribes can help physicians with a wide variety of tasks including the following:
- In-room documentation during patient visits
- Communicating and conveying information to nursing/allied health staff
- Retrieving prior health history documentation for review by physician
- Assisting in drafting patient notes for EMR
- Troubleshooting data entry and scheduling outpatient test appointments
Of course, all this value does come at a price, some of which is offset by increased provider productivity and caseload, as well as mitigation to the financial costs of burnout. Research has also shown the value of employing scribes. A 2019 study at the Mayo Clinic Department of Emergency Medicine showed that scribes actually helped lower costs while improving patient outcomes. This, they concluded, was because using scribes allowed their physicians “to work at the top of his or her license and do what only a physician can do.”
“[The cost] comes out of my paycheck,” says McVige. “And at the end of the day, I don’t care because I get to go home and spend time with my babies. I don’t have notes when I go home, and I’m not in tears in the middle of the night.”
If you are considering the addition of a scribe to your practice, you probably have more questions: How can I find a good one? What are the pitfalls? How long does it take to onboard a scribe? We will answer these questions and more in a forthcoming article, so stay tuned!