How do scribes assist in alleviating these burdens?
Dr. Murphy: Scribes assist in taking care of ancillary tasks and duties, core measures, coding, and meaningful use compliance. Obviously, scribes do not prescribe medications, touch patients, or engage in diagnosis, only provide ancillary clerical support. Our scribes have a particular interest in medicine, as many are pre-nursing, pre-medical, or pre-PA students.
In what settings do scribes practice?
Dr. Murphy: Scribes practice in a variety of settings, including emergency departments, inpatient rounds, outpatient practices, urgent care facilities, and even telemedicine structures. Of course, the nature and style of the scribe’s responsibilities will vary according to type of setting and needs of the individual practice, county, hospital, or region. It is not a “one-size-fits-all” approach.
What is your experience with physician and patient satisfaction?
Dr. Murphy: In my experience, scribes enhance the satisfaction of both physicians and patients. Many physicians have said to me, “Now that I don’t have to look at the computer all the time while I am with a patient, or rush through documentation and race to the next patient, I am finally doing what I went to medical school to do, which is to concentrate on the patient.” And patients are happier because the physician can focus on them, rather than on the computer screen, and are less rushed so they can be more present for the patient’s concerns.
Do scribes increase the costs to institutions and individual physicians?
Dr. Murphy: The idea that scribes increase healthcare costs is penny-wise and pound-foolish. Scribes allow physicians to be more efficient providers. Practices do not have to add more physicians, NPs, or PAs to allow the practice to grow because when documentation is done for a physician, he or she can take on more patients. In the case of a hospital, one ED physician receives a much higher salary than a scribe, but the scribe takes on some responsibilities of the physician so that new physicians do not have to be hired.
What impact do scribes have on medical errors?
Dr. Murphy: Having documentation take place in real time reduces error. If physicians do their charting at the end of the day, how can they remember details of every patient? In the event of a malpractice suit, these missing or incorrect details can become crucial. Additionally, details are important if the patient is transferred to the care of another practitioner.
Do patients feel scribes to be an intrusion?
Dr. Murphy: There are many options for addressing this concern. One is a legacy scribe—the physician dictates the notes and the scribe subsequently enters them into the EHR. Or the scribe is outside the room and the physician verbally dictates the notes and moves on to the next patient. Telescribes do their recording remotely through a built-in microphone in the room. A chaperone during an examination may also serve as a scribe.
How do you see the future role of scribes?
Dr. Murphy: We currently do not have prospective trials demonstrating long-term patient outcomes, but these studies are underway. I believe we will see reduced morbidity and mortality rates. Subjectively, I am sure that physicians and patients will both continue with increased satisfaction and that the incorporation of scribes into medical practice will continue to grow.