In-Person Medical Scribes: The Good, the Bad, and the Ugly

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We often hear the question: How does a medical scribe help a physician?

In an ideal world, medical scribes provide space for healthier and more productive patient visits, ease physician workload and mitigate burnout, all while operating at low hourly wages. Additionally, scribe work provides many young professionals an entry point into the medical field, specifically students waiting to be accepted into medical school.

Unfortunately, the reality is far from ideal. Let’s paint an honest picture and take a look at the Good, the Bad, and the Ugly when it comes to in-person medical scribes.

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The Good

Better Patient Care

In-person medical scribes provide much needed relief to physicians. They allow the physician to focus intently on patient care while the scribe dictates the session or logs the notes either by hand or in the EHR. In short, scribes handle the administrative tasks – dictation, notes, and patient charts – that often get physicians bogged down.

Increased physician focus most often presents itself through active non-verbal engagement, namely eye contact. A physician who isn’t busy scribbling notes or filling out the patient’s EHR is able to be more present with each individual, ultimately improving the quality of the visit. Studies have shown that patients who receive more engaged eye contact from their physician feel an increased confidence in themselves, the communication with their physician, and their perception of the quality of care. In-person scribes allow this more positive environment to exist.

Reduced Burnout

Additionally, doctors who hire medical scribes report feeling more satisfied with their work and the level of care they are providing. A 2018 study found that the use of medical scribes significantly reduced the amount of time spent doing EHR documentation and led to significant improvements in physician productivity and job satisfaction, suggesting that scribes may ease physician burnout.

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The Bad

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Cost

Unfortunately, all that glitters is not gold. Many physicians we’ve talked to tell us that the expenses of a medical scribe eventually don’t outweigh their hard costs. Because scribes require a baseline level of oversight and training, in addition to their salary (upwards of $20k, at minimum), physicians admit that they often increase their patient volume in attempts to offset those costs (Time and Money).

Really, though, the process just creates a negative feedback loop. More patients leads to more note taking and more hours for the scribe, and more necessary editing and oversight. In some cases, increasing patient load can shrink cost margins by a few hairs, but not enough to make up the difference. Costs are still high, and burnout still runs rampant.

The Ugly

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Intrusiveness

Additionally, we have to consider how scribes may negatively impact clinical settings. Have you ever tried to write an email with someone reading over your shoulder? Or wash the dishes with someone breathing down your neck? It can be invasive, and maybe even damage the quality of the final product.

Some physicians admit that having a scribe in the room with the patient can negatively impact what the patient is comfortable disclosing, and at times find them to be intrusive.

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Functional Creep

One of the biggest threats to patient information is what is referred to as “functional creep,” or the idea that well trained and trusted scribes often begin to take on tasks that are outside the scope of their job. Often this means asking the scribe to complete more in-depth tasks within the EHR, which can put physicians at risk of malpractice.