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  • Scribes

    Does anyone use scribes in an office based setting? I know a lot of ER docs who use them and most seem to like it. I do not know any primary care that do. I do not think it would work out well with my workflow but I can see it working well with others.
    Anyone have any good or bad experiences to share?
    Did it improve your productivity?
    Did it improve your job satisfaction?
    Any other thoughts?

  • #2
    I use one and sometimes two scribes for clinic volumes generally between 30-50 patients. They make a HUGE difference in my practice.

    Definitely improves my productivity exponentially when compared to working the EMR myself or paper charts. Job satisfaction is such that I would not want to work in a practice without scribes. I am a firm believer it also enhances patient care as I can focus on my exam and patient counseling while the scribe is in the background documenting, sending in meds, checking all the boxes (any falls in the last year?). There are inefficiencies in my practice for sure, but scribes are not one of them.

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    • #3
      We created a scribe company for our ER group, but scribe services are also offered to PCPs and office days for surgeons. The feedback is similar to TheDangerZone. While I do not have specific answers to your questions, I will pass on a simple observation: primary care folks who are used to them freak out (literally) if there is a gap in the scribe schedule.

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      • #4
        I can't really speak to the doctor side of things since I am not primary care. But I can say that when I go in for my annual physical the doctor spends more time looking at the computer than me and they miss about 10-15% of what I say. If I had a choice, I would prefer to go to a doctor that uses a scribe.

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        • #5
          Originally posted by pierre View Post
          I can't really speak to the doctor side of things since I am not primary care. But I can say that when I go in for my annual physical the doctor spends more time looking at the computer than me and they miss about 10-15% of what I say. If I had a choice, I would prefer to go to a doctor that uses a scribe.
          Thinking about it that way I do not think I would like extra people in the room if it could be avoided.
          I am a healthy person with no sensitive medical issues but I could imagine that would weigh on some of the patients.

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          • #6
            I enjoy the change of pace. The doc can spend 30 seconds at the end of a 10 minute exam talking directly to the scribe.
            The last minute the doc translates the conclusions for me and says next steps or results. Any questions? Out they go.

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            • #7
              Our scribe group works for the ED, ortho, cardiology, primary care, neurology, and others. The primary care docs over the age of 40 greatly prefer having a scribe as it take away the pain of the EHR and improves their work flow.

              However, while the cost of the scribe is easily born by the cardiology and ortho practices, in primary care it takes away a bit of profitability from the practice.

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              • #8
                reminds me of residency (radiology) when we were the scribes, we had one staff who would blow through some aged person pan scan from the ER, say something along the lines of "nothing acute, put some words on it"

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                • #9
                  My wife is in primary care (IM) at an outpatient academic clinic. They brought scribes in years ago. Big picture, it's been a win. From my take of what she's said over the years, it improved productivity although I don't think it improved job satisfaction. It's also hit and miss-most scribes are good but some are bad and she has to redo the whole note. She's also more of a perfectionist so she goes back and redoes a lot of notes. But the bad scribes definitely make her take up time correcting the note (though again she only usually makes minor modifications because most scribes are good)

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                  • #10
                    Originally posted by Lordosis View Post

                    Thinking about it that way I do not think I would like extra people in the room if it could be avoided.
                    I am a healthy person with no sensitive medical issues but I could imagine that would weigh on some of the patients.
                    Might suggest a counter point that having a witness in the room makes everyone feel more at ease.

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                    • #11
                      I'm sure everybody loves telling their doctor about their erectile dysfunction with a rando young lady in the corner typing into a computer

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                      • #12
                        Originally posted by Lordosis View Post
                        I'm sure everybody loves telling their doctor about their erectile dysfunction with a rando young lady in the corner typing into a computer
                        Better than Aunt Margie!
                        https://www.google.com/imgres?imgurl...MygPegUIARDmAQ

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                        • #13
                          Originally posted by Lordosis View Post
                          I'm sure everybody loves telling their doctor about their erectile dysfunction with a rando young lady in the corner typing into a computer
                          true, but it is also difficult to say that the doctor was having an erotic/inappropriate conversation about penises when there is a witness in the room.

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                          • #14
                            I don’t have a scribe but I can’t see how having one would be anything but an improvement. The biggest thing I hate about my clinic days is documentation. I enjoy seeing and talking to (most) patients, but then having to spend almost as long out of the room doing the paperwork as I spent in the room is painful.

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                            • #15
                              We are in the middle of a trial of virtual scribes. They log in remotely, the are only on the speaker listening (they don't speak) and one scribe is assigned to each doc for consistency. There is one back up scribe too, for vacations. I think this might be better than the person sitting in the room and watching the person type while they talk about ED. And this would also document the politically correctness of the conversation. The scribe can cue up orders, to be signed by doc, and can huddle with the physician between patients or after clinic for clarification etc. I am not part of the pilot group, but I'll let you know how it goes.

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