When was the last time you left a doctor’s appointment feeling truly heard?
Many of us are familiar with the awkward pauses in conversations as our doctor takes notes on our symptoms and condition. Communicating on either side of a computer doesn’t always feel comfortable, but we accept medical record keeping as a necessary part of care. What you may not know is that your doctor isn’t necessarily the only person to do it.
Increasingly, doctors are introducing a third person in the room: medical scribes. This relatively new role is designed to take administrative duties off of doctors’ hands – in turn, potentially easing pressure that leads to injurious, even fatal medical errors.
The Silent Partner
Though electronic health records (EHRs) were introduced to streamline and standardize healthcare documentation, research increasingly shows they only add to doctors’ burdens. Doctors spend an average of 15 hours per week on quality reporting and another 2 hours on administrative tasks. It’s the medical scribe’s job to free up at least some of this time.
The term “scribe” may sound medieval, but in healthcare, it’s an embryonic role. The concept has been around since the 1970s, but medical centers only began implementing scribe programs like Scribe America in the last decade. And according to a 2015 estimate from the American College of Medical Scribe Specialists, by 2020, there will still only be 100,000 medical scribes working in the U.S.
Yet medical scribes have an important and specialized position – which goes beyond simply typing up notes. They are trained to decipher medical terminology, handle insurance documentation, summarize patients’ visits in line with certain requirements, and recognize common chronic diseases, among other responsibilities. And detail is everything.
“Accuracy helps on many different levels,” said Tammy Combs, a registered nurse and director of clinical documentation improvement at the American Health Information Management Association, explaining that clinical documents need to be as specific as possible. In Medicare billing, for example, “congestive heart failure” doesn’t carry the same diagnostic weight as “acute systolic congestive heart failure.”
Though it’s uncommon, some patients might have concerns about privacy. But rather than infringe on it, a medical scribe acts as a silent, unobtrusive presence and must leave the room when asked. They typically don’t get involved with patient conversations or care. The point is to leave doctors free to do that, which could reduce their risk of burning out.
Could Medical Scribes Transform Healthcare?
According to the results of a Mayo Clinic survey published last year, more than half of U.S. doctors suffer from a growing epidemic known as “physician burnout,” defined by the Clinic as a “work-related syndrome characterized by emotional exhaustion and/or cynicism.” Many respondents identified “too many bureaucratic tasks” as the root of the cause.
At the same time, more patients are expressing dissatisfaction about how computer duties dominate medical visits. Even experts say it “dehumanizes” the medical profession. And worse, patients have been directly harmed by their doctors’ distractions. A recent study showed burned-out doctors are twice as likely to cause medical errors, another epidemic that’s led to increased rates of medical malpractice lawsuits and kills 440,000 patients a year.
The medical scribe role is still evolving. But many physicians support Scribe America’s belief that scribes can reduce medical-error triggers and improve patient safety.
“It’s incredibly beneficial to have another person in the room whom the patient sees as their advocate – another set of eyes and ears for accuracy,” said Dr. Kevin Hopkins, medical director of Cleveland Clinic’s Strongsville Family Health Center. “For me, it’s a no-brainer that this is a far better practice model.”
Early research supports the idea, too. A 2015 study found that scribes increased physician productivity. Another study from this year, which compared the performance of primary care providers (PCPs) working with and without scribes, found that PCPs associated scribes with improved work efficiency while 60 percent of patients said scribes had a positive impact on their visit.
And if that means patients aren’t experiencing medical errors, then scribes could indeed save lives.
“There’s a great opportunity out there for scribes and providers, for that scribe to take the burden off the providers and really improve patient care,” Combs said.