“If I have any choice in the matter, I will never go back,” says Colorado neurologist Pearce J. Korb, MD, about his use of medical scribes in clinical practice. “Now I walk in a room and I look at somebody face-to-face, patients and their families, and I talk to them. I have to admit as a young faculty member I was in that computer space and not looking at my patient. So, that’s huge for me.”
If you read our article, Have You Considered Adding a Medical Scribe to Your Practice?, you know that Dr. Korb is not alone in his enthusiasm for scribes. In fact, he joined Dr. Jennifer McVige (mentioned in that previous article) at the 2019 annual meeting of the American Academy of Neurology, speaking to a standing-room-only crowd about the benefits of using medical scribes.
“We are trying to fix the problem of egregious regulation of our documentation,” said Dr. Korb. Medical scribes are a popular way to do this—as evidenced by the fast growing medical scribe industry. By some estimates, there will be one scribe for every seven physicians in the U.S. by the year 2022.
As is the case with many industries rapidly rising to fill a need, this field is not regulated. Medical scribes are non-licensed and their background and training varies widely. This has led some to be critical of the practice of using medical scribes, citing invasion of patient privacy and the potential for inaccurate documentation that result in serious clinical errors.
Drs. Korb and McVige acknowledge these issues but say they can be overcome through careful hiring and thorough onboarding.
In his practice at the University of Colorado, Dr. Korb and his colleagues have found success training their medical assistants (MAs) to act as scribes. This means pulling from a pool of well-known and well-trusted individuals who already have the training to appropriately work in a medical setting.
At Dent Neurologic Institute, Dr. McVige and her colleagues have access to a stream of undergraduate and medical students doing research and clinical training at their organization. “We can talk with them and find out if there is anybody interested.” McVige also recommends consulting colleagues who already have a scribe, asking around in physician networks, and doing online job searches.
In their talk, Dr. McVige and Dr. Korb provided the following list of medical scribe companies as another resource:
Once you have found a good candidate, Dr. McVige recommends having them shadow you. This way you can find out if they will be a good fit, and they can find out if they are up to the rigors of the task. After that, it is important to have a good plan for on-boarding your new hire.
“I would advocate for a development period of around six months,” says Dr. Korb. “It takes at least six months to get someone to use the vocabulary and get up to snuff enough for this model to be profitable.” Doling out responsibility over time is also a great way to prevent errors. Dr. McVige recommends creating note templates, either prior to onboarding or as part of the process, as another way to ensure accuracy.
Both Dr. Korb and Dr. McVige emphasize that working with a scribe is a collaborative effort and their scribe’s work is always followed up with their own careful review. Think of it this way: A good scribe isn’t someone who just takes over the parts of your job you don’t like, it’s someone who helps you do your job even better than before.