Are Scribes Helpful?

By Katie Wike, contributing writer

Using a scribe to save time on medical records is tempting, but is it really worth the imperfections?

EHRs have added to the workload and stress for many physicians, and the use of scribes seems to be the perfect solution to the ever-growing amount of documentation. However, one study shows that, while hiring a scribe may be tempting, it also has its drawbacks.

For example, EHRs were designed to be used by physicians, not their quick-typing counterparts. “Well-designed EMRs should be serving as a rich and helpful resource for directly supporting the clinical encounter and clinician’s cognitive work — reminding the clinician about the patient, past problems, history and assessments, social history and issues, as well as overdue prevention and monitoring,” explains an editorial in the Journal of General Internal Medicine. “Otherwise the clinician has to rely on memory or the scribe searching and reading this information aloud during the encounter.”

Fierce Healthcare EHR reports that, while scribes were shown to be better at capturing large amounts of information into the record, they generally used templates which led to less predictable complex assessments. Also, use of scribes is known to justify and capture higher reimbursement though the author cautions, “It is ironic that one of the consequences of EMRs, initially touted as a way to decrease medical costs, is to drive practices to bring on scribes whose documentation practices could be contributing to the overall cost of medical care.”

Scribes are certainly helpful when overworked physicians need a hand with documentation, but an important question to ask is whether they are a helpful tool or a crutch for imperfect EHRs. “Although it appears medical scribes are in many ways irresistible and here to stay,” concluded the author, “their growth nonetheless raises broader questions about primary care work flow, staffing, clinical documentation, diagnostic assessments, provider burnout, and patient–provider–scribe relationships and communication.”