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PRODUCTIVITY

Does your office need a ‘medical scribe’?

In an effort to focus more on patient care and less on the clerical aspects of the job, physicians are increasingly turning to medical scribes. If you’re not familiar with the term “medical scribe,” you’ll definitely want to read on.

In many ways, a medical scribe is a new spin on a longtime position. For decades, physicians have dictated notes into a tape recorder, relying on transcriptionists to convert to typewritten reports.

Now, thanks to electronic health records, data entry is direct. In today’s digital age, information is immediately entered into a laptop computer or tablet during a patient’s office visit. A medical scribe performing the task shadows a physician as he or she examines patients.

Why can’t the physician update patient records?

The data entry process is time consuming. When a physician attempts to do it herself, it can detract from the amount of time spent diagnosing and discussing treatment with a patient and/or it can cause scheduling issues.

As practices struggle to deal with already tight appointment windows, the cumulative effect of minutes lost per patient can have a significant impact.

Studies show that medical scribes improve physician productivity, and physicians who use the services of scribes report less stress.

How do you find a scribe, and what are the job requirements?

Scribes are often medical professionals in training for other positions, such as physician assistant. The opportunity to work closely with physicians and observe physicians as they interact with patients makes working as a scribe very attractive to people interested in medical careers.

The job requires technical skills, attention to detail, knowledge of medical terminology, ability to deal with changing priorities, ability to respond quickly to instructions, a pleasant demeanor, and patience while in the presence of patients.

“You’ve got to have a ton of cerebral horsepower,” says Michael Murphy, MD and CEO of ScribeAmerica, a medical scribe training and management company.

He tells Medical Office Manager that “horsepower” is a needed asset. A person has to be able to come up from intense study and preparation and get up to speed in a fast-paced medical office, Murphy explains.

And not everyone makes it, he says, citing a 50 percent attrition rate.

ScribeAmerica’s program requires 120 hours of training, and it isn’t easy. In fact, Murphy says that medical assistants who attempt to transition to medical scribes often fail out of the program.

A scribe who completes training and meets other criteria is eligible for certification through the American College of Medical Scribe Specialists (ACMSS). The ACMSS administers an exam, the Medical Scribe Certification & Aptitude Test (MSCAT), which upon successful completion results in the Certified Medical Scribe Specialist (CMSS) designation.

If your practice doesn’t currently include a scribe, chances are a colleague’s practice employs one of these medical professionals. Murphy estimates that there are 12,000 to 13,000 scribes nationwide, and he says the number is growing – in part because of electronic health records but more because of the pressures of today’s health care environment, where everyone is asked to do more with less.

ScribeAmerica currently operates in 41 states and employs more than 3,300 scribes, as well as 500 higher-level medical professionals.

How does a practice implement a scribe program?

Murphy points out that scribes are for busy medical practices and advises against a scribe program until patient volume necessitates support.

Then, he recommends identifying goals for the program. For example, a goal might be to increase the number of patients a physician sees per day.

When assessing a scribe management company or an individual scribe’s level of expertise, it’s important to consider training, as not all programs are equal.

Once a decision is made to add a scribe to staff, Murphy recommends the practice embrace the scribe as part of the team; involve the person in day-to-day operations, meetings, and so forth. “Don’t treat them as a vendor, but as part of the family,” he says.

From an operational standpoint, he recommends understanding what scribes can and can’t do, and aligning expectations with what the job entails. The focus should also be on streamlining patient interaction with emphasis on distinct responsibilities among a team of three: physician, scribe, and medical assistant.

Finally, attention must be given to the bottom line. Medical scribes are typically paid between $10 and $20 per hour.

However, in a busy practice, this expense may be offset by an increase in physician productivity. A more efficient office may also result in greater patient satisfaction, which can lead to patient referrals.

At the same time, lower stress levels among physicians because of the support a scribe provides can have a positive impact on practices.

“We’ve had many physicians say, ‘You’ve just extended my career by five years; I was so burned out I was going to retire,'” Murphy tells Medical Office Manager.

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