Duke Health Referring Physicians


Are Scribes Right for Your Practice?

If yours is among the 70% of medical practices that now use electronic health records (EHRs), you may have some complaints and challenges. Indeed, challenges with EHR systems are common and have spawned a new class of employee, the medical scribe. A medical scribe is an unlicensed individual who handles computer data entry and helps physicians concentrate on care. For practices considering adding scribes to the payroll, here are some pros and cons to contemplate.

PRO: Better Care
For physicians, spending time entering data instead of focusing on patients can reduce quality of care. Notes produced by scribes tend to be more detailed and available faster. In fact, studies suggest that scribes can increase patient satisfaction and physician productivity.

CON: Unproven in Primary Care
Specialty practices pioneered the use of scribes, and it is unclear whether the benefits seen there can transfer into primary care to the same degree. Some question whether patients will be as accepting of a third person in the room with their family doctor, a setting in which some conversations depend on patient willingness to broach sensitive subjects.

PRO: Bottom-Line Boost
Data show that scribes, who make about $20 to $30 per hour, can increase productivity and revenues by as much as 50%, often more than covering the cost of their salaries and benefits.

CON: Unproven in Lower-Volume Settings
Because nearly all scribe-related data come from specialty practices—mostly high-volume fields, such as emergency care—it’s uncertain whether scribes can prove as cost effective in lower-volume settings.

“I’m not aware of any primary care physician in our client base who has hired a scribe,” says David J. Zetter of Zetter HealthCare, a consulting firm in Mechanicsburg, PA. Many primary care practices might break even, but profit boosting is probably rare, he adds.

PRO: Broad Options
The scribe field is surging, so hiring options abound. Some third-party vendors offer scribes as temporary, part-time workers. Practices can even hire off-site “virtual” scribes who take dictation over a microphone.

CON: Regulatory Hassles
Scribes cannot make computerized physician order entries under the new EHR Meaningful Use requirements unless they undergo certification training. Those who use scribes and received EHR Meaningful Use incentive funds may need to return them if they’re audited by the Centers for Medicare & Medicaid Services, according to Zetter.