Any facility developing a medical scribe workforce is going to seek the best candidates for their team. Many types of people are answering the call to become scribes, but medical assistants are one of the most appealing options for this role.
A Head Start on Clinical Scribe Training
One of the primary reasons a medical assistant can make such a great scribe is experience. Many who are purely medical scribes are seeking healthcare experience, but a medical assistant will already have it. Better yet, a medical assistant is often certified, granting them credibility to be the person completing a physician’s crucial documentation. The lack of a certification or background is a common concern of clinical scribe skeptics.
A medical assistant will already have basic background knowledge in medical terminology, anatomy & physiology, and pharmacology that are essential to being a successful scribe. Besides foundational knowledge, a medical assistant is also going to be familiar with the ethical standards involved in healthcare, such as confidentiality and how to interact with patients.
A medical assistant’s experience can drastically shorten the training process over teaching a scribe from scratch. Training a medical scribe with no background in healthcare can take several weeks or longer! Of course, hardly a shred of what is involved in healthcare or scribing can be adequately addressed within a few weeks. It can take varying amounts of time beyond training for scribes to become truly competent. A medical assistant’s familiarity with healthcare will allow them to focus their training time on learning to scribe without having to cram medical basics.
Transforming Medical Assistants into Healthcare Scribes
Already employed in many healthcare facilities, medical assistants offer the appealing option of cross-training current staff to work as medical scribes.
A major criticism of the changes caused by electronic medical records (EMRs) has been the necessity of hiring more employees to carry out tasks that were traditionally done easily by people already involved in the healthcare process. Filling the healthcare scribe role with a medical assistant is one model that may serve as a workaround to this issue.
Medical assistants cross-training as scribes will already have established professional relationships in their facility. This means:
- Reduced time for developing trust and workflow synchronization between medical assistant/scribe and physician
- Physicians reluctant to use scribes may be less apprehensive if a medical assistant is used
- Familiar to a facility's patients
While research by Koshy and colleagues has shown that most patients aren’t bothered by the presence of a scribe, using someone familiar to the patient such as a physician’s medical assistant could make it even less likely a patient will be uncomfortable.
Improving Clinical Practice Efficiency
Merging medical assisting and scribing duties into a single person is beneficial for multiple reasons. If a task can be completed just as efficiently with fewer people involved then it would seem likely that mistakes and misunderstandings will have less opportunity to happen.
One model in which medical assistants take on the scribing duties involves them staying with patients through the duration of their visit instead of working them up, leaving them so they can see the physician, and finally picking back up with them for check out.
Being present during the patient encounter gives the medical assistant a few advantages. They’ll have better context for the orders and tasks that result from the visit. Better yet, as the visit wraps up and the bulk of the documentation is complete, the medical assistant can begin working on the orders.
This gives them an advantage over other situations where the medical assistant may have to wait until the physician and scribe are done to even know what the orders will be. It’s easy to see how this model can improve efficiency!
Protecting Patients' Information
Perhaps more important is not the consolidation of work plus the business benefits, but the ability to minimize how many people handle patients’ protected health information (PHI). Logically, fewer people seeing PHI should make a breach of confidentiality less likely. Concern for patient security is especially heightened during the EMR transition, so any accommodation that can help improve it will likely be welcomed!
High-Quality Electronic Medical Record Completion
One of the perks of EMRs is the potential of completing encounter notes before the patient leaves the facility. This means details about visit outcomes can be shared almost instantly with patients and other providers involved in their care. Of course, providing such incredible access brings pressure to finish notes quickly.
Unfortunately, a completed note is not necessarily a good one! Notes that aren’t done correctly can cause inconvenience and disrupted workflow in minor cases. In the most severe instances, poorly complete electronic notes can have negative impacts on patients or even be life-threatening.
Note quality isn't compromised when a medical assistant acts as the scribe. Some research has found promising results looking specifically at how well a medical assistant can handle scribe duties. Using a standardized tool to measure note quality, a study by Misra-Hebert and colleagues found that notes scribed by a medical assistant were rated as superior to those completed by physicians.
The scale used, the Physician Documentation Quality Instrument (PDQI-9), rated various vital aspects of medical documentation, such as organization, usefulness, comprehensiveness, and being up-to-date. When these criteria are satisfied in a medical note, it is more capable of fulfilling all its intended purposes.
Benefits of Using Medical Assistants as Scribes
- Enhanced Staff Versatility
- Improved Patient Safety and Confidentiality
- Better Workflow
- Already Have Healthcare Experience
What Do Medical Assistants Think of Scribing?
Using medical assistants as scribes might seem like a no-lose bargain, but it’s not always well-received. To understand this, it’s important to keep in mind one of the great strengths of medical scribes. They’re eager for the privilege to complete a chore that few professionals in the healthcare force want to do. Physicians and allied healthcare employees did not go to school and receive extensive clinical training so they could spend their time writing medical notes, and it’s not uncommon for them to express this concern.
Medical assistants who have been with a facility for a long time and are more set in their ways can be difficult to cross-train as scribes, if they can even be convinced to try it. This potential path to increased efficiency and revenue could turn into a disaster for staff stability if cornerstone medical assistants flee in response to extensive documentation duties.
Employees should always expect an upward trajectory of responsibilities in the healthcare industry. However, absorbing what amounts to another job could be overwhelming to medical assistants who are comfortable with their place and have little to gain experience-wise or financially from adding scribing to their mountain of tasks.
While some medical assistants already on staff may have the potential and willingness to be turned into scribe hybrids, another approach has been to add the condition for each new medical assistant hired that the job will involve scribe duties.
The expectations of these medical assistants will be for the job to involve documentation, regardless of what they may have gone to school to learn clinically. This approach allows the transition to take place, but could limit the possibility of damaging current staff stability.
Searching for scribe jobs reveals that it’s common for facilities to have a requirement that applicants be medical assistants. This indicates that many facilities have made the decision on their own that a medical assistant background is necessary to do the job well.
Of course, the balance of scribe/medical assistant hybrids with those who are strictly a medical assistant or scribe will depend on a facility and its resources. In some settings, a medical assistant may have no choice but to pick up scribing duties… or leave.
Challenges of Using Medical Assistants as Scribes
- Can be overwhelming
- Could chase away good employees and deter others
- Poor implementation can decrease efficiency
- "I didn't go to school for this"
Another Option for Handling Electronic Health Records
Using medical assistants as scribes may not reduce the number of employees needed. Nonetheless, it provides another method for handling the burdens of EMRs that can enhance flexibility and improve efficiency. Many facilities may be hesitant to fully embrace the scribe movement, and their concerns are reasonable.
A medical assistant acting as a scribe offers an option with experience and credibility for facilities needing a way to complete their documentation without using scribes, transcriptionists, or the method of voice recognition that’s improving steadily, but not there yet.
Of the options for potential medical scribes, medical assistants provide one of the best possibilities. Their expectations may impact how willing they are to carry out scribe duties, but with adequate planning, compensation, and cooperation, a medical assistant can make a little more money while helping a facility increase efficiency and fulfill documentation requirements.