Imagine a physician running towards a patient’s room in a busy hospital. Now imagine a younger college-level student hot on their heels, desperately trying to multitask: typing on laptap computer, listening, and dodging others running in the opposite direction. Sounds like a madhouse, right? Well, this is the typical hustle and bustle of an onsite medical scribe and what my life was like when I worked for Physassist as an ER hospital scribe. After a short time, I changed jobs and worked at ScribeMD as virtual scribe. Each of these work environments have their own set of challenges. As I delve deeper into the life of a medical scribe, you will gain an understanding of just how tedious and challenging a scribe’s job can be.
What Do Medical Scribes Do?
A medical scribe, or medical transcriptionist, is a physician’s personal data entry clerk who enters real-time interactions between the patient and the physician in the electronic medical record (EMR), virtually or onsite. A medical scribe’s responsibility is to document the encounter the physician has with each patient, and is at no time obligated to impart medical advice. A medical scribe decreases a physician’s clerical tasks so that he/she can focus solely on and give undivided attention to the patient. Large hospitals to small private practices are employing clinical scribes to decrease a physician’s data entry burden. The use of scribes as data managers is an ingenious practice. This way, the physician can see more patients in the same amount of time.
Scribe duties include:
- Documenting physical examination results, family, social and past medical histories and procedures
- Generating referral letters for patients
- Searching for relevant past medical records
- Keeping track of imaging results and entering the results into the chart
- Bringing tests results to the physician’s attention
- Typing progress notes
- Inputting the patient’s disposition
A scribe dutifully performs their job in order to produce a well-written EMR that is reviewed and signed by the physician.
Physassist Scribes Training
As an international student, I was determined to enhance my knowledge of the American health system before medical school. Prior to college graduation, I decided to take time off from school to pursue avenues that would be beneficial for my resume. I was eager to gain extensive clinical experience in the health sector before matriculation. I first learned about the medical scribe role as a junior in college from a classmate, who was a seasoned scribe trainer with PhysAssist Scribes, one of the leading companies in the scribing industry. I was intrigued by the opportunity it presented and I was more than willing to experience it for myself. I became an onsite medical scribe soon thereafter.
I underwent an extensive 5-day scribe training session at Physassist’s secondary headquarters in Chicago before moving to onsite training at an emergency department in Florida. Training was inclusive of vast amounts of medical terminology, learning to write history of present illnesses (HPIs), noting review of systems (ROS), methodology, and enhancing our typing skills and speed. At the end of it all, we were given a comprehensive exam and after successful completion, moved on to the practical portion in our respective medical settings.
We had consistent, ongoing online training during our probationary period. It was nerve-racking to say the least. Shadowing physicians throughout their 8-12 hour shifts along with a scribe trainer was not easy. Although I am a night person by nature, working overnights and early mornings simultaneously was, initially, challenging. While I was very grateful for the opportunity, I could see the toll it was taking on my body and mind.
Typical Day of an Onsite ER Medical Scribe
Virtual Medical Scribe for a Nephrologist in Private Practice
After a brief stint with PhysAssist, I moved on to virtual scribing with ScribeMR, a role which I held for a year. Because of the comprehensive training I previously received, my transition to remote medical scribing was an easy one. I scribed virtually for a nephrologist in a private practice. Working onsite as well as virtual gives me the perspective of the pros and cons of working remotely.
The Pros of Telescribing
- The ability to work from the comfort of my own home without being seen by the physician and patient.
- Utilizing the short downtime between patients to stretch and/or eat.
- More comfort for the patients, who were sometimes uncomfortable with the physical presence of a third person in the examination room.
The Cons of Virtual Scribing
- Scribing onsite involved constant movement, whereas virtually you’re being sedentary for hours at a time. Personally, this caused increased strain and discomfort for me. Although, everyone will have a different perspective so depending on your circumstances this can be a positive.
- While the patient is unable to see or hear you, there are times the audio quality is poor, creating difficulties in hearing the patient as he/she confides in their primary care physician (PCP). Hence, writing a precise HPI and filling out the EMR can be difficult. This was a major setback.
- Also, there may be loss of phone or Wi-Fi connectivity during patient interactions. Behind the scenes, note taking was done in any form. In contrast, onsite note taking was restricted to the EMR.
- I recently trained with another scribe company, ScribeAmerica, who had some slight differences in their Telescribe department. Scribe America utilizes both audio and visual so the physician can see the scribe at all times via Skype. Scribing onsite involved constant movement, whereas virtually you’re being sedentary for hours at a time. Personally, this caused increased strain and discomfort for me. Although, everyone will have a different perspective so depending on your circumstances this can be a positive.
Virtual scribing has its pros and cons. However, I believe the cons outweigh the pros.