What Does a Medical Scribe Do?

become a scribe

What does a medical scribe do? The most fundamental role of a medical scribe is virtually unchanged from that of ancient scribes. They document important information! There are some nuances between settings, facilities, specialties, and preferences of different healthcare providers, but the premise remains the same. Following physicians while they see patients, medical scribes document everything that happens in the patient’s electronic chart using a computer. “Real-time transcriptionist” is one way a doctor has described me to a patient wondering who was following their physician into the exam room. In my experience scribing since 2011, this is partially true of what healthcare scribes do, but a great understatement of their overall impact.

The word scribe makes many people think of ancient times. The ability of scribes to record information has made them vital to society throughout history. While the scribe occupation may not have been very common in recent times, it is making a resurgence! Make no mistake, scribing has risen from its previous ancient image and been adopted by the healthcare industry to lighten the burden on healthcare providers as medicine transitions into the electronic age. Working as a medical scribe provides an experience that is nearly as close to the clinical action one can be, yet not quite hands-on. It is a challenging job, but can be very rewarding to those who can mix their typing skills and medical knowledge in a high-pressure environment that can be physically and emotionally taxing.

Why does the healthcare industry need scribes, and why now?

Before looking more closely at the different tasks a medical scribe may do, there’s an important question to answer. Why does the healthcare industry need scribes, and why now? Like many other industries, the electronic age has redefined the way things are done in healthcare. Maximum utilization of computers in healthcare means massive improvements in several domains, including cost, availability of information, and most importantly, patient care.

While it’s nothing new to have computers in healthcare, it is only recently that federal mandates have stripped physicians of their precious paper charts and declared that information must be entered directly into an electronic medical/health record (EMR or EHR). This has eliminated the need in many settings for transcriptionists, who were previously the bridge between paper charts and electronic charts. In addition to traditional documentation, there are numerous quality codes that must be reported for most patients. These codes are used to document the status and treatment of certain conditions and provide important data for entities such as insurance companies.

How Does a Medical Scribe Help a Physician?

Medical scribes help doctors have more face time with patients while the scribe completes the EMR and performs other clerical duties. There can be a lot of variation in the way scribes are used.

In many cases, physicians being forced to document and code visits on their own has been a nightmare. Doctors are very unhappy with EMR software because it makes them spend more and more time with computers and less time with patients. There’s no computer equivalent yet for the notoriously bad handwriting of physicians that helped them work so quickly before, so there is often a drastic decrease in efficiency when doctors are forced to bumble through the computer on top of seeing patients. Add in all the reporting codes mentioned above, and it can really slow them down. Worse yet, many patients are upset when their doctor spends most of a visit looking at the computer. This is where the scribe comes in!

What Does a Medical Scribe Do in Clinics?

I’ve worked in a variety of settings and specialties, but the biggest distinction I’ve seen is between scribing in clinics and scribing in hospitals. In clinics, scribes may have more responsibilities since the pace is slower and patients are more likely to be stable. Some of these responsibilities include reporting the quality codes mentioned earlier, as well as putting in orders and charges, all under the physician’s close supervision, of course. This provides great exposure to medical decision-making for scribes seeking experience for advanced healthcare careers. You’ll get to see what tests physicians order for which symptoms, as well as the variety of treatments they provide for different ailments and conditions.

Most of my experience has been in primary care working for family medicine and internal medicine doctors. Scribes in these settings must also document that preventive tests are current, such as colonoscopies and mammograms. Scribes are found in most medical specialties and the documentation requirements will vary.

What Does a Medical Scribe Do in Hospitals?

In hospital settings, scribes are heavily used in the emergency department, although some hospitals utilize them in other areas. Working as an emergency room scribe is a very different experience from scribing in a clinic. The pace is faster and the stakes are often higher due to the likelihood a patient will be in dire condition. Therefore, emergency room scribes’ responsibilities are usually parsed down to basic documentation of patient encounters. Nonetheless, scribes in emergency rooms are just as beneficial as they are in clinics.

In addition to documentation, scribes often help the physician in other ways. For example, the scribe can keep an eye on incoming tests and notify the physician when the results come in, which allows the provider to focus on something else in their pile of responsibilities.

The benefits and drawbacks of scribing in each kind of setting depend a lot on what you’re seeking. The hospital offers scribes more action. It also offers more possible shifts to work, since the hospital never closes. This provides a lot of flexibility in scheduling. On the other hand, scribing in a clinic involves a more predictable setting, although sometimes it can be just as intense as the ER. A clinic is more likely to have a regular schedule, which is good for those averse to working overnight, on weekends, or on holidays.

How to get started as a medical scribe?

It’s important to be aware that these healthcare scribe jobs are often very competitive and not everyone who tries makes it. So perseverance is important! Some people have trouble keeping up, and other people simply don’t like it. Bear in mind, as a scribe you’ll be documenting the front-lines of healthcare. You’ll see blood, breaks, breakdowns, and even deaths, so it’s essential to be comfortable in this type of environment.

There are a couple common ways someone can find a job as a medical scribe.

First, you can apply to one of the large medical scribe companies which have existing contracts with hospitals and other medical facilities.

Working at a large company:

I got my first break as a scribe through a large company that implements scribe programs in hospitals. One such company is called Scribe America. These types of companies hire at fixed periods several times throughout the year. There is regular turnover since many scribes leave for school after a few years, and because many of these large companies promote dedicated scribes interested in leadership to administrative positions. These companies select a few dozen applicants each time they hire, but not everyone picked makes it. To become a scribe, applicants must make it through a few weeks of classroom training and testing before even getting on the floor with a physician and live patients. Less 25% of the people in my training cohort made it through successfully, which should give you an idea of how difficult it can be to land a scribe job this way.

Second, you can apply directly for a position at a clinic or hospital.​

Gaining experience at an outpatient clinic:

I currently work for a privately-owned primary care clinic with three locations within a few miles of each other. These types of settings have variable hiring and training procedures. With my current employer, newly hired scribes hit the floor with live patients by the second or third day. Working for a low-intensity provider, new scribes will be trained by an experienced scribe one-on-one. As the new scribe watches and learns, the trainer will gradually relinquish control to the trainee, and the new scribe will be completing charts on their own within a few days. By the end of a few weeks, the new scribe will be done training and able to work for several providers. Learning never ends as a scribe though, as each day you’ll learn something new about health and medicine, or the healthcare industry in general.

Essential Skills for Medical Scribe Jobs

Computer competency is essential as a scribe. It’s especially important to not only be able to type at an above average speed, but to be able to do so while multitasking. You’ll need to be able to type, listen, and take notes as the physician bounces between dialogue with the patient and giving you notes and findings that go in various parts of the chart.

The places I’ve worked as a scribe are generally willing to hire people with little to no medical background, which makes this a great opportunity for people looking to find a way into the industry. Nonetheless, some exposure to medical terminology, anatomy & physiology, as well as pharmacology will make you a much more appealing applicant and more likely to complete training successfully! Many colleges and universities offer courses in these subjects, and you can also learn them through flashcard apps such as Quizlet or Brainscape. Some organizations offer scribe certifications, but as of 2017, they are not required by law. However, some facilities may require scribes to be certified.

Scribing is a growing field that is essential to the future of the healthcare industry. Whether someone wants a new career or a place to gain experience, scribing presents an exciting opportunity to learn and contribute to healthcare in a variety of ways. Scribes ease the burden on healthcare teams, help medicine progress into the electronic age, and most of all, improving patient care! Now that you know what does a medical scribe do, you can make a decision whether you want to apply for a job.