If a doctor wants to get back to the "joy of practicing medicine," they should consider working with an EHR scribe, said Sharona Hoffman, a law and bioethics professor and co-director of the Law-Medicine Center at Case Western Reserve University School of Law. That's because, as long as their scribe is reliable, most doctors will find that they get to spend more time with their patients, she said.
Because the doctor isn't sitting in front of their computer doing a lot of data entry, "they can do a comprehensive physical exam and talk to their patient. And they're thinking fully about the patient. They're not distracted," she said.
Still, the doctor needs to take full responsibility for reviewing their scribe's documentation in the EHR, said Hoffman.
Here are three additional considerations when it comes to working with EHR scribes:
Training matters. The scribe needs to have some medical training — it's not just a data entry job, insisted Hoffman. Scribes need to be conversant with medical terminology and they have to be very adept with the EHR. In order to realize efficiencies, the scribe needs to be able to do the documentation quickly and accurately, she said.
"The fact is, a scribe isn't a doctor. You have to trust that the scribe will maintain confidentiality and not talk about patients [outside of work]," she said. The expectation should be that scribes are documenting the patient visit comprehensively and accurately, according to Hoffman.
Budgetary concerns. If you're hiring a scribe, that's another salary on the books, said Hoffman. "Let's say a scribe is paid $40,000 a year. For some practices, it's well worth it. Others would say it's [cost-] prohibitive."
It's not just about the budget, though. If a doctor is able to focus all of their attention on their patient, that could translate into fewer errors and a reduction in malpractice claims, according to Hoffman. "That's because the physician isn't multitasking and possibly introducing errors that can increase malpractice."
Patient comfort. Some patients could feel uncomfortable with another person in the exam room. That's yet another reason to make sure that the scribe is someone who can be trusted to maintain confidentiality and not talk about patients, she said.
"Some patients may be uncomfortable having a non-healthcare professional in the room when they're talking about very private matters," she said. That said, Hoffman acknowledges that patients are increasingly accustomed to seeing their doctors accompanied by fellows or medical students during office visits. That's why making sure that the scribe is dressed in scrubs or similar medical attire can make a difference, according to Hoffman.
Practices also need to consider how scribes will be introduced to patients. "You can easily say, 'This is my scribe. She's going to be documenting your visit today, so I can focus on you 100 percent," she said.