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Clinicians who hate the copious documentation required by electronic medical records (EMRs) might wonder about the pros and cons of medical scribes. These healthcare team members sit in on medical visits and do all the typing and clicking while physicians concentrate on more “doctorly” tasks. Very little data has been collected to evaluate this division of labor.
Researchers analyzed interviews with 18 physicians who used scribes, 17 scribes, and 36 patients who were cared for in scribe-using practices. The results were largely positive. Physicians appreciated the opportunity to return to their customary tasks, although some found their notes to be worded in ways they might not have chosen. Patients appreciated receiving more of their doctors' attention, and some found scribes to be a helpful additional source of information and support during visits. Scribes who had other jobs in the office often felt overworked, torn between their responsibilities as nurses or medical assistants and their new writing duties. The theoretical concern that patients might resent the intrusion of a third party into the office visit was not supported.
Yan C et al. Physician, scribe, and patient perspectives on clinical scribes in primary care. J Gen Intern Med 2016 Sep; 31:990. (http://dx.doi.org/10.1007/s11606-016-3719-x)
Schiff GD and Zucker L.Medical scribes: Salvation for primary care or workaround for poor EMR usability? J Gen Intern Med 2016 Sep; 31:979. (http://dx.doi.org/10.1007/s11606-016-3788-x)
Comment
Although these data are not impartial — practices in which scribes had been tried and abandoned were not represented — the study represents an important first step in evaluating this new approach to medical practice. Still, editorialists argue that the best solution to the multiple problems incurred by our current EMRs might not be the workaround of a scribe but developing better software. I myself would argue that separating physicians from medical records is a mistake: Surely, integrating all available data regarding a patient's health into a coherent whole is one of our jobs — one that a good EMR should enable rather than obstruct.