Scribes Are The Answer?


I just saw this moronic blog on KevinMD entitled “Why medical scribes are the ultimate answer to our health IT woes”. Check it out as it will surely make you laugh. In glowing, rose-colored terms the physician, who writes it, pontificates that the way to fix our mess is life is just pay $15 an hour for a scribe.  It is that simple.  Sure, he understands that “it’s not realistic to suggest that it’s possible for any doctor to spend 100 percent of the day in direct patient care, but 10 percent is quite frankly, a little sick.” He is bothered that the system is “turning physicians into “type and click bots.”” That being said, he has the answer because he has “been in clinical practice for the best part of a decade and seen first hand in several hospitals this huge problem unfold, I am increasingly coming to the conclusion that medical scribes may be the ultimate answer to the problem of taking doctors back to where they belong. In direct patient care.”  Really?  Almost ten years? That long, huh?

After his extensive experience in practicing medicine, he gives his reasons why scribes would be great:

  • Physicians have more time to engage in direct patient care.
  • Physicians can see more patients and be more productive.
  • Increased physician job satisfaction, retention and lower burnout rates as they spend more of their day doing what they were trained to do and less time staring at a screen.
  • The scribes themselves are often college-age students who want to get into a health care profession. They are paid an hourly rate and are very happy to be there learning about medicine.
  • Hospitals benefit from happier staff, patients and higher productivity.

Now, what is missing from that list?  Let me see….hmmmmm….oh, yeah, the PATIENTS!  Do you think patients want scribes in the room?  Ask them.

This article was another example of the newer generation trying to fix a problem with technology and not with good service. And guess what, we are in a service industry?  They do not understand it and never will.

I can fix the IT health care woes.  Remove quality metrics.  Remove coding for billing.  Remove the government.  Remove the insurance companies. Done.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Scribes Are The Answer?

  1. DrG
    December 2, 2015 at 10:21 am

    You have discovered the solution to the problem. It seems so simple few will recognize it.

  2. Ben Van Raalte
    November 28, 2015 at 4:25 pm

    $15 an hour? For a reliable health care scribe that is well trained, knows computers and medical lingo, and is available 40 hours a week. Try $20 an hour minimum, add benefits, social security, work comp, etc and it would be lucky to find that skill set for $25 an hour in cost. $50,000 a year cost. Those of us not able to tell the insurance companies I need another $50,000 would see that $50,000 a year removed from our bottom line. Add IT costs, EHR costs and now we are talking $100,000 per year per physician for electronic health records, and we dont see any increase in reimbursement.

    The ER gets boatloads of $$ and they can afford scribes. No wonder the average ER doctor pay has increased 50% in the last 10 years and per hour worked ( residency hours included) is the highest in medicine.

    The author is clueless about costs and where money comes from.

  3. Pat
    November 28, 2015 at 12:35 pm

    If the author is worried about physicians becoming bots responsive primarily to their programming, then he should go find a mirror. What the hell is he but a robot who has accepted its programming regarding the “need” for all this counter-productive documentation?

    The additional, obscene assumption that this fool accepts is that the physician simply accept one more significant overhead expense; one that he would not have chosen on his own, and one that will not significantly improve his bottom line. Annual license fees, compensation fund fees, stupid *$&^#@ MOC and board renewal costs, additional CME costs, malpractice insurance, salaries, benefits, lease, lights, and so much more…all this crap has to be paid before the doc takes home a dime.

    The author won’t be able to pass along his increased costs to the patients he thinks he is defending, and they’ll be happy to complain anyway. And now this beaten down doc wants to add to those expenses in hopes that his chains will lie a little more lightly.

  4. Steve O'
    November 28, 2015 at 12:21 pm

    Naw, scribes are important – because they will help chip away at privacy, so that by 2018, we’ll have livestreaming video cameras in the exam rooms. (We double-pinky-promise that your rectal won’t make it onto YouTube, though)

    Here’s a hint for Dr. Sunneel Dhand – who blogs at his and fusses that “Health care information technology interferes with the doctor-patient relationship and physician workflow in ways that nobody could have imagined.

    It’s very simple:
    1. The system considers “revenue in” as earnings.
    2. The system considers “revenue out” as losses.
    3. Maximizing the efficiency of a physician leads to more losses.
    4. Minimizing the efficiency of a physician leads to more earnings.
    Every innovation, improvement, add-on, dodge or gizmo introduced will follow these laws. If some device could allow physicians to see sixty patients a day and capture earnings from that process, it would be shut down.

    Scribes and checkboxes and CPT coding for shitwork are all designed around that factor. STOP PATIENT FLOW SO WE CAN MAKE MONEY.

    And to quote Mr. Hammer, Can’t Touch This.

  5. Jralph
    November 28, 2015 at 8:55 am

    Hiring a scribe to help cover up bad tech and policies is just like giving a patient a new med to cover up side effects from the original one. Why not find the right med in the first place ? We may not be rocket scientists but this isn’t rocket science.

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