Another Ridiculous Study of the Week: Scribes Help

This came from the AAFP News (AFP journal):

Study: Scribes Help Reduce Physicians’ Administrative Burden

A study published online in JAMA Internal Medicine, titled “Association of Medical Scribes in Primary Care with Physician Workflow and Patient Experience,” followed 18 primary care physicians at two practices for a year. Scribes, or paraprofessionals who transcribe clinical visit information into the electronic health records (EHRs) in real time under physician supervision, were assigned to participants in three-month rotations. The use of scribes resulted in significant reductions in EHR documentation time and significant improvements in productivity and job satisfaction. Specifically, use of scribes was associated with less self-reported time spent on after-hours and weekend EHR documentation, more time interacting with patients rather than a computer during visits, and greater likelihood of completing documentation by the day after an encounter occurred. Eleven of the 18 participating physicians said they would be willing to accept additional patients if they could hire a full-time scribe. For more information, go to https://www.aafp.org/news/practice-professional-issues/20181018scribestudy.html.

Wait, help me out here.  They are staying that research shows that if someone does your work for you then you have less work?  Brilliant!

This is like saying that you can take pain medication after being punched in the f%cking face 1000 times and you will have less pain.  How about choosing not to get punched in the face in the first place?

(I also love how they got docs to sell their souls to pay for the scribe: “Eleven of the 18 participating physicians said they would be willing to accept additional patients if they could hire a full-time scribe.” LOL).

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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] 

  7 comments for “Another Ridiculous Study of the Week: Scribes Help

  1. Dr Mom
    December 6, 2018 at 10:58 pm

    Why is the solution always that doctors have to see more patients? Technology is fabulous. They can make high definition video games where people all around the world can join in real time. And those players are happy to pay a reasonable price for the experience. A voluntary EMR company (as opposed the current mandatory situation) couldn’t take my money fast enough if it would give me a service that made it quicker and easier to document the care I provide for my patients at a sane price. Then I might happily see more just because I want to.

  2. Dr. M Bouchard
    November 30, 2018 at 10:00 pm

    For a balanced view, I have worked with scribes for the last four years, usually premeds applying to med school. I see the scribe as a blessing for me, as they allow me to pay attention to my patients, and focus, and all the while I am modeling continuity of care, relationship medicine and the value of consistency and trust in medical practice, all of which are almost impossible to learn in medical school. Yes, they do add some cost, but it is really minimal, as the benefit of a less exhausted and chronically taxed physician is rather huge. I am willing to see the patients who need to be seen, and can do it with an open heart rather than froma frustrated and angry, exhausted physician place. I am clear that the mentoring is remarkably satisfying and valuable, as I currently have three ex scribes in medical training, connecting with me over their successes (all are remarkably capable history takers and can take histories while having conversations…imagine that), and I have the satisfaction of impacting a system that I find increasingly heartless with my own brand of medicine, yes, old school, but remarkably effective and cheap. So easy on the scribe idea. It may be a part of the solution…just possibly.

    • Doug Farrago
      November 30, 2018 at 10:07 pm

      LMAO, you’re obviously not the one paying for them.

  3. RSW
    November 27, 2018 at 10:25 am

    My first comment at my first EMR demo 30 years ago:

    “And how does all this information get in the record? . . . . Oh, I type it in . . . . Are you out of your frigging mind? That’s the stupidest idea I’ve ever heard in my life!”

    We haven’t progressed beyond that point.

  4. NCDC
    November 27, 2018 at 9:32 am

    Getting rid of EHR would save a lot of time, then you would also not need scribes!

  5. Dr.Will Sawyer
    November 27, 2018 at 8:13 am

    Physicians are a VERY expensive data entry person. Data entry was not one of the skillsets for being a good/average/great physician. I say “physicians step away from the key board!”
    Yes some of the data in an EMR can be valuable, but MOST is for billing purposes and to help create a paper trail if audited, except when the new “clinical judgement” strategy (“the patient wasn’t sick enough to need all that time”) is used by insurer.
    We physicians have enabled this EMR burden that accelerates burnout and scribes can be one solution for delaying burnout for those stuck on the treadmill.
    So Docs “keep your eyes on the patient, touch your patients and listen to your patients” let someone/something else do the typing!
    Set yourself free from the keyboard and it will feel like a breath of fresh air! Just one 32 year solo family medicine Doc’s experience!

  6. Dr Bonz
    November 27, 2018 at 7:35 am

    This is classic! Let’s add ADDITIONAL cost into the system to fix the problem that they created, and did not previously exist, in the first place. It’s like treating a bad side effect from a medication with an equally bad medication that has its own bad side effects.

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