Scribes have been used to document and record events for thousands of years. In modern medicine, the scribe’s function is to accompany the physician during a patient examination and document the visit in the patient’s medical chart.
In orthopaedics, a scribe is ideally either a physician’s assistant, nurse, or a certified athletic trainer who already understands the specialty. Less costly office staff members can also be trained as scribes, but may take longer to learn the medical terminology. Once trained, however, they are useful adjuncts on busy days or for covering vacations.
Reasons to use a scribe
In my opinion, the most important reason to use a medical scribe is that it enables the physician to concentrate entirely on the patient. Because the scribe performs the documentation function contemporaneously with the patient examination, the physician is not distracted with writing notes or typing on the computer.
Scribes, however, can perform several other functions that make them valuable resources. For example, the scribe is a witness/chaperone in the examination room. Because the note is documented contemporaneously with the examination, the physician cannot be accused of forgetfulness or inaccuracy because the note was dictated several hours or days after the examination. An individual may accuse the physician of inaccurate documentation, but the scribe is a disinterested party who documents what the physician says to the patient.
Scribes as chaperones can also be significant. Years ago, I was accused of assault during an independent medical exam. The case was dropped because the female scribe in the room was willing to testify that none of what the patient alleged actually happened. If I had been alone, a nasty court fight might have resulted.
Scribes have better handwriting than physicians and can provide more detail than the physician could possibly remember when dictating the note several days later. They can leave the room to retrieve splints, braces, or any other item that is not routinely stocked in the examination room, enabling the physician to continue discussing the medical condition with the patient without interruption.
Depending on their level of medical training, scribes can assist with administering injections, fitting braces, casting fractures, changing dressings changes, or removing sutures. Scribes can also participate in patient education, further explaining procedures or medication requirements as necessary.
Scribes may also be able to help schedule surgery or diagnostic testing and ensure that appropriate equipment is present in the operating room.
Finally, using a scribe saves time. The physician never has to do after-hours dictation in the office or bring charts home to dictate. The chart is completed when the physician leaves the examination room. A physician who sees 20 patients a day and spends 5 minutes per chart dictating or writing the notes saves more than an hour and a half of time by using a scribe. Independent of any of the other benefits, how much would you pay to get an extra hour and a half or more per day?
Although using a scribe may sound like a luxury to some, I have found that scribes more than pay for themselves in numerous ways, and I would never practice without one.
G. Klaud Miller, MD, is a member of the AAOS Practice Management Committee who is in private practice in Chicago. He can be reached at firstname.lastname@example.org