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Managing the Flow of Care Through Medical Scribe Program

Medical scribes work at the bedside with physicians, physician’s assistants, and residents to complete patient charts according to provider preferences and billing standards set by hospital administration and insurance companies. They also assist in the fluidity of care by performing tasks like alerting physicians when test results are received. Medical scribes have gained popularity in medical facilities in the last decade primarily as a result of the requirements that physicians see more patients and use electronic medical record systems for documentation. These demands have not only tended to depersonalize patient visits, but have also reduced patient and physician satisfaction because physicians fulfilling charting requirements take so much time that they are either forced to spend less time with patients or fall behind in completing their documentation. The primary role of a medical scribe is to help solve these problems by completing the patient’s charts and helping to manage the flow of care so that physicians can spend more time focusing on engaging and connecting with patients and planning their care.

Scribes are often undergraduate students or recent college graduates interested in pursuing a career as a physician or physician’s assistant. They are most commonly found working alongside physicians in emergency departments and Urgent Care Centers documenting patient-physician encounters, coordinating care, and assisting in the medical decision making process. Training programs vary in length and structure but all aim to teach scribes to appropriately use medical vocabulary, work inter-professionally on medical teams, and adapt to physicians’ personal charting preferences while fulfilling billing protocols.

The George Washington University Medical Faculty Associates (GW MFA) academic scribe program offers a unique experience for students as they prepare for their health care careers. Most scribes take a semester scribe class offered at GW but all scribes are required to take an exam on basic medical vocabulary and foundational concepts and work clinically with an experienced scribe for a minimum of two shifts in each department where they plan to scribe independently.

Under the guidance of Griffin L. Davis, M.D., M.P.H., assistant professor of emergency medicine and chief, Section of Emergency Medicine Administration, the program has expanded from the Department of Emergency Medicine into eight additional specialties in the span of approximately one year. GW MFA scribes have begun working with physicians in neurosurgery, orthopedics, urology, OB/GYN, oncology, internal medicine, rheumatology, and otolaryngology. Other medical departments are now requesting scribes because of the program’s proven success in improving patient care efficiency and reimbursements from proper documentation of patient visits. “Over the next year given our success in helping to improve documentation,” adds Davis, “we hope to continue to grow and offer services to other providers at MFA, develop new educational models for new scribes and potentially help with the upcoming EMR transition.”

Scribing presents a special opportunity for people planning to pursue medical careers because it grants the opportunity to not only observe the sacred patient-physician relationship first-hand but also work as an integral part the modern medical team. In reflecting on her experience as a GW scribe, Elizabeth Gall states, “I have learned a great deal about medical terminology, important questions to ask patients that lead to the correct differential diagnosis, effective ways to address patient concerns, and how to work with different EMRs.”

Scribes experience the variance in culture among specialties and must learn department-specific medical terminology, diseases, procedures, medications, and the intricacies of the medical decision making process in order to perform their role on medical teams. Scribes thus learn about the realities of medicine today through clinical immersion and have the opportunity to receive mentorship from staff, including medical students, residents, and physicians. Access to this depth of medical exposure is rare for pre-medical students, especially for those without any formal medical degree, which makes scribing highly sought after for those pursuing a career in the medical field.