Urologists who view electronic medical record documentation as a burden are turning to scribes. Scribes, many say, relieve them of that burden, freeing urologists and other providers to focus on patient care.
But scribes cost money—money that’s on top of what urology practices have already spent on EMRs.
Urologists tend to view working with scribes in a mostly positive light, while noting a few negative aspects. Some have developed best practices on working with scribes and shared them with Urology Times.
First, a look at the data on scribes
Studies examining the use of scribes in medical practice have been, for the most part, positive.
A PubMed search yielded one study of scribe use in urology. EMR scribes increase urologist satisfaction and don’t lessen urology practice patient satisfaction, according to the study, published in the Journal of Urology (2010; 184:258-62).
The study’s authors assigned EMR scribes to five academic urologists, then surveyed patients and physicians to determine acceptance and satisfaction. They found that patients had slightly higher satisfaction rates when scribes were present, at 93% versus 87%. But it was the physicians who were most dramatically impacted. Nearly 70% of urologists surveyed were satisfied with office hours when they had a scribe, versus almost 20% of those who were without a scribe.
A more recent urology-focused article, published in Urology Practice (2015; 2:101–5), found that medical scribes in an academic setting could increase patient flow and reduce the burden on providers by reducing computer charting. The model described in the study “is only financially prudent if the increased expenses are offset by additional revenue from increased patient visits,” the authors wrote.
Another study, published in ClinicoEconomics and Outcomes Research (2015; 7:489-95), looked at scribes’ yearly impact on physician productivity and revenue in a cardiology clinic. It found physician productivity was about 10% higher among those who used scribes. The use of scribes generated an additional annual revenue of $1,372,694 at a cost of $98,588, according to the authors.
The Journal of the American Board of Family Medicine published a review in 2015 on medical scribe use, identifying five studies, including the 2010 urology study. The authors found that although the number of studies was small, the research collectively suggests medical scribes improve “clinician satisfaction, productivity, time-related efficiencies, revenue, and patient-clinician interactions.” But more studies are needed, they concluded.