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A Posit Addressing Scribes “Healthcare organizations should provide medical scribes for their physicians.”

Background: In an April 6, 2014 article in the Wall Street Journal, a Minnesota cardiologist, Dr. Alan J. Bank, describes the benefits of having a medical scribe to offload the amount of data input and busy work that the physician has to do. The cost of the scribe was made up for by the increased productivity of the physician. Physicians spent more time looking at the patient instead of the computer screen. Patient satisfaction was not diminished. View the article at https://drive.google.com/ file/d/0By-WBPzYZRaBNU5QRnpIUFVuOHM/ view?usp=sharing. Note: Posits are aggressive statements intended to promote discussion. Results do not constitute valid polling data and may not reflect the position of the Editorial Committee, or the SSVMS Board of Directors. Results: 40/Agree – 9/Disagree. Commentary follows:

Comments or letters, which may be published in a future issue, should be sent to the author’s email or to e.LetterSSV Medicine@gmail. com.

I agree. They should be provided when they add value and efficiency to the physician work flow. They should not be provided if that doesn’t happen. Not all specialties would benefit from a scribe. The issues that arise are confidential conversations (they are well accepted by patients, but for some issues the scribe should leave the room), dependence by the physician and disruption caused by turnover, productivity (enough to justify the cost) and logistics/overhead (another work station etc.). Like most things “it depends.” − Thomas Atkins, MD Yes, of course, they should provide scribes. This would greatly enhance (“restore”) the quality of the “face-to-face” physician-patient encounter which used to be, and once again should be, a central tenet in the practice of medicine. −Scott Wigginton, MD I disagree. They should increase

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Sierra Sacramento Valley Medicine

reimbursement to cover the costs of a scribe. They could not provide scribes that would practically fit into anyone’s practice. −Andrea Willey, MD Great idea! Ever since the Kramerica Industries episode of Seinfeld, I’ve wanted a dutiful personal assistant. EHR has made certain things easier like e-prescribing and trending labs, but the amount of navigation, clicks, pop-ups, health maintenance, and “meaningful use” tasks tends to derail the human aspect of the visit. A scribe would help us return to “meaningful medicine.” −Nathan Hitzeman, MD It has been my experience that much of the important issues are gleaned from direct faceto-face contact with the patient; the diverted glance, the raised eyebrow, etc. −Harold Renollet, MD I disagree. Remember the days of transcriptionists and transcribers? Remember those screamingly-funny transcriptions that you had to sometimes read out in court? Providing “medical scribes” is just bringing back the same process under “a new and improved” name! Now instead of being in an office away from you, they will be at your elbow (what happens to privacy laws?) and in your way. Although they would create jobs, the cost and waste of time involved in every aspect of the making of a final report is phenomenal. Providers still have to read through the notes to make sure that the information transcribed is accurate, etc. (an additional delay). With the computer era, the Dragon has been a very valuable tool in writing notes; whatever the note may be, in the direct care of the patient. Like everything, learning to use the Dragon takes some personal time and effort, but once mastered, it is a great little tool that is lighter than the stethoscope, and

Profile for Sierra Sacramento Valley Medical Society

2015-Jul/Aug - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...

2015-Jul/Aug - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...