Can scribes boost FPs’ efficiency and job satisfaction?

While electronic medical records (EMRs) are important tools for improving patient care and communication, they bring with them an additional administrative burden for health care providers. In the emergency medicine literature, scribes have been reported to reduce that burden and improve clinicians’ productivity and satisfaction.^1-4 Additionally, studies have reported increases in patient volume, generated billings, and provider morale, as well as decreases in emergency department (ED) lengths of stay.⁵ A recent review of the emergency medicine literature concluded that scribes have “the ability to allay the burden of documentation, improve throughput in the ED, and poten­tially enhance doctors’ satisfaction.”⁶

Similar benefits following scribe implementation have been reported in the literature of other specialties. A maternal-fetal medicine practice reported significant increases in generated billings and reimbursement.⁷ Increases in physician productivity and improvements in physician-patient interactions were reported in a cardiology clinic,⁸ and a urology practice reported high satisfaction and acceptance rates among both patients and physicians.⁹

Practice management literature and an article in The New York Times have anecdotally described the benefits of scribes in clinical practice^10-12 with the latter noting that, “Physicians who use [scribes] say they feel liberated from the constant note-taking ...” and that “scribes have helped restore joy in the practice of medicine.”¹⁰

A small retrospective review that appeared in The Journal of Family Practice last year looked at the quality of scribes’ notes and found that they were rated slightly higher than physicians’ notes—at least for diabetes visits. However, it did not address the issues of physician productivity or satisfaction. (See "Medical scribes: How do their notes stack up?" 2016;65:155-159.)

The only family medicine study that we did find that addressed these 2 issues was one done in Oregon. The study noted that scribes enabled physicians to see 24 patients per day—up from 18, with accompanying improvements in physician “quality of life.”¹³ Absent from the literature are quantitative data on the feasibility and benefits of implementing scribes in family medicine.

Could a study at our facility offer some insights? In light of the paucity of published data on scribes in family medicine, and the fact that a survey conducted at our health center revealed that our faculty physicians felt overburdened by the administrative demands of clinical practice,¹⁴ we decided to study whether scribes might improve the work climate for clinicians at our family medicine residency training site. Our goal was to assess the impact of scribes on physician and patient satisfaction and on hours physicians spent on administrative tasks generated by clinical care.