Use scribes to improve efficiency and reduce burnout

Dan Smith, M.D., FACEP, senior coach, speaker and executive medical director for Studer Group and practicing emergency physician -

If you’re like me, you yearn for fulfillment and enjoyment in your medical practice, and that often means finding ways to be efficient so you have more time to focus on taking care of patients.

A significant challenge to clinician effectiveness and satisfaction today is the use of EHRs. Specifically, poor usability, time-consuming data entry, interference with face-to-face patient care and less fulfilling work content are all major factors of EHRs contributing to physician dissatisfaction, according to a RAND Corporation study.

Although EHRs have improved quality of care by providing clinicians with a better ability to enter care information real-time and remotely access that information, the negative aspects mentioned above lead to frustration and lack of engagement, a perfect storm that can contribute to physician burnout. (Mayo Clinic Proceedings, July 2016, Shanafelt et al.)

Throughout my recent years of practice and as a healthcare coach, I found one solution that helped relieve staffing and documentation burdens and provided me and other physicians more time for patient interactions and clinical decision-making. I have found a great practice adjunct is the use of medical scribes.

When trained properly, scribes can ease the clerical burden we have faced every day since the introduction of EHRs. In addition to enhanced physician productivity and clinician-patient interactions, scribes also contribute to improvements in:

Real-time data entry. Notes entered during the actual episode of care means fewer notes that require entry at the end of the day or another day, translating to enhanced work-life balance.

Revenue due to elevated productivity, better documentation accuracy, and reduction in down-coded charts.

Clinician engagement. This is particularly true if clerical burden and EHR use are known disengagement factors for a group or system.

Before making a decision to add a scribe to your team, ensure you have the capacity to onboard, train and support them. Scribe companies typically have these programs in place, but you will still need to mentor and train the scribe so they understand your preferences and practice nuances.

Once acclimated to the team, measure the return on investment (ROI) resulting from the use of scribes in your practice. While there is a financial ROI based on improvement of documentation and productivity, there is also an equally important non-financial ROI that will manifest as engagement and professional fulfillment. For me, the latter is far more important than the dollars spent or earned.

Dan Smith, M.D., FACEP, joined Studer Group in 2009. He serves as a senior coach, speaker and executive medical director for Studer Group, working in a variety of areas including medical practices, inpatient and emergency departments. Dan has coached, mentored and lectured at over 200 organizations in the United States, Canada, Philippines and Australia. He enjoys coaching and speaking on patient and physician engagement, performance excellence in the age of change, physician communication and physician performance feedback. He has trained over 9,000 physicians/APPs worldwide on communication best practices.

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