A randomized controlled trial of medical scribes found that scribes product significant improvements in overall physician satisfaction and charting efficiency, without detracting from patient satisfaction, according to the study published in the Annals of Family Medicine.
Researchers at Stanford University School of Medicine within the Center for Health Policy and Center for Primary Care and Outcomes Research, as well as the division of Primary Care and Population Health and the division of Epidemiology, sought to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction and charting efficiency.
The study involved physicians in an academic family medicine clinic randomly assigned to one week practicing with a scribe then one week without a scribe throughout the course of one year. Scribes drafted all relevant documentation, which was reviewed by the physician before attestation and signing. In encounters without a scribe, the physician performed all charting duties.
In the study, the researchers noted that more than one-half of all US physicians experience burnout, with primary care physicians having one of the highest rates. Among the largest contributors to burnout is a growing clerical workload. For every hour physicians provide direct face time to patients, two more hours are spent on EHR and desk work.
The study authors also noted that scribes are currently being used in more than 1,000 hospitals and clinics across 44 states. It is estimated that by 2020, there will be 100,000 scribes in the United States, or one scribe for every nine physicians. Despite the increasing presence of scribes, methodologically rigorous studies regarding their impact are lacking, the study authors wrote.
The researchers found that scribes improved all aspects of physician satisfaction, including overall satisfaction with clinic, having enough face time with patients, time spent charting, chart quality, and chart accuracy. Scribes had no effect on patient satisfaction. Scribes increased the proportion of charts that were closed within 48 hours.
The study authors noted that when working with a scribe, physicians were much more satisfied with how their clinic went, the length of time they spent face-to-face with patients, and the time they spent charting. “These findings suggest that scribes may have a protective effect on physicians’ well-being. Spending less time on documentation frees up the physician to pursue direct clinical care and care coordination, thus enhancing joy of practice and preventing burnout. In academic centers, scribes provide faculty physicians more time to teach medical students and residents,” the study authors wrote.
“To our knowledge, we have conducted the first randomized controlled trial of scribes. We found that scribes produced significant improvements in overall physician satisfaction, satisfaction with chart quality and accuracy, and charting efficiency without detracting from patient satisfaction. Scribes appear to be a promising strategy to improve health care efficiency and reduce physician burnout,” the study authors wrote.
