Abstract
PURPOSE Scribes are increasingly being used in clinical practice despite a lack of high-quality evidence regarding their effects. Our objective was to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction, and charting efficiency.
METHODS We conducted a randomized controlled trial in which physicians in an academic family medicine clinic were randomized to 1 week with a scribe then 1 week without a scribe for the course of 1 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. Our outcomes were physician satisfaction, measured by a 5-item instrument that included physicians’ perceptions of chart quality and chart accuracy; patient satisfaction, measured by a 6-item instrument; and charting efficiency, measured by time to chart close.
RESULTS Scribes improved all aspects of physician satisfaction, including overall satisfaction with clinic (OR = 10.75), having enough face time with patients (OR = 3.71), time spent charting (OR = 86.09), chart quality (OR = 7.25), and chart accuracy (OR = 4.61) (all P values <.001). Scribes had no effect on patient satisfaction. Scribes increased the proportion of charts that were closed within 48 hours (OR =1.18, P =.028).
CONCLUSIONS 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.
- medical scribes
- electronic health records
- work satisfaction
- patient satisfaction
- efficiency
- primary care physicians
- randomized controlled trial
Footnotes
Conflicts of interest: authors report none.
Funding support: This study was supported by a grant to the senior author (S.L.) from the Pisacano Leadership Foundation, the philanthropic foundation of the American Board of Family Medicine.
Disclaimer: The Foundation had no role in the design of the study; the collection, analysis, and interpretation of the data; and the decision to approve publication of the finished manuscript.
Previous presentations: A portion of this manuscript was presented at the Starfield Summit, April 23–26, 2016, Washington, DC; and the Society of Teachers of Family Medicine (STFM) Annual Spring Conference, April 30–May 4, 2016, Minneapolis, Minnesota.
- Received for publication December 6, 2016.
- Revision received April 15, 2017.
- Accepted for publication May 3, 2017.
- © 2017 Annals of Family Medicine, Inc.