Impact of Scribes on Physician Satisfaction, Patient Satisfaction, and Charting Efficiency: A Randomized Controlled Trial

The Article in Brief

Impact of Scribes on Physician Satisfaction, Patient Satisfaction, and Charting Efficiency: A Randomized Controlled Trial

Steven Lin , and colleagues

Background One of the largest contributors to physician burnout is a growing clerical workload requiring physicians to spend significant time working in the electronic health record. One strategy to decrease clerical burden is the use of scribes, non-licensed team members trained to document patient encounters in real time under the direct supervision of a physician. The objective of this study is to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction, and charting efficiency.

What This Study Found This study--the first randomized controlled trial of scribes--finds that they produce significant improvements in physician satisfaction without detracting from patient satisfaction. Over the course of one year, family physicians were randomized to one week in which scribes drafted all relevant documentation, which was reviewed and signed by the physician, followed by one week without a scribe in which physicians performed all charting duties. Scribes improved all aspects of physician satisfaction, including overall satisfaction and satisfaction with length of time with patients, time spent charting, chart quality, and chart accuracy. Scribes had no effect on patient satisfaction and increased the proportion of charts that were completed within 48 hours. Physicians were more satisfied with scribed charts than with their own.

Implications

• Spending less time on documentation, the authors note, frees up physicians to pursue direct clinical care, care coordination, and teaching activities, which may help prevent burnout.
• Scribes could complement a high-functioning electronic health record and, until electronic records are redesigned for improved functionality, could provide an immediate solution to the clerical burden EHRs entail.