Does Your Doctor Use a Scribe?

field notesLast time I went to the doctor, I waited forever until a nurse finally called me in to the exam room. Then I waited a little bit longer than forever, saw the nurse for a bit, and waited again for the doctor to come in. Overall my visit lasted about 40 minutes, but just 10 of them were spent with the doctor-who was looking at his computer most of the appointment.

Sound familiar?

To try and combat this problem and facilitate a more trusting doctor-patient relationship, medical scribes could become a common fixture in hospitals around the country. The current reliance on electronic records means doctors juggle their time between focusing on patients and focusing on logging data. Scribes shadow doctors and take notes for them, so doctors can spend time getting to know their patients. ScribeAmerica, a company in Florida that supplies scribes to medical practices, says that they have seen requests for scribes grow from 1,000 to 3,500 in just three years. They expect that number to increase even more.

In 2009, 10 percent of health care facilities used electronic records. Now almost 70 percent are keeping electronic records. The American Medical Association and RAND published a study determining that record keeping can put a damper on doctor-patient relationships.

“I can’t tell how depressed they are while I’m doing this and looking at a computer screen and they’re sitting behind me,” said one doctor in the study.

The article from the US National Library of Medicine National Institutes of Health posits that the more time physicians spent with their patients, the more satisfied their patients were and the better their outcomes were, health-wise. The patients asked more questions and were more knowledgeable about their health status. The researchers also found an association between shorter visits and increased prescribing practices from physicians.

This practice of using scribes could mean better results for all patients, but especially work comp patients. If doctors are only half paying attention and half entering data, they might miss important context clues that could lead to better treatment. If a worker is beginning to get frustrated or down, a distracted doctor might not pick up on their body language or emotional cues. I’m not saying doctors are therapists, but if they are 100 percent focused on the patient they are going to be more tuned into what they are saying and be more likely to recognize symptoms that are common to those suffering a work injury- depression, hesitancy to return to work, etc. Spending more time with patients could also combat the over-prescribing problem going on in workers’ comp. Without the distraction of trying to simultaneously keep records and see patients, doctors can really talk to a patient to try to figure out an alternative course of treatment rather than just writing a prescription for painkillers and sending them on their way.

The NIH article suggests several ways that physicians might use the time they currently do have in a more efficient matter. Things like setting an agenda early on in the visit, actively listening to the patient and their story, and paying attention to the patient’s emotional cues might have a great effect on how the patient feels after that visit. Utilizing scribes can help physicians that are stretched too thin to catch a break and really commit their full attention to the patient.

What's your take? Continue the discussion with others over at the WCInsights LinkedIn Group.
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