Despite the now widespread use of medical scribes, there are few studies out there that objectively measure the results of their use. A literature review out of the Journal of the American Board of Family Medicine identified five studies from 2000 to 2014 analyzing the impacts on clinical practice of using a scribe.
The results were as follows:
These were the biggest takeaways from the article and we wanted to highlight some of them because they help provide some objective information about using scribes in a clinical practice that is naive to them.
The full article can be found here: https://www.jabfm.org/content/28/3/371
We recently updated our physical exam training to include a brief discussion and demonstration of some of the most common neurological tests performed outside of basic motor and sensory function. These tests include pronator drift, Romberg's, finger-to-nose, heel-to-shin, gait and tandem gait. It may be unnecessary for some medical scribes, but those going to medical school or physician-assistant school may find it informative. It is required in the emergency department scribe training course, but optional in the primary care scribe training course. Enjoy!
We were recently asked why Medical Scribe Training Systems is not a certified academic partner of the MSCAT and its providing organization, the American College of Medical Scribe Specialists (ACMSS). Our answer? Essentially, we choose not to pay for something without utility. The American College of Medical Scribe Specialists (ACMSS) was created as a branch from Scribe America and is not an accredited licensing program, so it has no impact upon healthcare services. Although Scribe America is probably the largest medical scribe company in the US, we have our own training philosophy. Our courses include lectures, readings and activities to understand basic medical terminology, physical examinations, HPI terminology, labs, medications, and more! We know that memorizing every detail in any scribe training courses is unrealistic, but just like most medical school curricula, we believe that a solid theoretical understanding of clinical medicine will lay the foundation for what is eventually a far greater medical scribe, and can serve as reference material long-term. So essentially, being "certified" by the Medical Scribe Certification and Aptitude Test bears little clinical significance, is not required to become a medical scribe, and does not correlate to the clinical competency of a medical scribe.
Meaningful use is a big deal for primary care physicians and it's important for scribes to have an understanding of what meaningful use is, what the rationale for it is, and how it affects clinical practice. Medical Scribe Training Systems just released a five minute lecture detailing the objectives and implications of meaningful use for the primary care scribe.
We have overhauled our previous physical exam training videos and just introduced the first of three detailed instructional videos about the physical exam. This first video includes an overview of the general, HEENT and neck exams including topics like:
Dr. John Hickner, Editor and Chief of the Journal of Family Practice Discusses the Shortcomings of Many Medical Notes
In his recent editorial in the October edition of the Journal of Family Practice, Dr. John Hickner (MD, MSc) notes that many doctors fail to adequately document three portions of the medical note: history of present illness (HPI), assessment and plan.
"After reviewing many charts from several organizations, however,
I’m concerned that 3 important elements of documentation are getting
short shrift in our increasingly computerized and regulated environment:
the history of present illness, the assessment, and the plan."
Dr. Hickner was kind enough to chat with us at the American Academy of Family Practice Conference that ended yesterday. Like us, he wants medical notes to tell the story underlying the patient's present visit; not just a checklist of symptoms. The emphasis of quantity over quality by the healthcare system and electronic medical records (EMRs) has eroded the quality of the HPI. During our conversation at the conference, he acknowledged that scribes may have a role in solving the dearth of quality documentation by some medical doctors. You can read his full article on the Journal of Family Practice website. And again, it was a pleasure chatting with Dr. Hickner at the conference.
Medical Scribe Training Systems will be at the American Academy of Family Practice (AAFP) in Washington D.C. Thursday October 23 through Saturday October 25. This is your chance to ask us any questions about the logistics of having and training a scribe. We will be located in the Technology Pavilion in between eClinicalWorks, e-MD and Cerner. Come check us out!
We recently updated and upgraded our primary care scribe training manual! The improvements include a new chapter titled "Management of Chronic Diseases." It details the monitoring, management and medications used to treat the most commonly encountered chronic diseases in family practice and internal medicine including type II diabetes, hypertension, hyperlipidemia, and hypothyroidism. You can check out the new edition on Amazon.
The American College of Emergency Physicians branch in Connecticut (CCEP) recently published its Spring newsletter. In it, medical scribe and soon-to-be medical student Elizabeth Wilcox recommended the Ultimate Medical Scribe Handbook to physicians looking to hire their own scribe:
"If you are looking to have scribes at your facility, you could
certainly hire a scribe company. But if you have some patience
and access to pre-med students, I urge you to make use of them!
Grab a few intelligent self-starters, buy them The Ultimate
Medical Scribe Handbook (available on Amazon), give them a
computer on wheels, and a name badge. In no time flat, you’ll
have a scribe."
This is exactly what we believe! For primary care physicians that work regular hours and have access to an undergraduate pre-medical community, you can hire your own scribe and train them yourself! The Ultimate Medical Scribe Handbook and our online training can definitely help you in that endeavor and reduce your long-term costs. You can read the full article by Elizabeth here.