The Doctor (and Scribe) Will See You Now
Become a Medical Scribe
So you want to work in healthcare, but still aren’t sure what to do or how to do it. Wouldn’t it be great to work in a job that’s not only fun and challenging, but gives you a window on the wide world of healthcare in 2015 and beyond?
Consider being a medical scribe, a healthcare professional who intelligently shares the provider's burden of data gathering and electronic medical record or EMR documentation. No, this doesn’t involve quill pens and papyrus scrolls.
Think of the job as being a personal assistant to the physician, or a physician collaborator who facilitates fast-paced workflow at point of service—you won’t touch patients or handle bodily fluids or dispense medical advice or interpretation of same.
Where the Jobs Are
Because of the adoption of electronic health records or EHRs, and ICD-10 looming large, job opportunities increase daily as the industry transitions to using more scribes, says Kristin Hagen, president and CEO of the American College of Medical Scribe Specialists or ACMSS. “We anticipate having 100,000 scribes by the year 2020,” she projects.
As a staffing firm, ScribeAmerica recruits, hires, trains and manages scribes, and is considered a dominant force in this career genre as the largest medical scribe company. Begun in 2004, the company has nearly 7,200 employees at almost 900 U.S. hospitals in 46 states. “Patients like to hear what the doctor is saying about their exam,” says the company’s CEO, Michael Murphy, MD. “At the same time the scribe can document that in real time.”
He reminds prospective scribes that the bulk of scribe hiring isn’t actually done through a hospital, but is outsourced to companies like ScribeAmerica. “We’re a vendor that contracts with hospitals, which like many other businesses and other professions, may prefer not to manage scribes case due to ancillary costs such as workers’ compensation, taxes and more,” says Dr. Murphy.
The company provides services for emergency medicine—where scribes were first utilized—and for hospitals, outpatient and urgent care and even has telescribes.
What You Need
To work for Scribe America, you’ll need a high school diploma, while a college degree or current enrollment in same is preferred. You must commit to two years part-time or one year full-time. If you’re a student, this opportunity may be just right for you.
Once hired, you’ll participate in a paid, three-step training program that includes an online component, then classroom experience, followed by an “on-the floor” period. You’ll work with an experienced scribe and undergo periodic reassessments. Expect compensation in the $10 to $20 per hour range, with opportunities to excel within ScribeAmerica management should you choose not to pursue a higher-level healthcare career such as physician assistant or nurse practitioner. Up to 30 percent of well-prepared company employees ultimately do go on to other healthcare jobs, says Dr. Murphy.
If you’re wondering about certification, “We mandate all scribes get certified, based upon their specialty,” says Dr. Murphy.
Scribes don’t have to be licensed or certified through formal training, but ACMSS has certified academic partners that provide training programs and the organization offers three levels of certification.
“Certification is necessary to protect our healthcare system,” says Kagen. “It also sets minimum standards for those who work on patient care records.”
Note that scribes are not transcriptionists who listen to provider’s recordings and transcribe them, she says. “Scribes chart directly into the EHR.”
A Window into Healthcare
“If you have a lust for learning about healthcare, and want to know how and why things are done, it’s a great job,” says Kristin McKenzie, chief scribe at Florida Hospital Winter Park and co-chief scribe at Florida Hospital Altamonte.
With two years as a scribe, McKenzie knows job one is documenting the patient-provider encounter. “Scribes go into the room with the provider so the doctor doesn’t have to worry about documentation,” she says. “The doctor can have a hands-on experience with the patient and pay more attention to that encounter.”
The scribe documents the interaction and decision-making, including the entire work-up with lab tests, radiology results, and directions for admittance or discharge.
Currently, she’s still charting on a T-sheet by hand, as her hospitals eventually transition to EMRs. “Shorthand is a savior,” she says, “as we keep up with everything doctors are saying.”
McKenzie, who typically works in the ER, has also done outpatient cardiology. With a bachelor’s degree in health sciences, she’s planning to be a PA and feels that being a scribe has “given me an invaluable head start into the world of medicine.”
She’s also applying to a school where she’ll already know people in the business, which can translate to more security and career growth potential.
Every job has pluses and minuses, no matter how insignificant. Days can be long, McKenzie admits, between 10 to 12 hours, not unusual in healthcare. That’s sometimes challenging if the physician for whom she scribes has a bad day—as everyone does, as it’s a close working relationship. The pair may see 12 patients on a slow day and 40 on a busier one.
Understanding How Doctors Think
Working one-on-one with providers and understanding their thought processes as they treat patients provides a constant source of learning and motivation for Jonathan Flynn, scribe for more than three years. He works at multiple sites for Florida Emergency Physicians and for community health systems.
Flynn also wants to go to medical school as a PA, NP or physical therapist. “For anyone who wants to go to another level in medicine, because of the exposure, there’s no better opportunity than being a scribe,” he says.
With two classes remaining before he obtains his bachelor’s degree, he appreciates being able to “see” medicine in practice instead of just reading about it in a book. Along with ER experience, he has worked in outpatient clinics for neurology, internal medicine and pediatrics.
Although some doctors say it’s been hard to “let go of the chart,” they admit to the many benefits of working with a scribe, as documented by emergency physician “Shadowfax” on the website KevinMD, and with a dose of good humor.
“Now it’s easy,” he writes. “I like my job better. I’ve never felt like I was one of those docs susceptible to burnout, but it is endemic within emergency medicine. For someone who is riding that razor’s edge, a scribe could be the difference in job satisfaction between having to leave the field and keeping their career going another decade…Now I just need to figure out how to get them to blog for me.”