Criticisms of Scribing

My research centers around a scribing program proposal for Olde Towne Medical Center, presenting an obvious bias toward the benefits of scribing. However, it is simultaneously important to provide weaknesses of scribing programs in order to ensure that scribes are properly utilized and that the center can create effective workarounds in the program’s initial stages to prevent difficulties down the road.

Patient Discomfort

A topic which I have already touched on in a previous blog post is negative patient reactions toward the presence of scribes. Patient discomfort is a seemingly small problem which can lead to serious consequences in terms of affecting the patient’s ability to answer questions accurately, their ability to describe their medical problems or simply confide in their doctor. A common solution to this issue which many of my providers have employed is to simply ask the patient if he or she feels comfortable allowing me to record their visit. However, this is a luxury that can only be afforded to providers who are experienced with the electronic medical record and can record the visit themselves. In addition, the idea of having a scribe in the examination room recording in real time revolves around the idea of accuracy. The sooner the information can be recorded, the better.

Electronic Medical Record Mistakes

Although many scribes understand the importance of accuracy in their job, they are still, in reality, young (majority undergraduate) students who are not as familiar or as comfortable with medical terms and clinical responsibilities as experienced nurses and providers. Therefore, mistakes do happen, ranging from spelling errors and grammar mistakes to mixing up patient information because of working overtime and being forced to complete the charts later. As a result, a checks and balances system must be put into place in order to ensure that all mistakes are caught. Lackey employs an oversight system with a head scribe and an experienced physician administrator reviewing charts. Another method of preventing mistakes is to simply make training more intensive- a difficult task because many scribes are college students with limited free time slots. As a result, it may be difficult to give scribes the thorough training they need because many clinic scribes volunteer once a week and are not able to practice using the electronic medical record outside of patient visits or chart corrections. It is akin to learning to play an instrument during once a week lessons without being able to practice on your own time.