Free Clinic Scribing vs Hospital Scribing

An important aspect of my research is the distinction between scribing in hospital vs free clinics. Although at first, it may seem like an insignificant difference, in reality the settings play a major role in the demands placed on scribes.

Free clinics, for better or worse,  place their survival in the hands of their volunteers- especially in terms of providers. There is typically a small core of paid employees in order to ensure that there is regularly scheduled staff on hand, but a large bulk of the work is foisted onto the shoulders of dedicated volunteers. However, the volunteers themselves suffer from a particular selection bias not suffered by hospitals. What is the provider demographic that can devote the most time and energy to such time-consuming work? -Retired providers. Men and women who have stopped working full-time long ago, whose children are grown and no longer need tending. As a result, this population of older providers have grown up in the age of pen and paper as opposed to our generation’s comfortable use of technology. Scribes are naturally preferentially assigned to these volunteer providers in order to allow the clinics to gain a larger provider staff while simultaneously maintaining accurate electronic medical records.

However, this creates many unexpected problems for the scribes themselves. A major issue that occurs is the provider’s lack of understanding of the electronic medical record system. Although they do not have to physically operate the system themselves, the providers are still responsible for giving scribes the information they need in order to ensure an accurate record- information that the scribes cannot ascertain themselves. Even though these are very experienced providers, their unfamiliarity with the demands of the electronic system can result in communication difficulties with the scribes, confusion and ultimately a poor record of the patient’s visit.

A potential solution may be to provide mandatory orientation to new volunteer providers about the electronic medical record. This seminar would solely focus on the medical and administrative aspects of the clinical visit that must be accounted for so that providers serve patients with a better understanding of the necessary documentation.


  1. I’ve never really been to any doctor’s or clinic other than the health center at the College. So I only have a really vague idea about how the healthcare system works in United States. Not to mention what scribes do. But after reading your blog and thanks to my one-time oppotunity of shadowing, at least I know something about documentation behind the reception desk.
    I understand how awkward it could be when a patient sees the third person while trying hard to describe his/her condition. But I can’t agree more with documenting in details is vital – especially when it comes to some symptoms tricky.
    I also noticed that there maybe a software could be helpful when I did the shadowing. Doctors can record their voices and the software would auto-translate the voices to words for documentation. (It could even send out emails automatically.) I figure that anything that’s user-friendly (or elder-generation-friendly) might be a great help in the field of healthcare.