In all, most physicians in our group consider the scribe program a worthwhile investment for improving their job satisfaction. As with EMRs, once a scribe program is fully implemented, it is hard to remove it from the ED’s culture.

Summary

Scribes are a significant change to the standard practice patterns of emergency departments. EMRs usually increase the amount of time providers spend documenting patient care, and computerized physician order entry creates new interruptions and workflow impediments. As emergency physicians are required to add more tasks to the list of daily activities during a clinical shift, off-loading some of the responsibilities to a personal recording assistant decreases interruptions, increases patient contact time, improves patient satisfaction, and improves physician job satisfaction.

The cost of implementing a scribe program is not inconsequential, and the benefits will vary depending on individual department characteristics. At busy sites with increasing volume, the capacity increase can allow the scribe program to pay for itself with increased average level-of-service billing from improved documentation, slower increase in physician coverage based on improved productivity, and better physician retention/group stability.

Contributor Disclosures

Contributors

Dr. Patel is Associate Medical Director, Department of Emergency Medicine, Community Hospital, Munster, Ind., and Medical Director, Community Hospital Immediate Care Center, St. John, Ind. Ms. Rais is a medical student at Saint James School of Medicine, Netherlands Antilles. Dr. Kumar is Chairman and Medical Director, Department of Emergency Medicine, Community Hospital, Munster, and a Clinical Instructor at the University of Chicago Medical School. Dr. Robert Solomon is Medical Editor of ACEP News and editor of the Focus On series, core faculty in the emergency medicine residency at Allegheny General Hospital, Pittsburgh, and Assistant Professor in the Department of Emergency Medicine at Temple University School of Medicine, Philadelphia.

Disclosures

Dr. Patel, Ms. Rais, Dr. Kumar, and Dr. Solomon have disclosed that they have no significant relationships with or financial interests in any commercial companies that pertain to this article.

Disclaimer

ACEP makes every effort to ensure that contributors to College-sponsored programs are knowledgeable authorities in their fields. Participants are nevertheless advised that the statements and opinions expressed in this article are provided as guidelines and should not be construed as College policy. The material contained herein is not intended to establish policy, procedure, or a standard of care. The views expressed in this article are those of the contributors and not necessarily the opinion or recommendation of ACEP. The College disclaims any liability or responsibility for the consequences of any actions taken in reliance on those statements or opinions.