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Medical scribe responsibilities - Job description
Posted: Mar 15, 2015
Just saw an ad in my rural area for a scribe, M-F, 7-5. Isn't that 50 hours a week? I've been wondering what the responsibilities of a scribe would be, though this could certainly vary depending on the practice and its location. This practice is paying $8/hour. How on earth would a scribe write/type fast enough to keep up with real-time conversations between doc and patient, and get everything in the record before being rushed into the next patient visit? At least MTs have a foot pedal and can back up or pause! This is a lot of responsibility for a low-wage position. Like many of you, if a clerical person entered the exam room with my PCP, I would politely ask her/him to leave. I can't imagine a nonprofessional taking notes during a doctor's visit like a court reporter. "This position is designed to facilitate patient flow through XXX practice and ensure an accurate and complete medical record for each patient. The Medical Scribe assists the medical provider by accompanying them during the medical history-taking and exam, recording details of both into the medical record, and coordinating departmental resources regarding tests, orders, radiology, and results. Performs clerical and information technology functions for providers in the clinic setting, including primary responsibility for the operation of the electronic health records and electronic dictation systems. The primary goal of this job is the increase the efficiency and productivity of the provider. Must be able to anticipate physician needs to facilitate the flow of the clinic. Must be discreet, tactful, and unobstructive in performance of duties so as not to distract medical staff from patient care. Good judgment, organizational ability, initiative, attention to detail, and the ability to be self-motivated are especially important. Must be adaptable and versatile. Must be detail oriented and have the ability to multi-task. Good attendance is an important element of this job." Current ARRT. Certification in MR preferred. High school diploma or equivalent required. Certification as a Medical Assistant required. Minimum of two years experience in health care preferred.
Scribes do not record everything like a - court reporter
[ In Reply To ..]Find out what the job really is before you disparage it.
I don't think your opinion on scribes being in the room is going to carry a lot of weight with anyone.
This Stuff - see msg
[ In Reply To ..]It's probably not 50 paid hours. They will probably require you take a lunch eachy day of whatever amount of time to total 40 hours; otherwise, they'd be required by law to pay you overtime.
Scribes (as noted above) do not record conversations! They record BP, pulse, etc.
This was not an "opinion" - It was an actual job posting...
[ In Reply To ..]taken from the newspaper. Good grief. Can anybody post here without being attacked? Get a life.
50 hours a week - Long lunch?
[ In Reply To ..]I'm not able to address the rest of the ad, but maybe you get a long lunch or they pay OT, maybe it's a typo. In this type of job, you definitely need to be there until all the patients are seen so if the doctor runs late or is double booked, they will need you. My work day is 9 hours but we don't get paid for our lunch time, I'm guessing it's something like that. Maybe the facility closes from 12:00-2:00 and everyone takes a long lunch, it could be a lot of different things.
There was nothing wrong with the job posting. - sm
[ In Reply To ..]The job posting is the second paragraph. Nothing wrong with it at all.
The problem is with the commentary in the first paragraph, which expresses a misunderstanding of what scribing is.
It is NOT chasing around after a doctor verbatim-parroting what he and the patient say. It is writing a summary, or the appropriate elements, of that into the EHR. That can include checking selections already there. Plus some other duties.
Most of you seem to have tunnel-thinking about this. You do not seem to be able to conceive of anything other than exactly what you do now, only standing up catching diseases in an examining room.
It would help if you all were more open-minded and willing to give this a chance. Hating it on principle only hurts yourself. The jobs that you do not step up to fill will simply be filled by someone else. Yours will go away and at that point no one would hire you as a scribe because you have no experience. Lose, lose.
Nothing wrong with job posting - Hidden agenda
[ In Reply To ..]There is nothing wrong with questioning something before diving in. I personally think they are expecting a lot for $8.00 an hour and it also sounds as if there is not much margin for error, I would certainly hate to be assuming thatI I know what the provider means and/or wants. I'm looking at it from the standpoint of being a patient; I don't want a bunch of extra bodies in the exam room. My doctor mentors medical students and I hated it when they were in the exam room for my visits. Not everyone who does transcription makes crap wages, FYI. I can only speak for myself but I am paid well doing QA on site and personally don't care if the job doesn't last longer than 5 years because I will be at retirement age. Maybe becoming a scribe is not everyone's cup of tea. Just because it is there, everyone does not need to run out and do it. I'm guessing that the majority of people are in the same age group as myself and they don't want to start over. How many places do you think will want to hire scribes that are age 60-plus? This is a job for a younger person, perhaps someone interested in nursing. It seems that you have a hidden agenda, you seem to be pushing this pretty aggressively.
If you do not want to do it - sm
[ In Reply To ..]If you don't want to do it, fine, but don't discourage others by misrepresenting what the job is.
Someone on this board - who also does in-house QA, coincidentally enough - does the same thing about coding. They took a coding course and couldn't get a coding job, so now they hang around the coding board posting discouraging comments about jobs, schools, pay, and everything else. They think coding is too much responsibility, too.
You don't know the pay potential for this job. It might start at 8 and go up. It might have been a misprint. It might be very reasonable for a trainee position, considering that some scribes are making 20 and up.
Job description... - MT
[ In Reply To ..]Scribes work the hours that the physician works. You will be in each exam room with him, from start of the day until whenever he finishes seeing patients. You may come in early to do prep work, which involves looking at the daily schedule, seeing why patients are coming in, and looking at prior notes to better understand a patients history. You will not work as a court reporter, typing every word said. You will work in real time, however, and will need to know what pertinent information needs to be extracted from the physician-patient encounter and entered into the note. Much of this is based on billing. There are key points in each section of the note that must be touched upon in order to bill certain amounts and to get tests like MRIs approved. This is where knowledge and training comes in. If your notes are detailed enough, you have to get additional input from the physician so items aren't being denied. MT basic knowledge is crucial to be an excellent scribe, but further training and skills are needed, because scribes have to make different types of decisions rather than typing exactly what is dictated. As far as entering vital signs, it depends on the practice. Some have scribes doing MA activities and some do not.
Do you really see that lasting? - Good for you
[ In Reply To ..]First of all, now we have 3 people in the exam room; the physician, the MA and the scribe. I'm assuming due to legal issues that the scribe is not permitted to be present for the entire exam; I don't want you there for my pelvic exam, the doctor and the nurse are fine, thank you, and I certainly don't want people coming and going from the exam room all the time. I don't know how others feel, but I don't know if I would be very comfortable sharing with 2 or 3 extra people in the exam room. My facility is into cost effectiveness and saving money. They are not going to hire nurses, MAs and scribes when the doctor and nurse/MA can do the documentation. Scribes will be needed but it is probably not going to be as big as you imply. If it catches on, I see a lot of contract workers so the facilities don't have to pay big wages or benefits. In my area, MAs probably make $14 and hour and do it all including the documentation. I just don't see hiring an MA and then a scribe at $17-20 an hour, it's just not cost effective. Someone has to carry liability insurance, which means that the doctor's malpractice insurance goes up or the facility pays more in premiums. Be careful with what you enter to try and get more money out of the insurance companies, do the words medical fraud mean anything to you?
Reply is a bit strange... - MT
[ In Reply To ..]Your reply is strange. It really does not address anything that I stated, nor was your attitude required.
I'll address your reply as best as possible. The office that I worked in did not have 3 people in the exam room. This is the problem, you do not understand the role of a scribe correctly.
The MA rooms the patients. She goes to the front office, calls them back, takes their weight and vital signs. She then reconciles their medications and enters the history (HPI) into the note.
The doctor and scribe then enter the room. He does a brief review of the HPI. The scribe checks this against what the MA input and makes changes accordingly.
He then goes on to examine the patient. He is supposed to dictate the exam to the scribe as he is performing the exam. Some physicians simply examine the patient and expect the scribe to know range of motions, etc. I worked for orthopedic surgeons, so I watched and recorded range of motions on my own, positive/negative McMurray's and Lachman's, etc. based on the patient's reaction to the exam. It's quite easy to tell if a McMurray's exam is positive or not. At this point, if McMurray's is positive, for example, I know that the patient has a possible meniscal tear.
Then we get to the assessment and plan. I enter possible meniscal tear as the assessment. The plan will be to either order an MRI scan or go straight to arthroscopy, depending on what the patient and doctor decide to do. The scribe enters what they discussed, what options were provided, and what we are proceeding with (MRI).
The scribe also documents x-rays (if performed) and the results of the same, which the physician dictates off ("Your x-rays look okay," meaning x-rays are normal). An example of a normal knee x-ray would be: Three-view right knee x-rays were performed and demonstrate no significant degenerative changes, no evidence of fracture or dislocation.
All documentation must be correct and justify MRI or arthroscopy. This is where knowledge beyond medical transcription is necessary. This is more along the lines of coding.
The doctor and I would see approximately 50 patients per day. After 1 year in that role with that patient load, I had a total of 2 patients that asked that I leave the room. That's it.
With that patient load, an MA and a scribe are both necessary. The MA at our facility scheduled surgery, made phone calls, ordered MRI's, etc. She could not have scribed and done MA duties at the same time. It's physically impossible.
And, yes, the physician can and will pay a scribe great money if the scribe is good. A good scribe can increase the amount of patients that he sees per day by up to approximately 5 more patients daily. That more than pays for the scribe's wages. Plus, if the scribe has a good personality, it makes the physician's day brighter. They have someone to talk to, someone to vent to.
Honestly - Flo
[ In Reply To ..]I'm not comfortable with the idea of scribes. I don't mind a nurse or MA in the room with the doctor, but to have someone there just clacking away on a computer while the doctor is all up in my business is not at all acceptable to me and I will ask that person to leave or find another doctor who does not use a scribe. I've asked students to leave before. It's not for me and I know I'm not the only one who feels that way.
That's your choice... - MT
[ In Reply To ..]As I said, two patients asked if I would step out of the room. Other patients were happy that I was there. They would rather a scribe to the computer work than having the doctor stare at the computer while trying to talk to them, and they even mentioned that to me. Plus, scribes wear scrubs, so they have no idea if you are a scribe, an MA, or a nurse. We all wear the same uniform :)
You are in the minority - sm
[ In Reply To ..]You are in the minority and I think that much of your objection is due to what you "imagine" will happen.
No one stands there "clacking away." That is your imagining of something you have never seen based on outrage that your job is disappearing.
Scribes are partners with the physician and have a valuable role in freeing the physician from having to attend to a computer. Most patients appreciate that.
You know, you all here complain about physicians not paying enough attention to you because of the EHR, and then you complain about the solution. You can't have it both ways.
A lot of older women would never go to the gynecologist because they were sure everyone there was "looking at them." If they did go, they whispered, blushed, and cringed. The truth is that is not what happens. Nobody can see your "business", as you put it, except the doctor. Thinking that everyone can, and that they CARE, is unbelievable self-absorption.
Talk about self absorption - Flo
[ In Reply To ..]I simply stated my preference. You are the one who seems to think they know everything. I have great doctors who do their own documentation and I never feel neglected. It is immaterial to me if a person cares to see my business or know about it. I don't want them there whether they care about it or not. If you want to be a scribe or talk people into being scribes that is your business. I simply don't think it's a going to take off as a viable profession.
You seem to be unbelievably full of your self. You remind me of Informatics.
To reply is a bit strange. Probably more people - would ask scribes to leave
[ In Reply To ..]if they did not mind speaking up and saying just that. Some people when seeing a doctor think of high and mighty and would never impinge on anything that goes on in the office. Others surely know this.
No, probably they would not - sm
[ In Reply To ..]They probably wouldn't think anything of it, because they would see the scribe as another healthcare team member.
You have a vested interest in objecting to scribes, because you think they are taking your job away.
Personally, I would prefer a scribe in the room, where I can hear what is going on and what is being recorded, to my information being sent out to some woman's home, where her relatives, husband, and the plumber can hear all about it. None of my providers send out dictation. They do it themselves, and I think that is great.
MT v. scribes - curious
[ In Reply To ..]Still seems to me like MT would be preferable to this new position of scribe, but if we are going to be replaced, my question to those in the know: Does anyone have an idea how long we have? 2 yrs, 5 yrs, 10 yrs?
Another question: If they figured they would have the technology to replace MTs, why send so much to India for just a short amount of time? Why train all of those inexperienced people for a job that wouldn't last?
Informative videos available - on YouTube. nm
[ In Reply To ..]x
We are not being replaced by scribes - My thoughts
[ In Reply To ..]For many scribe jobs, the MAs or CNAs serve as scribes. I personally do not see this job taking off, facilities are not going to hire one person to take vital signs and another person to document information. I don't think scribes are going to be allowed in the OR. I said it before, my facility uses interns and residents to act as scribes. MT is not being eliminated, it is being offshored, those people will probably have jobs for quite a while and if they don't, well it really doesn't matter. I think there is going to be a need for editors and QA staff for a while in the United States, maybe 5 more years.
You are not being replaced by scribes - sm
[ In Reply To ..]You are being replaced by EHRs with point and click and front-end SR.
Scribes are simply a job field that is opening up to deal with EHRs and the cognitive overload they push onto physicians.
No one EVER said scribes would be in the operating room. Where you got that is a mystery.
I don't know why you keep bringing up interns and residents, either. Documentation is part of their training. They are not describing, even if it appears that way to you.
Phooey, for 8 dollars an hour you are required - to do it all and mind read
[ In Reply To ..]I am amazed you are required to "anticipate" as in know what the doctor wants as in mind reading plus all that other for less than you would make at Wal-Mart. I am just amazed so much asked for so little and a 50 hour week to boot.
Scribe - NoWay
[ In Reply To ..]They advertised here in Illinois; $8.35 an hour - two 50-hour weeks of training at NO PAY. Would have to sign a TWO-YEAR CONTRACT to stay doing it at the hospital and they furnish the uniform (big deal)! At $8.35 an hour, one couldn't afford to BUY their uniforms! Nothing but indentured servitude is what it is!
I asked my own doctor one time what his - scribe was paid and was told
[ In Reply To ..]$8.00 an hour and I live in a town of over several million, not small rural place.
Considering that you may be making less than - minimum wage ...
[ In Reply To ..]...what is the problem? It is more than most of you make now.
It is not what I make or what I have made - Think is disgraceful to even
[ In Reply To ..]require such background education, the responsibilities of all listed, anticipation of what the physician wants (thinks), this is ridiculous. I have not made $8.00 an hour since the early 70s, probably. My VR is excellent and easy to make about $15.00 per hour or more.
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