A community of 30,000 US Transcriptionist serving Medical Transcription Industry

Scribe vs Transcription - LST

Posted: Apr 25, 2013

Does anyone have any information on working as a scribe, directly following the physician and typing in the room with the patient? I was offered a position as a scribe in a local clinic. I have done transcription for many years, but never as a scribe. I'm kind of nervous about not being able to start/stop the dictation, use shortcut keys, etc. I was told with the platform they use, there is no way to make shortcuts. Everything will be straight typing and that I would need to keep up with the doctor as she sees the patients and she sees up to 40 patients a day.

No offense, but thats about the most ridiculous - thing I ever heard of. Why in the

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world doesn't she just go ahead and dictate and hire you to type the gosh dang reports?!?! I mean really, its the same thing. The only difference is you would be doing it live. She still wont have time to access and review the records you type till the end of the day.

I cant seem to wrap my mind around why they would rather you follow the doctor around from patient to patient and type as you go rather than sit and do all the dictations and type at once - Anything to alleviate the transcriptionist I guess.

Sorry, I dont really have an answer to your question. I hope they dont expect a written narrative from you..maybe a summary, but a written narrative per patient would be asking a lot without shortcuts.

I've seen ads asking for scribes - MomOfFive

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My only question is, do the patients really want a stranger in there writing/typing everything down? I'm not sure that I would. It sounds like an interesting position, but I do wonder if the patients will have an issue with it.

They couldn't pay me enough to traipse around after - an MD all day, type standing up, and - (sm)

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to have to come into close contact with probably every disease on the planet.

I've seen few job ads like the one described above. Most seem to want pre-MD students, or PA-C's to simply add data input to their regular medical skills.

As soon as I learned of this "devolved" MT offshoot, it made my flesh crawl. I'd rather be the voice of a gigantic plastic clown-head, asking people if they want fries with that.

-Meerkat

I would do it. - anon

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It's not like typing a regular report. It will be bursts of information. Also if it is M-F 9-5 clinic hours with a good hourly wage, paid holidays and benefits, you would be crazy not to take it.

My recent experience with a doc with a scribe.sm - stressedmt

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I broke my foot last week Thursday and saw an ortho doc on Friday. I also went back to see him yesterday so he could cast me leg. He had a scribe following him the whole time for both visits. Naturally, because I am an MT, I was curious. She came in the room both times before the doc even did and asked me what I was being seen for, how I broke my foot, my pain scale, if I was taking any regular meds and the doses, allergies, where I had x-rays, etc. While I was telling her things, she was creating my medical record for that visit. My record was completely typed up for him when he came in the room and she was there to add the treatment plan when he was talking. By the time I walked out of that office, my records was already created and in place. It was kind of cool but as I was sitting there watching her, I was thinking that it was one more thing that is making medical transcription a dying profession.

Stressedmt - That makes a lot more sense. I was - picturing her following..sm

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the doc around all day from one room to the next typing as fast as she can verbatim what was coming out of the doctors mouth and subconciously having to decipher what and what not to type into the record.

The way you explained it makes perfect sense. That sounds logical and well-organized. Like the above person said, Mon-Fri, clinic job, benefits, and a decent hourly wage...then it would not be a bad job. I guess I had the wrong idea about scribes. Apologies to OP.

Did you have private time - with the doc??

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xxx

Private time? Why would she need private time. - Im sure you can always ask scribe to step out if n

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In general... - not for the cast thing

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I don't want someone else standing there other than an R.N. or a doc. Maybe the ortho thing is okay, but I do not want a non-medical person hanging out in the doc's office with me. It would be extremely awkward to just ask the person to leave if something was coming up I wanted to discuss privately.

Private time - MT

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You want them to step out to discuss something private, even though the scribe or MT would type what you discussed at your appt anyway? What difference would it make if they were in the room or listening with headphones?

Nonmedical person??? - Wondering

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You are ok with an RN being there, but everyone else is now "nonmedical"? Where is that coming from?

What about LPNs, medical assistants, physician assistants, and . . . yes . . . MTs?

Few RNs work in doctors's offices anymore.

The person you figured was a nonmedical scribe was not some clerk, but more likely an MA, PA, LPN, or another medical professional qualified to ask those questions and elicit complete information.

Maybe even a medical professional called a scribe.

She wasn't just typing. Her job goes as far as collecting the information first-hand and assisting the physician in retrieving lab, x-ray, and other data and summarizing it.

If you want that job, find out where she got training and get it yourself. If you don't want it, don't insult the qualifications of the person doing it by calling them "nonmedical."

No private time with doc.nm - stressedmt

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x

Ask scribe to step out briefly if you need private time. - Sure they can respect that.

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"My recent experience..." - cr

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That's better than having the doctor sit facing the computer and typing the whole time rather than listening to the patient, which has been my recent experience as a patient with doctors.

People feel as you do - see message

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I think it would just be creepy having someone not part of the exam in the room. Not to mention, your privacy. Chances are, the person scribing and the patient live in fairly close proximity to the clinic. I'm sure they sign HIPAA agreements, but can you really trust that person not to tell someone you know that they saw you there?

It is NOT the same as MTSO where we type reports, even though we have a patient name. On the off-chance we even recognized the patient name and that the account was in our own town, we still don't really know, because we don't have a face to put to the name.

RE: to people feel the same as you - sm

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your scenario is no different than working for your local hospital doing transcription and coming across reports of people you know.

I once typed a report on my next door neighbor, but because of HIPPA of course I could not knock on her door and ask her how she was doing or come home and tell my husband "Hey guess what?" I typed on the neighbor today and you would never believe whats wrong with her.

I have typed several reports on people that I know personally when I worked for the hospital where I live, but never ever did I jeopardize my job by talking about it to anyone. Same thing with a Scribe, they are held to the same confidentiality standards and HIPPA laws we are.

And by the way, THEY ARE MEDICAL STAFF. Ancillary medical staff, but still medical staff. They just dont have the degrees and education that doctors and nurses do, but they are still considered medical staff, as they are dealing in direct contact with the patient. I dont see the difference in having a scribe in the room versus having a nurse or tech in the room..same thing as far as Im concerned, just without the credenials.

Sorry, but... - see msg

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I still say it's not the same. An MT is behind the scenes, not sitting in the same room as the patient. I think the patient would feel extremely uncomfortable having someone they know right there, upfront---I guess depending on what the problem is. If my big toe hurt, I wouldn't mind. But if it was something very personal, I most certainly would mind an acquaintance sitting there with me--especially if the acquaintance is known to have a big mouth or something.

I do realize there's no guarantee a nurse or doctor doesn't have a big mouth, but the more people you bring into the equation, the more likely your personal medical info can get out.

In a case like that where you know them personally - I think they would pull...

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someone else in instead of using that person in order to respect your right to privacy and be in compliance with HIPPA. Im sure there would be a nurse or some other tech or scribe present for situations like that.

My feeling is that having a scribe in the room is no different than having the secretary sm - not for me

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or even the doctor's transcriptionist in the room at the same time. I realize they are going to get all the information about my visit anyway through the doctor if he were to dictate the report after seeing me. But as far as I'm concerned, whether I'm there for a simple ingrown toenail or something waaaaay more personal, that is between me and the doctor and the nurse and those are the only ones I want in the room during my visit.

Scribes - 2bz2sleep

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One of my clients at a surgery center has a scribe handle his office dictation. She follows him around with a tablet and just taps on the screen. I was so amazed. Tap tap tap, done. I was not to amazed or thrilled when I saw the actual report though.... She had virtually no medic al experience per se, as I had to spell out everything for her.

My experience was a nightmare. - sm

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I am always so glad I know a little bit about medical stuff when I go see doctors.

I was going to have surgery recently. It was an incisional surgery.

The doctor told me at my initial eval.

Well the scribe put it down as laparascopic.

Got to the facility and the nurse doing my intact said oh were during a laparascopic surgery with mesh.

I said no doctor clearly said in office incisional and no mesh unless needed.

Well that put the place in a tail spin and they had to correct everything.

They also had my allergies wrong.

That all had to be corrected and then I had to do a skin test on op of it as they did not want to give me the wrong antibiotic, which I had clearly said I was not allergic to.

Just make sure you know everything that is going on this day and age in the medical world. Just saying.

A scribe put down I was allergic to a leg brace - Precious

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Leg brace, what leg brace?? Another report had me listed with HIV. That I returned to the scene of the crime to set that straight and talked with the manager there. Unbelievable errors being made.

That's like my report had my PMH wrong, - Backwards Typist

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my allergies wrong, and had me on 3 pain meds: Percocet, Aleve, and Oxycodone....I wasn't on ANY.

Everything was corrected except part of my PMH and the meds so far. This, after a year of trying.

That sounds like a nightmare... - sm

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I took my son to the ER with strep, and the ER doc was using a scribe. I was just looking at this woman banging away on her laptop while he dictated *as he was examining my son*, which I thought was the craziest thing I had ever seen. I'm told that scribes are where our profession is headed, at least in my town it's gaining popularity.

What's so crazy, really? It's just a different way, with its - own set of pluses and minuses. Note

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that those errors witnessed by others are the same-old that slobby, negligent docs and transcribers have always inserted into reports. Good docs working with good assistants produce good records, and don't we all see plenty of both all day long?

It's just weird... - sm

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Obviously if it was an exam of a very personal nature, she would have had to leave the room, but it was still odd having her there. My son was sitting on the gurney being examined, while she was standing right next to him, laptop on the gurney, typing away. I guess I'm just one of those private people who prefers to have nothing but a doctor and/or a nurse in the room.

Sorry, I sort of missed that it was the privacy - issue for you. Now, my first real

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experience with medicine was when I had my first baby at 18 in a teaching hospital. Over the next couple days after the delivery what seemed like an unending stream of young men in white coats would come in, pull up the sheet and give me an earnest inspection, being SO careful to be conspicuously clinical. One might have been in twice, but if so I didn't catch it. I think it was the whole rotation.

Then there was the fact that I was in a 6-bed room. Fun, truly, I really enjoyed it, with various nurses and aides showing me how to nurse, etc., etc., but by the second day, when a husband quickly averted his gaze and I realized my sheet and gown had slipped off my right chest, I realized I had become totally unembarrassable.

I must admit I really prefer to avoid any unnecessary displays these decades later, though. Clothing is my friend. :)

This board seems regrettably short on personal experience, - but you know you have to do it. :)

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From the descriptions from a patient point of view, it looks like the docs are making their transcribers' time more well used by expanding their duties to handle some of the simpler physician-patient interactions. In other words an expansion of skills, but solidly based on those you already have.

Regarding 40 patients a day, in a clinic wouldn't you think a fair number of them would have existing records you'd be making quick adjustments to?

If you do take the job, would you please come back and help fill in the giant knowledge gap?

Just took a scribe job - NewScribe

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I just took a scribe job with an oncologist. My doctor also sees 40+ patients a day. Basically you bring up there old chart and just click boxes to update then do a summary of the visit at the end. They do not want word for word. The vacation, days of with pay, holidays and benefits are top of the line. Also the salary is unbelievable. I will be working 4 9 hour days and 1 4 hour day, weekends off. Just waiting on my background check to come back.

My Scribe Experience hehe - MTSearching

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I was in the ER not long ago as I was having chest pains due to all the stress lately (they admitted me), and the ER's cardiologist had a scribe with him. He was a petite guy and looked to be maybe 20 years of age, which was a bit weird for me as I was lying on the gurney in my skimpy gown and already feeling weird and rather vulnerable. The doctor stood next to me and then the scribe stood next to him, and he somehow balanced his laptop on a bent, raised knee and typed away. That took some skill!

At first, I noticed he was giving me covert glances, so I really felt a bit uncomfortable, but then I got involved in answering the doctor's questions and fully forgot about the scribe. Then, at one point, and I can't remember what I said, but I nervously cracked a joke after the doctor said something, and the scribe laughed, too, reminding me that he was actually present. Ewwww....

Then the doctor asked me what I weighed, but there's no way I was going to say in front of the scrawny scribe, so I said that I can't remember. lol

When the doctor examined me, including pressing about on my abdomen, with the scribe standing there, I wanted to crawl under the gurney! I was trying to calm myself down, thinking that the scribe is part of the medical team, but I know he's sort of not--more like clerical staff!

Kept wanting to ask him how he became a scribe, but I couldn't find a good moment, and I actually just wanted him to go away.

I did see the doctor and his scribe a couple other times passing by, and I almost laughed again. The scribe was following him like a puppy dog! I was lying there thinking that this is the state of my career, that it's gone to the dogs, so to speak!

I just wonder why some hospitals are going to scribes? - FBL

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Is it cheaper than an MTSO's rates, or just more accurate than VR? Faster turnaround? Very curious as to reasons and what MTSO's will do in response to the trend. Surely they won't take it lying down.

I was an ophthalmic scribe - Mrs. K

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I scribed for a two doctor team during clinic for over 6 years and absolutely loved doing it. It's the reason that I trained to do transcription so I could still work and be home with my three young children. The job is entertaining, rewarding, and mostly fun. I fully intend to return when my kids are in school unless I find an ophthalmic transcription job.
You'll develop a close relationship with your doctor and find that you can anticipate her next move. Sometimes it's monotonous but you will have days where you will see some awesome things :)
I was also an assistant to the doctors so I was able to be involved with procedures and testing.
If you decide to take the position, I hope you enjoy it like I did.

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