My journey using a medical scribe in the ER

I own an exquisite Mont Blanc Meisterstück fountain pen, gifted by my team on my tenth anniversary in our emergency medicine team.

Though I've always been fond of fountain pens since my university days, this luxurious pen, which I'd probably never buy myself, arrived just as we transitioned from a mix of paper and dictation records to the Electronic Medical Record (EMR) system. This transition meant that I rarely used the pen, except for the occasional prescription signing.

I've always been technologically inclined. The shift to EMR was something I welcomed, as it significantly improved my documentation. With my fast typing skills, the shift to full doctor documentation on EMR slightly increased my work. My colleagues had varied responses – some embraced it, others were reluctant, and a few simply refused to adapt.

But, changes kept coming. We began testing the waters with medical scribes.

I had been neutral about introducing scribes, given my busy schedule and other priorities. However, an ambitious young doctor from our team took the lead, impressively setting up the scribe program. After observing for some time, I decided to try it out.

Here are my insights after roughly twelve shifts with my dedicated scribe:

Our arrangement involves paying a fixed rate to a scribe provider, who recruits mostly pre-med students from a nearby university. Doctors interested in scribes register and choose their desired shifts. The scribe fee is deducted from our pre-tax earnings. About one-third of our doctors have opted in, especially for the peak shifts.

Having a scribe initially felt strange, but the feeling quickly subsided. I introduced myself, along with my scribe: “I’m Dr. Shadowfax, and this is Jenny, assisting me today.” Patients seldom commented on the scribe’s presence. The scribe would step out during certain sensitive procedures and was mostly unobtrusive during the patient history-taking, jotting down details while I verbally examined patients, making the experience engaging for them.

Having someone do administrative tasks like organizing charts or collecting reports was new to me. I've always been self-reliant. Letting someone handle these duties initially felt like a loss of control, but it's the primary reason for having a scribe.

The dynamics of my work changed. It was refreshing to focus solely on patient interaction without distractions. The scribe’s notes ensured I didn't miss essential details. The quality of their notes varied, but with guidance, they adapted and became more attuned to relevant information.

The pace of my work also improved. Relying on the scribe for documentation meant I could see patients more swiftly. Despite increased productivity, it's debatable whether the cost of the scribe is offsetting the benefits, especially during slower shifts. Yet, I hope that as more colleagues join the program, we all stand to gain.

Above all, using a scribe has enhanced my work-life quality. The mental fatigue of constant documentation is gone. The time saved allows for breaks, personal tasks, and an on-time departure at shift's end. For those teetering on the brink of burnout in emergency medicine, a scribe might be a game-changer.

While it's early days, my experience with the scribe program has been largely positive. Now, if only I could get them to blog for me.