Remember the Latin phrase “Primum non nocere”? It means “First, do no harm.” Most of us physicians committed to it when reciting the Hippocratic Oath, back when we were first embarking on our careers in medicine.
Sadly, today’s technology threatens this sacred physician-patient relationship. Electronic health records (EHRs), although much-needed, have created perverse, unintended consequences for the patient experience.
To be clear, EHRs are inherently good. They’re the backbone of better-coordinated care, more structured health data, and improved health outcomes. But it’s now a well-documented fact that physicians are burdened by the cumbersome clerical work that’s often brought about by implementing and using EHRs.
And the real victim of these unintended consequences is the patient.
The hallmark of a positive patient-physician relationship is a narrative — one that’s told by the patient and heard by the physician. EHRs have interrupted these two-way conversations.
Now, many patients speak to physicians’ backs as they type furiously to capture data into EHR systems. Physicians are no longer active participants in patient narratives, but rather data capturers who are more concerned with clicking boxes than actively listening and processing. Patients are frustrated. Physicians are exhausted. Satisfaction scores are gloomy.
But there is a way around these problems.
Medical scribes are a fast-growing solution for removing technology from the patient-physician relationship. Why should highly-trained physicians devote 44 percent of each clinical day to data entry and clerical tasks? With an estimated 20,000 scribes currently working across the U.S., physicians are discovering documentation assistants as a way to preserve the sanctity of the patient-physician relationship while reaping the many benefits of EHRs.
Recently, our scribe staffing team received a call from a private practice in North Carolina. The physicians wanted to know how soon they could bring on medical scribes. Why? Because their patients told them to. They’d experienced the benefits of scribes at another specialty group in the area and were now demanding the same positive, face-to-face interactions with their doctors elsewhere.
Granted, some oppose scribes as a solution. Challengers describe hiring scribes as Band-Aids and encourage physicians to instead advocate for product improvements and advancements.
Yes, EHRs do need to better suit physician users’ needs. But we can’t wait for vendors to improve their products. Physicians and patients need help now, if for no other reason than to preserve those all-important patient-physician interactions. And there’s no guarantee future EHR improvements will significantly decrease the amount of time spent documenting patient data. Scribes are a proven, viable, long-term solution.
In fact, many physicians (including myself) used medical scribes long before EHRs were widely embraced. And you can bet those early adopters will continue to employ scribes even after EHR systems are fully optimized. Direct, engaged interaction with patients is simply too great a sacrifice to make without their assistance.
Brian Clare is an emergency physician and founder and CEO, eScribe Management Services.
