Decreased reimbursements, burdensome documentation requirements and increased patient demand are driving the need for scribes. Scribes can move throughout a clinic — loading images, retrieving patient data, documenting assessments and care plans, entering new data, coding visits, performing patient education and assisting with procedures. A scribe's purpose is to improve the overall efficiency and quality of patient care.

"Everything the scribe does is intended to increase the quality of the exam while decreasing the amount of physician time required to perform the exam," says Larry Patterson, MD.

Qualities of a Successful Scribe
A scribe must wear many hats in order to excel. Scribes should be multitaskers and quick learners who are also outgoing, flexible and resilient.

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When interviewing potential scribes, Jim Ohlenforst, ophthalmology manager at Charlotte Eye Ear Nose and Throat Associates, says he tries to identify existing staff members who are "detail-oriented, willing to learn and have a very good work ethic. They also have to be assertive enough to keep the physician on task and ask questions when they don't understand something."

Increased Efficiency and Improved Care
So, what roles will this multitasker fill in order to justify the cost of adding a new member to your staff?

"Besides being bright and fast on their feet, scribes need to be compassionate," says Andrew Antoszyk, MD, partner at Vitreoretinal Service for Charlotte Eye Ear Nose and Throat Associates. "A scribe deals with people who have a serious disease, may have to wait a long time for treatment, and may need to be seen on a frequent basis. A good scribe makes a patient feel more like family than just a patient undergoing a procedure."

David M. Brown, a partner at Retina Consultants of Houston, says he only selects educated professionals to assist him during his examinations. He calls his assistants administrative technicians, not scribes. "They're involved in high level communications with the patient, and also planning and documentation," he says. "For example, I may have a patient with a macular hole. I recommend surgery, talk about scheduling surgery and how to arrange positioning with the right posture. I'm talking about post-op pain relief. The administrative technician understands and reinforces what I say and, after surgery, follows up with the patient."

Michael Harris, MD, a partner at Associated Retinal Consultants of Kenilworth, NJ, LLC, remembers feeling skeptical about scribes. He has been using them for 15 years, gradually doubling his average number of visits per hour from four to eight. "We were hesitant at first because we knew a scribe would mean hiring more staff and increasing our overhead," he says. "But a consultant recommended going in this direction after analyzing our practice. What sold us was one comment: 'How would you like to see more patients in less time, and leave more refreshed at the end of the day, feeling better about the care you have provided and making patients feel that they have received better care?' Who wouldn't want that? We bought into the concept, a little bit at a time. We incorporated more and more scribes, and it has been a winning formula for us."

"Scribes are extremely important to maximize a physician's efficiency and help maintain a stable income stream in the ever-changing and regulated healthcare environment," says Dr. Antoszyk. "Gross revenue increases but so do expenses, which means that net revenue is stable to slightly decreased. The other caveat is that we're working a lot harder. Reimbursements are decreasing. Patients, justifiably, want to get through your office in a timely fashion. You're going to need to work with increased efficiency, and using scribes is one way to achieve this objective."

If you're looking to increase your overall quality of care, consider adding a scribe to your staff.