![]() ![]() Studies have demonstrated the strong negative influence of EMRs on physician–patient communication and rapport. Verghese 16 describes the concept of the ‘iPatient’, where the growing demands of charting and interpreting massive amounts of electronic data are fundamentally eroding the physician–patient relationship. In the EMR era, physicians are spending more and more time in front of computers rather than face-to-face with patients and their families. The potential benefits of scribe programmes to physicians and patients are substantial. This article explores potential benefits and challenges of establishing scribe programmes at academic medical centres from the perspectives of the major stakeholders. We propose that the integration and expansion of medical scribe programmes into academic medical centres offers an attractive solution to address current challenges in healthcare delivery while simultaneously bridging the gap between premedical and medical education. In a time when marked changes are happening in both healthcare delivery reform and medical education redesign, academic medical centres should be at the cutting edge, not playing catch up. Today, only a handful of academic medical centres have established medical scribe programmes, some using commercial scribe vendors and others creating their own homegrown programmes ( table 1). Scribe programmes also provide attractive opportunities for pipeline development by giving premedical students the opportunity to engage in authentic workplace learning experiences that add tremendous value to patient care. 15 In comparison, academic medical centres have been slow to adopt the use of medical scribes, even though they potentially stand to gain the most from new models of care that directly address issues of physician productivity, patient satisfaction, quality of care and faculty burnout. ![]() These hospitals hire scribes trained and managed by for-profit companies like ScribeAmerica, PhysAssist Scribes, Elite Medical Scribes and at least 19 other companies. The vast majority of US hospitals that are using scribes are non-academic institutions. ![]() While there is a growing body of literature demonstrating the benefits of medical scribe programmes for all stakeholders-patients, physicians, healthcare systems and students in training-they have been mostly limited to the private sector. 7–10 Scribes have been hailed as ‘the next big thing’ in modern medicine, 11 and credited for increasing physician efficiency and productivity, 12 improving both physician and patient satisfaction, 13 increasing revenue and creating returns on investment, 14 and providing scribes-most of whom are students in premedical training-the opportunity to gain real-world experience that is invaluable for their future careers in medicine. 6 These numbers are projected to increase exponentially as the use of scribes expands beyond emergency departments into the outpatient setting of both small and large healthcare delivery systems across the country. 3–5 The American College of Emergency Physicians estimated that in 2011, more than 400 physician groups at over 1000 US hospitals were using scribes. While the use of scribes as a means to improve physician efficiency in emergency departments has been reported as early as the 1970s, 1 2 it is only recently that the popularity of scribes has skyrocketed and captured the attention of the medical community. Medical scribes are trained to record clinical documentation in real time for physicians providing patient care. ![]() The rapid emergence of medical scribes in the electronic medical record (EMR) era is changing the practice of medicine. ![]()
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