October 04, 2017
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Scribes significantly improve physician satisfaction

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Steven Lin
Steven Lin

Scribes were associated with significant increases in all aspects of physician satisfaction evaluated in a recent study published in Annals of Family Medicine.

According to study background, there will be one scribe for every nine physicians by 2020.

“Despite the recent exponential growth of the scribe industry, there has never been a randomized controlled trial done on scribes and their effects on physicians and patients,” Steven Lin, MD, of the division of primary care and population health, department of medicine at the Stanford University School of Medicine, told Healio Family Medicine. “Our [study] is the first ... to explore this in a scientifically rigorous way.”

For the study, Lin and colleagues randomly assigned physicians in an academic family medicine clinic to 1 week with a scribe, followed by 1 week without a scribe, for a 1-year period. Scribes prepared all applicable documentation, which the physician checked before signing and attestation. During encounters without a scribe, the physician did all charting duties.

Outcomes included physician satisfaction based on a five-item questionnaire that gauged physicians’ perceptions of chart quality and accuracy; charting efficiency as determined by time to chart close; and patient satisfaction based on a six-item questionnaire that gauged items such as physician explanations, listening skills, sense of caring and amount of time spent with patient.

Overall, 1,475 patient satisfaction questionnaires and 361 physician satisfaction questionnaires were completed.

According to results, scribes benefited all aspects of physician satisfaction. Specifically, scribes improved the proportion of charts that were closed within 2 days (OR = 1.18; 95% CI, 1.02-1.36); time spent charting (OR = 86.09; 95% CI, 19.58-378.41); overall satisfaction with the clinic (OR = 10.75; 95% CI, 5.36-21.58); chart quality (OR = 7.25, 95% CI, 3.42-15.39); chart accuracy (OR = 4.61; 95% CI, 2.11-10.06); and face time with patients (OR = 3.71; 95% CI, 1.91-7.21).

“We were somewhat surprised to find that patient satisfaction did not improve with scribes,” Lin said. “However, our ability to detect a difference in patient satisfaction was limited due to a ‘ceiling effect,’ meaning that patients were highly satisfied with or without scribes.” – by Janel Miller

Disclosures: The authors report no relevant financial disclosures.