Impact of Medical Scribes on Physician and Patient Satisfaction in Primary Care

• Published in: Journal of general internal medicine : JGIM 2018-07, Vol.33 (7), p.1109-1115
• Main Authors: Pozdnyakova, Anastasia, Laiteerapong, Neda, Volerman, Anna, Feld, Lauren D., Wan, Wen, Burnet, Deborah L., Lee, Wei Wei
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Allied Health Personnel - psychology; Allied Health Personnel - standards; Attitude of Health Personnel; Burnout; Documentation; Electronic health records; Electronic Health Records - standards; Electronic medical records; Emergency medical services; Female; Health care; Humans; Internal Medicine; Job Satisfaction; Male; Medical personnel; Medicine; Medicine & Public Health; Middle Aged; Occupational health; Original Research; Patient Satisfaction; Patients; Physicians; Physicians - psychology; Physicians - standards; Pilot Projects; Primary care; Primary Health Care - methods; Primary Health Care - standards; Prospective Studies; Workflow; Young Adult
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-018-4434-6

Background Use of electronic health records (EHRs) is associated with physician stress and burnout. While emergency departments and subspecialists have used scribes to address this issue, little is known about the impact of scribes in academic primary care. Objective Assess the impact of a scribe on physician and patient satisfaction at an academic general internal medicine (GIM) clinic. Design Prospective, pre-post-pilot study. During the 3-month pilot, physicians had clinic sessions with and without a scribe. We assessed changes in (1) physician workplace satisfaction and burnout, (2) time spent on EHR documentation, and (3) patient satisfaction. Participants Six GIM faculty and a convenience sample of their patients ( N  = 325) at an academic GIM clinic. Main Measures A 21-item pre- and 44-item post-pilot survey assessed physician workplace satisfaction and burnout. Physicians used logs to record time spent on EHR documentation outside of clinic hours. A 27-item post-visit survey assessed patient satisfaction during visits with and without the scribe. Key Results Of six physicians, 100% were satisfied with clinic workflow post-pilot (vs. 33% pre-pilot), and 83% were satisfied with EHR use post-pilot (vs. 17% pre-pilot). Physician burnout was low at baseline and did not change post-pilot. Mean time spent on post-clinic EHR documentation decreased from 1.65 to 0.76 h per clinic session ( p  = 0.02). Patient satisfaction was not different between patients who had clinic visits with vs. without scribe overall or by age, gender, and race. Compared to patients 65 years or older, younger patients were more likely to report that the physician was more attentive and provided more education during visits with the scribe present ( p  = 0.03 and 0.02, respectively). Male patients were more likely to report that they disliked having a scribe ( p  = 0.03). Conclusion In an academic GIM setting, employment of a scribe was associated with improved physician satisfaction without compromising patient satisfaction.