#001: How to get started using a scribe in your practice

Read Time: 4 minutes

Many doctors get burnt out with medical documentation.

I was getting that way as well until I started using a scribe in my practice. 

I'm going to teach today the steps to find and train a medical scribe for the first 30 days.

It is important to learn what to expect when trying to find a scribe and specifically how much time you will have to allocate in training. 

I felt a little like giving up for the first 30 days and I'll tell you why.

After I was in 1 month then I never want to stop.

Scribes make your practice better here's what to expect in the first 30 days. 

Here is what I will cover:

1. How to find a scribe?

2. How to prepare for using a scribe?

3. Scribe training schedule

4. Scribe frustrations

How to find a scribe

In our practice we looked at different scribing services.

There were options of a dedicated scribe service or just a virtual assistant that did scribing and other tasks as well. We opted for a stand alone scribe service.

We also considered having a staff scribe in the office or using a virtual scribe.

Our treatment rooms were small and we were having difficulty finding staff in general to work in our office and therefore we chose to use a virtual scribe.

Finally, there are options for US or foreign scribes.

Since we were starting out we decided on the foreign scribe to save some money but if I could do it again a US based scribe even though it is slightly more expensive may have been the way to go since I still have a difficulty understanding the accent of my scribe when talking to him. 

How to prepare for using a scribe?

In order to prepare for using a scribe our office was asked a number of questions and the company wanted to know our workflow, prescriptions we typically used and our common shortcuts.

Since we had been using our Athena EMR for a number of years this was all set up.

I was able to put together a number of templates, files, macros and items requested. This I was able to put together in a few hours for the company. 

Scribe training schedule

Once they had all the information I was under the expectation that my scribe would be up and running in 2 weeks.

They would watch me for a week and then start doing notes.

This is where I was a little off.

Even though my scribe is a pharmacist by profession from India he didn’t know podiatry.

I had to teach him what I was treating and how I did my notes and use my shortcuts. This was through showing my screen as I was doing my notes for about the first month. 

This is the most tedious process to show your screen daily and have the other person learn how to do notes.

In each encounter I had my device that allowed my scribe to hear me talking and I had to connect my screen to Microsoft Teams and share my screen so he could see what I was doing.

This slowed me down in the treatment room for the first 30 days.

After he started to see the repetition my scribe started to do more of the notes. 

He first started with the assessment and plan and then as he was more able he started to work on the physical exam findings.

I developed a way of explaining what the patient had with more detail so my scribe could understand.

At this time I have had my scribe for about 2 months and he can do most of the physical exam findings, letters to PCP, and plans for my patients. 

My current work flow is seeing patients and then every 4-5 patients I go back to my office and show my screen and make corrections on the notes that he has done.

My busy days have become easier for me and most importantly I can focus on treating the patient. 

Scribe frustrations

I don’t want you to think it is all roses with a scribe.

As I mentioned in the beginning I wanted to give up the first month but then things got easier.

You have to be patient with your scribe.

Here are a few of my frustrations with the process. 

• Process was slower than expected for training
• They didn’t use my preparation work and templates
• When scribe sick the replacement offers minimal help 
• Some add ons for EMR my scribe can not use
• Setting up EMR access was challenging to give access
• Technology was confusing in the beginning with Microsoft Teams and device I was using
• On slow days not sure if worth the money
• I was hoping for better notes 

Would I do it again, yes!

Am I afraid if my scribe leaves, yes!

My company assures me they have a training system for backup and substitute scribes but there is always that concern in the back of my head. 

Have a great week.