Public Health Study Finds Medical Scribes Help Physicians See More Patients and Reduce Screen Time

Ever wonder why the soundtrack to a doctor’s exam is as much computer keys clacking as requests to “say ahh” or health advice? Physicians are asking the same thing.

They’ve always written clinical notes, but the increasing amount of time spent documenting billing details for insurance companies has become a major source of job dissatisfaction and burnout. A new study led by a University of Maryland School of Public Health researcher published Monday in JAMA Internal Medicine shows that collaborating on clinical documentation with other team members can help give doctors and other providers more time to spend on patient care all without losing vital information.

“Providers are already stretched thin and under intense pressure to see more patients all while documenting large amounts of information,” said Nate Apathy, assistant professor in the Department of Health Policy and Management. “So we looked at how using medical scribes and other forms of teamwork for documentation can reduce that burden.”

Apathy conducted the study with collaborators from the University of California, San Francisco and the University of Minnesota. Their longitudinal study considered documentation practices and weekly visit volume of more than 18,000 outpatient doctors—mostly primary care physicians and some medical and surgical specialists—across more than 300 U.S. health care organizations over a nine-month period. Of this total, 1,024 doctors adopted some kind of teamwork for clinical note-writing.

“We found the vital thing is not just having teamwork for documentation, it is how much the non-physician collaborators are doing,” Apathy said.

Of those providers using scribes and other forms of documentation collaboration, all were able to increase their volume of weekly patient visits. But only those whose teams wrote at least 40% of their note content actually reduced the doctor’s time spent writing notes.

On average, visit volume increased by 6% and documentation time decreased by 9.1%. After a 20-week learning period, visit volume rose 10.8% and documentation time fell 16.2%. For high-intensity adopters (those who had others write more than 40% of their notes), weekly documentation time went down by more than an hour (a 28.1% decrease), a relatively large time savings.

“Our research shows that when doctors use teamwork to complete their notes, whether that’s with a medical scribe in the room, a virtual note-taking service or just shared note-writing with other clinical team members in their offices, they can see more patients and, crucially, spend significantly less time with their nose in a computer,” said Apathy.