Who is behind the scenes of Scribes4hire?
This course was created for scribes, by scribes, under the guidance of a board certificated emergency medicine physician. Most of the scribes that were involved with the creative process have spent 1-2 years improving the course before gaining acceptance to medical/professional school. Each year, a new group of the highest achieving scribes become involved and improve the course. This course will continue to evolve over the years as new, exciting ideas are introduced for better ways to teach, learn, and master the material that will produce the next generation of scribes.
Learn more about Scribes4Hire.
“What is an Electronic Medical Record (EMR)?”
An electronic medical record is a digital version of a paper chart that contains all of a patient’s medical history from one practice. As a part of the American Recovery and Reinvestment Act, all public and private healthcare providers and other eligible professionals (EP) were required to adopt and demonstrate “meaningful use” of electronic medical records (EMR) by January 1, 2014, in order to maintain their existing Medicaid and Medicare reimbursement levels. Starting in 2015, if you were an eligible provider and have not attested to meaningful use of your EMR, a monetary penalty was applied to your Medicare reimbursement. The penalties continued to increase yearly as more providers eventually became compliant and changed their paper charts to digital versions.
How is a medical scribe different from a transcriptionist?
People often assume that a medical scribe does the same job as a transcriptionist. However, these positions are two completely different ways to get the same product of a completed patient’s note. A transcriptionist takes a dictation, or recording, that the physician creates and types the recording word-for-word into the patient medical chart. This is done over the phone and many transcriptionists are at home or in another building typing the medical note without having any contact with the provider.
A scribe, in contrast, accompanies the provider in the room or listens to the patient encounter, gathers the patient’s history and story, and creates the chart using his or her own words. The physician will tell the scribe physical exam findings, and the scribe is responsible for accurately documenting those findings into the chart. The physician does not have to even think about the chart or documentation. The provider will read over the chart once and correct anything that he or she would like to change and then sign the note. The longer the scribe and the physician work together, the better the scribe knows exactly the provider’s writing style and what he or she would like in the note.
What is a medical scribe?
A medical scribe specialist is an individual highly trained in medical documentation, who assists healthcare providers throughout a patient encounter. Medical providers have traditionally submitted written documentation or verbally dictated a patient’s chart. However, with the advent of the Electronic Health Record (EHR), providers were required to perform the clerical aspect of patient charts, leaving a limited amount of time for a physician-patient interaction.
A medical scribe specialist acts as a personal assistant to the provider for recording medical records. This is done by supporting the documentation and clerical needs of the physician. A medical scribe’s main responsibility is to document findings in a patient’s chart, which is found directly in an Electronic Health Record (EHR), by observing the patient encounter. Because of the EHR, there is an overwhelming amount of data that a physician is required to record. The burden of the clerical responsibilities has made patient and physician satisfaction low.
A scribe service provides a physician with increased time with their patients, decreases charting burdens, and improves physician’s efficiency, which subsequently expedites the patient’s care and increases the satisfaction of both the physician and the patient. In an effort to increase physician productivity and efficiency while enhancing the quality of patient care, the medical industry is shifting to the use of medical scribes.
How much should I pay my scribe?
Medical scribes are paid an hourly wage. The rate of the hourly wage is dependent on the cost of living at the location of the medical scribe’s clinic or hospital, the minimum hourly wage in the state of employment, and the number of years of medical scribing experience. A fair starting wage for a scribe is around $8-$16 per hour. If a scribe has previous medical scribing experience, then $1-2 more an hour would be appropriate. At this time, most scribes are found through medical scribe companies. The companies typically charge the physician >$24 per hour and then pay the scribe $8 to $18 per hour after they train them depending on the state.
What kind of background check should the scribe undergo?
The scribe should have the same background checks that are done for every employee that works at the clinic/hospital.
Does the scribe have to submit to a drug screen or be tested for TB?
This should follow your clinic/hospital policy that is consistent for all employees that work in the healthcare field. Most hospitals and clinics have all employees tested for TB and will have the scribe perform a drug screen before they start employment. The standard 10-panel drug screen is performed most commonly. A drug screen is often repeated if the medical scribe changes departments and/or starts working for a new physician in a different satellite clinic.
Where do you find scribes?
Clinics and providers usually post positions on job boards to find a scribe. The disadvantage of finding a scribe on job boards is that they are not trained. It takes a lot of time and energy to train a scribe. Scribes4hire job board only allows scribes to post for a scribe position after they have completed an intensive scribe training course. A scribe that does not have any training is not very useful to a provider in completing notes. Some providers have a medical assistant that they already know and will have them do their charting. The medical assistant will also need to take a course in medical scribing, which is offered on Scribes4hire, to give the physician a quality note that encompasses enough detailed information to communicate with other providers, protect the physician from potential legal liability, and encompass all the elements for billing that ensures third party payment.
How long can I expect my scribe to work for me?
Traditionally, medical scribes were college graduates that were taking off one “gap” year before starting medical school. They used medical scribing as an opportunity to learn and start medical school with a huge advantage over their peers.
Because of the implementation of the electronic medical records, scribes have become a commodity that most physicians have started using to decrease burnout from their career. The use of medical scribes has also decreased physicians from charting fatigue. Physicians with scribes no longer have hours of medical charts to finish after a long day of seeing clinic patients or performing procedures. The physicians have also been able to get back to patient care instead of staring at a computer screen typing in data, while their patient is talking. They don’t have to rush out of the room after talking to a patient to write down the important elements before they are forgotten during the next patient interview. Medical scribes are allowing physicians to get their lives back and have more free time for their families and hobbies.
There is not enough gap year professional students to cover all the physicians that would like to employ a scribe. The medical scribe profession is now starting to become populated with people that are choosing medical scribing as a career or with people with a medical background that are looking for a new way to use their medical training. With some medical jobs, such as transcribing, decreasing in the medical field because of physician self entry, scribing is becoming increasingly more popular and people are choosing this as a long term career. With the increasing demand for accurate, complete charting in medicine, medical scribing is quickly starting to become one of fastest-growing careers in the medical field.
“If I see 30-40 patients in a shift, can a scribe keep up with my charting?
Medical scribes can type 50+ WPM and they can quickly analyze the information that patients are providing. The scribe starts writing medical notes as soon as the patient starts to provide his or her history. Many of the notes are completed before the physician finishes the exam. The scribes also can use templates, dot phrases, and smart phrases to speed up completion of their medical charts, resulting in them being very efficient.
How does a scribe get credentialed at the clinic or hospital?
Medical scribes are credentialed and provided EMR access from the clinic’s human resource department.
Does the scribe get a background check?
Yes, all people that have the potential to be around patients should have background checks and healthcare giver checks routinely, as would any other healthcare professional.
How is the scribe paid?
Since the scribes are employees of the clinic, they are paid on the same payroll and schedule as all other clinic employees. The pay periods for many clinics and hospitals are biweekly; however, this varies by site.
Is there a way to “test out” the personality and potential fit in the clinic with a scribe before starting the entire hiring process?
Yes, when we are interested in a scribe for our scribe company, we offer them a shadow shift. They come to the shift as an observer and shadow the physician for the entire day. This is better than an interview for both the physician and the scribe because the physician can spend a longer time with the scribe. This gives the provider a sense of the scribe’s personality, and it is extremely helpful to the scribe because it gives them an idea of what the job is really like. They usually know immediately if the position is a good fit for them. If the provider or scribe does not feel like the clinic is a good fit, the hiring process does not need to be completed. This saves a lot of paperwork for an employee that will not be with the company for a long period of time. We offer multiple shadow shifts to prospective scribes. Most of the scribes only shadow one shift since they typically know immediately how they feel about the job. When other scribe companies are also offering a position to a scribe, we will sometimes have a scribe return for a second shadow shift when they are deciding which company to join. You will find, just like with physicians choosing a medical specialty, different specialties just “feel right” to scribes even though they are early in their medical journey. Some scribes already know what style of medicine they would choose to spend most of their time observing. Shadow shifts can really help both you and the scribe decide if you are the best fit.
What should a scribe wear?
Scribes should wear scrubs with comfortable shoes. This illustrates that they are part of the healthcare team and takes out all the problems that can come with how a person reflects his or her own identity through clothing choices. Business casual is usually used as appropriate apparel by many professionals, but we have discovered that business casual can cover a wide range of clothing options.
Are medical scribes full or part time?
Medical scribes can be either full or part-time. If a scribe is still in college, they are usually part-time. If you need a scribe to cover a full-time clinic, then you can either use one full-time scribe or two part-time scribes. Both scenarios work well for the team. We would recommend that if you hire a scribe, it is with the understanding that this should be their only job. When a scribe has a second job, it usually causes conflicts with the provider when they have to work late at a clinic, pick up extra calls or extra days for their partners, or work a shift that is set up for walk-in patients.
How should a scribe be scheduled?
If a scribe is scheduled with one provider, the scribe’s schedule should mirror the physician’s schedule. The medical scribe should work the same hours that the doctor works. The scribe should not request vacations when the provider is scheduled to work, and their vacations should be planned for the same weeks that the provider is on vacation.
If there are multiple scribes that cover a clinic, we would recommend an economical electronic scheduling software system. This not only verifies that all the shifts are covered with no confusion, but it also enables scribes to block out times for their classes if they are still in college and makes trading with other scribes much easier and more efficient.
What is an acceptable reason to miss a shift?”
If the scribe misses a shift, they should give prior confirmation with their provider that they will not be at work that day or they should get a medical note from their primary care physician stating that they could not work. The one exception is if they have documented proof of an interview at a professional school! In that case, they should also get a huge congratulations!
What if a scribe misses the shift and does not call in advance?
This is considered a no call, no show. All clinics and hospitals should have a zero-tolerance policy. There are many scribes that would love to have the job, and you deserve to have dependable staff as part of your team.
How should discipline be handled by the clinic staff?
There should be a standardized form that the scribe signs when they are written up. After three times of being written up, the scribe should be relieved from his or her duties.
What should be the scribe’s professional clinical demeanor?
The scribes are there for one reason and that is to complete the provider’s charts. They should not be interacting with other staff members, patients, or doing things that draw attention away from the patient. If it is noticed that the scribe is an extrovert, they should be kindly taken behind closed doors and instructed in no uncertain terms that they are in this role to observe and write notes through observations and not to talk during their shift. If this continues, they should be given a written warning.
Is it appropriate for a medical scribe do non-clerical work for the physician?
Medical scribing for the professional student is similar to doing an externship or internship in the business field. They are there primarily to do the patient’s notes, but if there are things they can do to make the physician’s life easier like picking up food or dropping off dry cleaning this is completely acceptable. If this is your intention, I would make sure that during the interview you ask the scribe directly if they would have any problems doing odd jobs for the providers. Most scribes not only will say yes but will enjoy a break from the routine to perform these duties. This does not include cleaning the office or making beds. Those tasks are the responsibility of other clinic staff members. Medical scribes generally want to be physicians someday, and the providers are their role models. They are always pleased when they feel they are really helping the doctor and making their physician’s day better.
What criteria should scribes uphold in regards to appearance?
The scribe is a direct reflection of your clinic. They should be professional in appearance with good hygiene. It should be made clear that they should look the same way when they end their employment with the clinic as the day they are hired. A typical situation where you might see a scribe change their appearance is if they have outdoor hobbies such as hunting, or when a new hair fashion starts that involves hair dyes, unique hairstyles, or cuts. We have found that if this is addressed at the time of the scribe being hired, it does not ever become a problem.
What if a scribe is hired, and it is not working out?
Medical scribes that have never practiced in a clinical setting have a steep learning curve over the first three months. They are not only learning what it is like to work in a professional setting, but they are also learning how to write and perfect a medical note (something that takes physicians 4 years of medical school and 3-7 years of residency to figure out). This might even be the first job that a medical scribe has ever had. Some scribes start strong and then taper off to a consistent standard, while others don’t seem to understand anything for the first one to two months and then something clicks, and they end up being your strongest scribe.
We have worked with so many variations in the scribe learning curve and have discovered that by three months, you will have a good predictor of what your scribe will be like. This is the point that you need to make a choice about whether to continue working with the current scribe or find another scribe to take their place. We advise all providers that they should keep a list of corrections in their charts they make over the first 2-3 months after the new scribe starts. The provider should use them to teach the scribe the way the provider would like his or her notes done. The provider should have weekly and/or biweekly meetings to review these corrections. This will improve the notes significantly in a short amount of time. In general, the scribes really want to do well at their job and have great pride in getting the charts completed exactly how the provider wants them (remember these scribes were you before you got into medical school). If you give them some guidance at the beginning, you will have to enjoy the scribe’s exceptional work for a long time.
What if I decide the scribe does not fit with me?
If the scribe does not fit with you, the medical scribe will go back on the Scribes4hire job board, unless there is something in their character that makes them unsafe to practice in any medical situation. They will likely find another provider and with the tools that they learned from their first job experience, they will probably do a much better job at the second clinic. The provider has three months on the job board, so the provider can also go back on the Scribes4hire job board. With the experience of knowing the attributes that make a scribe a good fit, the provider will choose a new scribe that hopefully will be a better fit.
However I recommend at this time, you pick a couple of scribes that will do a shadow shift, so you can better decide for yourself who you would prefer to work with. We would like all the providers and scribes to rate the experiences they had with each other. This will be reflected in their star rating, and you can provide comments. By taking your time to fill this out, you could be saving another provider all the same headaches that you just went through. Remember, as physicians, we are in this together!
What are the standard requirements when hiring a scribe?
Scribing can be a physically demanding job. The applicant must be 18 years or older, must type 30+ WPM, must be able to work both weekends and holidays if necessary, must be able to stand for long periods of time ranging from 4-12 hours, and must be able to speak and write fluent English.
What should the policy be for cell phones or smartphones in the clinic?
Cell phones or any type of smartphone should not be allowed in the clinic or patient’s room. Most people own these devices and should be instructed to leave them in their car or in a locker. If there is a true emergency, all hospitals and clinics have a main number that can be called to reach any employee.
How does the Job Connection Posting Board make this course unique?
When the scribe completes the course training, they will be allowed to post their résumé on the job board. At that point, you will be able to view and contact all the scribes who already have the training to fit your specific criteria and are looking for employment through the Scribes4hire website. The providers and scribes on the Job Connection Posting Board are located throughout the entire United States. You can contact the trained scribes directly in your area. The trained scribes will also be able to contact your clinic or hospital at this time to apply for a job. This gives the provider an opportunity to screen through multiple candidates for the medical scribe position. The Job Connection Posting Board provides physicians, hospitals, and clinics the tools to hire a highly qualified, trained medical scribe at a fraction of the cost of using a scribe staffing company. In most cases, the hourly rate charged to the clinic for scribe services is cut in half, with no upfront cost of training a scribe for several weeks before they can scribe for the provider.
What is the grading policy?
The Scribes4hire course is rated as a difficult and challenging course to complete. This assures providers that the medical scribes on the job board were held to a high standard during their coursework. Core medical terminology and concepts are presented and must to be mastered. The student is also provided with formal instructions on how to document a medical note. After the medical scribe practices 40 patient encounters, they will be required to document a note for their written final. The goal of the written final is to complete an error-free chart under 10 minutes while observing a patient scenario. The grade of the course will be based on the quality of the final written note. If their medical note is on the borderline between two grades, the score on the multiple-choice final will be taken into consideration to determine the final grade of the class. The scribe will be given a final rating system based on stars. 5 starts= A, 4 stars=B, 3 stars=C, 2 stars=D, and 1 star=F.
How can I know how to set up a scribe in my practice?
Scribes4hire offers three packages for providers. We have a Standard, Deluxe, and Premier Package.
The Standard package offers you access to trained medical scribes for 3 months on the Scribe Connection Job Posting Board. This should provide enough time to find, interview, and work with a scribe ensuring the scribe is a good fit in your medical practice. When your scribe is accepted to medical school, you can sign up for another 3 months, which should provide plenty of time to find a replacement. If the scribe you choose is doing this for a career, then you will likely have to pay them a higher rate, but you would not have the turnover of medical students doing a “gap year”.
The Deluxe package provides you with all of the services offered in the Standard package with an extended membership of 6 months.
The Deluxe package also provides you with a step-by-step approach about how to integrate a scribe into your medical practice, including how to find, hire, and set up a scribe in the clinic, process the scribe’s paperwork, and obtain immunization records. You will be instructed on how to coordinate with IT so that the scribe’s notes correspond with your notes, as well as have access to standard dot phrases and templates that you can adjust to your own practice style to get the quality of notes that you desire. In addition, you will also be instructed on how to perform a background check, verify immunizations, and send the scribe for a drug screen and TB test, which are usually required in most medical facilities.
The Premier package provides you with all of the services provided in the Standard and Deluxe memberships with 6 months of service and you will be assigned a personal care representative. The personal care representative will be your personal contact to answer questions or concerns and help you navigate through the hiring and credentialing process.
You will have access to trained scribes from the Scribe Connection Job Board that can help facilitate this transition to staffing medical scribes. You will be provided with “soft tips” on how to train the new scribe in the first couple of months. The more that you educate them at the beginning, the faster they will be able to provide a perfect note, leaving you with much less work. If you already have a medical assistant or someone in mind for the position that you would prefer to use as your scribe, we will provide you with an online course for them to enroll in free of charge.