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.
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.
Entities:
Keywords:
burnout; doctor–patient relationship; electronic health records; patient–doctor communication; physician well-being; primary care; primary care redesign; scribe
Authors: Tait D Shanafelt; Omar Hasan; Lotte N Dyrbye; Christine Sinsky; Daniel Satele; Jeff Sloan; Colin P West Journal: Mayo Clin Proc Date: 2015-12 Impact factor: 7.616
Authors: Mark Linzer; Sara Poplau; Stewart Babbott; Tracie Collins; Laura Guzman-Corrales; Jeremiah Menk; Mary Lou Murphy; Kay Ovington Journal: J Gen Intern Med Date: 2016-05-02 Impact factor: 5.128
Authors: Maria Alcocer Alkureishi; Wei Wei Lee; Maureen Lyons; Valerie G Press; Sara Imam; Akua Nkansah-Amankra; Deb Werner; Vineet M Arora Journal: J Gen Intern Med Date: 2016-01-19 Impact factor: 5.128
Authors: Emily D Dolan; David Mohr; Michele Lempa; Sandra Joos; Stephan D Fihn; Karin M Nelson; Christian D Helfrich Journal: J Gen Intern Med Date: 2014-12-02 Impact factor: 5.128
Authors: Chen Yan; Susannah Rose; Michael B Rothberg; Mary Beth Mercer; Kenneth Goodman; Anita D Misra-Hebert Journal: J Gen Intern Med Date: 2016-04-29 Impact factor: 5.128
Authors: Lisa S Rotenstein; Matthew Torre; Marco A Ramos; Rachael C Rosales; Constance Guille; Srijan Sen; Douglas A Mata Journal: JAMA Date: 2018-09-18 Impact factor: 56.272
Authors: Tina Shah; Andrea Borondy Kitts; Jeffrey A Gold; Keith Horvath; Alex Ommaya; Opelka Frank; Luke Sato; Gretchen Schwarze; Mark Upton; Lew Sandy Journal: NAM Perspect Date: 2020-08-03
Authors: Ellis C Dillon; Ming Tai-Seale; Amy Meehan; Veronique Martin; Robert Nordgren; Tim Lee; Teresa Nauenberg; Dominick L Frosch Journal: J Gen Intern Med Date: 2019-10-28 Impact factor: 5.128
Authors: Lauren A Peccoralo; Carly A Kaplan; Robert H Pietrzak; Dennis S Charney; Jonathan A Ripp Journal: J Am Med Inform Assoc Date: 2021-04-23 Impact factor: 4.497
Authors: Anastasia Pozdnyakova Piersa; Neda Laiteerapong; Sandra A Ham; Felipe Fernandez Del Castillo; Sachin Shah; Deborah L Burnet; Wei Wei Lee Journal: BMC Health Serv Res Date: 2021-07-11 Impact factor: 2.655