Next big thing: integrating medical scribes into academic medical centres

The rapid emergence of medical scribes in the electronic medical record (EMR) era is changing the practice of medicine. Medical scribes are trained to record clinical documentation in real time for physicians providing patient care. While the use of scribes as a means to improve physician efficiency in emergency departments has been reported as early as the 1970s,1 ,2 it is only recently that the popularity of scribes has skyrocketed and captured the attention of the medical community.3–5 The American College of Emergency Physicians estimated that in 2011, more than 400 physician groups at over 1000 US hospitals were using scribes.6 These numbers are projected to increase exponentially as the use of scribes expands beyond emergency departments into the outpatient setting of both small and large healthcare delivery systems across the country.7–10 Scribes have been hailed as ‘the next big thing’ in modern medicine,11 and credited for increasing physician efficiency and productivity,12 improving both physician and patient satisfaction,13 increasing revenue and creating returns on investment,14 and providing scribes—most of whom are students in premedical training—the opportunity to gain real-world experience that is invaluable for their future careers in medicine. While there is a growing body of literature demonstrating the benefits of medical scribe programmes for all stakeholders—patients, physicians, healthcare systems and students in training—they have been mostly limited to the private sector. The vast majority of US hospitals that are using scribes are non-academic institutions. These hospitals hire scribes trained and managed by for-profit companies like ScribeAmerica, PhysAssist Scribes, Elite Medical Scribes and at least 19 other companies.15 In comparison, academic medical centres have been slow to adopt the use of medical scribes, even though they potentially stand to gain the most from new models of care that directly address …