All About Being A Medical Scribe (In My Limited Experience)

I have been a medical scribe in Pediatric Emergency Medicine for a little over 2 years, and for a large portion of that time, I have been a scribe trainer. While I haven’t been a scribe long enough to say I have made a career out of it, my experience is, surprisingly, longer than many. As a result, I am often approached by peers, friends, and classmates with questions about this growing field. It’s quite often that I meet someone, they exclaim “Oh, my friend is a scribe!” and proceed to talk about crazy stories they have heard or interests they have in the field. Since I have only worked with at one hospital throughout my experience (and I have been fortunate to love my site), my scope and outlook is fairly limited. (Although, I have experienced scribe work under the management of two different companies here at my hospital, which has broadened my understanding of scribing.) In an attempt to capture all of the inevitable questions in one place, I would like to compile my thoughts all in one place.

As a freshly minted pre-medical student, I knew it was imperative to have clinical experience. Since I had virtually no medical connections other than my own, current physicians, I was looking for any way to get my foot in the door to start learning and forming connections. At this time, I didn’t even know that medical scribes existed. I was looking for some sort of technical or clerical position that required little to no experience when I happened to find a scribe listing on a general careers website through UT-Dallas. The position required training that would be provided through the company and a brief assessment of my mastery of the material. After googling what a scribe was and what they did, I decided to apply and hope for the best!

I have absolutely loved my experience as a scribe. There was a steep learning curve in the beginning as I learned new medications, anatomical terms and medical conditions that would be used in composing a medical note. Learning the terminology took significantly longer than learning how to navigate the electronic medical record or master the flow of the emergency room. To this day, I never leave a shift without learning something new. This is the part of my job that I love the most. I am fortunate to work alongside physicians who foster an educational atmosphere and are willing to answer my questions about patients and medical conditions we encounter.

Furthermore, I have found the emergency room to be a perfect environment to start my exposure to medicine. While the field lacks chronic, long term follow through with patient care due to it’s singular interaction style set up, patients with conditions relevant to all specialties utilize the ER for care. As someone with very limited health care experience prior to my position as a scribe, I found that this set up was a great way to learn about the different specialties and some of the types of patients relevant to each. Of course, no emergency room is going to be quite a comprehensive as a specialty in regards to the depth and breadth of types of conditions and treatments plans outlined by each specialty, the diversity of the patient base and the range of acuity levels has given me a little taste of everything. In fact, I didn’t even know that an interventional radiologist was a specialty prior to starting my job, and I surely couldn’t tell you what a urologist or a nephrologist actually did before I started. My knowledge has continued to grow as I have worked additional shifts with the hospitalist service in the same hospital. I have finally been able to see what actually happens after we admit someone to the hospital from the ER. Although I rarely see a patient both in the ER and then again on the admit floor, this extra experience has given me an idea of what the longitudinal process is like for patients and families.
I have a better understanding of the importance of continuity of care and how other doctors reference medical notes to provide comprehensive medical treatment and evaluations for patients.

In addition to providing direct clinical observation and education about the conditions addressed by each medical specialty, working as a scribe has given me a better idea regarding the scope of a physician’s job. I work alongside physicians who help implement updates and changes to the electronic medical record technology as a member of IT to improve charting quality and accessibility. I work alongside physicians who present educational seminars regarding common ailments, such as rashes or drowning. These seminars are presented to other medical practitioners, the public, or as consultations in news stories. I work with doctors involved in research regarding standards of care and patient outcomes. The opportunity to learn about the vast scope of a physician’s career and the options open to them to pursue their interests has been inspiring. It has made me evaluate other areas of care outside of clinical visits to discover my own interests and aspirations in health care.

While I would not trade my experience for anything in the world, and I am fortunate to have had advancement opportunities with my scribe company and a network of support from the staff around me, just like any job, there are negatives. Some people find the stress and hectic atmosphere that can accompany emergency medical care to be overwhelming and nerve racking. (I am lucky to say that I am definitely not one of those people, and I find that I thrive in those high pressure moments). Additionally, given the amount of work and knowledge scribes have to accumulate to perform their job successfully, I find that the field as a whole is grossly underpaid. I made significantly more money as a nanny and as a camp counselor than I do as someone responsible for the creation of my physician’s legal documents on his/her behalf. And trust me when I say that this is, in fact, a legal document. The medical chart is one of the most important documents of a patient’s visit and is used for insurance and legal purposes. This position takes a lot of responsibility and active participation. A lazy scribe not only makes a doctor’s job harder during their shift, but also adds to their work load outside of shift times and leads to shoddy record keeping. Poor quality work is not tolerated. The last negative that comes to mind is the hours. I will be the first to tell you that a 10 hour shift often flies by faster than my previous 4 hour shifts at other jobs, but most other jobs are open during regular business hours or have reasonable daytime hours. This is not the case in the emergency room. The ER is open 24/7. That means working holidays, overnight, crazy hours, or cramming in a shift after a long, busy day.

Every job is going to have downsides. However, if you look at the big picture, I have found this position to find an amazing opportunity that has connected me to the medical field and given me more knowledge regarding the scope of a physician’s job and the ground level impact that healthcare has on patients and families. I am blessed to have a company and a hospital that is supportive of me and makes every shift feel like a positive step forward in my adventurous journey towards a life filled with patient care.

Up next in my scribe adventures is learning a new electronic medical record system! Scribe education never ceases.