Scribing

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


I worked as a medical scribe in Pediatric Emergency Medicine for a almost 3 years, and for a large portion of that time, I have been a scribe trainer. While I wasn’t 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 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 here.

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 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 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 know I never left a shift without learning something new. This was the part of my job that I loved the most. I was fortunate to work alongside physicians who foster an educational atmosphere and were willing to answer my questions about the 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 my specific specialty of practice lacked chronic, long term follow through in 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, but 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 continued to grow as I had additional shifts with the hospitalist service in the hospital. I was finally 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. Because of this, I developed a better understanding of the importance of continuity of care and learned 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 worked alongside physicians who helped implement updates and changes to the electronic medical record as a member of the hospital’s IT team to improve charting quality and accessibility. I worked alongside physicians who present educational seminars regarding common ailments, such as rashes, gun safety, or drowning. These seminars are presented to other medical practitioners, the public, or as consultations in news stories. I worked 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 was inspiring. It 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 found that I thrived 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 did 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. If crazy work hours are not your forte but you would like to be a scribe, finding a clinical position or outpatient facility to work for may be your best option. The ER is not everyone’s cup of tea.

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

Without my experience as a scribe, I would have never learned as much as I know now and I would never have formed relationships with some of my current friends. I would never have met my mentors, and I am sure I wouldn’t be a medical student without their help. Scribing truly transformed my pre-medical experience and gave me the drive and passion I needed to know that the medical field is the right career field for me. For that, I am forever grateful.

Tristan
Advertisements