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A Busy Doctor’s Right Hand, Ever Ready To Type

Mon, 01/13/2014 - 8:55am
Katie Hafner

Amid the controlled chaos that defines an average afternoon in an urban emergency department, Dr. Marian Bednar, an emergency room physician in Dallas, entered the exam room of an older woman who had fallen while walking her dog. Like any doctor, she asked questions, conducted an exam and gave a diagnosis — in this case, a fractured hand — while also doing something many physicians in today’s computerized world are no longer free to do: She gave the patient her full attention.

Standing a few feet away, tapping quickly and quietly at a laptop computer cradled in the crook of her left arm, was Amanda Nieto, 27, Dr. Bednar’s scribe and constant shadow. While Ms. Nieto updated the patient’s electronic chart, Dr. Bednar spoke to the woman, losing eye contact only to focus on the injured hand.

“With a scribe, I can think medically instead of clerically,” said Dr. Bednar, 40, who works at Texas Health Presbyterian Hospital Dallas.

Without much fanfare or planning, scribes have entered the scene in hundreds of clinics and emergency rooms. Physicians who use them say they feel liberated from the constant note-taking that modern electronic health records systems demand. Indeed, many of those doctors say that scribes have helped restore joy in the practice of medicine, which has been transformed — for good and for bad — by digital record-keeping.

“Having the scribe has been life-changing,” said Dr. Jennifer Sewing, a family medicine practitioner in St. Louis, who used to spend late nights at her computer finishing electronic patient charts. Now, she can relax with her family or go to bed instead.

Dr. Michael Murphy, the chief executive of ScribeAmerica, a company based in Aventura, Fla., that supplies scribes to hospitals and medical practices, estimates that there are nearly 10,000 scribes working in hospitals and medical practices around the country, with demand rising quickly. At his company alone, the number of scribes deployed to clinics and emergency departments has risen to 3,500 from 1,000 in the past three years. Many of them are people like Ms. Nieto, who works for PhysAssist, a company based in Fort Worth. Training typically takes between 15 and 21 days, and is done by the companies themselves. She plans to enter a master’s program to become a physician assistant.

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