Describing the Scribe: How We Help Clinicians

The last patient of the day had arrived just before sunset. He presented with his wife of 25 years, his co-historian. I typed this reflexively, automatically, perhaps even lazily into the HPI. He didn’t know what’s wrong with him. He thought maybe he just needed his inhaler replaced. His wife knew better. She said she wanted her husband back.   

I looked up at them, this couple who’d been through life together since high school and reminded myself why I’d spent the past year scribing, and why I want to spend my next phase of life in medicine. My first responsibility as a scribe is to document patient information accurately. But, in essence, I’m also writing the patient’s story as it will be told in their chart. And every patient’s story matters.

Dr. Kerkvliet started with a few open-ended questions. He’d known this couple, both patients of his, for years as their PCP. His eye contact was steady and kind. The patient said he’d had trouble sleeping, ate little, and couldn’t bring himself to go to work some days. He’d bought a video game to play with his children at Christmas but couldn’t find the energy to play it. Most significantly, his mother passed a few months ago, and he still felt guilty that he couldn’t have done more for her.   

After confirming the patient had no suicidal ideation, Dr. Kerkvliet provided a script for Wellbutrin, a referral to a therapist, and a one month follow up. He also spent quality time talking with the patient about life, and what was important to him. At the end of the visit, the patient remarked, “You know, doc, this is the most I’ve talked to anyone in the past week.”   

By having the time to really listen to his patient, Dr. Kerkvliet was able to open up a space for him to talk at length, accept that he was depressed, and have hope he could get better. In general, Dr. K’s patients appreciate that he can spend more time interacting with them, rather than having to click through EPIC EMR prompts. That’s my job. Sure, sometimes we run long, but a patient will leave his office feeling seen rather than simply being seen.  

Here are 3 main benefits of having a medical scribe as part of your clinic:   

1. Scribes help clinicians focus on the joy of medicine. 

By writing the encounter note, scribes allow clinicians to focus on clinical reasoning, patient interaction, and other meaningful aspects of their work without the distraction of having to type.  

 2. Scribes help handle medical documentation.  

The clinicians I work with no longer have to spend hours after clinic checking their notes or performing other clerical duties. This frees them up for other tasks, or self-care to decrease burnout.   

 3. Scribes allow clinicians to fully engage with their patients.  

Clinicians who work with scribes don’t have to spend half of an encounter looking at a screen. Instead, they can practice connecting with patients mindfully, with active listening. And, when the last patient of the day arrives, they truly can make time for them.   

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.