You are sitting in your doctor’s office or in the emergency room.  When the doctor strides in, you are briefly delighted: now you will get the attention you need! Within seconds, though, you become dejected.  The doctor glances at you for a few seconds now and then, but most of this expert’s attention is reserved for the computer screen.  Many doctors seem glued to their computers, reading data, asking questions based on what they read, typing – so that it’s easy to feel that you aren’t the center of attention.

  Sound familiar?  It’s not only patients who find this arrangement unsatisfactory. Doctors aren’t very happy about it either.  They probably went into medicine because they were interested in caring for patients – but today, they often feel as if they are serving computers instead.

Good reasons for using electronic medical records abound.  Among these are that improved accuracy and availability of records, coupled with systems that can remind doctors of follow-ups needed and alert them to dangerous drug combinations or other problems, can save lives. 

But if neither doctors nor patients are happy with this third presence in the examining room – the computer – what are the alternatives, to get the benefits electronic medical records offer without the downsides?

Believe it or not, the solution a rapidly growing number of hospitals and physician practices have hit upon is to add a fourth presence – a third person – to the doctor visit:  the medical scribe.  And what is that?

The most common definition of “scribe” offered by several dictionaries is an individual who wrote by hand hundreds or thousands of years ago when most people could not read and write; this learned person was one of the few in a community who could capture the spoken word on paper.  The last and most modern definition is a journalist.

So what exactly is a “medical scribe”?

This term, while honoring the important role of scribes in the past, defines a new field that has become formally recognized in only about the last decade or so. Medical scribes are individuals who join the doctor in the examining room to take notes and find information, typically in the electronic medical record, so that the doctor can focus on the patient.

Dozens of start-ups today train and sometimes directly provide medical scribes to more than 1,100 hospitals and doctors’ offices in 44 states, including Arizona.  Medical scribes have at least a high school degree, and undergo a brief training program (typically a few weeks).

If your doctor proposes that a medical scribe join the two of you during a doctor’s visit, should you agree or not?  Next week’s column highlights some pros and cons of using medical scribes.