Medical scribes take notes for doctors during patient visits, typically on a computer, and look up information for them in the patient’s electronic medical record.  Doctors are thus free to concentrate on their patients. The New York Times quoted one very happy doctor as saying, “With a scribe, I can think medically instead of clerically.”

Physicians say that patients appreciate having the doctor engage with them instead of with the computer and therefore don’t object to having the medical scribe in the room.  Using medical scribes, doctors may also return calls and address other needs faster, relieved of many recordkeeping burdens.

Not everyone is ecstatic.  A recent article in JAMA, the journal of the American Medical Association, squarely opposed the use of medical scribes, for three reasons. 

First, the authors worry that using scribes as a workaround will reduce pressure to improve badly designed electronic record keeping systems.  In effect, they advocate forcing up to half a million doctors to keep being frustrated with their computer systems for years, hoping that their collective misery and anger will force improvements in the technology. 

Second, scope creep could mean that medical scribes are given tasks that far outstrip their training.  For example, doctors may be tempted to allow scribes to enter medical orders, a practice strictly forbidden by regulatory agencies because errors made by these workers – who are required to have only a high school education and typically 1-3 weeks of training – could cause grave harm.

Third, the doctor won’t see the alerts and warnings that flash on the screen, pointing out potential problems such as dangerous drug interactions; the scribes typing might ignore alerts since their role is to silently take notes – not make medical judgments or interrupt the doctor – and thus patients may be hurt. 

So where does all this leave you?  If a doctor wants to have a medical scribe take notes, consider agreeing, unless you believe that you will hold back in talking to the doctor with someone else in the room.  If you agree, but during the appointment realize that you are uncomfortable, ask that the medical scribe step out of the room.

Whether a scribe is present or not, take your own notes, ask how any proposed tests will help you, make sure you know your diagnoses, understand your treatment options and choose the ones that best fit your needs, and follow up to make sure that agreed steps are taken.  When you get a copy of your medical records later, check to ensure that the record is complete and accurate. 

In other words, your job as the patient stays exactly the same, whether or not a medical scribe is in the room when you meet with the doctor.