The American College of Medical Scribe Specialists estimates that by the year 2020, 100,000 medical scribes will be employed by myriad healthcare organizations around the country. This is good news for not only those that are on the hunt for a position writing in the medical industry, but it’s good for the physicians utilizing a medical scribe’s services, as well as for the patient, who will receive the undivided attention from their doctor and get more out of their office appointments. The utilization of a medical scribe is also great for health organizations because it boosts the productivity of the providers, leaving room to see more patients in a given day.
Medical scribes are employed to take much of the clerical workload associated with federally mandated Electronic Health Records (EHR) off of doctors as they see and diagnose patients throughout the workday. Scribes aide physicians with such tasks as EHR navigation, retrieval of diagnostic results, documentation of visits, and applicable medical coding.
Dermatology and Skin Health in Dover recently became one of the first dermatology practices in the state of New Hampshire to employ a medical scribe to help facilitate the growing demand of EHR files, and to enable the practice to better the overall experience of their patients. Below you’ll get an inside look at a “day-in-the-life” with Derm Skin’s own medical scribe, and recent University of New Hampshire graduate, Parker Woolley:
What does a medical scribe do? Walk us through a typical day…
Woolley: My shift is from 8-5 with an hour lunch break from 12-1. My whole job is to free up Dr. Alissa Lamoureux from the electronic medical record system, so that she can pay 100% attention to the patient. I am essentially the middleman between the physician and the medical record. I record all of the diagnoses, prescriptions, symptoms, biopsies, lab orders, follow-ups, and other typical medical information that happens during a dermatology visit.
How long have you been scribing for?
Woolley: I started my position as a medical scribe in June of 2016. I had been accepted to ScribeAmerica, which is essentially a nation wide collection of medical scribes, to scribe in Boston. However, Laurie Seavey, the practice manager of Dermatology and Skin Health, asked me if I would like to come on board as a medical scribe. Last summer I had interned for Laurie's non-profit organization for skin cancer prevention called Make Big Change, so I was already familiar with the practice and the great staff that works at Dermatology and Skin Health. I quickly said ‘yes’ and began medical scribing within a week or two.
Are there any associated technologies that you utilize?
Woolley: Dermatology and Skin Health utilize the software Modernizing Medicine (www.modmed.com). This software is incredibly user-friendly and very intuitive. The whole office uses the OS X operating system made by Apple. This means that everyone uses either iMac Desktops or iPads. I myself use an iPad, which contains 1,700 diagnoses, 400 histories, 400 plans, 1,000 anatomical parts and 25,000 high-resolution medical images.
What do you enjoy about your position at Dermatology and Skin Health?
Woolley: I enjoy learning while working at Dermatology and Skin Health. It blows my mind how much Dr. Lamoureux knows and I feel very comfortable asking her any questions I have about the visit, diagnoses, prescriptions, and so forth. I have definitely learned quite a bit about dermatology during my time working at the clinic. I can honestly say that I learn something new every single day I am here. Even after my shift today I learned about a new procedure that involves injecting deoxycholic acid (Kybella) into the area underneath the chin to essentially destroy adipose cells (fat cells). This procedure can help alleviate the appearance of the double chin.
How did you learn about medical scribing and what it was/entailed? Was it a profession you sought out, or is it something more of a useful tool to get you more experience in a medical environment?
Woolley: I recently graduated from the University of New Hampshire with a major in Finance and a concentration in Pre-Medical Studies. Over the years I have basically heard of every single job/position that has to do with healthcare. I knew that I wanted to gain more experience before applying to medical school, but at the same time needed a job that was relatively easy to enter into (compared to other medical professions). I believe this was a good choice for me because I am still studying for the new, revamped MCAT that I plan to take in late winter/early spring of 2017.
I have learned way more than I had anticipated and to a much greater degree as well. I think that this job provides an invaluable experience and insight into what a dermatologist does. Dr. Lamoureux also underwent an internal medicine residency, so from time-to-time I am able to learn a little bit about that specialty as well.
How long did it take to become a trained medical scribe?
Woolley: I did not do any didactic training to become a medical scribe, other than what I learned in my undergraduate biology and biochemistry classes. I trained in the practice using the software for about ten days with Sunny Wencek and Angela Kneeland, two medical assistants at Dermatology and Skin Health. Previously they had been rooming the patient in conjunction with medical scribing for Dr. Lamoureux. They did a great job orienting me and making sure I knew the ropes during my training.
What do you, as a medical scribe, add to the overall medical care experience of a patient?
Woolley: I think it is important that the patient does not feel ignored or unimportant during their visit. Everyone, at least once, has gone to see the doctor, whether it be for a annual check-up or a more specialized visit, only to have the doctor facing away, typing on the keyboard or staring down at a clipboard on their lap, documenting what is going on throughout the course of the visit. The physician does not mean to be rude, but the body language that corresponds to these documentation periods can make the patient feel like their symptoms are being downplayed.
If one were to observe my body language during a visit with the patient, they would see that 80% of the time my eyes are glued to the iPad and my fingers are furiously typing in documentation that Dr. Lamoureux has spoken aloud. I typically only look up to pinpoint the exact measurement and location of her biopsies, diagnoses, and observations. If one were to watch Dr. Lamoureux throughout the visit, they would see that 99% of the time her eyes are on the patient, either making eye-contact or looking into her dermatoscope to decipher whether or not a location is benign or malignant.
What do you add to the overall working experience of a physician that you’re scribing for? In other words, what is the benefit of having a medical scribe on staff?
Woolley: After the visit has ended and the patient has left for the checkout window, Dr. Lamoureux will look at the entry I have made in the patient's medical record. She is the final say in the note and makes sure all the prescriptions are correct, the diagnoses are accurate, and that nothing was missed during the visit. There was a slight learning curve in the beginning of my training, but for the most part I have become proficient at documenting the encounter. I suppose that my job may not be necessary for every patient that comes into the clinic. Typically, suture removals and Botox follow-ups are relatively straightforward. The majority of patients are very satisfied with the way their wounds from excisions are healing. The patients who have cosmetic procedures, such as Botox, are almost unanimously extremely happy with the results. These two types of visits typically require little documentation, because the majority of it was done in the prior visit. However, when patients come in for full-checks, the documentation can become exhaustive. It obviously depends from patient to patient, but some can have dozens of benign nevi and/or seborrheic keratoses, both of which are harmless, normal conditions of many skin types. All of these spots are documented and there are obviously many more diagnoses that can add up from patient to patient, such as: cherry angiomas, telangiectasias, lentigos, idiopathic guttate hypomelanosis, fibrous papules, basal cells, squamous cells, melanomas, intradermal nevi, xerosis, pruritus, tick bites, ecchymosis, and the list goes on... I guess in short, I take some of the "behind-the-scenes" workload off for Dr. Lamoureux. There’s a lot of value in that – enabling the physician to put the entirety of their focus on the patient.