A qualitative study of provider burnout: do medical scribes hinder or help?

Abstract

Objective Provider burnout is a crisis in healthcare and leads to medical errors, a decrease in patient satisfaction, and provider turnover. Many feel that the increased use of electronic health records contributes to the rate of burnout. To avoid provider burnout, many organizations are hiring medical scribes. The goal of this study was to identify relevant elements of the provider–scribe relationship (like decreasing documentation burden, extending providers’ careers, and preventing retirement) and describe how and to what extent they may influence provider burnout. Materials and Methods Qualitative methods were used to gain a broad view of the complex landscape surrounding scribes. Data were collected in 3 phases between late 2017 and early 2019. Data from 5 site visits, interviews with medical students who had experience as scribes, and discussions at an expert conference were analyzed utilizing an inductive approach. Results A total of 184 transcripts were analyzed to identify patterns and themes related to provider burnout. Provider burnout leads to increased provider frustration and exhaustion. Providers reported that medical scribes improve provider job satisfaction and reduce burnout because they reduce the documentation burden. Medical scribes extend providers’ careers and may prevent early retirement. Unfortunately, medical scribes themselves may experience similar forms of burnout. Conclusion Our data from providers and managers suggest that medical scribes help to reduce provider burnout. However, scribes are not the only solution for reducing documentation burden and there may be potentially better options for preventing burnout. Interestingly, medical scribes sometimes suffer from burnout themselves, despite their temporary roles.

Electronic medical record-related burnout in healthcare providers: a scoping review of outcomes and interventions

“…Despite this prevalent theme, there was no available data that discussed possible time-saving interventions, such as employing scribes, to decrease provider hours spent on EMR. 36 Furthermore, only one included study addressed perceived support from their organisation in EMR implementation and training. Providers must be able to rely on organisations to provide the necessary resources to assist in administrative duties, to efficiently train clinicians and staff, and make improvements to increase workflow efficiency.…”

“…Time spent on EMRs was found to be a strong indicator of burnout among providers. Despite this prevalent theme, there was no available data that discussed possible time-saving interventions, such as employing scribes, to decrease provider hours spent on EMR 36. Furthermore, only one included study addressed perceived support from their organisation in EMR implementation and training.…”

The Role of Scribes in Orthopaedics

“…Physicians reported spending more time with patients face to face and less time charting during and after clinic visits with the use of scribes 18 . Providers felt less burned out and more satisfied as they qualitatively noted that scribes improved work-life balance while also increasing efficiency during clinic hours 19 . As physicians redirect their attention toward patient care, they reported feeling less rushed and more satisfied with their connection with patients as the distraction from the EMR decreased during patient encounters 20 .…”

“…Providers can also improve scribing documentation by being more organized in presenting information and willing to teach and provide constructive feedback to the scribes 41 . Owing to varying individual styles of communication and the preferred level of interactions with the scribe among providers, we recommend the provider and the scribe establish a systematic method for relaying clinical information, including the option of asynchronous scribing in case the physician feels that having a “live” scribe is less preferable.…”

“…Comparing prescribe and postscribe cohorts, scribes aided in productivity and helped increase total work relative value units per hour by allowing physicians to maintain a more efficient workflow 31 . In addition, scribes can help alleviate the economic cost of burnout by reducing burnout rates and premature retirement rates among physicians 19 . Turnover expenses includes cost of physician recruitment, lost revenue during recruitment, and training and adjustment time for the new recruit 32 .…”