Physician Assistants and Medical Scribes

Physician Assistants and Medical Scribes

The word scribe is Latin for scribere, which means "to write." A scribe has been known historically for recording events, making written copies of documents, and more recently, "transcribing" word for word. Medical scribes have emerged most recently in response to the extensive use of EMR into clinical practice from widely used handwritten and dictation methods. 

What Role do Medical Scribes Have in Healthcare?

Medical practices, hospitals, and typically lots of emergency departments hire medical scribes to relieve the providers unequipped with rapid typing skills or who cannot simply find their way around on EMR software. A medical scribe serves to record the actions and words spoken as they occur. Scribes cannot implement their own observations into the medical record. The scribe documents the activities of the provider as they occur and must include the name and signature of the provider who performed the encounter. The provider is required to attest of his/her presence during the encounter, verifying they have reviewed the scribe's documentation and the accuracy. The provider must also sign and date the encounter. 

What are the Benefits of Medical Scribes? 

(This one's for you, providers)

• Improved productivity - mitigate inevitable slowdown
• Enhanced clinical documentation
• Provider satisfaction greatly increased
• Completion of medical records ensured
• Patient satisfaction increased - thought to be due to provider's increased attention to patient, rather than computer screen and keyboard

Who is Authorized to Use a Medical Scribe?

Physicians, physician assistants and nurse practitioners are all providers authorized to use scribes to document their patient encounters. 

So, Why Draw My Attention to Scribes? 

1. If you are ill-experinced and new to the profession, becoming a scribe can be a great way to become acquainted with healthcare and to gain entrance into other positions, such as a patient care technician, a medical assistant, or any other type of tech. 
2. During your career you might be asked by your supervising physician to perform tasks mentioned above; tasks of a scribe, not a physician assistant. The use of a PA as a scribe is not only a waste of a highly intelligent medical professional, but can subject practices to allegations of fraud and abuse. It's important to remember your role in healthcare: to perform the history, physical examination, and medical decision making components of a patient encounter, and submit a claim to a payer for such services. 
1. Medicare says that when a PA/NP and a physician both provide documentation in the medical record of patient encounters (i.e. they both participated), these encounters cannot be billed under the physician's NPI (National Provider Identifier) because they do not meet necessary requirements for the service to be billed by the physician. 
2. If the PA performs the history of present illness, the physical exam, and/or the medical decision-making - then the "shared visit" rules must be met to bill under the physician's number to the Medicare program. If those requirements are not met, the encounter will be billed under the PA's NPA with reimbursement at 85% of the physician fee schedule. 
3. It's okay if you don't understand all of this "mumbo-jumbo" stuff now. It will begin to make more sense as you become more acquainted with healthcare later. For now, start with the basics. 

Pre-PA Students: Want to become a scribe? Need healthcare experience (HCE) for your CASPA application? PhysAssist Scribes is just one company of many that hires scribes. 

If you have experience as a scribe, I encourage you to comment on this article about your experience as a scribe for others and leave any advice for other pre-PA students wishing to join the scribe workforce.