It is often offered as a solution to help those physicians who are chronically behind in completing their clinical documentation and entering the charges for their encounters, but in general it has been found that the chart completion rates of these poorly performing physicians does not significantly improve with the help of a medical scribe. This has been found to be helpful for some physicians, but only for the physicians who are already high performers. The scribe enters the relevant information into the EMR for the physician, presents available information from the EMR such as medication lists and test results, and enters orders for the physician. This service involves hiring a person who stands at the physician’s side during every patient encounter. Until recently, the best commercially available solution to the problem of EMR intrusion into patient care has been the medical scribe. Is this what I went to medical school for? Is this why I spent my precious second and third decades of life staying up all night long caring for patients with sepsis in the ICU? If I fail to do this, then I get penalized on quality metrics. I still have to sort through paper printouts from other EMR systems when I see a new patient coming from a different doctor, find when they had their pneumococcal vaccine or mammogram, and then manually input that information into my EMR. Does my EMR remind me when my patient is due for his pneumococcal vaccine or her mammogram? No. Certainly, my experience in clinical medicine has been that the use of EMR systems has created more meaningless clerical work and reduced the amount of face-to-face time available for clinical care, all while failing to provide any significant improvements in safety or clinical decision-making support. There is general consensus that the widespread adoption of EMR systems has been a significant contributor to physician burnout and a primary cause for the documented increase in numbers of physicians who report symptoms of burnout. I understand intellectually the scope of the problems related to physician burnout, and I have experienced it personally. During that time I have seen my professional energy getting more and more hijacked by meaningless, clinically useless and often frankly insulting clerical work. I have been practicing general Internal Medicine for over 20 years, both in inpatient and outpatient settings, and in urban, suburban, and rural communities. This is a short information piece about new real-world solutions that I as a practicing clinician am very excited about. Unfortunately, there has been very little work (other than opinion pieces and editorials) on designing real-world solutions that can alleviate physician burnout and thereby increase access, affordability and quality of care within our healthcare system. There has been a robust amount of work published on investigating the extent of the problem, its costs to the system, and its causes. Physician burnout is a major problem plaguing our modern healthcare system.
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