The first randomized controlled trial of scribes finds that they produce significant improvements in physician satisfaction without detracting from patient satisfaction. The use of scribes--team members who document patient encounters in real time under physician supervision--has gained considerable popularity as a strategy to decrease physicians' clerical burden, although high-quality evidence of their effects has been lacking.
In this study, over the course of one year, family physicians were randomized to one week in which scribes drafted all relevant documentation, which was reviewed and signed by the physician, followed by one week without a scribe in which physicians performed all charting duties. Scribes improved all aspects of physician satisfaction, including overall satisfaction (OR 10.75) and satisfaction with length of time with patients (OR 3.71), time spent charting (OR 86.09), chart quality (OR 7.25), and chart accuracy (OR 4.61). Scribes had no effect on patient satisfaction and increased the proportion of charts that were completed within 48 hours (OR 1.18, P =.028). Physicians were more satisfied with scribed charts than with their own. Spending less time on documentation, the authors note, frees up physicians to pursue direct clinical care, care coordination, and teaching activities, which they suggest is likely to help prevent physician burnout. Scribes could complement a high-functioning electronic health record and, until electronic records are redesigned for improved functionality, could provide an immediate solution to the clerical burden they entail.