1 To our knowledge, there are no studies that have assessed the effect of scribes on physician productivity or revenue generation over a prolonged period of time in a real-world clinic setting. 16 We previously performed a prospective, controlled, pilot study involving four physicians working 130 clinic hours that demonstrated large improvements in physician productivity and revenue generation in a cardiology clinic. A study performed in the ER demonstrated that the use of scribes increased patients seen per hour by 0.8, and work relative value units (wRVUs) generated per hour by 2.4. In addition, there are little data on the effects of scribes on physician productivity and revenue in the clinic (or other settings). Although scribes have been involved in medical care in emergency rooms (ERs) for well over a decade, they are infrequently used in the clinic setting. Medical scribes are trained assistants who perform multiple documentation tasks under physician supervision to assist physicians during their care of patients. 12 – 15 An additional strategy to improve physician productivity is the use of medical scribes. Strategies used to improve physician productivity (and reduce costs) include the use of physician extenders (nurse practitioners, physician assistants, among others) and the implementation of clinical pathways. 4 Many factors are potentially adversely affecting physician productivity including increased use of electronic medical records (EMRs), 5, 6 increased paperwork, 7, 8 increased medical bureaucracy and regulation, 9 physician burnout, 2, 10, 11 and increased volume of data available per patient. Physician productivity critically affects many aspects of health care including patient access to care, 1 cost of care, physician 2 and patient 3 satisfaction, quality of care, and physician reimbursement. Physician productivity is an important and understudied component of health care in the US and across the world.
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