What is a medical scribe?

You are probably thinking, Joyce, how on earth do you know what this is. Have you done it? Do you know people who have worked as scribes? Show me all of your credentials!

I can assure you, I have a handle on what a scribe is and all things about scribing. At least I hope I do, I did spend 6 years doing it!

So what is a medical scribe? 

A medical scribe is someone (usually pre-med, pre-PA, or pre-nursing) that follows a physician around and types up their notes for them. Your whole job is to type down what is dictated to you and what you hear/infer between the patient and the provider: in person, in real-time. This is different from a transcriptionist. As a scribe, it is your job to completely capture the HPI or patient’s story on your own, and be able to write it down in a medical legal document that is grammatically correct and flows well. This is seriously the hardest thing to learn. It took me a while to really get the hang of it, and every scribe I trained had a hard time with it too.

Why? Well its difficult because you have to follow the conversation between the physician and patient, the patient will not go in order of how you are taught, may have 10 complaints, and you also have to switch the conversation from layman’s terms to medical terminology. All of that is a lot, and having to type it in real-time because the conversation DOES. NOT. STOP. is also difficult. I know it sounds scary, but after doing it several times with a trainer by your side it gets easier. You are going to want to be good at multi-tasking for this job.

There are sections of the chart that are directly dictated to you, such as the physical exam findings and the medical decision-making (if you are in a specialty that does this). Otherwise, the remainder of the chart is inferred between provider-provider conversations, interpreting lab results, and more provider-patient interactions.

Even though there is a steep learning curve with being a scribe, once you get the hang of it, you can do it in your sleep. Or at least I felt I could!

What skills do I need?

First off, because there is a very steep learning curve and you basically get paid in medical knowledge, I only suggest you go after this job if you are thinking about going into medicine or some sort of medical career. If you are not, then don’t bother because it will be a lot of work for you to learn and you won’t benefit from using the knowledge later.

Here is a list of skills that as a former trainer will help you the most:

• semi-fast typing ability.
• multi-tasking
• ability to learn a vast amount of material in a short amount of time
• good listening skills
• ability to take criticism and grow
• resourcefulness

That’s it. You learn everything else on the job. You need no previous knowledge on anything other than you want to put in the work and hope you like what you see so you can continue on in the medical field. But why this list?

Although you do not need to be able to type fast, it will greatly help you. The faster you are able to type what you hear, the less you will miss and the easier it will be for you to go back and form your jumbled notes into coherent, medical sounding sentences.

For resourcefulness, make Google and spell check your BFF. Learning how to navigate your charting system to help you find old notes for what you’ll need will also greatly help. You’ll thank me later.

Now I’m interested! How to I find a job?

There are some major scribe companies that have been churning out scribes for years. They have a system down pat and this is where most scribes start:

• PhysAssist
• ScribeAmerica
• Elite Medical Scribes
• ProScribe
• Iscribes
• Medical Scribe Systems

Are just to name a few. I worked for the two biggest companies: PhysAssist and ScribeAmerica. You can usually go on their website and see if there are any sites near you that you can work at and if they are hiring. As scribing is a high turn over job, even if they aren’t hiring right that second, you can put in your application and they will usually always be going through their applicants to prime them for the next position that is open.

You can also find jobs directly through the hospital system itself. I at one point ended up working at a “homegrown” program (which just means the hospital itself is running the program). You can check your local hospitals or hospital systems to see if scribing jobs are available there. For some of these positions, you may have to know someone who is already a scribe there and they can get you in. If they are large enough though, they will be able to have a more direct link online for you to apply.

Lastly, if you know a physician who wants a scribe to hire privately and they are willing to teach you how they want you to scribe for them, you can do that as well! I at one point was also scribing privately for a provider in this fashion, however this one is much harder to ascertain especially if you don’t have any contacts with physicians.

What’s the selection process like?

Just like with most jobs now, there is an online application. Most places know you are a college student, but beware that if you put you are only available on Saturdays from 9am-12pm you won’t get selected. You need at least 2-4 days availability. This doesn’t mean that you will work that much, but you do need to have time to show up for work. Some places, like in ER’s or hospitals, there are shifts for 24 hours. So in those cases, are you willing to work nights? If not, make sure you are available for a decent amount of afternoons or mornings.

You may also be asked to move your class schedule. What this means is come next semester, are you willing to take your classes all on Tues/Thurs? Or Mon/Wed/Fri? If this is a feasible option for you, then this not only allows scribe employers to see you are flexible, but that you are truly interested in this job.

You may be asked to take a typing test as well so they can see what your wpm (or words per minute) is. The faster you type, the better you’ll be selected. Most places will take a 50 or 60 wpm or above, but personally unless you can type 80 wpm and above, you will struggle a lot.

Should they like you, then yay! Your next step is usually a virtual interview. Likely through Skype or FaceTime. You will need to dress professional for this, it is an interview.  Brush up on the company’s website, their motto, what they stand for, etc. Mostly, they know you likely have never worked a day in your life and are just looking to see if you can give professional and competent answers.

Once all of that is said and done you are hired! There is a conditional with this hire though. You must pass training in order to be completely hired. You will get paid during training, but just know that if you cannot keep up or progress along well in training, they will never let you be on your own.

What is taught to me?

Most scribe companies (at least PhysAssist and ScribeAmerica) put you through about a 2-2.5 week crash course in all things medical scribing in something called “classroom training”. For PhysAssist, (remember this was 6 years ago for me so it may have changed) I was flown down to Texas for a crash course at their headquarters. This meant that they put me up in a hotel and we went to class all day to learn about being a scribe. For ScribeAmerica, they did training at the individual site you were going to be working at, so this could have meant training during the day or night, depending on when the trainer was available.

For this part of training, you need to breathe, sleep, eat all things medical scribe training related. You will be tested at every step of the way to make sure you can pass. Why? They need to know you can think fast on your feet, learn quickly, and synthesize a large amount of information. Because once you are out on that floor, it’s just you. 

Helpful tip: As a trainer I knew most of what I was teaching to my scribes during this classroom training would not be retained, and that anything they needed for their specific speciality would be re-learned on the floor. Most of these trainers and companies know this, but they still want to know you can do well when they make you jump through hoops. In your future in medicine, nothing will be handed to you either, so you might as well get used to it!

You will learn:

• medical terminology
• what is a chart and the breakdown of a chart/what goes in each section
• how to start listening and typing what you hear (this will be what is dictated to you)
• how to start navigating a chart electronically
• lots and lots of practice scenarios!

After you pass classroom training, you get to see real patients with a trainer in something called “floor training”. Here you will put to use the listening/typing skills you started to learn, will have to start putting in information in the correct part of the chart, you’ll have to get your provider dictations correct and the patient’s story correct, and basically you’ll be doing the whole chart! This chart will be kept electronically as part of the patient’s health record and can be shared with other hospitals if needed to ensure the patient’s care is seamless.

As time goes on, your trainer will help you less and less as you gain more confidence and skills to do all of this on your own. Once a trainer gives you the green light, you are officially a scribe!

Phew! Thanks for coming along on that ride with me, hopefully this helps clear up some questions you may have about scribing.

 

Disclaimer: I understand that the above post makes it sound like scribing is very difficult. Well, it is, but it’s not a mountain that you cannot climb. I prefer to give a realistic view on things because that is what I would want to know. If you are truly interested in becoming a scribe, you should know the amount of work you will need to put in to pass all the required steps. Once you get the hang of scribing (which can be a couple of months), it really is straightforward.