PTA vs Scribe for HCE?

[simply dave]

Hello everyone, 

 

I have an opportunity to be hired at two different places for different responsibilities one as a PT aide (not an assistant, sorry can't edit the topic title) and the other as a possible scribe (but starting as a ophthalmic technician).  I realize different schools prioritize different forms of PCE and I will be contacting the schools I want to apply for for clarification.  I have to choose one--both are full time positions. 

 

But in general, which would be benefit me more? 

 

Thanks! 

[MusicalPA]

My husband was a PT aide, or rehab tech is what they called him. He had a year's worth of hours working for them. He got into PA school with that(along with clinical hours from being an Athletic Training student). Not sure which one is necessarily better. 

[clapperjoe]

I've been a scribe for the last 13 months and I absolutely love it. I've been scribing for an ENT during the entire time, and for the last 8 months have also scribed at an Internal Medicine clinic. At the IM clinic, I continue to work with an MD, DO & NP on a weekly basis and have learned so much as to what goes into primary care such as medications, physical exams, diagnosis', and everything else in between. Also at the IM clinic, there was a 4th year medical student working with them for several weeks and when it came to handling the EMR, to put it nice, he struggled. I wouldn't want to be the new guy and not be very competent with an EMR. Meanwhile at ENT, I've learned the many ways to treat sinus infections, ear infections, thyroid management, etc, and have actually been asked several times for some advice at the PCP clinic. All in all what I'm trying to say is, scribing has allowed me to witness medical decision making at very high levels for over a year, and although I'm still waiting admittance into a PA program, I feel very prepared to move forward once I finally do begin PA school, hopefully this fall or the next.

 

I should also add that last summer, I worked in two cardiac rehabilitation clinics and in one of them, I worked with the physical therapist aide on a regular basis. He was responsible for treating about 16 patients a day, and while this was good hands on work as I was able to directly work with patients for two months, it doesn't compare to the information I've learned from scribing. 

 

Ultimately, it is your decision and I think you have to choose between these two things: actual patient contact hours that ultimately won't have a huge impact as a future PA, or scribing hours that will carry over into your career as a PA.

 

If by some chance I didn't make any sense or you want some additional clarification weighing the pros and cons between your respective choices, drop me a PM and I'd be happy to elaborate.  

[pastudentw]

My advice would be look into your top choices for PA programs you would like to attend or the majority you plan on applying to to see which one they would value more. Technically a scribe isn't "hands on" actually touching the patient and some programs may side that way. Other programs may accept scribe work as a great patient care experience since it does translate into valuable experience as a PA and will count it as "hands on" experience since it is valued that way. I think a PT aide is pretty safe that most programs would accept it.

The key for the most valuable patient care experiences are those that give you more chances to provide direct healthcare to patients. The more responsibility you have in that position may be "valued" higher even though all positions in the healthcare system are important.

Consider which position you would allow you to cast a wider net for schools, which one you would enjoy more and which one would give you the best advantage while in school and clinically relevant experiences. 

Personally, I was an EKG tech (performed 12 leads, stress tests and scanned holter monitors) and medical laboratory scientist. This means I'm really good at reading EKGs and heart rhythms but I know that is only one (but still very important) slice of the pie. The people in my class who have EMT/paramedic experience clearly grasp things faster (just my opinion and observation so far so take it with ease).

[south]

 I've learned the many ways to treat sinus infections, ear infections, thyroid management, etc, and

feel very prepared to move forward once I finally do begin PA school, 

it doesn't compare to the information I've learned from scribing. 

 

 

Whoa there just a second, Tex.

 

Not knowing a single other thing about you, I can confidently state that's an attitude that will get you into serious trouble.  If you go into an interview or PA school and say or honestly believe these things, you could be in for a serious bruising.  

 

I too was a scribe and scribe trainer for 13 months (formal school EPIC in the ED).  No greater fan of scribing than I.  But I want to let you in on a little secret...much of what you are learning right now...is wrong.  

 

You heard that right.  Unless it is on the PANCE and/or on your exam, the only thing that recalling specifics from your scribing days will do is cause you to miss questions and answer incorrectly when asked questions on clinical rotations.  And get pissed off because you know it's "wrong"!

 

I'll give you an example.  What are your #1 and #2 drugs to give for CAP?  How about Nosocomial?  Got your answer?  

 

Your answer is wrong.  It is different everywhere.  The drugs I learned in the ED as a scribe were different than the drugs I gave on clinicals, and in fact were different from the drugs listed on the PANCE as correct.

 

I happened to be in infectious disease at the time, and many of the "first line" drugs were near 100% resistant in my area.  So the doc was like, "no, no, no--who told you that?"

 

Specifics - you have to learn and unlearn them depending on which environment you are in.  You can and might very well learn: 

one thing now,

another in didactic,

another in clinicals,

and another for the PANCE (which by the way may be a few years ahead or behind any of these other modes).  

 

I'm not saying it's everything...but we have ALL been there where in multiple choice test, ALL of those answers will probably work.  One of them may have been yanked off the shelves by the FDA, but was it before or after this test was written?  I just came off this rotation, and I KNOW this is right answer...but this EOR exam is from didactic year...crap...these answers all look good to me...

 

Get the picture here?  I just wanted to say something, not trying to be an ass about it.  It's just something you are going to have to adapt to.

 

I think scribing is great, but "carrying it forward into your career" is overstating it quite a bit.  We had a number of scribes in my class, my school liked them, and the general experience was great, and the documentation part was nice, but I think most of them would agree that the rest was a double-edged sword.

 

To the OP's question, neither of those opportunities would be in the top tier (because the scribe is not a sure thing and it sounds too focused).  Sure you can't get a CNA or Patient Tech position somewhere?

 

Schools vary somewhat, but the top tier is where you are touching and treating patients.  Nursing, Patient tech, EMT.  Followed by scribe.  Bringing up the rear is stuff like lab and phlebotomy.  PT aide ?  I dunno - maybe in there somewhere.  

[8404PA]

Be a CNA or Patient Tech. You need REAL hands on patient care, not just observation and jotting things down. I'm not looking down on scribes but I think its a cop-out for HCE for PA school, and not the best prep work (except that first week where you learn to write SOAP notes).

 

You can also be awesome and be a combat medic, which is the foundation of the profession. 

[karebear12892]

Former ER scribe/current PA student here. If I had to do it all over, I would hands-down be a scribe again. This was the best pre-PA school job I could have ever asked for. As a scribe, you gain insight into the medical decision making of a healthcare provider that no other experience offers.

 

Just like any other job, as a scribe, you get out of it what you put into it. I told the physicians I worked with that I wanted to learn as much as possible --- so they taught me how to interpret labs, EKG's, x-rays, etc. After the physician looked at the EKG, they would hand it to me and ask me what I thought. If a patient was wheezing, they would say, "come over here and take a listen to this person's lungs and tell me what you hear. What tests do you think I'll order?" For two years, I strived to learn something new from every patient encounter, and I never hesitated to ask questions if I didn't understand the provider's train of thought. 

 

By the time I started PA school, I already had a basic knowledge of differential diagnoses for just about any complaint. I already knew the doses and indications for common drugs. After spending literally thousands of hours attached at the hip with an ER doctor, I had already been exposed to the presentation, work-up, and treatment for a variety of diseases and injuries. Yes, I still have plenty to learn. But I have a very solid foundation on which to expand my knowledge. 

 

I am not saying that hands-on experience isn't valuable --- it certainly is. But I firmly believe scribing can be outstanding preparation for PA school if you're willing to make the most out of it. 

[SedRate]

Hello everyone,

 

I have an opportunity to be hired at two different places for different responsibilities one as a PT aide (not an assistant, sorry can't edit the topic title) and the other as a possible scribe (but starting as a ophthalmic technician). I realize different schools prioritize different forms of PCE and I will be contacting the schools I want to apply for for clarification. I have to choose one--both are full time positions.

 

But in general, which would be benefit me more?

 

Thanks!

Whichever one has more opportunity to learn. Scribing might be good in the right setting, such as the previous poster's experience. Unfortunately, not all providers are as willing to teach or take the time out to show a scribe certain things.

 

Consider CNA/PCT at a hospital or ER instead. You will work directly with patients, learn how to communicate with family, learn bedside manner, and how to communicate with other members of the healthcare team. The nurses can be a wealth of knowledge and may even show you how to do certain procedures, such as how to start IVs, give injections, and hook up a 12-lead, just to name a few. You might also have opportunities to watch or assist (aka, hand them stuff) during bedside procedures including suturing, reductions, ultrasound, PICC, central lines, splinting, codes, and the list goes on.

 

An office setting may limit your exposure, especially if they're paying you. They will likely want you to do your job and scribe rather than get paid to learn and ask questions. Sure, you can observe and absorb things, but I'm not sure that's the best pre-PA experience, especially if it's in an ophthalmology setting as your post suggests.

[clapperjoe]

Whoa there just a second, Tex.

 

Not knowing a single other thing about you, I can confidently state that's an attitude that will get you into serious trouble.  If you go into an interview or PA school and say or honestly believe these things, you could be in for a serious bruising.  

 

I too was a scribe and scribe trainer for 13 months (formal school EPIC in the ED).  No greater fan of scribing than I.  But I want to let you in on a little secret...much of what you are learning right now...is wrong.  

 

You heard that right.  Unless it is on the PANCE and/or on your exam, the only thing that recalling specifics from your scribing days will do is cause you to miss questions and answer incorrectly when asked questions on clinical rotations.  And get pissed off because you know it's "wrong"!

 

I'll give you an example.  What are your #1 and #2 drugs to give for CAP?  How about Nosocomial?  Got your answer?  

 

Your answer is wrong.  It is different everywhere.  The drugs I learned in the ED as a scribe were different than the drugs I gave on clinicals, and in fact were different from the drugs listed on the PANCE as correct.

 

I happened to be in infectious disease at the time, and many of the "first line" drugs were near 100% resistant in my area.  So the doc was like, "no, no, no--who told you that?"

 

Specifics - you have to learn and unlearn them depending on which environment you are in.  You can and might very well learn: 

one thing now,

another in didactic,

another in clinicals,

and another for the PANCE (which by the way may be a few years ahead or behind any of these other modes).  

 

I'm not saying it's everything...but we have ALL been there where in multiple choice test, ALL of those answers will probably work.  One of them may have been yanked off the shelves by the FDA, but was it before or after this test was written?  I just came off this rotation, and I KNOW this is right answer...but this EOR exam is from didactic year...crap...these answers all look good to me...

 

Get the picture here?  I just wanted to say something, not trying to be an ass about it.  It's just something you are going to have to adapt to.

 

I think scribing is great, but "carrying it forward into your career" is overstating it quite a bit.  We had a number of scribes in my class, my school liked them, and the general experience was great, and the documentation part was nice, but I think most of them would agree that the rest was a double-edged sword.

 

To the OP's question, neither of those opportunities would be in the top tier (because the scribe is not a sure thing and it sounds too focused).  Sure you can't get a CNA or Patient Tech position somewhere?

 

Schools vary somewhat, but the top tier is where you are touching and treating patients.  Nursing, Patient tech, EMT.  Followed by scribe.  Bringing up the rear is stuff like lab and phlebotomy.  PT aide ?  I dunno - maybe in there somewhere.  

 

Hey Tex,

 

I guess what I was trying to get at is scribing has been a great experience, I've learned a lot within the last year, and I think OP would benefit more from scribing than being a PT aide if he continues to pursue PA as his future career. Karebear12892 said it great in that I've also taken advantage of my scribing experience - I've learned to interpret audiograms, CT scans of the sinuses, & MRI of the IAC's, but I never said that I'm ready to be thrown into the fire and can begin treating patients today.

 

Also, I did say that I will be using the information moving forward, but I never stated I'm not going to learn what I have to once PA school begins. I understand there are many different ways of treating different conditions, and there is still a lot I haven't been exposed to. Once I get into school, I'm pretty confident my way of thinking will change as I'm not stuck in my ways in my mid-20's. That would be highly inappropriate and kind of defeat the purpose of pursuing PA school. 

 

All in all, OP was asking for insight on scribing versus PT aide, and I gave my insight. I appreciate you putting in your two cents, but maybe a little less criticism next time. Good luck in PA school and with your future career as a PA.

[south]

Fair enough; maybe you'll take pause before you trot that out at an interview and you'll get into the school of your choice and then cruise through the documentation part.  Strive for level 5!

 

I am a research wonk and did a detailed analysis of all 126 PA schools (this was 2013 and by the time I was done there were 131) comparing the classes I had and my hours of experience as a scribe and EMT.  I set up a separate email account and called or emailed around 58 programs about scribe hours for HCE (and a few other questions). I got a few from SDN and maybe even this forum as well, I don't remember.

 

Of these 58, 4 accepted scribe as HCE, and one - the program from which I ended up graduating - ranked it as quality, especially in my interview.  

 

Obviously, I now know my interviewers well, and they have admitted that it was my EMT experience and other background items that provided the kick that i needed.

 

Backing out my analysis against the - what - 200 plus programs out there now, that suggests that something like...12 - 15 + programs are going to accept it as HCE.  Looking at the PA Student forums here over the last year or so, that seems about right, even accounting for any errors I might be making.

 

So say whatever you want, but your 150,000 hours of super high quality scribe is going to be largely ignored by ~90% of programs.  They have their rules and biases, and my opinion on it doesn't matter.

 

I'll echo almost all of my colleagues - get some other experience touching and treating.  EMT, CNA, Tech.  That's what I did and it's what got me in. 

 

I think a bit of both is an absolutely deadly one-two combination.  I think even like some crazy low 200 hours of scribe and tech each, that candidate would get a second look.  

 

My opinion only and as we say in my former career - "errors may be large" - but I kinda been there.  Best of luck to everyone.

[prepa1112]

Hey there, 

 

You've gotten a lot good advice so far. I just wanted to throw my experience in here, too. 

 

I was an optometric technician for a while, and that's how I got my PCE. I prepped the patient (history, meds, bp, diagnostic testing, visual acuities, eye drops, altered contact lens rx, etc.) and also scribed once I was in the room with the Optometrist. I was a first-time applicant and will be entering my first-choice program this May! I think you just need to make sure the school doesn't value one job over the other. Make sure you get as much out of the job as you can! Be passionate about the job you choose to do and it will show when you interview at PA schools. 

 

Good luck!

[south]

You know, one of you guys should start a thread about schools you have found where scribe is accepted as HCE 

[rev ronin]

I have precepted (primary, not just the occasional staffed case) for 3 NPs and 3 PA students.  The PA student who had been a scribe was BY FAR the best at documentation, and was a much stronger clinician than I would have suspected for someone lacking the 'hands on' experience.  I've come around, and now hold scribing in much higher esteem... sometimes it's not about touching the  patients so much as it is about seeing, hearing, and thinking about them medically, it would seem.

[karebear12892]

You know, one of you guys should start a thread about schools you have found where scribe is accepted as HCE 

 

Great idea! I might just do that :) 

[south]

was a much stronger clinician than I would have suspected for someone lacking the 'hands on' experience.  I've come around, and now hold scribing in much higher esteem... sometimes it's not about touching the  patients so much as it is about seeing, hearing, and thinking about them medically, it would seem.

 

Right on.  As I've said, no bigger fan of scribe than yours truly, and my comments are always how the system is, not how I think it should be. 

[LIBK13]

My PCE consisted of about 375 hrs scribing in urgent care and ~1000 hrs as a PT aide when I applied. I left the scribing job because I relocated and because I saw so many schools did not count it but all the schools I looked at DID count PT aide. From my experience I developed great relationships with patients and sometimes felt I played a larger role as a PT aide but in the end feel like scribing is superior experience in preparing you for your future career. I spent my days assisting PAs after all! Also my scribe job included taking vitals, getting a history and chief complaint etc and performing rapid diagnostic tests (strep/flu, urinalysis) and THEN present to the provider so in hindsight I think it was amazing experience and wish I didn't leave that position (the schools I got into all DID accept scribing). However, I know a lot of scribes don't leave their computer in many places. Still I think it will serve you better experience-wise...though can't say what schools think ;)

[enc3221]

I worked as a scribe/CNA in an outpatient GI office for 2 years prior to PA school. I was primarily a scribe but also would occasionally take vitals, get the chief complaint, and assist during procedures. Without the scribe experience, I don't think I would have felt ready for PA school. I worked with four different providers so I was able to observe how each of them does things differently. If you're lucky enought to work with providers who support your career goals, you'll have the opportunity to ask questions and interact with patients. In my opinion, definitely scribe if you get the opportunity!

[ndpa09]

A few years ago scribing was heavily looked down upon as HCE on here (EMEDPA)...I never understood why. 

I worked as both an ER tech and a scribe but being a scribe was by far the best medical experience I had. Typically as a scribe we would see about 16 patients a day - that's seeing first hand 16 different pt presentations, H&Ps, lab orders - all while documenting them gaining valuable EMR experience. I had a handful of classmates who were scribes and to my knowledge they all did very well in school and had a ton of clinical experience to draw on, in terms of patients and things they had seen in the past.

If you are familiar with the basic things you can pick up as a scribe (common labs, meds, medical terms etc.) then it makes it so much easier to take the next step and start interpreting things and putting everything together. 

 

ClapperJoe, while a little of the top, will probably be well prepared and hit the ground running in PA school. While his peers who were CNAs may not even know what a cmp is or what it consists of. Or how to construct a decent SOAP note. Those small things help.

Outside of being a nurse, paramedic, or perhaps a RT I think being a scribe is the best experience you can have going into PA school or medical school for that matter.

 

[simply dave]

Thanks everyone for replying with your input.  Unfortunately right now, the main thing for me is what schools deem as primary means of PCE to get me into school vs what would better prepare me as a PA student / working PA.  

 

As an aside, I started as a PT aide volunteer to see if it's a good fit and I like the patient contact when I'm showing them directly how to do exercises, setting them up etc.  I like the people aspect of the job, but in all honesty, I feel like I'd get bored intellectually after awhile.  It seems like a lot of busy work.  No offense to anyone who has done the job before--it's just my initial impression.  This may change as I learn more about the job, but after 10 hours, so far it seemed like more of the same.  Don't get me wrong seeing people improve is rewarding.

 

I like the idea of seeing different patients with different issues and wrapping my mind around ailments and how the doctor would treat them with the scribe job.  

 

Back to my original thought, I'll be contacting all 15+ schools I'm interested in and seeing where they stand. 

 

Thanks again everyone, feel free to keep this thread going as it helps others reading. 

[greenmood]

I had 10 years of experience as a PT aide prior to PA school. I got to go everywhere in the hospital and see a huge variety of patients. I also spent some of that time working in outpatient sports medicine and at a pediatric clinic for kids with congenital and developmental disabilities.

 

It was wonderful experience. Yes, you will probably become bored if you never change things up or try to do anything new. If all you do is put gait belts on and help transfer patients, your mind will give out well before your back does. When I quit to go to PA school I was also doing wound care and lymphedema, and teaching a developmental gymnastics class.

 

In any job, you need to maintain intellectual curiosity. Find opportunities. It is a skill that will help you be happy as a PA.

[simply dave]

Just a quick update in case anyone is wondering.  

 

My top pick for schools: says Scribe > PT aide

2nd pick: Scribe doesn't even count.  PT aide does as well as ophthalmic technician.  

3rd pick: Scribe doesn't even but.  PT aide does as well as ophthalmic technician.  

4th pick Scribe > PT aide > ophthalmic technician

 

I'm waiting to hear back from other schools.  

 

I'm leaning towards taking the ophthalmic technician job that will hopefully lead to the scribe job.  Also the ophthalmic technician job pays more and offers benefits/401k vs the PT aide job. 

[perezn1]

How does one become a scribe? 

[Jdabrowski]

How does one become a scribe? 

I checked on indeed.com for scribing jobs. I luckily found a private clinic which pays me much higher than large scribe programs and I get to be much more involved. I do not believe there is any certification you need to do for this, but it is helpful to have a background in medical terms, and I will say having a pharmacy background before this I know the drugs, the doses, and what they are prescribed for. Spelling most of the drugs is the bigger problem. Just start with googling Scribe positions in your area. Hope this helps! As much as people bash on being a scribe you get a lot out of it if you put in the time to learn and ask questions. This has been an insightful experience in my book, and I am VERY glad I have the opportunity to do this.

[Jdabrowski]

Former ER scribe/current PA student here. If I had to do it all over, I would hands-down be a scribe again. This was the best pre-PA school job I could have ever asked for. As a scribe, you gain insight into the medical decision making of a healthcare provider that no other experience offers.

 

Just like any other job, as a scribe, you get out of it what you put into it. I told the physicians I worked with that I wanted to learn as much as possible --- so they taught me how to interpret labs, EKG's, x-rays, etc. After the physician looked at the EKG, they would hand it to me and ask me what I thought. If a patient was wheezing, they would say, "come over here and take a listen to this person's lungs and tell me what you hear. What tests do you think I'll order?" For two years, I strived to learn something new from every patient encounter, and I never hesitated to ask questions if I didn't understand the provider's train of thought. 

 

By the time I started PA school, I already had a basic knowledge of differential diagnoses for just about any complaint. I already knew the doses and indications for common drugs. After spending literally thousands of hours attached at the hip with an ER doctor, I had already been exposed to the presentation, work-up, and treatment for a variety of diseases and injuries. Yes, I still have plenty to learn. But I have a very solid foundation on which to expand my knowledge. 

 

I am not saying that hands-on experience isn't valuable --- it certainly is. But I firmly believe scribing can be outstanding preparation for PA school if you're willing to make the most out of it. 

I wish I could like this post all over again! I was literally told by two people that my hours in scribing would not account for much, but have followed the same path as you and since I have started my doc has guided me through interpreting lab results, EKG's, Xrays, etc and I have had to help him in very minor procedures by holding equipment while he was cutting something etc. I also have a very decent background in pharmacy so this part was easy for me to know the drugs, what they are used for, how they are dosed, and was even able to remind my doc that some of these medications are in liquid form or could be compounded easily. As an extra I volunteer in a hospice center and assist in feeding, clothing, and bathing pts and follow one around who has severe dementia so she doesn't get into other rooms etc.

[Dmurphe18]

Hello, I am currently working as a cushion orthotic fitter and retaking classes trying to apply for the 2018 year, I fit orthotic equipment like back knee and ankle braces as well as regularly collaborate with doctors about patient best interest, would this count as good patient contact experience? I don't want to waste my time if this will not help me in the long run. I also have a very low gpa of 2.6 and a 2.5 bio gpa. Are my chances realistic for being a pa? Any feedback is very appreciated thank you!