Scribe Work

[amthrasher]

I was just offered a job as a scribe (from Scribe America), working in the emergency dept of the local hospital functionally being an assistant to the physicians in the dept. From everything I have heard about the job, from ER docs I know, the interviewer etc, this sounds like a really good position for gaining knowledge and experience. Not to mention Im most interested in working professionally in the ED. Im really just looking to fulfill my experience requirements for PA school. Has anyone in this forum worked as a scribe and then been accepted to PA school? It sounds like technically this is not a "hands on" job but it does sound like I can learn a lot more than I would as a tech. What do you think? Should I take this job to fulfill my PA school work experience? I think it sounds great, but a year from now I don't want to be kicking myself for making the wrong decision.

[EMEDPA]

AGREE, it's shadowing, not hce.

I wouldn't accept someone who had only scribe time.

[Hemegroup]

I third PAMAC and EMEDPA. Excellent experience, but still not hands on. Do both. Ideally you could also work as a tech in the same ED! Man would that be a dream!

[amthrasher]

Thanks for the good feedback. I think Im going to take the job and Im starting a EMT course on monday, so hopefully I can just shift from the scribe job to a tech position after I have my EMT cert.

[HLReed]

I worked for Scribe America before starting PA school.

Couple things:

It's not direct patient care, but it is definitely not shadowing. You will be expected to do a lot (once again, not directly to patients) and the work load and pace will be intense. It is not a cushy job. You can learn a ton about how an ED runs, you can learn about diagnostic tests and labs. You can get some insight into history taking and physical exam. Its a nice little review of med term. For my job they sat us in a classroom for a month before we even started.

 

I worked this while I was also working as a mental health tech (among many other jobs). The knowledge was great but I would not have felt good walking into an interview with this as my only experience. (My supervisor wrote in her email pitching the job that it "counts as HCE for PA school!" which made me laugh.) The pay for the first 6 months is insulting, but its not really about the money, I suppose. It is not a job that I would say puts you "in the trenches" with patients, but it has its own challenges and rewards. I felt ahead of the game when we learned history taking in PA school, which none of my other jobs had exposed me to.

 

Your plan sounds solid. My additional advice is to try to get exposure in areas outside of the ED. I worked a job in Radiology that I thought was going to be boring but every day in PA school I am thankful I did. I learned a ton and realized that interventional radiology is awesome, especially for the PAs at my hospital. Just keep an open mind.

 

There is nothing you learn in the classroom or in a rotation that can exactly replicate the unique experiences you get from your healthcare jobs (or other life experiences, for that matter). The bits of insight you gather are unique to your region, hospital, patients, and fellow providers and workers. If you are an open minded person, you will learn a lot that you wouldn't have absorbed through PA school. You might work with a doctor or PA that has unique knowledge to share with you. Or you might see patient populations that you will not work with again. For example, no pysch lecture or rotation will ever give me the insight I received by spending 8 hours a day 1-on-1 (or 1-on 8) will patients in my mental health hospital. I will keep the lessons from that job forever. Good luck to you.

[NewtonsApple]

 

I worked this while I was also working as a mental health tech (among many other jobs).

 

Having worked both as well ( and as an EMT), I can say that for me, my psych degree and working as a mental health tech has prepared me more than my other jobs thus far into didactic year.

[fyrelight74]

I work as a combo clinical medical assistant and scribe for a family practice doctor. I've essentially written my own job description, as I am his first scribe. I assist with everything in the room as an MA such as minor surgeries, procedures, but also record all the details of the visit. This has been a great boon to my medical terminology, as I often add details that I see, that aren't offered by the doctor verbally. I also add diagnoses and treatments and completely write the HPI. In addition, I scan the chart before visits to give the doc a brief 60 second breakdown prior to the visit of what occurred at the last visit and any important details such as recent labs, etc. In the room, I suggest tests and treatments (after learning them from the doc... simply reminding him of what we have done for other patients, etc). I check kidney function on labs if the doc is about to prescribe NSAIDS or other meds that may affect the kidneys. Same for liver function tests. I've also reminded the doc of drug-drug interactions that I see on the EMR (as he is not looking at the computer during the visit). Prior to appts, I import labs and notify doc of any important abnormal values. I'm the one person that the doctor will allow to take phone calls regarding possible emergencies including chest pain, etc... to the point the office staff will pull me out of a room to let me take the call. I have made judgement calls on the fly during phone calls if needed, running them by the doctor later. He is fine with that. I have received radiology results before the doc arrives in the morning and immediately put in STAT referrals. I feel I've had very good experience as a scribe/MA, better than I would have had if I had stayed with my MA training that I began with. I feel more prepared for PA school than I would have been had I stayed an MA. BUT, my experience may be vastly different from other scribe positions.... I don't know. Other scribes, what are your experiences? Similar, or are you less involved in decision making?

[EMEDPA]

scribes I have seen at 2 of my jobs in the emergency dept do no decision making as they have no medical training. they are mobile transcriptionists. some of the docs will discuss cases with them(but not for their input, more to educate them) others just say " for the hpi write this"....".

again, I think scribe is fine for shadowing but unless it is like the experience of the previous poster it is not health care experience...medical asst. is great experience for pa school. several of the ma's I work with now are in the process of preparing for pa school and they will be way ahead of those without similar experience.

[marilynpac]

That maybe true where you're at emed, maybe in other areas they are used differently. I've seen LPNs function anywhere from glorified CNAs to doing everything that an RN does...depends on the dogma...

[EMEDPA]

true, but consider they are unlicensed to do anything so any bad outcome is on the provider...giving advice over the phone and writing referals without input from a provider could be construed as "practicing medicine"

all the scribes I know are folks who are bio majors who didn't get into medschool on the first round so they are spending a yr taking more classes, retaking the mcat and working scribe as " medical experience".

ps the lpn's I work with for the most part are better than many of the rn's...it's about the yrs of experience, not the classroom training...

[fyrelight74]

true, but consider they are unlicensed to do anything so any bad outcome is on the provider...giving advice over the phone and writing referals without input from a provider could be construed as "practicing medicine"

I must clarify that I only do referrals and such because I know what the doctor would ask for.. sort of a verbal protocol. For example, if radiology recommends, doctor will always refer. Doing it STAT is just a matter of being around him and knowing what he would want. Phone calls... well I know what questions to ask to determine if they should call 911 or come in later... if in doubt, I would defer to the doctor. I know my place.

[fyrelight74]

I agree. I'm in the process of training our other MA to take my place when I'm gone. Then they will bring in another MA to take her place... which is mostly rooming patients, doing refills and getting vitals. It would be nice to have 2 scribe/MAs but I don't think that will ever happen, as it takes so much time to train someone for the position, and that only happens after the person has been working there for some time and knows the protocols, the EMR, etc. Doc would never bring in someone off the street to be his scribe/MA right off the bat.

[EMEDPA]

I must clarify that I only do referrals and such because I know what the doctor would ask for.. sort of a verbal protocol. For example, if radiology recommends, doctor will always refer. Doing it STAT is just a matter of being around him and knowing what he would want. Phone calls... well I know what questions to ask to determine if they should call 911 or come in later... if in doubt, I would defer to the doctor. I know my place.

I was responding to marilyn, not to your specific situation. she was talking about scribes with no medical training having broader roles...when I was an er tech/ma I actually did a a lot of what you describe(minus the charting part) ie referals, phone advice, ordering films, etc

for the most part a lot of it is common sense("grandpa is drooling and can't move his r arm. should I call 911 or wait for his appt tomorrow?").

[fyrelight74]

Just wanted to share an experience I had the other day. The other MA (who does rooming, vitals) had an incredible migraine and went home before we ever saw patients. Doctor was about to freak out, but I told him I could do both jobs. He looked at me like I was nuts, and said that we didn't have any choice, he guessed.

 

So, I'd room a patient, and while getting vitals, interview them. From my scribing training, I was able to get most of the information at that point in order to fill out the HPI and the ROS. Then I would bring the doctor in, finish the scribing duties including prescriptions, etc. Then I would sneak out of the room about 5 minutes before doctor was done (usually he's just re-emphasizing something at that point), briefly review the next patient's chart and then room them.

 

We totally rocked that day! We were out for lunch on time, and ended the day on time as well! Doctor was amazed! I guess my scribing training has really helped me know what questions to ask in order to simplify things before the doctor ever gets in the room. The only thing I had to put on the back burner was importing lab results, doing refills, and referrals.. things that could wait a bit anyway.

 

Doctor asked me the next day if I was worn out, I told him that I was fine.. no difference. He said I must thrive under pressure. I guess I do. It made the day go fast, and I liked using my interviewing skills.

[hypermartyr]

I work as a Physician and Physician Assistant scribe in an ED, and am doing so with the idea that there is no better way to see first-hand what it is like to work as a PA, and to gain valuable experience in an Emergency setting. Additionally, I am convinced that it will give me a huge advantage when PA school starts. The current trend for PA schools is to not accept scribe experience because they say it is not direct patient care. On the other hand, ALL the PAs I work for in the ED state that they wish scribing had been an option when they were gathering health care experience, and all agree that schools in the very near future will either begin accepting scribe experience, or they will miss out on very skilled candidates. Many have even offered to contact my chosen schools and explain the role and value of scribe experience. So, in answer to your question, it is a risk to work as a scribe in the current environment, but it is also highly likely that scribe experience will be more widely accepted in the very near future. In my case, I am counting on the latter.

[NewtonsApple]

While my work as a scribe in the ED may have given me insight into the duties of a PA, it did not compare to working as a Mental Health Tech or EMT in regards to patient contact or health care experience.

[fyrelight74]

I work as a Physician and Physician Assistant scribe in an ED, and am doing so with the idea that there is no better way to see first-hand what it is like to work as a PA, and to gain valuable experience in an Emergency setting. Additionally, I am convinced that it will give me a huge advantage when PA school starts. The current trend for PA schools is to not accept scribe experience because they say it is not direct patient care. On the other hand, ALL the PAs I work for in the ED state that they wish scribing had been an option when they were gathering health care experience, and all agree that schools in the very near future will either begin accepting scribe experience, or they will miss out on very skilled candidates. Many have even offered to contact my chosen schools and explain the role and value of scribe experience. So, in answer to your question, it is a risk to work as a scribe in the current environment, but it is also highly likely that scribe experience will be more widely accepted in the very near future. In my case, I am counting on the latter.

 

The idea of whether it is direct patient care or not depends on the situation. Scribing can be so varied. In my scribing/MA job, I interact with the patients constantly... asking for clarification, explaining things when they ask questions (as when the doc steps out for a few minutes to grab cryo, etc)... I also assist with all the procedures because I'm already in the room. Doctor never has to worry about asking for a female assistant when doing a breast exam or pap smear, because I'm already there.

[jalldredge]

I found that it is not always helpful when asking people about what is "good" experience. Almost all of these posts speak negatively about being a scribe, but they have very little experience in that matter. Some state that the HPI is dictated to the scribe by the physician - this is not always true. I composed all of the HPIs and the ER doc reviewed them later. I worked as an ER scribe for 1.5 years. I received multiple interviews (including Duke and Samuel Merritt) and I am currently in PA school right now. If you believe it is good experience and can portray this in your statement - then it will be just fine.

[just_me]

Lucky you to have two of you there.....I do all of that on a daily basis and have been since I started there. I usually get to importing lab results, doing refills, and referrals either early before my shift starts....when he goes to lunch.....the end of the day or on a T of Th when he is not seeing patients.

 

Just wanted to share an experience I had the other day. The other MA (who does rooming, vitals) had an incredible migraine and went home before we ever saw patients. Doctor was about to freak out, but I told him I could do both jobs. He looked at me like I was nuts, and said that we didn't have any choice, he guessed.

 

So, I'd room a patient, and while getting vitals, interview them. From my scribing training, I was able to get most of the information at that point in order to fill out the HPI and the ROS. Then I would bring the doctor in, finish the scribing duties including prescriptions, etc. Then I would sneak out of the room about 5 minutes before doctor was done (usually he's just re-emphasizing something at that point), briefly review the next patient's chart and then room them.

 

We totally rocked that day! We were out for lunch on time, and ended the day on time as well! Doctor was amazed! I guess my scribing training has really helped me know what questions to ask in order to simplify things before the doctor ever gets in the room. The only thing I had to put on the back burner was importing lab results, doing refills, and referrals.. things that could wait a bit anyway.

 

Doctor asked me the next day if I was worn out, I told him that I was fine.. no difference. He said I must thrive under pressure. I guess I do. It made the day go fast, and I liked using my interviewing skills.

[just_me]

In regards to applying to PA programs the phrase "direct patient care" is described as hands on on and dealing with the care of patient directly. Many programs go on to give examples such as vitals, injections, blood draws etc. While interacting is definitely ueful, there are many positions where you can interact with patients (registration rep, transporter, food service, etc.) but if you are not directly involved (hands on) with the care of said patients, then the programs that require that type of interaction will not count it towards that requirement.

 

Getting that definition from the program itself is more useful than guessing or assuming. When I applied I called every program I looked at to see if they accepted my blood bank phlebotomy experience and while teh majority did a couple said no.

 

The idea of whether it is direct patient care or not depends on the situation. Scribing can be so varied. In my scribing/MA job, I interact with the patients constantly... asking for clarification, explaining things when they ask questions (as when the doc steps out for a few minutes to grab cryo, etc)... I also assist with all the procedures because I'm already in the room. Doctor never has to worry about asking for a female assistant when doing a breast exam or pap smear, because I'm already there.

[fyrelight74]

In regards to applying to PA programs the phrase "direct patient care" is described as hands on on and dealing with the care of patient directly. Many programs go on to give examples such as vitals, injections, blood draws etc. While interacting is definitely ueful, there are many positions where you can interact with patients (registration rep, transporter, food service, etc.) but if you are not directly involved (hands on) with the care of said patients, then the programs that require that type of interaction will not count it towards that requirement.

 

Getting that definition from the program itself is more useful than guessing or assuming. When I applied I called every program I looked at to see if they accepted my blood bank phlebotomy experience and while teh majority did a couple said no.

 

Unfortunately, scribing is just not listed on any program that I know of... you would have to call every program and ask. I think it's just not that well known yet... a need that's increasing as EMRs become required. I KNOW I have hands on patient care experience, plus I have learned more scribing than I ever did as an MA doing the vitals, drawing blood and such.