Is a Medical Scribe consider HCE?

[AnSkY2125]

I am just curious if I can use my position as a medical scribe as HCE?

[Dunedain]

Some schools consider it as HCE but there are much better choices out there with regard to patient interaction.

[JohnnyM2]

This question has been debated at length in multiple threads. You can do a search or look at the following:

http://www.physicianassistantforum.com/index.php?/topic/12876-Medical-Scribe

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[EMEDPA]

does it count? depends on program.

should it count? no.

[JohnnyM2]

does it count? depends on program.

should it count? no.

It seems that there is a lot of variation in scribe programs. Some are terrific but, it seems, others may not be as good. EMEDPA has some extremely insightful posts but I completely disagree on this one. That it shouldn't count is just his opinion. Perhaps he should have said that. Sorry EMDPA, though I respect your experience, your prejudice on this issue is apparent. For the OP, check with the schools you want to apply to. Theirs is the only opinion that matters.

 

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[EMEDPA]

It seems that there is a lot of variation in scribe programs. Some are terrific but, it seems, others may not be as good. EMEDPA has some extremely insightful posts but I completely disagree on this one. That it shouldn't count is just his opinion. Perhaps he should have said that. Sorry EMDPA, though I respect your experience, your prejudice on this issue is apparent. For the OP, check with the schools you want to apply to. Theirs is the only opinion that matters.

 

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fair enough. in my opinion, most scribe programs do not provide adequate experience for attending pa school. I have heard of some hybrid programs which do, in which the scribe is also an er tech and does some hands on work, but this is not common. a scribe is basically a mobile transcriptionist doing some shadowing. they have no input into patient care, don't ever touch patients or do procedures and simply write down what they are told or order what they are told to order. I have worked at several places that use them and understand the concept well. There is some value in seeing cases and how different providers approach different complaints, but that is basically shadowing, not actual work.

[Dunedain]

I've worked in a ED before and IMO scribe HCE was always a cop out for people who didn't want to touch patients or be involved with hands on care. Anyone can transcribe, the purpose of HCE is determine if you really want to be in HC and or utilize a person's prior medical knowledge. A scribe fulfills none of those. As EMED said, it's basically paid shadowing.

[cnguyenle]

I think medical technologist experience > scribe experience in my opinion but to most schools it isnt due to lack of patient contact

[JohnnyM2]

I've worked in a ED before and IMO scribe HCE was always a cop out for people who didn't want to touch patients or be involved with hands on care. Anyone can transcribe, the purpose of HCE is determine if you really want to be in HC and or utilize a person's prior medical knowledge. A scribe fulfills none of those. As EMED said, it's basically paid shadowing.

Really? I know a bunch of scribes who are working hard to get into PA school or med school. Scribe requires no certification and offers a great learning experience. Many of these scribes use the job for "paid" HCE and volunteer as, basically, MAs for hands on. One advantage of being a scribe is flexibility to take pre-reqs.

I don't quite see why being an ER tech or EMTb helps you determine that you want to be in HC and being a scribe doesn't. It just seems snobbish to make that assertion.

 

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[Will352ns]

I have found that scribe does have some practical uses in school.  They have the "lingo" down pat.  We went to the couple of former scribes in our class for advice on H&P's when we were learning them.  Big help for those who had little in hospital charting experience.  

[Saraya]

Full disclosure: I was a scribe pre-PA so I'm probably biased but I believe that each experience is unique (Tech v. Scribe v. etc) and valuable in unique ways.

 

I spent 8-12h/day with a PA/MD/DO. Not even other health care professionals get that kind of one-on-one time with a provider. I was privy to multiple provider's professional and personal thoughts on healthcare and I experienced the day in the life of a provider on a daily basis.

 

I was introduced to EMR, HPI, ROS, PE, DDx, Labs, Assessment, Plans, Imaging, Interpretation, Pt Disposition, Rx, Billing and many, many different elements involved in charting.

 

I watched PAs present and work with SPs, RNs, ERTechs, RTs, social workers, EMTs, Police, and of course patients.

 

I saw tons of I&Ds, lac repairs, reductions, LPs, aspirations, and procedures I'm probably forgetting.

 

The long and the short of it is, after 2000 hours of scribing, I'm sure I had a good idea of whether or not I was still interested in being a PA and that has to be considered valuable to a PA program trying to weed out people that have no idea what a PA even does.

 

In no way am I trying to overstate the experience but to say it's "paid shadowing" is inaccurate and truly depends on what the recipient wants from the experience. I'm not saying it's better HCE than an ER Tech but to be outright dismissive of it is unfair. For what it's worth, I've latched onto my EMT buddies for their experience when it matters, and they've latched onto me for mine. Kumbaya! =)

[Dunedain]

I'm not saying you don't glean information from being immersed in the ER but you don't have any hands on work nor can you have a physical effect on patient care. Schools ask for healthcare experience which by your definition could be a billing clerk in a back room because they read charts and diagnoses all day or a lab/pathology clerk in a hospital. All of the things you mentioned I could simply youtube or buy a few books online to learn, the only difference is you saw it in person. You spent a lot of 1:1 time with a provider acting as his transcriber viewing different cases, how's is that not paid shadowing? Just calling a spade a spade.

There's something about hands on patient care that can not be replicated and if a person does scribe work in ADDITION to CNA, EMT or what have you then I think that's fine. But to say scribe work is sufficient for a profession that has always been grounded in building up providers with extensive medical work backgrounds is not the right answer. That's what med school is for.

Tldr: Being a scribe isn't a bad immersion experience but it needs to be backed up by some hands on patient care

[EMSGuy1982]

Really? I know a bunch of scribes who are working hard to get into PA school or med school. Scribe requires no certification and offers a great learning experience. Many of these scribes use the job for "paid" HCE and volunteer as, basically, MAs for hands on. One advantage of being a scribe is flexibility to take pre-reqs.

I don't quite see why being an ER tech or EMTb helps you determine that you want to be in HC and being a scribe doesn't. It just seems snobbish to make that assertion.

 

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Maybe you could go down to your local fire department and do some ride time with an EMT and it might clear up the difference between a scribe and an EMT. I don't believe it is snobbish at all to say that experience as an EMT vs scribe isn't the same, because it isn't. Working in EMS for the last 12+ years has really given me a foundation on what providing 1:1 care to a patient is all about and I fell in love with it. It gives me confidence that when I graduate that I can always fall back on my experience in EMS when the stuff hits the fan. I've never been a scribe but I am interested in knowing how typing while others are providing care to the patient can give you the same feeling when you don't touch a patient.. I have to agree that scribes have the medical language down pat though.

[db_pavnp]

It is natural for individuals to idealize / glamorize the work they have personal experience with.  Those who are less pleasant to be around at parties disavow the value of other individual's experience.

[Guest Paula]

Scribe companies advertise that being a scribe is good experience for pre-PA and premed students to get health care experience.  At least I saw that on one company's web site. 

[EMSGuy1982]

It is natural for individuals to idealize / glamorize the work they have personal experience with.  Those who are less pleasant to be around at parties disavow the value of other individual's experience.

I never said or tried to "disavow" experience as a scribe. I couldn't do that since I have never been one. I can only speak from my side of the topic. I think that everyone brings something to the table. I am attending a program that loves diversity in a class, so much that they do allow scribes to count their hours as paid healthcare experience. I was just simply giving my opinion when someone stated that they couldn't see how being an EMT or ER Tech helps you determine that you want to be in health care.

[alster]

If you look at CASPA, the sections are patient care experience and other HCE.  I think scribe is very good experience for PA school, but it typically doesn't allow you to work hands on with patients.  So that's where the schools' preferences come in. 

 

I'd heard great things about what you can learn as a scribe and applied for a position in the ER of the hospital I work at as a PCA.  I was even hired and flown out to train, but the hospital had an issue about working at the hospital through an outside company and also working directly for the hospital on a floor.  Couldn't suffer the pay cut from PCA to scribe (gah that's sad... so much for that degree in engineering...), so I never ended up working as a scribe, but I am honestly grateful for everything I learned during training and can't imagine what else I would've picked up with a few months in the ER.  My company was very specific, however, about scribes having no part in direct patient care and being prohibited from placing hands on patients. 

 

I think this shift in requiring "healthcare experience" rather than "patient care experience" (in terms of what schools will accept for hours) mirrors the shift in the applicant pool over time from experienced medics, rns, etc. to recent college grads.  From what I've heard, scribing gives great experience relevant to PA school and working as a PA, but, I also see the value in acquiring experience that actually involves caring for patients.  Just a tip for anyone wanting to do both, maybe aim for different hospitals!  (I would've applied for a different company in a different hospital, but by the time everything went down, I was only a few months away from starting PA school and it didn't make sense.)

 

And to answer the OP even though other people already have... check with the schools you're interested in! 

[Saraya]

I'm not saying you don't glean information from being immersed in the ER but you don't have any hands on work nor can you have a physical effect on patient care. Schools ask for healthcare experience which by your definition could be a billing clerk in a back room because they read charts and diagnoses all day or a lab/pathology clerk in a hospital. All of the things you mentioned I could simply youtube or buy a few books online to learn, the only difference is you saw it in person. You spent a lot of 1:1 time with a provider acting as his transcriber viewing different cases, how's is that not paid shadowing? Just calling a spade a spade.

 

There's something about hands on patient care that can not be replicated and if a person does scribe work in ADDITION to CNA, EMT or what have you then I think that's fine. But to say scribe work is sufficient for a profession that has always been grounded in building up providers with extensive medical work backgrounds is not the right answer. That's what med school is for.

 

Tldr: Being a scribe isn't a bad immersion experience but it needs to be backed up by some hands on patient care

I can't argue that hands on patient care is valuable. We have a prior SF Medic that spent 3 years doing field trauma in Afghanistan. I imagine his HCE is far greater than mine and all things being equal, on the day we graduate I'd want to be triaged by him over 99% of my class including myself. But that's not really the world we live in. If HCE is to be the ultimate determinant in what will make a good PA, why don't we just require an RN x3-5y and be done with it?

 

Don't get me wrong, I'm not undervaluing what EMTs do, quite the opposite, but I do think some people are undervaluing how much a scribe can pick up simply through osmosis. Sitting next to an ER provider for that long will teach you a lot about the profession. I don't recall billing clerks being taught about EKGs and STEMI vs. NSTEMI or watching 1000s of exams or looking at imaging and being shown what an infiltrate looks like or pulmonary edema, so that's hardly a fair comparison.

 

I'm not sure I'll change your mind but I know that I will be a good PA and I know that scribing gave me some invaluable insight. I also know that I will be humble when working with people that have more therapeutic experience than I do. I hope you'll help bring us into the fold.

[Will352ns]

 

Don't get me wrong, I'm not undervaluing what EMTs do, quite the opposite, but I do think some people are undervaluing how much a scribe can pick up simply through osmosis. Sitting next to an ER provider for that long will teach you a lot about the profession. I don't recall billing clerks being taught about EKGs and STEMI vs. NSTEMI or watching 1000s of exams or looking at imaging and being shown what an infiltrate looks like or pulmonary edema, so that's hardly a fair comparison.

 

This is well said.  Much can be said for soaking up the environment.  The scribes in my class are doing very well...they pick up on things pretty quick because they have at least seen it before.

 

If all someone in this VERY tight job market can get is scribe for experience....good on them.  At least they understand that going in with nothing isn't right way to go.  Give me a former scribe over someone with zero experience (the trend nowadays) any day.

 

This said, hands on it still a better way to go IMO, but it isn't the end all be all some imply.  There are folks in my class who have good HCE (PCT, EMT...ect) and they struggle.  

 

These are the direct observations of a current student.  2nd year.

[Lemon Bars]

Scribing generally counts as part of your overall health care experience. It would be best for your application to also have some hands on patient experience, to round out this part of your application. I am learning a ton about primary care medicine as I scribe, far more than I learned at my hands on experience as a nurse aide that's for sure. Usually I start reading past notes and learning about a patient's condition even before the patient is placed in an exam room.

 

It's true that a EMT or paramedic would have the experience to handle emergency situations, but we rarely have people collapse in our clinic and there's a hospital two blocks away plus there are plenty of nurses and doctors on staff. Not every medical situation is an emergency. There is value in learning how a clinic runs, what tests are generally ordered for what conditions, and how providers conduct interviews with patients and make their diagnoses.

 

I feel that my scribe job is excellent preparation for PA school. I've offered to cross-train as a back office medical assistant for more hands on experience and my bosses are considering it. To compare a scribe to a billing clerk is pretty insulting. That's kind of like saying all the EMT does is help lift the patient and drive the ambulance.

 

There is a ton of medical work being done and a scribe is right in the middle of it, working, learning, observing intensely so that the scribe can note everything that's going on with the patient. I'm lucky in that my providers often take the time to explain their medical decision making to me because they know I'm trying to get into PA school.

[db_pavnp]

I am learning a ton about primary care medicine as I scribe, far more than I learned at my hands on experience as a nurse aide that's for sure.

 

As you note, diversity of experience is probably beneficial for a scribe, however I think the above line is important and under emphasized around here.

[VT PA]

I've worked as a scribe and a CNA. Both have been valuable experiences in their own way. As a CNA I was able to become comfortable touching patients, and I learned how to interact with someone who needed re-assurance and calming. As a scribe in a busy ER, I've been able to see all medical emergencies first hand and document them in real time. As a CNA where I worked, I never would have seen an emergency thoracotomy, running a code blue, intubation procedures, hip reductions, stroke assessment scale exams, lumbar punctures, trauma care, etc. And being there in the room is not the same as watching a YouTube video. Where I work the ER techs and nurses are very supportive of the scribes, and they realize that we do more than "shadow." I've shadowed PA's, NP's and physicians; trust me, there is a difference between shadowing and scribing. As a scribe you learn the process of medical decision making. However, I do think it is important to gain direct hands on experience as well. On CASPA, I listed CNA as direct patient care experience and listed scribing as other healthcare experience, so that the schools could see that I knew the difference between the two, and they could make a decision on their own regarding the quality of my different experiences. 

[EMEDPA]

where I work the er techs are present at every code at the table and the scribes are in the far corner entering orders as providers call them out....

[VT PA]

where I work the er techs are present at every code at the table and the scribes are in the far corner entering orders as providers call them out....

Of course the techs are present at the table. The reason I became a scribe is because I was injured as a CNA and had to have an involved surgery on my knee. I couldn't lift patients while recovering and decided that instead of staying home and collecting worker's comp, that I would become a scribe as I was healing and finishing pre-reqs. I don't regret switching, because I have learned so much from the doctors I work with. Your experience as a scribe probably depends where you work. The PA's in our ER have also been very supportive of and involved with helping the scribes that are applying to PA programs (and I know scribes who have had interviews and have been accepted to schools). But, I think you're going to be better off if you have a combination of direct patient care (such as ER tech, CNA) with scribing, both at application time and during your schooling. Then again, I'm no expert.

[EMEDPA]

sounds like you have great varied experiences and will be a strong candidate.. I can understand why you did some time as a scribe and I think it makes sense in your particular situation.