chiefPA Posted May 16, 2012 Share Posted May 16, 2012 Does anyone have experience with scribes in the ED? The reason I ask is that there is language by the Joint Commission that specifically uses the term "licensed independent practitioner" and it makes it seem like a PA cannot have someone scribe for them Link to comment Share on other sites More sharing options...
Friction Posted May 16, 2012 Share Posted May 16, 2012 We use scribes in our ED, however, they solely rotate with the MD/DO's... they only people who ever go into pt rooms with our PA's are the nurses. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 16, 2012 Moderator Share Posted May 16, 2012 pa's use scribes at 2 places I work. I personally don't use one as we have to pay them and I don't think they are worth the trouble. you have to dictate the chart to them then proof read it and correct them and pay them 9-10/hr out of your salary( we pay 1/2, hospital pays 1/2). I think I am faster and have better documentation without one quite honestly. they allow lazy folks to see the same # of folks they normally see but have more internet time in my experience.... Link to comment Share on other sites More sharing options...
ajnelson Posted May 19, 2012 Share Posted May 19, 2012 Two of the EDs I work in have scribes. In the both, they are pretty much limited to the docs. In the one, we used them quite a bit to help make sure we were documenting everything that our company and hospital wanted in a new computerized charting system. I've worked with them a few times, its nice to have them pull in all of your results, but I'm faster doing it myself than telling others what to type, and I have to proofread my chart more closely than if I had just done it myself the first time. And I really haven't found that they save me that much time. Link to comment Share on other sites More sharing options...
sunny2spot Posted May 19, 2012 Share Posted May 19, 2012 Only MD/DOs use them at my ED, but they're phasing them out completely in the next few months due to cost. Link to comment Share on other sites More sharing options...
rsandoval79 Posted May 19, 2012 Share Posted May 19, 2012 The hospital I work at started the scribe program, and yes we use scribes with MD's and PA's ...they just can't go with the residents...but I think with all the computer charting, orders, and the amount of patients that are growing scribes are definitely needed! Plus scribes make good PA students...I know a few scribes that have gone on to PA school...excellent HCE Link to comment Share on other sites More sharing options...
Guest Posted May 19, 2012 Share Posted May 19, 2012 I am a scribe in ED. It is true that we only work with doctors but some of us are nice enough to help out PA's as well... :) Also doctors do not double-check our work except for very few very particular doctors. I'd say 5/20 in ED do it. Oh well. No doctor has gotten into any trouble for a bad chart that I know of. Link to comment Share on other sites More sharing options...
LIPPER Posted May 19, 2012 Share Posted May 19, 2012 Had to take my kid to the ER bc of a choking episode (was afraid had a bolus lodged)... After 3hr wait, then 1hr wait in the room the MD and a scribe came in.. All of 5 min of an eval. Then my son bolted up and said he thinks it just dislodged an went down... After being able to keep liquid and food down we got discharged.... That bill WITH insurance and after a 40% professional discount was $495, and $83 bill from the er md billing group.....just checking in, and 1 set of vitals...... I'd say based on how I got raped, the hospital can afford the scribes all day long.... Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted May 20, 2012 Moderator Share Posted May 20, 2012 you just paid for the folks who skip out on their bill, that's how it works. if everyone paid the rates would be a lot lower...not defending it, just pointing it out. Link to comment Share on other sites More sharing options...
pvdude Posted May 20, 2012 Share Posted May 20, 2012 you just paid for the folks who skip out on their bill, that's how it works. if everyone paid the rates would be a lot lower...not defending it, just pointing it out. Agreed. The ed is taken advantage of a lot. Link to comment Share on other sites More sharing options...
rsandoval79 Posted May 20, 2012 Share Posted May 20, 2012 I am a scribe in ED. It is true that we only work with doctors but some of us are nice enough to help out PA's as well... :)Also doctors do not double-check our work except for very few very particular doctors. I'd say 5/20 in ED do it. Oh well. No doctor has gotten into any trouble for a bad chart that I know of. Every PA in our ER has a scribe Link to comment Share on other sites More sharing options...
fyrelight74 Posted May 20, 2012 Share Posted May 20, 2012 Plus scribes make good PA students...I know a few scribes that have gone on to PA school...excellent HCE I was a scribe in a family practice office. Was great experience... I retained a lot of it and use it in PA school now. Of course the experience varies on how much you are allowed/trained to do. My doctor did not dictate to me... I gathered the information from his interview with the patient. His exam I had to ask for his findings, of course. Then I entered the dx and plan the best I could. He checked them over at the end of the day. It saved him time because he could not type. The difference: before a scribe, he dictated and did other paperwork from 5pm to 8pm most evenings, after scribe, usually about an hour or hour and half for paperwork and chart review. Cost wise, it was beneficial because he already had 2 MAs and he just trained one of us as a scribe. I had to drop some of my duties to do the scribing, but it didn't significantly put a stress on me or the other MA. It actually made me better at my other duties.... I would get lab results in, and I remembered the conversation from when we ordered them, so I knew what I was looking for and could report to the doc, rather than simply passing all the labs onto him. I also got in the habit of "chiefing" to him... look over the chart before we go in the room, give him the low down on the recent visits, any results that had come in, and anything pending. Link to comment Share on other sites More sharing options...
NoClinic4Me Posted May 21, 2012 Share Posted May 21, 2012 We use scribes and I think it's fantastic. It makes me quite a bit more efficient overall. It also makes the interaction with the patient much more "connected". I talk to the patient while taking the history and rarely have to look away as the scribe is documenting the answers to my questions. With that being said, a good scribe is an asset while a poor scribe is a liability. Ours are excellent now after being well trained and I love working with them. As for the LIP think, I believe that was recently clarified by CMS to include PA's and expect joint commission to follow that in short order. As for how they get paid, that's an agreement between our group and the healthcare system we work as contractors for. Individual providers do not have to pay out of pocket. If I did, I would not do it as it doesn't personally benefit me financially (at least not directly). It benefits the group financially. Pat Link to comment Share on other sites More sharing options...
jaygator76 Posted June 11, 2012 Share Posted June 11, 2012 We use scribes and I think it's fantastic. It makes me quite a bit more efficient overall. It also makes the interaction with the patient much more "connected". I talk to the patient while taking the history and rarely have to look away as the scribe is documenting the answers to my questions. With that being said, a good scribe is an asset while a poor scribe is a liability. Ours are excellent now after being well trained and I love working with them. As for the LIP think, I believe that was recently clarified by CMS to include PA's and expect joint commission to follow that in short order. As for how they get paid, that's an agreement between our group and the healthcare system we work as contractors for. Individual providers do not have to pay out of pocket. If I did, I would not do it as it doesn't personally benefit me financially (at least not directly). It benefits the group financially. Pat do you have any documentation reflecting this? our docs use have been using a scribe company for 2 years now and have been trying to get scribes for midlevels as well but the barrier has been the JC stance of the 'licensed independent practitioner' as above. imo, they would be beneficial. think how fast you can street URI's/tooth pains/chronic back pains..... Link to comment Share on other sites More sharing options...
jaygator76 Posted June 11, 2012 Share Posted June 11, 2012 We use scribes and I think it's fantastic. It makes me quite a bit more efficient overall. It also makes the interaction with the patient much more "connected". I talk to the patient while taking the history and rarely have to look away as the scribe is documenting the answers to my questions. With that being said, a good scribe is an asset while a poor scribe is a liability. Ours are excellent now after being well trained and I love working with them. As for the LIP think, I believe that was recently clarified by CMS to include PA's and expect joint commission to follow that in short order. As for how they get paid, that's an agreement between our group and the healthcare system we work as contractors for. Individual providers do not have to pay out of pocket. If I did, I would not do it as it doesn't personally benefit me financially (at least not directly). It benefits the group financially. Pat do you have any documentation reflecting this? our docs use have been using a scribe company for 2 years now and have been trying to get scribes for midlevels as well but the barrier has been the JC stance of the 'licensed independent practitioner' as above. imo, they would be beneficial. think how fast you can street URI's/tooth pains/chronic back pains..... Link to comment Share on other sites More sharing options...
jaygator76 Posted June 11, 2012 Share Posted June 11, 2012 We use scribes and I think it's fantastic. It makes me quite a bit more efficient overall. It also makes the interaction with the patient much more "connected". I talk to the patient while taking the history and rarely have to look away as the scribe is documenting the answers to my questions. With that being said, a good scribe is an asset while a poor scribe is a liability. Ours are excellent now after being well trained and I love working with them. As for the LIP think, I believe that was recently clarified by CMS to include PA's and expect joint commission to follow that in short order. As for how they get paid, that's an agreement between our group and the healthcare system we work as contractors for. Individual providers do not have to pay out of pocket. If I did, I would not do it as it doesn't personally benefit me financially (at least not directly). It benefits the group financially. Pat do you have any documentation reflecting this? our docs use have been using a scribe company for 2 years now and have been trying to get scribes for midlevels as well but the barrier has been the JC stance of the 'licensed independent practitioner' as above. imo, they would be beneficial. think how fast you can street URI's/tooth pains/chronic back pains..... Link to comment Share on other sites More sharing options...
NoClinic4Me Posted June 11, 2012 Share Posted June 11, 2012 do you have any documentation reflecting this? our docs use have been using a scribe company for 2 years now and have been trying to get scribes for midlevels as well but the barrier has been the JC stance of the 'licensed independent practitioner' as above. imo, they would be beneficial. think how fast you can street URI's/tooth pains/chronic back pains..... Working on it, stay tuned..... Pat Link to comment Share on other sites More sharing options...
NoClinic4Me Posted June 11, 2012 Share Posted June 11, 2012 do you have any documentation reflecting this? our docs use have been using a scribe company for 2 years now and have been trying to get scribes for midlevels as well but the barrier has been the JC stance of the 'licensed independent practitioner' as above. imo, they would be beneficial. think how fast you can street URI's/tooth pains/chronic back pains..... Working on it, stay tuned..... Pat Link to comment Share on other sites More sharing options...
NoClinic4Me Posted June 11, 2012 Share Posted June 11, 2012 do you have any documentation reflecting this? our docs use have been using a scribe company for 2 years now and have been trying to get scribes for midlevels as well but the barrier has been the JC stance of the 'licensed independent practitioner' as above. imo, they would be beneficial. think how fast you can street URI's/tooth pains/chronic back pains..... Working on it, stay tuned..... Pat Link to comment Share on other sites More sharing options...
NoClinic4Me Posted June 12, 2012 Share Posted June 12, 2012 Here is what I have. See http://www.wapa.org/docs/Professional-Practice/Professional-Issue-Briefs/LIP-Clarification---Joint-Commission-Perspectives- It is from the Joint Commission news letter. Also from the joint Commission. : Licensed independent practitioner Program: Hospital Definition: An individual permitted by law and by the organization to provide care, treatment, and services without direct supervision. A licensed independent practitioner operates within the scope of his or her license, consistent with individually granted clinical privileges. When standards reference the term licensed independent practitioner, this language is not to be construed to limit the authority of a licensed independent practitioner to delegate tasks to other qualified health care personnel (for example, physician assistants and advanced practice registered nurses) to the extent authorized by state law or a state's regulatory mechanism or federal guidelines and organizational policy. Source: Glossary, Comprehensive Accreditation Manual for Hospitals (CAMH), e-dition accessed online April 14, 2011 Hope it helps, Pat Link to comment Share on other sites More sharing options...
NoClinic4Me Posted June 12, 2012 Share Posted June 12, 2012 Here is what I have. See http://www.wapa.org/docs/Professional-Practice/Professional-Issue-Briefs/LIP-Clarification---Joint-Commission-Perspectives- It is from the Joint Commission news letter. Also from the joint Commission. : Licensed independent practitioner Program: Hospital Definition: An individual permitted by law and by the organization to provide care, treatment, and services without direct supervision. A licensed independent practitioner operates within the scope of his or her license, consistent with individually granted clinical privileges. When standards reference the term licensed independent practitioner, this language is not to be construed to limit the authority of a licensed independent practitioner to delegate tasks to other qualified health care personnel (for example, physician assistants and advanced practice registered nurses) to the extent authorized by state law or a state's regulatory mechanism or federal guidelines and organizational policy. Source: Glossary, Comprehensive Accreditation Manual for Hospitals (CAMH), e-dition accessed online April 14, 2011 Hope it helps, Pat Link to comment Share on other sites More sharing options...
NoClinic4Me Posted June 12, 2012 Share Posted June 12, 2012 Here is what I have. See http://www.wapa.org/docs/Professional-Practice/Professional-Issue-Briefs/LIP-Clarification---Joint-Commission-Perspectives- It is from the Joint Commission news letter. Also from the joint Commission. : Licensed independent practitioner Program: Hospital Definition: An individual permitted by law and by the organization to provide care, treatment, and services without direct supervision. A licensed independent practitioner operates within the scope of his or her license, consistent with individually granted clinical privileges. When standards reference the term licensed independent practitioner, this language is not to be construed to limit the authority of a licensed independent practitioner to delegate tasks to other qualified health care personnel (for example, physician assistants and advanced practice registered nurses) to the extent authorized by state law or a state's regulatory mechanism or federal guidelines and organizational policy. Source: Glossary, Comprehensive Accreditation Manual for Hospitals (CAMH), e-dition accessed online April 14, 2011 Hope it helps, Pat Link to comment Share on other sites More sharing options...
jaygator76 Posted June 26, 2012 Share Posted June 26, 2012 thanks pat, forwarded that right to our CEO/president of our group. Link to comment Share on other sites More sharing options...
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