PhysAssist Scribes for eMRs [Necessity or Frivolity?]

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On Human eHR Input Devices [aka Personal Secretaries]

By Dr. David Edward Marcinko MBA CMP™


What it Is – How it Works?

According to their website, PhysAssist Scribes provide turn-key solutions, recruits, interviews, trains and certifies staff, schedules and maintains highly-trained human eHR input scribes for their clients [$8-10/hour wages]. Emergency room departments and physicians were an initial target market.

Data Input Services

Scribes provide real-time charting for physicians by shadowing them throughout their shifts and performing a variety of tasks including recording patients’ history and chief complaints, transcribing the physical exam, ordering x-rays, recording diagnostic test results, and preparing plans for follow-up care, etc.

Typical Clients

Clients are mostly hospital based physicians, but one can imagine progressing down the food chain to large medical practices and even to solo practitioners as technology advances and HR costs are reduced. So, give em’ a click, and tell us what you think.

Reported Benefits

  • Increase physician performance
  • Increase physician job satisfaction
  • Increase overall patient satisfaction
  • Improve chart accuracy
  • Decrease patient length of stay
  • Increase communication among ED staff
  • Improve physician recruiting and [retension] retention.

Related story:


  • It seems implausible to me that in order to facilitate the widespread use of eMRs, one has to hire another layer of bureaucracy in order to input the patient encounter. Is this an indictment of the various speech recognition systems or physician keyboarding ability? I am not a technophobe but eHRs are not yet up to pragmatic-use snuff. This is reminiscent of jeweled encrusted “buggy-whips” of the 1850’s. They were expensive, cumbersome and added no utility; but were “nice-to-have” devices for the affluent until the internal combustion engine came along [i.e. non-solo or small group medical practitioner].
  • Of course, injecting another human resource [i.e. personal secretary] into the data input equation increases privacy breach possibilities for this protected health information [PHI]. And, it is not exactly the model of a contemporary and lean micro-medical office.
  • Does a secretary-scribe really have to be “certified”? Won’t a good typist do just as well? Is this an example of vertical integration in the PhysAssist business model?  How long till the scribes join the labor-union movement and seek employment benefits?
  • What happens to the doctor, patient and data input chain when a scribe quits, or is a no-show for work?
  • What ever happened to Occam’s razor (or Ockham’s razor), often expressed in Latin as the lex parsimoniae (translating to the law of parsimony, law of economy or law of succinctness), which is a principle that generally recommends selecting a hypothesis that makes the fewest new assumptions. IOW: KISS
  • Of additional interest to note is the misspelling of the word retention, as “retension” on the website. Not a very good impression for a transcribing firm; or am I just an aging editorial curmudgeon?
  • Are e-MR scribes a necessity or mere frivolity?


And so, your thoughts and comments on this ME-P are appreciated. Are such secretary scribes a “covered entity” or “business associate” under the HIPAA laws with the needed paperwork, etc? Or, is this an Obama administration job creation initiative?

And, feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.


Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact:


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15 Responses

  1. Free Electronic Medical Records?

    Interesting post, Dr. Marcinko. Did you know that about seventy-five thousand patients in Sonoma County, CA can now take their medical records with them wherever they go, thanks to Epic’s new MyChart app created for the iPhone, iPad or iPod touch.

    The app is free and offered to patients at Sutter’s Pacific Medical Foundation.



  2. Dorothy,

    I hope the above is not a gimmick to “lock-in” patients thru a proprietary eMR system.
    But, for the doctors however, true inter-operable eHRs are imperfect, ineffective and downright primitive to date. This will change, but not today – or even tomorrow.



  3. Making eHR Corrections

    Addressing concerns expressed by hospital and healthcare provider groups, a bill–passed by the California Senate earlier this month to make it easier for patients to examine their electronic health records (EHRs) when modifications were made–saw substantial changes when it came under consideration by the state.




  4. U Gotta be Kidding!

    This is the dumbest idea I have ever heard of. A needless make-work job just waiting for obsolescence.



  5. Back to the Future

    Kirk – This is another Obama work program. Jobs here today – gone tomorrow or back to the typing pool.



  6. Joint Commission issues guidance on use of scribes

    The Joint Commission has issued guidance to clarify its position that hospitals may use unlicensed scribes to input patient information into a hospital’s electronic health record or chart if certain requirements are met.



  7. Scribe Solution

    With advent of changes in the practice of emergency medicine place constraints on productivity goals. The amount of non-clinical work like documentation and clerical duties a physician must perform and the inherent inefficiencies associated with it alleviate the rising cost of providing quality patient care in a timely and efficient manner.

    So, physicians assistants or clinical information managers can be used as a low cost solution to improve physician’s bottom line and reduce the burden of non-clinical work physicians face.

    We do all that is mentioned in this post i.e. recruits, interviews, trains and certifies staff, for our clients.

    If you’d like to learn more about how medical scribes can assist physicians visit

    Scribe Solution (@scribesolutions)


  8. Scribes Allow Docs To Focus On Patient

    Dr. Marcinko – Without much fanfare or planning, scribes have indeed entered the scene in hundreds of clinics and emergency rooms. Physicians who use them say they feel liberated from the constant note-taking that modern electronic health records systems demand.

    Indeed, many of those doctors say that scribes have helped restore joy in the practice of medicine, which has been transformed – for good and for bad – by digital record-keeping.

    But, really?

    Dr. Moza


  9. The disturbing confessions of a medical scribe

    … As a pre-medical student working next to several other doctor-hopefuls in a high stress environment, this medical scribe is frustrated on an ethical level …

    Here is why.

    Dr. David Edward Marcinko MBA


  10. Do medical scribes threaten patient privacy?

    Dr. Marcinko – There is no accepted definition of what scribes do or what their background or training should be. There is no mechanism for licensure of them in any state. They are poorly defined medical assistants.

    The field is in its infancy and its ultimate role in our health care system is unclear. Yet, HIPAA and privacy issues abound.

    Dr. Kamar


  11. 7 reasons to consider a medical scribe

    The time providers spend capturing data during a patient visit could be better utilized in a number of areas. Here’s how scribes can help.

    But, still a flawed idea; IMHO.

    Dr. Schuster


  12. EHRs increase labor costs in healthcare … We’ve been had!

    “Medical scribes defy electronic health-record technology logic – The old saw about technology says it destroys jobs in some sectors and creates new ones in others.”
    By Darius Tahir for Modern Healthcare
    December 31, 2014

    Tahir adds, “The growth of what are essentially medical secretaries is puzzling, given that most sectors have disposed of those kinds of manual jobs.”

    Even as it becomes more expensive to “Meaningfully Use” EHRs according to Obama’s HITECH blunder, he also cut physicians’ resources needed to pay the scribes – a rapidly growing healthcare stakeholder group: “Multiple Pay Cuts Hit Doctors In 2015 – A flurry of pay cuts for doctors hit today as physicians struggle to implement electronic health records, deal with new measurements to improve quality and deal with myriad changes in Medicare and Medicaid reimbursement formulas.”
    By Bruce Japsen
    Forbes, January 1, 2015

    Japsen adds that by 2019, physicians could be subjected to penalties that reduce Medicare payments by 13 percent unless they comply with Obama’s half-baked HITECH ideas. “No other segment of the health care industry faces penalties as steep as these and no other segment faces such challenging implementation logistics” –
    Dr. James Madara
    American Medical Association CEO

    D. Kellus Pruitt DDS


  13. EHR Scribes

    Dr. Marcinko – Already a passing … fad.



  14. Medical scribes are on the rise, but standards lacking

    Nearly 1 in 5 physicians now employ medical scribes, many provided by a vendor, who join doctors and patients in examination rooms. The U.S. has 15,000 scribes today and their numbers will reach 100,000 by 2020, estimates ScribeAmerica, the largest competitor in the business.

    Regulation and training are not rigorous. Scribes are not licensed. About a third of them are certified and that’s voluntary, according to the sole professional body for scribes.

    Dr. Moza


  15. SCRIBES?

    Why medical scribes are the ultimate answer to our health IT woes?



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