Quick Question for EX-Medical Scribes

[Ed Tom Bell]

I am an aspiring med student in his gap 18 months. I've been offered a position as a medical scribe. The company is allowing me to choose from a very wide variety of hospitals. Should I go for a tier 1 trauma/teaching hospital? Or will the experience be similarly beneficial no matter where I work?

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[Jabbed]

Go for the center with more beds or higher acuity patients. Stay as far away as possible from urgent cares.

 

[Polonium-210]

I am an aspiring med student in his gap 18 months. I've been offered a position as a medical scribe. The company is allowing me to choose from a very wide variety of hospitals. Should I go for a tier 1 trauma/teaching hospital? Or will the experience be similarly beneficial no matter where I work?

Level 1 would be ideal, even better with a burn unit. All specialties will be on call and you'll get some good stuff. Outpatient clinics are also good because there you scribe S.O.A.P. notes. Try to get exposure to both. Which company will you be with?

 

[Ed Tom Bell]

Level 1 would be ideal, even better with a burn unit. All specialties will be on call and you'll get some good stuff. Outpatient clinics are also good because there you scribe S.O.A.P. notes. Try to get exposure to both. Which company will you be with?

Thanks for the info!! I'll be working for .

 

[Pacna]

Oh yeah, t1 for sure. You'll probably also have to work in urgent cares/'urgency rooms' as well, but you can always swap those hours for more game time (though believe me, you'll get sick of game time and might like some runny noses).

 

[Ed Tom Bell]

Thanks all. This is really helpful.

 

[kevinsword91]

Consider working as inpatient medical scribe(if that is an option). You see all the more seriously ill patients from the ER on the hospital floor and ICU. You get to follow patients during the course of their treatment which may be preferable to the brief time one would get in ER/UC setting.

 

[mehc012]

I worked in a semi-rural hospital and also shadowed through a t1 academic center, and I would go with the private, semi-rural one every time. I got waayyy more one on one time with the attendings, got to know the actual individual consulting docs very well, to the point that I was offered shadowing gigs with the main general surgeons for the area, etc. I felt that I was able to get a lot more in-depth experience at the smaller place. The scribes I saw at the big med center didn't even have 1 individual doctor on their shifts, they bounced around chaotically trying to make sure all of the residents and attendings were covered and relied on the nurse to write down the pertinent material for them to collect if they showed up late...aka made the nurses do half their job for them. They didn't seem to have any personal relationship at all with their docs or their nurses. Don't know what kind of LORs they'll get, either.

 

[Polonium-210]

I worked in a semi-rural hospital and also shadowed through a t1 academic center, and I would go with the private, semi-rural one every time. I got waayyy more one on one time with the attendings, got to know the actual individual consulting docs very well, to the point that I was offered shadowing gigs with the main general surgeons for the area, etc. I felt that I was able to get a lot more in-depth experience at the smaller place. The scribes I saw at the big med center didn't even have 1 individual doctor on their shifts, they bounced around chaotically trying to make sure all of the residents and attendings were covered and relied on the nurse to write down the pertinent material for them to collect if they showed up late...aka made the nurses do half their job for them. They didn't seem to have any personal relationship at all with their docs or their nurses. Don't know what kind of LORs they'll get, either.

That is a rather unusual setup. Scribes are typically contracted to one physician at a time. Attempting to chart for more than one physician often results in charting/billing errors that leave physicians exposed to litigation should it arise. Charting for other individuals beside independent practicing physicians is a breach of contract in the absence of contract to do between the scribe and physician management comapny. If there is a contract, in that case there still is only one scribe for one physician. Scribes that are late are typically fired after one or more tardies. For missing information, a scribe is the physician's shadow so there is no excuse for a scribe to being miss information in clinic, unless the physician steps to the bathroom and then happens to see a patient in the hallway when they come out. If that is the case, then a good scribe would be aware of that idiosyncrasy and always keep tabs on where the physician is. Nurse charting and physician charging are two different beasts. You could certainly ask the charge nurse for information such as time of accident (or even approach the EMTs who delivered a trauma patient) but not physical exam findings. I scribed for multiple physicians at a lead trauma hospital and got to know them very well. One even bought me a $250 stethoscope for medical school. I'm sorry your experience was poor but it certainly is an atypical one and sounds as if the company for whom you worked was an overall poor scribe company.

 

[mehc012]

That is a rather unusual setup. Scribes are typically contracted to one physician at a time. Attempting to chart for more than one physician often results in charting/billing errors that leave physicians exposed to litigation should it arise. Charting for other individuals beside independent practicing physicians is a breach of contract in the absence of contract to do between the scribe and physician management comapny. If there is a contract, in that case there still is only one scribe for one physician. Scribes that are late are typically fired after one or more tardies. For missing information, a scribe is the physician's shadow so there is no excuse for a scribe to being miss information in clinic, unless the physician steps to the bathroom and then happens to see a patient in the hallway when they come out. If that is the case, then a good scribe would be aware of that idiosyncrasy and always keep tabs on where the physician is. Nurse charting and physician charging are two different beasts. You could certainly ask the charge nurse for information such as time of accident (or even approach the EMTs who delivered a trauma patient) but not physical exam findings. I scribed for multiple physicians at a lead trauma hospital and got to know them very well. One even bought me a $250 stethoscope for medical school. I'm sorry your experience was poor but it certainly is an atypical one and sounds as if the company for whom you worked was an overall poor scribe company.

No, my scribing experience was wonderful, it was more along the lines of what you describe.

I later shadowed in a trauma center and there I saw that the scribes were running around like chickens with their heads cut off. I found it incredibly bizarre because I was used to the other one. I'm glad your place worked it out, though it does seem to me like balancing residents and attendings would be weird.

And for the record, the nurse wasn't telling them HER findings, she was writing down the findings that the doctor would dictate and then the scribe would get that list from them later if they missed the start of the case (which they often did because it was so disorganized). She was basically doing half of the scribes' jobs for them and it was pretty sad, imo. Maybe the scribes on the shifts I saw just sucked or something, though it did seem to me that they had fewer scribes than doctors, so maybe that was the issue.

 

[mehc012]

That is a rather unusual setup. Scribes are typically contracted to one physician at a time. Attempting to chart for more than one physician often results in charting/billing errors that leave physicians exposed to litigation should it arise. Charting for other individuals beside independent practicing physicians is a breach of contract in the absence of contract to do between the scribe and physician management comapny. If there is a contract, in that case there still is only one scribe for one physician. Scribes that are late are typically fired after one or more tardies. For missing information, a scribe is the physician's shadow so there is no excuse for a scribe to being miss information in clinic, unless the physician steps to the bathroom and then happens to see a patient in the hallway when they come out. If that is the case, then a good scribe would be aware of that idiosyncrasy and always keep tabs on where the physician is. Nurse charting and physician charging are two different beasts. You could certainly ask the charge nurse for information such as time of accident (or even approach the EMTs who delivered a trauma patient) but not physical exam findings. I scribed for multiple physicians at a lead trauma hospital and got to know them very well. One even bought me a $250 stethoscope for medical school. I'm sorry your experience was poor but it certainly is an atypical one and sounds as if the company for whom you worked was an overall poor scribe company.

No, my scribing experience was wonderful, it was more along the lines of what you describe.

I later shadowed in a trauma center and there I saw that the scribes were running around like chickens with their heads cut off. I found it incredibly bizarre because I was used to the other one. I'm glad your place worked it out, though it does seem to me like balancing residents and attendings would be weird.

And for the record, the nurse wasn't telling them HER findings, she was writing down the findings that the doctor would dictate and then the scribe would get that list from them later if they missed the start of the case (which they often did because it was so disorganized). She was basically doing half of the scribes' jobs for them and it was pretty sad, imo. Maybe the scribes on the shifts I saw just sucked or something, though it did seem to me that they had fewer scribes than doctors, so maybe that was the issue.

 

[mehc012]

That is a rather unusual setup. Scribes are typically contracted to one physician at a time. Attempting to chart for more than one physician often results in charting/billing errors that leave physicians exposed to litigation should it arise. Charting for other individuals beside independent practicing physicians is a breach of contract in the absence of contract to do between the scribe and physician management comapny. If there is a contract, in that case there still is only one scribe for one physician. Scribes that are late are typically fired after one or more tardies. For missing information, a scribe is the physician's shadow so there is no excuse for a scribe to being miss information in clinic, unless the physician steps to the bathroom and then happens to see a patient in the hallway when they come out. If that is the case, then a good scribe would be aware of that idiosyncrasy and always keep tabs on where the physician is. Nurse charting and physician charging are two different beasts. You could certainly ask the charge nurse for information such as time of accident (or even approach the EMTs who delivered a trauma patient) but not physical exam findings. I scribed for multiple physicians at a lead trauma hospital and got to know them very well. One even bought me a $250 stethoscope for medical school. I'm sorry your experience was poor but it certainly is an atypical one and sounds as if the company for whom you worked was an overall poor scribe company.

No, my scribing experience was wonderful, it was more along the lines of what you describe.

I later shadowed in a trauma center and there I saw that the scribes were running around like chickens with their heads cut off. I found it incredibly bizarre because I was used to the other one. I'm glad your place worked it out, though it does seem to me like balancing residents and attendings would be weird.

And for the record, the nurse wasn't telling them HER findings, she was writing down the findings that the doctor would dictate and then the scribe would get that list from them later if they missed the start of the case (which they often did because it was so disorganized). She was basically doing half of the scribes' jobs for them and it was pretty sad, imo. Maybe the scribes on the shifts I saw just sucked or something, though it did seem to me that they had fewer scribes than doctors, so maybe that was the issue.

 

[cjfarrell21]

I honestly don't think your experience will differ all that much... but even though I am still scribing, I'll give you a little anecdote

I was originally hired last year as a scribe for an outpatient family practice. For the most part I would see pretty simple cases such as follow ups, ankle sprains, runny noses, etc etc. Occasionally you'll get someone who walks in with chest pain and is having a heart attack, but unfortunately we have to send them to the ER for workup so we never see the whole case in that regard.
After working for a few months in FP, my boss asked me to go out and help train/staff/work a new level 1 trama center he was setting up. So I went out there and did about a month+ish of work there. Obviously being a trauma there were obviously more exciting cases (i.e. MVA's, strokes, drunks, gun shot wounds, etc etc), so that was a definite plus, but after a few shifts it all became more or less the same. There would be occasionally be something new and different, but at some point all the MVAs started to mix together and seem the same. Once they had someone promoted to manage the site I was offered the opportunity to either stay or go back to my FP. I chose the latter, despite the interesting cases, and greater net income I would have received in the ER.

There were two reasons I chose going back to the FP. 1) the way the schedules were set up with set times for patients, I was able to get to know the physicians very very well. I've got to know them on a personal level and I've been able to ask them questions about patients and medical school, etc. Working in the ER, most of the physicians were always busy (with good reason of course), but it was rare to ever get to speak to them about the patient cases or ask questions when I was unsure of things. I'm not sure if anyone has had different experiences in the ER, but that was mine. 2) I personally want to go into primary care, so I thought it would be a good opportunity to be exposed to the specialty I was most interested in. Even though this may change in the future, it's definitely been good to be exposed to what I think I want to do for the rest of my life. So my advice would be to ask yourself how much you value getting to personally know your physicians, and to also keep in mind what you're interested in since it appears like you have many options!