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cab10839

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Pre-med student looking into becoming a medical scribe to gain clinical exposure. If anyone has worked as a scribe, I would be grateful if you could help guide my decision by answering a few questions...

1. What made you want to become a medical scribe?

2. How did you receive training for the job/what type of training did you receive?

3. What was a typical day like as a scribe?

4. Rewards?

5. Drawbacks?

Thank you!

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Pre-med student looking into becoming a medical scribe to gain clinical exposure. If anyone has worked as a scribe, I would be grateful if you could help guide my decision by answering a few questions...

1. What made you want to become a medical scribe?

2. How did you receive training for the job/what type of training did you receive?

3. What was a typical day like as a scribe?

4. Rewards?

5. Drawbacks?

Thank you!
I'm currently a scribe at an ER.

1. I decided to become a scribe because of the clinical exposure and access to physicians. Shadowing is great and all, but being a scribe helped me get closer to the doctors and I gained a lot of clinical knowledge I never got in shadowing.

2. Training was by the company I work for. I didn't have to have any experience beforehand.

3. Typical day in the ER: We work 8 hour shifts and typically see 18-25 patients during that time period. You see everything in the ER, from flu to appendicitis to terrible traumas. Every shift is different for me, but the gist of it is the same (see a bunch of patients and type up a lot of notes).

4. Rewards: Clinical exposure, learning about the lives of the physicians I work with, learning how to deal with death and tragedies, meeting a lot of great physicians.

5. Drawbacks: can make you pretty cynical, especially when working in the ER. Long hours if you are in class.
 
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Pre-med student looking into becoming a medical scribe to gain clinical exposure. If anyone has worked as a scribe, I would be grateful if you could help guide my decision by answering a few questions...

1. What made you want to become a medical scribe?

2. How did you receive training for the job/what type of training did you receive?

3. What was a typical day like as a scribe?

4. Rewards?

5. Drawbacks?

Thank you!

Current ER (Trauma Level I + other locations) Trainer Scribe w/ PhysAssist

1. What made you want to become a medical scribe?

I needed clinical experience, but EMT and CNA/MA certs cost too much. The hiring process and work is straight forward. Good clinical experience and you get to really see the day of a (ER) doc.

2. How did you receive training for the job/what type of training did you receive?

A week of online stuff, then eight shifts in the hospital training. Very relaxed and graduated. It was a good enough process. I have some complaints about the generic online training, but it still helps.

3. What was a typical day like as a scribe?

8-10 hour shifts with anywhere between 0 and 40ish patients depending on speed of day, location, and number of providers. The vast majority are 15-20.

4. Rewards?

Decent pay if trainer or otherwise, but not good (tbh). Flexible as hell hours. Good experiences.

5. Drawbacks?

Pay. Stupid bureaucratic bs. Lack of super in-depth patient interactions.
 
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Pretty similar experience to those above as a scribe. I am a trainer, and my only advice to you is to make sure you can type quickly. The company I work for has canned a lot of trainees lately due to speed issues.
 
Pre-med student looking into becoming a medical scribe to gain clinical exposure. If anyone has worked as a scribe, I would be grateful if you could help guide my decision by answering a few questions...

1. What made you want to become a medical scribe?

2. How did you receive training for the job/what type of training did you receive?

3. What was a typical day like as a scribe?

4. Rewards?

5. Drawbacks?

Thank you!

Currently an ER scribe

1. What made you want to become a medical scribe?

Honestly I took the job to pass time before beginning medical school, but it has served as a great way to gain a lot of clinical exposure and create great relationships for the docs, nurses, and other scribes

2. How did you receive training for the job/what type of training did you receive?

This long ass unnecessary online program with multiple training shifts which honestly sucked

3. What was a typical day like as a scribe?

Come in work for a specific doctor (changes constantly, gotta keep up with their preferences) for an 8-12 hr shift about 3-4 times a week. See about 25-30 patients a shift (averaging about 45 lately, thanks CNN and flu season). It gets pretty hectic sometimes but having a good friendship with the doc really makes the time pass smoothly

4. Rewards?

Good relationships and clinical exposure, I have learned a crazy amount that will help a lot come fall

5. Drawbacks?

Sometimes it gets hectic and frustrating, overnights are the woooorst, pay sucks
 
Being a scribe was one of the best things I did as a pre-med. I highly recommend it for the clinical exposure it offers, even if it pays terrible (which it does).
 
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Through what companies did you all apply through? I've had no success with Scribe America
 
I worked for PhysAssist. It was fine. The pay is horrible, but that’s true of all the scribe companies, I think. Like others have said, I got a ton of clinical exposure. Also LORs and role models, plus an in-depth look at doctors I DON’T want to imitate.
 
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Being a scribe was one of the best things I did as a pre-med. I highly recommend it for the clinical exposure it offers, even if it pays terrible (which it does).
I would also recommend working in the ED for the clinical experience, although I have heard that you get to do more of the MDM charting as an in-patient scribe
 
Worked for PhysAssist in the ED of a decent community hospital for about 15 months. Pay is horrible, but it’s great experience in understanding how hospitals and doctors actually work. Worked with some excellent physicians who are also willing to write LORs (they all know you’re trying to break into medicine). I was taking post-bacc classes at the same time, so most of the shifts I worked were overnight. Not an ideal situation, but if you are willing to make it work it’s totally doable (got straight A’s). All depends on how much you put in to get as much out of it as you can.


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I worked as a scribe for 4 months, or about 300 hours. In the end, I didn't stick with the position because I felt like after learning the basics (How to write a chart and medical terminology) I wasn't learning a lot more. I also got a new job, which limited my time a lot and meant I couldn't make the shift minimum.

1. What made you want to become a medical scribe?

I became a scribe because I wanted to learn more about medicine. It's one of my few clinical experiences. I started doing research early in college and I never had time to do clinical volunteering since there were no nearby hospitals and I didn't have a car. I saw the opportunity to become a scribe while I was on the job hunt for a parttime position and I thought it would be really helpful to me and my application. I really enjoyed working as a scribe, but I needed to save up to pay for medical school myself, so when I was offered a full time position somewhere else with literally six times the pay ($30 full time vs $10 at 20 hrs/week), I decided that I needed to take it.

2. How did you receive training for the job/what type of training did you receive?

I worked for CEPAmerica (Vituity) in southern California. A month before our official start date, we received a 50 page packet of terms to memorize, understand, and correctly be able to spell. In addition, we needed to do a bunch of self study modules and EPIC training. Approximately 1 week before our start date, we had mandatory classroom training, which was 2 8-hour days in a classroom with the senior scribes in which we went over the basics of charting, use of EPIC, and did some practice HPIs. After the classroom training, each scribe had a minimum of 5 and a maximum of 10 training shifts. At the end of each shifts, a senior scribe would assess your knowledge and ability to work and decide if you were ready for an evaluation shift. If you finished your 10 shifts and then 2 evaluations (12 shifts total) without passing, you would be let go.

3. What was a typical day like as a scribe?

The hospital I worked at was a level 2 trauma center, so this may be different than other hospitals. During our shifts, you would practically follow every step the physician took. It was important to stay with them at all times, because sometimes they walked off and you would lose them in the massive ED for about 30+ minutes. I'd generally take notes on interactions with the patient, noting things like OLDCART and pertinent negatives. Next, either in the room or just outside, the physician would dictate their physical to me and I would complete the entire chart for the physician. This would include the HPI, Physical, any procedures, any dictations for imaging or EKGs, and sometimes dictations of differential diagnoses. At the end of my shift, I would check to ensure the charts were complete, sign off on them, and give them to my assigned provider.

4. Rewards?

Learning: There is so much medical knowledge you gain as a scribe, especially after your training ends and you are able to finish charts much faster. The additional downtime will let you grill your assigned provider about anything medicine related. Many of the providers will also go over interesting cases with their colleagues during their downtime, and you can have them explain the cases to you. It gives you a good opportunity to get letters of recommendation and experience in the hospital setting. One thing I thought was funny is that I got to experience the dark humor of the hospital staff when they were tucked away in their pods.

5. Drawbacks?

Mostly, its really time consuming, has a high learning curve, and pays like crap. 2 of those 3 things are true in medical school though, and you don't get paid. One drawback I noticed in myself is that working in an ED makes you cynical really quickly. You'll see a lot of frequent fliers and the moment you get in their room, you know that they aren't really there for any reason (One example is a patient who was 95 and came in almost daily because they were having aches. The physicians used to joke and say ddx: being old). You have to be careful not to fall into that kind of thought process, as it'll really effect your empathy towards patients and ability to be a good physician in the future.
 
1. What made you want to become a medical scribe?

I did it as something to do as a gap year. And I wanted to increase my clinical hours.

2. How did you receive training for the job/what type of training did you receive?

On job training. Did classroom training online (but could do in person), and then Floor training with all the physicians. Classroom training was basically a crash course in pathophysiology and med terms so you could understand what you were documenting. Floor training was practice working in the EMR and each doctor's specific style.

3. What was a typical day like as a scribe?

I work in family practice so my days are typically 8-5 Monday thru Friday. I get the chance to see a variety of cases and acuity levels.

4. Rewards?

The obvious answer is clinical hours. LORs for sure. I got two LORs from doctors I work closely with this application cycles. I have seen many patients multiple times, and they keep asking for updates on applications. I get to see the continuity of care by seeing patients multiple times a year. I see some odd cases. I watched someone get told they have cancer, or someone get told their condition has improved so much their medications are cut in half. I have seen Ups and Downs of care, and it is something I appreciate.

5. Drawbacks?

Sometimes the hours. I would love to work more some times, as it is a day job hours. And pay, but I did not sign up to really do this for the pay. But otherwise I really enjoy my experience.
 
Currently scribing full-time in outpatient internal medicine and cardiology.

1. What made you want to become a medical scribe?

Wanted a gap year job and needed a bit more clinical exposure and shadowing

2. How did you receive training for the job/what type of training did you receive?

I work through one of the large national companies. Training is pretty standardized and involved some low-stress classroom training with quizzes/ tests for a couple weeks followed by stressful floor training for another week or two.

3. What was a typical day like as a scribe?
Get to clinic ~15min before the first patient (earlier for cardiology to pre-chart all their echo, cath, perfusion reports, etc.). Sit in the team room as the physician and go into the patient rooms with them. Work on the chart in the room (mostly typing history, exam findings, diagnoses/ plan for the patient), then sometimes go straight to another patient and scramble to finish the last note, or maybe get a few minutes back in the team room to finish the note. Rinse and repeat... (literally thousands of times for me now).

4. Rewards?
Essentially paid shadowing experience. Developing physician role models and maybe get LORs. You also learn so much from pure exposure. I probably couldn't have named a single blood pressure medication after graduation, for example. After just a few months of scribing, I could name probably at least 15 antihypertensives including class, brand name, common side effects, typical doses, and indications.

5. Drawbacks?
It's both boring (clerical work) and stressful (healthcare and patients) at the same time. If you're stuck with a difficult physician, I'd imagine it would be terrible. Or if your chief scribes or other managers are bad. This is very site dependent. Pay is pretty terrible for how hard you might work (we make a maximum of $10 per hour).
 
1. What made you want to become a medical scribe?

Needed medical exposure. I had done some EMT volunteering and pretty much nothing else directly medical. This gives you one of the most realistic experiences of what the physician's day to day life is like which is an advantage over something like a PCA/PCT/EMT or volunteer things. It worked with my school and EC schedule.

2. How did you receive training for the job/what type of training did you receive?


My company (PM for specifics) is a corporate thing based in a different state but has a large presence in my locality. We applied and took a super basic typing test online before we began online training. We were drug tested and had to update vaccines. After learning to do basic charts and "passing," we got trained on the specific EMR we use and had a number of residency shifts with trainer scribes. After a while of being on our own we could get scheduled in our low acuity area which is faster and branch out into some clinics. We also could progress to becoming trainers. Different companies usually have comparable training with some differences in online vs in house and number of shifts. If you have a small company or private arrangement with a physician, you may have more personalized training. Ours helped us learn medical terms, what is important in an HPI, and how to accurately document for billing and legal reasons (as well as the things you learn along the way in clinic).

3. What was a typical day like as a scribe?

Every scribe and company is different. I work in the ED in a busy suburban facility. Some trauma but not a Trauma Center so the craziest cases are usually shipped out or do not come to us. Enough stabbings, GSWs, and MVCs to keep it interesting at times though. Medically interesting cases often enough - borders low income areas and is a draw from across state lines. We work 8, 9, and 10 hour shifts, usually between 7 and 16 per month for most scribes. Shifts are staggered throughout the day and include overnights, weekends, holidays. We staff 24/7. They work around our school schedule.

We use laptops and follow the physician from room to room, prepping charts and documenting the patient encounters. We take dictation for physical exams and consults, etc. We also follow and document procedures: So far I have seen I&D, central lines, ear wax removal, cardioversion (electrical, chemical, and modified Valsalva), arthrocentesis, chest tube insertion, epistaxis management, foreign body removal, foley catheter insertion, IO infusion, intubation, CPR, lac repair, suture removal, lumbar puncture, procedural sedation in combo with ortho injury reduction, paracentesis, arterial blood draws, almost a baby delivery...there have been thoracotomies and cricothyrotomies but I wasn't there for them. Some people die - this is good for perspective but is obviously sad.

Sometimes it is overwhelmingly fast paced, sometimes it is super quiet. Usually somewhere in the middle where it is steady. We often get out 30 minutes to an hour early. The earliest I ever got out was almost 3 hours early. The latest was almost 2 hours after a late night shift. Some places have an on-call schedule but we do not. We work with one physician each shift and there is a roster of a couple dozen docs. There are PAs and NPs as well but we do not document for them. Some places wear scrubs, some wear polos and khakis.

Over about 18 months I have over 2000 hours and over 4500 patient encounters with about 30 different docs (rough estimates).

4. Rewards?


Depends on place. Pay sucks, raise schedule sucks, even incentives to work short term at other locations suck. Although one reward is getting paid (even the small amount) for shadowing. Don't get into it for the pay though, just view it as a bonus. Fantastic views of what the daily life of the doc is like. You can ask questions about the medicine and how to succeed in school. Some docs like teaching more than other buts you can always learn something new daily (really!). They often buy us lunch or coffees. Some people get letters of rec. Sometimes shadowing connections or other gigs like research projects or babysitting for the docs kids outside of work (rarely even drinks or partying with the docs). It really depends what you put into it. A trained monkey could be a minimally passable scribe but to get the max out of it you need to work to improve, learn things, and be trusted by the docs.

5. Drawbacks?


It is not "direct patient care". My company is not allowed to have patient contact although I feel comfortable in anonymously saying the physicians will often have us go confirm certain details with the patient or get water if the nurse/techs are busy. Some physicians will also show us cool things on exam if the patient is okay with it (listening to murmurs, looking through otoscopes at cool things, etc.). In this regard, the PCA/PCT/EMT/whatever is better, but less interaction with the docs. It hasn't been a problem on the interview trail and I got into multiple schools, drawing on this experience for essays and interview responses. Some people die - this is good for perspective but is obviously sad. You are exposed to a lot of illness and I have never felt in danger but there are "gross" sights and smells and you will likely get a URI/the flu at some point due to just overwhelming amounts of these complaints. Aside from that, the late nights can be disruptive and you may not like some docs. You may not like the environment of the ED. In that case, try to find a company/arrangement where you aren't in that environment.
 
ED scribing is really dependent on where you work. Some EDs we average ~20-25 patients whereas others 30-40 is the norm, the patient population makes the biggest difference. Also a very large percentage of ED physicians are burned out.
 
1. Clinical hours. It was strongly recommended by my pre-health adviser (I later learned they often don't know what they're talking about but I think this advice was solid)
2. The scribe company gives new hires maybe 50-100 slides worth of information to learn - nothing worse than a lecture or two of a biology class. We were then tested on it and you supposedly need 90%+ but it was pretty easy. I got two training shifts because the company was in dire need of new scribes and couldn't be bothered to have someone hang around and train me, at the time. But now, new scribes get to train for 5 or more shifts. A girl who worked elsewhere said she trained a few weeks to be an ER scribe.
3. I'm an outpatient orthopedic scribe. I think our location is pretty relaxed and what I do gets to be pretty mechanical. We fill in the patient's chart as the doctor is speaking, maybe ask for a few clarifications, then rinse and repeat. Shifts can be 4-11 hours, depending on how quick the doctor is (and how late the patients are lol)
4. Something around $10/hr which is better than making nothing shadowing. The clinical experience is good and you get to work closely with doctors who can answer a lot of questions and (hopefully) write a great LOR. I think it's also improved my typing speed a bit. I was a little over 80wpm to start. I'd guess I'm closer to 90 now.
5. I make significantly more as a barista on the weekends than as a scribe during the week. The pay is not great. I've heard some locations can be stressful and some of the docs can be abrasive but I haven't experienced that personally.
 
As for learning how to be a scribe, I recommend a book by Ryan Davis called “How to be a Medical Scribe.” It’s a quick read, but useful in learning some of the terms, workflow, etc
 
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