Medical Scribe in Psychiatry Private Practice

[Indodo]

Has anyone used a medical scribe for their private practice?

I was considering the pros

1) It seems a lot of relatively bright people want to do this as prep for medical school. It could be fun to work with bright young energetic people.
2) I would have to worry about typing while talking. Although I am relatively tech savvy, I hate EMRs and find them to be disruptive in patient care.
3) I would probably increase efficiency and decrease stress. It is possible that the scribe may may for themselves...although I have no idea what a scribe is paid.

and cons.
1) Cost
2) Privacy (although this may be a benefit as well).
3) If I were to hire a student, I am concerned about reliability. Spring break, finals, intermittent class schedules etc.

If anyone else has any thoughts or has had good/bad experiences please let me know. I am also interested in cost range. I am in california. BTW, I am asking specifically for private practice, not ER, kaiser, CMH etc.

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[Shikima]

What about confidentiality?

 

[digitlnoize]

What about confidentiality?

Scribes get HIPPA trained.

Source: was a scribe.

 

[Indodo]

What did you get paid per hour?

I'm not concerned about confidentiality as I am sure scribes are trained. My problem is that in psychiatry, patients have a rapport with me. They may not want a second person in there, particularly someone very young.

 

[digitlnoize]

What did you get paid per hour?

I'm not concerned about confidentiality as I am sure scribes are trained. My problem is that in psychiatry, patients have a rapport with me. They may not want a second person in there, particularly someone very young.

$8/hr. I'm not sure how it would work for psych. I would sell it to the patients that they are trained experts in note taking, and using them to take your notes will help you be a better doctor for your patients. You'll have more detailed more accurate notes and they are pre-med and there to learn too. Give them the option to drop out.

 

[Indodo]

8 bucks...well thats good to hear...its slave wages but it means I can afford one.
I imagine I can have the scribe do other random things with patients that don't want a scribe. With enough training, I could probably get excellent service from someone who is paid 12/hr.

This is starting to sound appealing.

 

[drno31]

I've known some people who have worked for some big scribing (is that a word?) companies, mostly in an ED setting. They get pretty extensive training on terminology and what kind of information is pertinent vs non pertinent for a particular chief complaint. The individual might be paid by the company something like $8/hour with the promise of a good looking resume filler, but I don't know how much the company charged the facility to send the scribes.

My point being, if a private practice doc was to hire a pre-med for a low hourly wage to do some scribing without any prior medical experience or documentation training, the investment in time needed to train the scribe might not be worthwhile.

 

[Venous]

As a current psych resident and former ED scribe, the real benefit comes in the increased revenue. In the ED, the use of scribes increases the financial return per patient by anywhere from $100-2000. I got that from a facebook post from the company I used to work for, so... Now, most of that is because of the small amount of coding training that scribes get. They learn how to, not fraudulently, construct a note to meet certain billing levels. This is typically something in which medical students and residents do not get great education. Regarding the use of a scribe in a private psychiatric practice, you may not see the finanical gains that would make it worth it. If you're wanting it just to avoid having to use EMR, then you'll probably have to have him available full time and fully trained in escribing etc.

Also, I was paid $15-18 per hour depending on shift, and my company even offered scribes health insurance and retirement plans.

 

[hamstergang]

As a current psych resident and former ED scribe, the real benefit comes in the increased revenue. In the ED, the use of scribes increases the financial return per patient by anywhere from $100-2000. I got that from a facebook post from the company I used to work for, so... Now, most of that is because of the small amount of coding training that scribes get. They learn how to, not fraudulently, construct a note to meet certain billing levels. This is typically something in which medical students and residents do not get great education.

Seems like if the med students/residents just got that coding training, they'd make even more money since they could not pay the scribe to do work that others are fully capable of doing.

 

[michaelrack]

Seems like if the med students/residents just got that coding training, they'd make even more money since they could not pay the scribe to do work that others are fully capable of doing.

The problem is that is that in a majority of cases, an academic attending is not allowed to use a medical student's/resident's note in that manner for billing purposes. IN other words, if an attending is rounding with an intern on an academic rotation, he can not bill off that intern's note in the same way he could if he had a scribe with him. Now if a private practice doc wanted to hire a medical student (during his off-school hours) to work as a scribe, that would be a different story.

 

[Shikima]

The problem is that is that in a majority of cases, an academic attending is not allowed to use a medical student's/resident's note in that manner for billing purposes. IN other words, if an attending is rounding with an intern on an academic rotation, he can not bill off that intern's note in the same way he could if he had a scribe with him. Now if a private practice doc wanted to hire a medical student (during his off-school hours) to work as a scribe, that would be a different story.

I thought they could, as long as they see the Pt and it's not just staffed with them. Example, Medicare needs to be seen by the attending per CMS rules.

 

[michaelrack]

I thought they could, as long as they see the Pt and it's not just staffed with them. Example, Medicare needs to be seen by the attending per CMS rules.

I am not sure of the details, but I don't think a student's note can be used for much. As far as residents, I believe he can "agree" with certain parts, but part of the note needs to be the attending's own and the attending can't say that the resident is acting as a scribe for him (he can't just sign the resident's as his own). Someone currently in academia may know more about this subject- and I believe it is different for new vs f/u

 

[notdeadyet]

I thought they could, as long as they see the Pt and it's not just staffed with them. Example, Medicare needs to be seen by the attending per CMS rules.

The attending needs to drop a note, or they are not billed. A licensed doc is needed to bill for it. An attending can write an "addendum" to a medical students note and that can qualify. But a med student's note on its own does not.

 

[Venous]

To clarify what I meant about med students and residents: I didn't mean that med students and residents should be taught billing in order to benefit the institution NOW, I meant that since med students and residents aren't typically taught much about billing, it makes sense that when they graduate and move to private practice they still don't know the ins and outs of billing. Hence, a doctor in private practice right now may not want to learn all this, so ~$10/hr to an interested party who could help increase revenue may be worth it. A current med student or resident may want to familiarize themselves with basic note requirements and the different levels of service, as this could be quite beneficial for future practice.

 

[clusterF]

How long do you think it would take to train a scribe? I imagine these kids are bright, I am not talking about career scribes.