Monday, December 7, 2015

Return of the Scribe

Augustine of Hippo allegedly "wrote" all of his massive works by means of scribes. That was in the 4th and 5th century. Scribes were employed extensively throughout the Roman world and managed to survive at least halfway through what we know as the Middle Ages.

It appears as if they are returning with a vengeance thanks to the ACA! All hail the Scribe!

As noted by Kaiser:

A national campaign for electronic health records is driving business for at least 20 companies with thousands of workers ready to help stressed doctors log the details of their patients’ care — for a price. Nearly 1 in 5 physicians now employ medical scribes, many provided by a vendor, who join doctors and patients in examination rooms. They enter relevant information about patients’ ailments and doctors’ advice into a computer, the preferred successor to jotting notes on a clipboard as doctors universally once did. 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. After buying three rivals this year, it employs 10,000 scribes working in 1,200 locations.

Another source for an increase in health care costs! They accompany a physician into the office with a patient and as the physician examines the patient the Scribe records all that happens.

Now we do see some major issues:

1. Scribes are unregulated and are privy to highly sensitive information. What I may tell my physician I may not want some minimum wage typist to be privy to.

2. Scribes may copy the wrong thing, or too much. Watch out for the lawyers. Once it is written it cannot be unwritten, easily!

3. Scribes cost money. Not only do they get paid for their rime but the physician should review and remark on what they wrote. That just adds costs if you will.

The list of Scribe issues continues. But as that Congressperson said; "...you have to pass it in order to see what is in it...".

Welcome to America! Oh yes, perhaps we can get those buggy whips back again when we go all green.