Medical Scribing

I will tell any pre-med student willing to listen that scribing with a physician is the jackpot of pre-med experiences. Scribing gives you direct patient exposure, access to a physician so you can ask questions about their medical experience, and it pays! Medical exposure is so important to the medical school application (and it’s becoming increasingly harder to find shadowing opportunities, thanks to COVID) but just as important is the opportunity to watch a physician in action every day to figure out if this life is really what you want. 

For most docs, the days of paper charts are long gone. Almost everything in medicine is done electronically and certain things have to be included in the patient note in order to get paid for the visit. A scribe generally goes into each patient room with the physician and stands or sits off to the side and documents the visit. They put into the computer the medical history that the patient gives the physician and documents the exam as the physician tells it to them while she or he is doing it. They also include the plan as given to the patient by the physician. And they document anything else that the physician wants included in the note. The physician is still responsible for reviewing and signing the note, but it’s a significant help to have someone else typing it. Basically, if you have a good scribe, when you walk out of the room, you’re done with that encounter. I don’t have a scribe right now and I spend sooooo much time charting. It’s really ridiculous, I realize as I’m typing this. I do notes between patients, while I eat my lunch, at the end of clinic when everyone else has left, in the evening on my sofa listening to Lizzo; it seems to never end! Ideally, I could do the note right after each patient, but that’s not realistic because I have to move on to the next patient who is waiting for me, so, they tend to pile up. But I do like to get them done on the same day so I don’t forget to include anything important…and because more are just going to be added the next day anyways. So, I find myself doing many many notes at home in the evenings most days. In my case, it’s just me and the dog and she doesn’t care that I spend the evening in front of my computer as long as I’m dishing out dog treats, but for people with spouses and children, I could imagine this gets problematic. My partner in clinic who has a young family refuses to take notes home and interfere with her family time, so she stays at the office until she has finished every note from the day. That’s a dedication I don’t have. I like my sofa and patio furniture better than my office chair.

Patient-physician interaction

Admissions committees want to see in your application that you have an understanding of the patient-physician relationship. I cringe when looking at applications and the applicant has never seen a physician in action with a patient. How can you convince anyone that you want to be a doctor if you’ve never watched one interact with a patient in real life?? (because Grey’s Anatomy doesn’t count!) Regardless of what specialty you’ll later choose, you still need to be able to interact with patients! And so we want to see this in the application…that you’ve made the effort to understand the personal side of medicine. This is truly where the best responses to “why do you want to be a doctor?” or “describe a meaningful medical experience” come from. Shadowing is certainly one way to get this exposure (and is the most common way) but so is being a medical scribe. You go into every room with the physician, so you can’t help but to have an understanding of how important it is to have good bedside manners, to be competent and up-to-date, and to be compassionate.

Personal contact with the physician/healthcare team

Spending this much time with a physician and the healthcare team gives you great insight to the reality of working in an office, ER, hospital, etc. You’re able to see the flow of the day and better understand the role each member plays in the healthcare team. You may begin an experience thinking you want to be a physician and end up realizing you want to be the social worker (it happens!). As a scribe, you’re not a strange student who comes in a few times and everyone has to be on their best behavior when you’re there because they don’t know you; instead, you’re a part of the team and you really get a good understanding of the dynamics of medicine and practicing medicine that you wouldn’t get from “just” shadowing in the office a few times. As mentioned earlier, this close interaction with the physician may also give you an opportunity to ask questions, both personal and professional. Questions about their journey to medical school and application tips, what they love/hate about their job, etc. They would also be a GREAT writer of a letter of recommendation. And they can teach you some medicine along the way too! I’ve had scribes when working in the ER or urgent care who I knew were pre-med so I’d show them interesting things during the exam or debrief them upon leaving the room. Now scribing is different from shadowing, it’s a job, so you shouldn’t necessarily expect the assigned physician to give you a mini-med school course every day (I was just extra), but it sometimes happens. And the longer you are with them and form a relationship and they become invested in you, the more likely it is that teaching moments will happen naturally. 

An inside look at your future career

Scribing is not meant to be your career, it’s meant to introduce you to your career. The turnover rate is usually pretty high among scribes—because people are leaving for a medical professional school…or because they decided they hate the whole idea of medicine…which is something you’d rather figure out sooner than later. But one great thing about being a scribe is that you’re in the middle of it…and you really get a look at if this (practicing medicine) is something you can, or want to, do for the next 40 years. It may also help you decide on a specialty that you love or one that you can absolutely cross off the list early and never look back at again! You can also start making a list, based on what you see, of characteristics that you do (or don’t) want to have as a future physician.  

Making some money 

Scribing is also a chance to make some money. The pay may not be awesome (minimum wage or a little higher at most places) but the experience to see the practice of medicine firsthand, over and over, is invaluable. If you’re able to work while in college and maintain your course load and grades, scribing is gonna be a much better bet than working at the carwash, I’m just sayin’…. 

Training

There are agencies that offer online and in-person training. Usually, the facility that you’re employed with will set up any extra training you need. This includes learning common medical jargon, learning what needs to be included in notes for billing, learning how to interact in the clinical setting, etc. The most important part, in my opinion, is learning what the physician wants from you—and that just comes with time. 

How to find a scribe job?

ERs in large and small hospitals and urgent cares are great places to look. Local physicians (in private practices or university clinics) also hire scribes. Physicians of all specialties from pediatrics to ENT to surgery have scribes. So there really are several options. I will say that you don’t need to try to find a scribe job only in the field you think you’re interested in. One, because you probably don’t really know what you’re interested in yet. And two, because remember the biggest goals are to understand the patient-physician interaction, work as part of the healthcare team, and figure out if medicine is for you. 

There are scribe agencies that train and place students at facilities. All of the scribes in our local ER used to come from such an agency, I’m not sure if they still do. You can Google these kinds of places near you; make sure they’re legit! They likely offer virtual training. Also check out indeed.com. I literally just went to it and typed in scribe and Alabama and 15 pages of positions came up. Fifteen! You can also ask physicians you know; they may be looking for a scribe themselves or know of colleagues who are looking. I have a friend who recently took over a new practice and was looking for a scribe, and she happened to casually mention it to me one day. And I happened to have a pre-med mentee in town who was perfect. It worked out great. She’s even staying around this Summer to scribe during her break. I can’t stress to her enough how valuable this experience is to her application and to her affirming that she really wants to be a physician. And it’s great for my friend too because it allows her to be more efficient in her workday!

So, if you’re looking for a student job, being a scribe is one that you should add to the list. A medical scribe is a significant help to the physician and, as a student, it gives you the much needed exposure to a physician, patients, and medicine, and is a chance to make some money in the process. And it makes your med school application shiiiiiiiine!!

Are you currently scribing? Have you thought about it but just not moved forward? Do you have any questions or comments about scribing? If so, feel free to leave comments below or send me an email!