Episode 16 – Save A Doctor – Hire a Scribe

In this episode, you’ll hear from three physicians who work with medical scribes.  If you haven’t had experience with either in-person or virtual (remote) scribes, this episode will give you a pretty good picture. First, Dr. Christopher Obetz, CEO of Emergency Care Consultants (ECC) and featured guest in Episode 15, talks about launching their scribe program 15 years ago.  Scribes work right alongside the physician, taking notes and doing data entry in the electronic medical record. 

Dr. Obetz describes how the scribe program and the resulting “very robust, descriptive and helpful notes” were a big part of turning the Emergency Department into the “nerve center” of Abbott Northwestern Hospital, a quaternary referral center.  They have about 200 scribes and lease scribe services to other medical and surgical specialties.  Many scribes continue their education and then return to ECC as physicians, physical therapists, and physician assistants.

  • Scribes helped ECC become an early adopter of the EMR
  • From an emergency room to a “nerve center”!
  • Physicians as problem solvers who don’t mind “tinkering” with processes
  • Scribes play a role in helping to address diversity issues

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Then hear from ophthalmologist Dr. Barbara Blodi, a retinal specialist and the leader of the Fundus Photograph Reading Center, a highly specialized research center with an international reputation for its excellence. Dr. Blodi, a physician leader and researcher, spends about 25% of her time seeing patients in her office practice. She relies on her virtual (or “remote”) scribe to increase her efficiency in clinic and free her up to focus on her patients. 

  • Scribes allow her to complete her work with no “carry over”
  • Patients are grateful to see that she is more present during the visit
  • Scribes make it easier to balance teaching, patient care, research and leadership responsibilities
  • A quality issue: we want the right information in the chart 
  • Unlike many initiatives in healthcare—scribes increase both patient and physician satisfaction 

Third up in our Scribe podcast, hear from Dr. Mark Lucarelli, an oculofacial plastic surgeon who is also in the ophthalmology department at the University of Wisconsin.  He was already steeped in LEAN improvement processes when UW Health launched a scribe pilot program in dermatology and ophthalmology.  His practice and team benefitted from the integration of a well-oiled LEAN team with the use of a remote scribe.  He found that in surgery the EMR was useful, but in clinic the EMR burden was onerous. Dr. Lucarelli, at the peak of his expertise with over 20 years as an oculofacial surgeon, wasn’t sure how much longer he would practice. For him, the scribe program was a “game changer.” You will hear his enthusiasm for his scribe and his profession as he describes his ability to focus on the patient, provide excellent quality care, and have family time again.

  • The combination of LEAN and remote scribes reoriented his team toward creating an excellent, efficient, personalized patient experience 
  • A misconception about scribes? That they just input a progress note—but they do so much more
  • His only regret? He wished he had worked with a scribe much earlier in his career

Meet the Guests:

Christopher* Obetz, MD is an emergency medicine physician, and the President and CEO of Emergency Care Consultants (ECC) in Minneapolis, Minnesota. ECC is a “physician-owned, independent, and democratic” organization responsible for both outstanding emergency care and outstanding emergency medicine careers in ten hospitals in the Twin Cities area.  Dr. Obetz has been leading ECC for the last decade.  The organization is known for its consistent high quality care and service, excellent business outcomes and sustained high satisfaction among physicians and staff. Innovation is fueled by ECC’s high physician involvement model and purposeful collaboration with all stakeholders. 

*known as Topher by family, friends and colleagues

Barbara Blodi, MD is a retina specialist and professor in the Department of Ophthalmology and Visual Sciences at the University of Wisconsin as well as the Medical Director of the Fundus Photograph Reading Center, a core imaging lab for clinical trials in retinal research. It is one of the top such imaging centers in the world and researchers from government, academic and pharmaceutical institutions rely on the reading center for their expertise in interpreting results of clinical trials.  Dr. Blodi serves as the principal investigator at the FPRC for several NIH-sponsored grants and pharmaceutical trials in diabetic retinopathy, macular degeneration and other retinal conditions.  Dr. Blodi is a full professor, and this year, she was awarded the Matthew Davis Professorship at the UW, and she gives talks all over the world on the work done in the Fundus Photograph Reading Center.

Mark Lucarelli, MD is a specialist in Oculofacial plastic surgery and is the Dortzbach Professor in the Department of Ophthalmology and Visual Sciences at the University of Wisconsin – Madison.  Dr. Lucarelli serves as the Oculoplastics fellowship director, Service Chief of Oculoplastics, and Medical Director of the University Station Ophthalmology Clinic. Dr. Lucarelli is the immediate past president of the American Society of Ophthalmic Plastic and Reconstructive Surgery and is considered a national leader in his field.

Resources: 

Emergency Care Consultants
https://www.facebook.com/UWMadisonEyes
https://www.instagram.com/uwsavingsight/
https://www.linkedin.com/school/uwmadison/mycompany/
Mark Lucarelli, MD:  mlucarel@wisc.edu
Why Doctors Hate Their Computers by Atul Gawande (The New Yorker)
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Death by a Thousand Clicks by Fred Schulte and Erika Fry (Fortune Magazine and Kaiser Health News)
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