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. Perhaps 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 they hear about patients' ailments and doctors' advice in 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.
Regulation and training are not rigorous. Scribes are not licensed. About a third of them are certified and that's voluntary, according to the sole professional body for scribes. The American College of Scribe Specialists was created by ScribeAmerica's founders in 2010.
"This is literally an exploding industry, filling a perceived gap, but there is no regulation or oversight at all," says George Gellert, regional chief medical informatics officer at Christus Santa Rosa Health System in San Antonio, which uses scribes.
Others suggest that scribes can be a benefit to doctors and patients by shouldering the minutia of recording many of the details on a computer. "They're capturing the story of a patient's encounter – and afterword, doctors make sure everything is accurate. That way the doctor can focus on interacting with the patient and give them good bedside manner," says Angela Rose, a director at the American Health Information Management Association, a professional group that has published a set of best practices for scribes.