A new study published in Journal of the American Board of Family Medicine shows that integrating scribes into a primary care setting can benefit clinic operations, joy of practice, quality of care, and patient experience. These positive outcomes go beyond reducing charting burden and may all play a role in preventing physician burnout.

Burnout among US physicians is a serious and growing problem with profound implications for society. More than half of all US physicians are experiencing professional burnout, and family physicians have one of the highest rates of burnout among the specialties. The immense clerical burden felt by physicians is one of the leading causes of burnout.

To decrease the clerical burden felt by physicians, many US hospitals and clinics have adopted the use of scribes. Scribes are non-licensed individuals trained to document patient encounters in real time under the direct supervision of a physician. Scribes assist with charting, recording laboratory and radiology results, and supporting physician workflow with electronic health record (EHR) data entry.

Scribes are increasingly being used to help alleviate this burden, yet few published studies investigate how scribes affect physicians' daily work, attitudes and behaviors, and relationships with patients and the workplace. Using a longitudinal observational design, data were collected, over 1 year, from 4 physicians working with 2 scribes at a single academic family medicine practice.

Physician experience was measured by open-ended written reflections requested after each 4-hour clinic session. A data-driven codebook was generated using a constant comparative method with grounded theory approach. A total of 361 physician reflections were completed, yielding 150 distinct excerpts; 289 codes were assigned.

The 11 themes that emerged were further categorized under 4 domains. The most frequently recurring domain was clinic operations, which comprised 51.6% of the codes. Joy of practice, quality of care, and patient experience comprised 22.1%, 16.3%, and 10.0% of the codes, respectively.

The study findings suggests that integrating scribes into a primary care clinic can produce positive outcomes that go beyond reducing clerical burden for physicians. Scribes may benefit patient experience, quality of care, clinic operations, and joy of practice. By identifying relevant themes and domains, the investigators have set the groundwork for future, robust qualitative or mixed-methods studies on scribes in primary care.