Implementation of medical scribes in an academic urology practice: an analysis of productivity, revenue, and satisfaction

  • Benjamin J. McCormick
  • Allison Deal
  • Kristy M. Borawski
  • Mathew C. Raynor
  • Davis Viprakasit
  • Eric M. Wallen
  • Michael E. Woods
  • Raj S. Pruthi
Original Article
  • 12 Downloads

Abstract

Purpose

Pressure on physicians to increase productivity is rising in parallel with administrative tasks, regulations, and the use of electronic health records (EHRs). Physician extenders and clinical pathways are already in use to increase productivity and reduce costs and burnout, but other strategies are required. We evaluated whether implementation of medical scribes in an academic urology clinic would affect productivity, revenue, and patient/provider satisfaction.

Methods

Six academic urologists were assigned scribes for 1 clinic day per week for 3 months. Likert-type patient and provider surveys were developed to evaluate satisfaction with and without scribes. Matched clinic days in the year prior were used to evaluate changes in productivity and physician/hospital charges and revenue.

Results

After using scribes for 3 months, providers reported increased efficiency (p value = 0.03) and work satisfaction (p value = 0.03), while seeing a mean 2.15 more patients per session (+ 0.96 return visits, + 0.99 new patients, and + 0.22 procedures), contributing to an additional 2.6 wRVUs, $542 in physician charges, and $861 in hospital charges per clinic session. At a gross collection rate of 36%, actual combined revenue was + $506/session, representing a 26% increase in overall revenue. At a cost of $77/session, the net financial impact was + $429 per clinic session, resulting in a return-to-investment ratio greater than 6:1, while having no effect on patient satisfaction scores. Additionally, with scribes, clinic encounters were closed a mean 8.9 days earlier.

Conclusions

Implementing medical scribes in academic urology practices may be useful in increasing productivity, revenue, and provider satisfaction, while maintaining high patient satisfaction.

Keywords

Medical scribes Efficiency Productivity Satisfaction 

Notes

Authors’ Contribution

BJ McCormick: Project development, Data Collection, Data Analysis, Manuscript writing/editing. A Deal: Data analysis. M Borawski: Data collection, project development, Manuscript editing. MC Raynor: Data collection, project development, Manuscript editing. DP Viprakasit: Data collection, project development, Manuscript editing. EM Wallen: Data collection, project development, Manuscript editing. ME Woods: Data collection, project development, Manuscript editing. RS Pruthi: Project development, Data Collection, Manuscript writing/editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval/informed consent

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Urology, UNC School of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Lineberger Comprehensive Cancer Center, Biostatistics and Clinical Data Management CoreUniversity of North Carolina at Chapel HillChapel HillUSA

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