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Jokes about physicians' handwriting are endless. But now that healthcare is going paperless, handwriting is no longer a big issue. Yet electronic systems pose their own problems. Data entry cuts into the time a doctor can spend with the patient.

That's especially true in the emergency room where the pace is rapid and the majority of patients are in serious condition.

Creating The Medical Record

To solve this problem, the emergency department of Abbott Northwestern Hospital launched a physician scribe program in April 2006 — the first such program in the Twin Cities. A scribe follows the emergency physician into the patient's room and enters information into a computer on wheels, using a specially designed template.

As the doctor dictates, the scribe records the patient's medical history, the reason for the visit and the results of the physical exam. The scribe enters orders for lab tests and X-rays, records the results of diagnostic tests, and helps the physician and the nurses keep track of the patient in the ER. After the doctor reviews the chart, he or she enters the diagnosis and plan of care, and signs the chart electronically.

"We are creating the medical record in real time," says Joe Schmidt, a physician scribe at Abbott. "This allows doctors to maintain eye contact with patients instead of focusing on a clipboard or a computer. They can spend more time on patient care since they don't have to worry about charting. And the medical record is more complete."

Needed: A Desire To Learn

Applicants to Abbott's scribe program must be planning to attend medical school. Preference is given to candidates who have completed organic chemistry. In addition, candidates must be independent, responsible and reliable. Above all, they must have a strong desire to learn.

Part-time scribes commit to working a maximum of 11 shifts a month for two consecutive years. Full-time scribes commit to a maximum of 20 shifts a month for one year. Scribes are never scheduled to work when they have class — but everyone works a rotating schedule that includes days, nights, weekends and holidays. Scribes work with the same doctor for an entire eight-hour shift, but they're usually assigned to several different doctors in the course of a month.

A Sense of Accomplishment

According to Emergency Care Consultants, the group that provides care for patients in Abbott's emergency department, scribes have an opportunity to:

• Learn the responsibilities of being a physician.

• Craft an individual style by observing and learning from different doctors.

• Learn about different medical specialties.

• Become fluent in the language of medicine.

• Become accustomed to standards of medical coding and documentation.

• Prepare for medical school interviews.

• Increase time management skills.