With internists and family physicians consistently reporting higher rates of burnout than the national average for all specialties, a study shows that pairing primary care physicians with a remote scribe can result in “significant improvements in physician wellness.”
Before being assigned a scribe, 70.3% of physicians in the study reported burnout based on the Mini-Z single-item burnout measure. That number dropped to 51.4% after using a scribe—a 26.8% decrease. For physicians who didn’t receive a scribe, the share feeling burnout rose over the study period to 60.3%, up from 50%.
“The fact that that measure captured a reduction in burnout is telling. ... It is basically a self-described perception that they are feeling better,” said the study’s corresponding author, internist Mark A. Micek, MD. He is associate clinical professor in the medicine department at the University of Wisconsin School of Medicine and Public Health.
Physicians with scribes were more likely to report that they were in a joyful workplace and in a supportive work environment. They also had a good work pace and had less EHR stress compared with colleagues who weren’t assigned scribes, according to the study, which was published in the journal Healthcare and supported by an AMA Practice Transformation EHR Use Research grant.
“Scribes improve the way that people feel the flow of their work is going. It is relieving work from them, so I think it is easy for them to translate that into the sense that their burnout relative to their work is going down,” Dr. Micek said.
Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.
Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.
Since 2020, the AMA Practice Transformation EHR Use Research grant program has provided more than $1.5 million in funding to researchers nationwide to conduct 15 high-impact studies so far.
Having a scribe to assist physicians with documentation and other electronic health records system tasks in real time during clinical visits cut physicians' EHR time by as much as 66 minutes for every eight hours of a physician’s patient scheduled time, researchers found. That included about 30 minutes less of EHR time outside of the scheduled workday.
The vast majority of the reduced EHR time—about 54 minutes—was attributed to physicians spending less time on note writing.
“Note writing isn’t a fulfilling part of our work,” Dr. Micek said. “We want to be fulfilled by engaging with patients and looking at them and talking with them—not writing notes. Reducing our engagement with the EHR lets us move that engagement elsewhere.”
The study took place at University of Wisconsin Health, a large academic health care system with 34 primary care clinics caring for nearly 300,000 patients in the Madison area. It included nearly 200 primary care physicians who practiced general internal medicine, family medicine and general pediatrics and adolescent medicine.
Under the pilot program, individual scribes were paired with one physician. The scribes provided their services remotely for 37 physicians, while 160 physicians were controls in the study. The scribes joined visits via an audio-only cellphone connection to hear and document visits in real time. They were expected to join all the physicians’ clinic sessions and document clinic notes and pending orders for co-signature. When the scribe completed the notes, they went to the physician for review, editing and a co-signature.
The research builds on earlier findings by including “a larger number of physicians and a separate comparison group without scribes to control for changes in outcomes due to factors unrelated to our scribe intervention,” the study’s authors wrote.