In the Spring of 2021, I found myself between jobs as I worked on my medical school application. I was seeking meaningful work that would allow me to make a difference in the lives of patients like my previous healthcare positions while also satisfying my intellectual curiosity in a similar manner to my undergraduate studies.
Discussions with my former coworkers, along with a number of internet searches, confirmed that working as a medical scribe combined the best of both worlds. Scribe-X, in particular, caught my eye due to the ability to work remotely from home in a variety of healthcare settings. Soon after applying, I set up my home office and was assigned to a provider (a dual naturopath and nurse practitioner) for a low-income community clinic in a different state.
During my time as a scribe, I grew significantly both personally and professionally. While I certainly can’t capture all the skills I’ve gained as a scribe, I’ve tried to summarize some of the most important takeaways from the past 14 months.
When most people think of medical scribes, the first thing they typically think of is the electronic medical record (EMR). As scribes, our primary duty is to document provider-patient encounters to improve the accuracy and quality of chart notes and allow providers more face-to-face time with their patients. However, charting is more than just typing notes. EMRs are like cell phones or computers in that users continually learn new ways to use them. While my EMR appeared complicated at first, I soon became comfortable navigating within patients’ charts. I even found myself teaching my provider and her colleagues new EMR tricks once I became an experienced scribe. I know these skills will serve me well as I begin charting notes for my own patients in the future.
Flexibility is essential in healthcare. I can’t think of a single shift over the past year where everything went exactly as expected. As an organized and methodical person, I love to plan. However, healthcare is a fluid system where plans often change, and situations evolve over time. Maybe the scheduling team will make a mistake and double book you twice in the morning while three of your afternoon patients cancel their appointments. Maybe a parent will bring in three of their children for check-ups at the same time when they were all scheduled separately. Maybe your routine physical will report chest pain, and the entire visit changes course to focus on their heart and lungs. While these situations can certainly be stressful, they can also be exciting at times. Working as a scribe has helped me better adapt to this unpredictability and succeed in these challenging conditions.
When it comes to communication, people have different preferences for how they like to convey information and how they like to receive information. Some people like communication to be blunt and get directly to the point. Others like to take longer and soften their words and may explicitly say what they want.
As a scribe, I worked as a team both with my provider, and with her coworkers. I have a different temperament than my provider, who has a different temperament than her MA and so on. Working on a team with people of different personalities and communication styles has helped me better understand individual differences and has prepared me to work as part of a varied healthcare team.
As a natural people-pleaser, this lesson is one that is easier said than done. A provider does a good job if their patient leaves the visit happy…right? Unfortunately, patient satisfaction and patient well-being can sometimes come into conflict. While a provider should certainly aim to make their patients happy, a provider's ultimate goal is their patient's well-being.
But what if a patient demands antibiotics when their infection is viral and not bacterial? Or a patient calls you to ask for a medical exemption to a school or workplace policy you don't think is medically indicated? How about when a patient has their heart set on surgery, but you don't feel comfortable with a plan that aggressive until you try some "softer" treatments first?
While these conflicts do not represent the majority of cases, I have learned that occasional disagreements between patients and providers are inevitable. By observing the interpersonal conflicts my provider experiences with her patients, I feel better equipped to address instances of disagreement with my future patients.
Because I worked in a remote position with Scribe-X, I had the advantage of working with patient populations that look very different from those in the cities near me. Many of my provider's patients are immigrants from either Africa or Southeast Asia. Many healthcare workers learn that Muslims fast during Ramadan, and Jehovah's Witnesses can't receive blood transfusions. However, differences exist within each cultural or religious group.
Among our Muslim patients, for example, some will try to fast during Ramadan even if diabetic or actively breastfeeding, while others will not. Unfortunately, some patients do not feel comfortable discussing their culture or religion with their provider, even if it is medically relevant. If the patient doesn't volunteer the information, it's up to the provider to ask.
Through caring for these patients, my provider helped me better understand how culture and religion can influence health and how many individual differences there are in each of these factors. I also better understand the types of cultural and religious questions to ask while taking patient histories. Additionally, I know that I must continue to learn about different backgrounds to better care for the diverse patients I will serve as a physician.
Now, approximately 14 months, 1,400 shift hours, and 4,400 patients later, I know I made the right choice in choosing to work as a medical scribe. Through this practical exposure to the joys and struggles of healthcare and the mentorship of my provider, I am even more sure of my future career plan of becoming a physician.
There are undoubtedly difficult days as a scribe, but there are also days when patients really make you feel appreciated or cause you to laugh out loud, or your provider tells you how much better their shift went because they had you by their side. If I could go back in time one year, I would still choose the same position as a remote medical scribe. While the road to becoming a physician is challenging, I'm confident in the abilities I have gained working as a scribe, and I feel more than prepared to enter medical school this fall.
