Impact of scribes on physician satisfaction, patient satisfaction, and charting efficiency: a randomized controlled trial
Open accessAbstract
PURPOSE Scribes are increasingly being used in clinical practice despite a lack of high-quality evidence regarding their effects. Our objective was to evaluate the effect of medical scribes on physician satisfaction, patient satisfaction, and charting efficiency. METHODS We conducted a randomized controlled trial in which physicians in an academic family medicine clinic were randomized to 1 week with a scribe then 1 week without a scribe for the course of 1 year. Scribes drafted all relevant documentation, which was reviewed by the physician before attestation and signing. In encounters without a scribe, the physician performed all charting duties. Our outcomes were physician satisfaction, measured by a 5-item instrument that included physicians’ perceptions of chart quality and chart accuracy; patient satisfaction, measured by a 6-item instrument; and charting efficiency, measured by time to chart close. RESULTS Scribes improved all aspects of physician satisfaction, including overall satisfaction with clinic (OR = 10.75), having enough face time with patients (OR = 3.71), time spent charting (OR = 86.09), chart quality (OR = 7.25), and chart accuracy (OR = 4.61) (all P values <.001). Scribes had no effect on patient satisfaction. Scribes increased the proportion of charts that were closed within 48 hours (OR =1.18, P =.028). CONCLUSIONS To our knowledge, we have conducted the first randomized controlled trial of scribes. We found that scribes produced significant improvements in overall physician satisfaction, satisfaction with chart quality and accuracy, and charting efficiency without detracting from patient satisfaction. Scribes appear to be a promising strategy to improve health care efficiency and reduce physician burnout.
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Strategies to reduce documentation burden, including team documentation, automatic speech recognition technologies, and 2021 E&M coding changes have been implemented with variable impact.
“Strategies to reduce documentation burden, including team documentation, 9-13 automatic speech recognition technologies, 14 and 2021 E&M coding changes 15 have been implemented with variable impact.16”
From Ambient artificial intelligence scribes: utilization and impact on documentation time (2025) · cites this paper as [9]
The Physician Satisfaction, Charting Efficiency, and Discussion sections report that scribes improved physician satisfaction and chart-closing time but did not change patient satisfaction. This supports variable impact for team documentation, but the paper does not evaluate automatic speech recognition or the 2021 E&M coding changes, so it cannot establish the impact of those strategies. (LLM, conf=0.87)
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“The others were a quality improvement study not designed to create generalizable knowledge(18) and a research study that measured satisfaction with documentation time as a proxy for documentation time.(19) Thus, the impact of medical scribes on PCP productivity remains unclear.”
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“Available Now The use of medical scribes, or nonclinical staff who collect and enter data into EHRs in real time for the clinician, eff ectively reduces clinician time spent on documentation and provides other distinct advantages [20,21].”
BackgroundUse of an AI scribe and electronic health record efficiency
Pearlman, K., Wan, W., Shah, S., & Laiteerapong, N. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.37000 · Cited by 45 · see citing works
Tran, B. D., Chen, Y., Liu, S., & Zheng, K. (2020) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa020 · Cited by 38 · see citing works
Robots in healthcare as envisioned by care professionals
Soljacic, F., Law, T., Chita-Tegmark, M., & Scheutz, M. J. (2024) · Intelligent Service Robotics · doi:10.1007/s11370-024-00523-8 · Cited by 34 · see citing works
“One study found that overall physician satisfaction increased when a scribe took over the routine and time-consuming task of recording information in electronic health records[72].”
Physician EHR Time and Visit Volume Following Adoption of Team-Based Documentation Support
Apathy, N. C., Holmgren, A. J., & Cross, D. A. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.4123 · Cited by 34 · see citing works
The effect of remote scribes on primary care physicians’ wellness, EHR satisfaction, and EHR use
Micek, M. A., Arndt, B. G., Baltus, J. J., Broman, A. T., Galang, J. S., Dean, S. M., Anderson, M., & Sinsky, C. A. (2022) · Healthcare · doi:10.1016/j.hjdsi.2022.100663 · Cited by 33 · see citing works
Safe use of the EHR by medical scribes: a qualitative study
Ash, J. S., Corby, S., Mohan, V., Solberg, N., Becton, J., Bergstrom, R., Orwoll, B., Hoekstra, C., & Gold, J. A. (2020) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaa199 · Cited by 32 · see citing works
Benjamin, I. J., Valentine, C. M., Oetgen, W. J., Sheehan, K. A., Brindis, R. G., Roach, W. H., Harrington, R. A., Levine, G. N., Redberg, R. F., Broccolo, B. M., et al. (2021) · Circulation · doi:10.1161/cir.0000000000000963 · Cited by 35 · see citing works
Clinical Documentation and Patient Care Using Artificial Intelligence in Radiation Oncology
Luh, J. Y., Thompson, R. F., & Lin, S. (2019) · Journal of the American College of Radiology · doi:10.1016/j.jacr.2019.05.044 · Cited by 29 · see citing works
Self-citationOne Year of Family Physicians' Observations on Working with Medical Scribes
Sattler, A. L., Rydel, T. A., Nguyen, C. T., & Lin, S. (2018) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2018.01.170314 · Cited by 30 · see citing works
“The qualitative data used in this research were collected as part of a larger randomized controlled study of scribes, described elsewhere in the literature.(13) Physicians were assigned a schedule of 1 week practicing with a scribe alternating with 1 week without a scribe.”
MethodSelf-citationClinical Documentation for Intensivists: The Impact of Diagnosis Documentation
Sanderson, A. L., & Burns, J. P. (2019) · Critical Care Medicine · doi:10.1097/ccm.0000000000004200 · Cited by 29 · see citing works
“However, studies have shown overall improvements in physician satisfaction related to patient care, documentation, and work-life balance after the implementation of a scribe program (79, 85).”
BackgroundInterventions to Reduce Electronic Health Record-Related Burnout: A Systematic Review
Kang, C., & Sarkar, I. N. (2023) · Applied Clinical Informatics · doi:10.1055/a-2203-3787 · Cited by 33 · see citing works
“…hospitals, 20,21,25,30,32,33,38,39,45,46,51,57,59 62,63 general internal medicine, 24,26,41,48,50,53,57,60 oncology, 23,27,29,43,54 family medicine, 35,52,56,61 urology, 36,47 general surgery, 34 dermatology, 44 and radiology practices, 42 large health networks and systems, 28,37,40,49,55 and…”
BackgroundPhysician Burnout and Timing of Electronic Health Record Use
Micek, M. A., Arndt, B. G., Tuan, W., Trowbridge, E. R., Dean, S. M., Lochner, J., Sampene, E., & Pandhi, N. (2020) · ACI Open · doi:10.1055/s-0039-3401815 · Cited by 27 · see citing works
“Indeed, physician satisfaction has been shown to improve with interventions that distribute EHR tasks to other members of the health care team, 23,24 enhance physicians ’ EHR ef fi ciency through pro fi - ciency training, 25,26 and improve note documentation.”
Naehrig, D. N., Schokman, A., Hughes, J. K., Epstein, R. M., Hickie, I. B., & Glozier, N. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046599 · Cited by 26 · see citing works
Nguyen, O. T., Turner, K. L., Apathy, N. C., Magoč, T., Hanna, K., Merlo, L. J., Harle, C. A., Thompson, L. A., Berner, E. S., & Feldman, S. S. (2021) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocab272 · Cited by 28 · see citing works
Owens, L. M., Wilda, J. J., Grifka, R. G., Westendorp, J., & Fletcher, J. J. (2024) · Applied Clinical Informatics · doi:10.1055/a-2337-4739 · Cited by 25 · see citing works
“12 Anotherrecentrandomizedcontrolledtrialofvirtualscribesin a specialty clinic had similar fi ndings.”
The Use of Medical Scribes in Primary Care Settings
Ziemann, M., Erikson, C. E., & Krips, M. (2021) · Medical Care · doi:10.1097/mlr.0000000000001605 · Cited by 23 · see citing works
Heckman, J., Mukamal, K. J., Christensen, A., & Reynolds, E. E. (2019) · Journal of General Internal Medicine · doi:10.1007/s11606-019-05352-5 · Cited by 22 · see citing works
Factors contributing to burnout in dermatologists
Colon, A., Gillihan, R., & Motaparthi, K. (2020) · Clinics in Dermatology · doi:10.1016/j.clindermatol.2020.02.002 · Cited by 22 · see citing works
Concerns of Primary Care Clinicians Practicing in an Integrated Health System: a Qualitative Study
Anderson, E., Solch, A. K., Fincke, B. G., Meterko, M. M., Wormwood, J. B., & Vimalananda, V. G. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-020-06193-3 · Cited by 23 · see citing works
The Productivity Requirements of Implementing a Medical Scribe Program
Miksanek, T. J., Skandari, M. R., Ham, S. A., Lee, W. W., Press, V. G., Brown, M. T., & Laiteerapong, N. (2020) · Annals of Internal Medicine · doi:10.7326/m20-0428 · Cited by 22 · see citing works
“Although Basu and colleagues modeled an initial period of decreased productivity with scribes, other studies have shown that productivity does not decrease as a scribe starts training and that physician satisfaction with a scribe does not change over time (12, 34).”
BackgroundBenjamin, I. J., Valentine, C. M., Oetgen, W. J., Sheehan, K. A., Brindis, R. G., Roach, W. H., Harrington, R. A., Levine, G. N., Redberg, R. F., Broccolo, B. M., et al. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.04.004 · Cited by 22 · see citing works
Pediatrician Electronic Health Record Time Use for Outpatient Encounters
Overhage, J. M., & Johnson, K. B. (2020) · PEDIATRICS · doi:10.1542/peds.2019-4017 · Cited by 22 · see citing works
Abu, H. O., Anatchkova, M., Erskine, N. A. K., Lewis, J. M., McManus, D. D., Kiefe, C. I., & Santry, H. P. (2018) · Applied Nursing Research · doi:10.1016/j.apnr.2018.09.006 · Cited by 21 · see citing works
“Furthermore, given that most physicians would prefer to engage and spend time with their patients rather than with cumbersome electronic documentation and increasingly onerous regulatory requirements that are only peripherally related to patient care, efforts, such as the use of scribes to reduce the time needed for e…”
BackgroundElectronic Documentation in Pediatrics: The Rationale and Functionality Requirements
O’Donnell, H. C., Suresh, S., Webber, E. C., Alexander, G. M., Chung, S. L., Hamling, A. M., Kirkendall, E. S., Mann, A. M., Sadeghian, R., Shelov, E. D., et al. (2020) · PEDIATRICS · doi:10.1542/peds.2020-1682 · Cited by 21 · see citing works
“Research in this area is limited and has shown discrepancies in whether scribes have led to improvements in provider efficiency and satisfaction.(67,68) Technology to Enhance Data Reuse”
BackgroundRuppel, H., Bhardwaj, A., Manickam, R., Adler‐Milstein, J., Flagg, M., Ballesca, M. A., & Liu, V. X. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.0512 · Cited by 20 · see citing works
“Characteristic Searchesa (N = 4 328 330) Searches per user of search feature Median (IQR) 4 (1-28) Range 1-51 784 Time of day Morning (6:00-11:59 AM) 1 794 822 (41.”
BackgroundMetal-on-Metal Total Hip Revisions: Pearls and Pitfalls
Law, J. I., Crawford, D. A., Adams, J. B., & Lombardi, A. V. (2020) · The Journal of Arthroplasty · doi:10.1016/j.arth.2020.01.011 · Cited by 19 · see citing works
Assessing the Efficacy and Clinical Utility of Artificial Intelligence Scribes in Urology
Moryousef, J., Nadesan, P., Uy, M., Matti, D., & Guo, Y. (2024) · Urology · doi:10.1016/j.urology.2024.11.061 · Cited by 18 · see citing works
SummQA at MEDIQA-Chat 2023: In-Context Learning with GPT-4 for Medical Summarization
Mathur, Y., Rangreji, S., Kapoor, R., Palavalli, M., Bertsch, A., & Gormley, M. R. (2023) · Clinical Natural Language Processing Workshop (ClinicalNLP) · doi:10.18653/v1/2023.clinicalnlp-1.51 · Cited by 19 · see citing works
Effect of Medical Scribes on Outpatient Oncology Visits at a Multidisciplinary Cancer Center
Gao, R. W., Dugala, A., Maxwell, J., Falconer, P., Birkeland, A. C., Divi, V., & Rosenthal, E. L. (2019) · JCO Oncology Practice · doi:10.1200/jop.19.00307 · Cited by 17 · see citing works
Trockel, M., Menon, N. K., Makowski, M. S., Wen, L. Y., Roberts, R., Bohman, B. D., & Shanafelt, T. D. (2022) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2022.06.035 · Cited by 16 · see citing works
Views of institutional leaders on maintaining humanism in today’s practice
Gilligan, M. C., Osterberg, L. G., Rider, E. A., Derse, A. R., Weil, A., Litzelman, D. K., Dunne, D., Hafler, J. P., Plews-Ogan, M., Frankel, R. M., et al. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.04.025 · Cited by 16 · see citing works
“[47-48] Some of the work that needs to be done (e.”
BackgroundNorth, F., Matthews, M. R., Iqbal, A., Post, J. A., & Ebbert, J. O. (2025) · Digital Health · doi:10.1177/20552076251403211 · Cited by 15 · see citing works
Danak, S. U., Guetterman, T. C., Plegue, M. A., Holmstrom, H., Kadri, R., Duthler, A., Yoo, A., & Buis, L. R. (2019) · JMIR Medical Informatics · doi:10.2196/14797 · Cited by 16 · see citing works
“Overall, patients were pleased with the medical care they received and were satisfied, regardless of scribe presence, which is consistent with the literature [13,14].”
Thit, W. M., Thu, S. W. Y. M., Kaewkungwal, J., Soonthornworasiri, N., Theera-Ampornpunt, N., Kijsanayotin, B., Lawpoolsri, S., Naing, S., & Ngum, W. P. (2020) · Healthcare Informatics Research · doi:10.4258/hir.2020.26.3.185 · Cited by 14 · see citing works
“EMR system deployment increases the quality of healthcare services [16] as well as physicians’ satisfaction [17].”
BackgroundResidents’ Perspectives on Careers in Academic Medicine:
Lin, S., Nguyen, C. T., Walters, E., & Gordon, P. (2018) · Family Medicine · doi:10.22454/fammed.2018.306625 · Cited by 14 · see citing works
Self-citationLin, S., Duong, A., Nguyen, C., & Teng, V. (2021) · Academic Medicine · doi:10.1097/acm.0000000000003757 · Cited by 14 · see citing works
Self-citationBaxter, S. L., Gali, H. E., Chiang, M. F., Hribar, M. R., Lucila Ohno-machado, A., El-Kareh, R. E., Huang, A. E., Chen, H. E., Camp, A. S., Kikkawa, D. O., et al. (2020) · Applied Clinical Informatics · doi:10.1055/s-0040-1701255 · Cited by 13 · see citing works
Gagliardi, J. P., Bonanno, B., Hinz, E. M., Musser, R. C., Knudsen, N. W., Palko, M. J., McNair, F., Lee, H., & Clay, A. S. (2020) · Academic Medicine · doi:10.1097/acm.0000000000003729 · Cited by 13 · see citing works
“This effect may extend to their supervising physicians, who have reported greater satisfaction when they are able to delegate elements of documentation.(13) Supervisors who spend less time on the intricacies of documentation may have more time to give to patients as well as learners.”
BackgroundDo You Know What Your Scribe Did Last Spring? The Impact of COVID-19 on Medical Scribe Workflow
Gold, J. A., Becton, J., Ash, J. S., Corby, S., & Mohan, V. (2020) · Applied Clinical Informatics · doi:10.1055/s-0040-1721396 · Cited by 13 · see citing works
Kwan, B. M., Hamer, M. K., Bailey, A., Cebuhar, K., Conry, C. M., & Smith, P. C. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-021-07246-x · Cited by 13 · see citing works
“This echoes findings of a prior study in which use of scribes in an academic family medicine setting improved physician satisfaction and clinic efficiency.(39) Staffing and scheduling should aim to ensure retention of the increased MA-clinician ratios and regular provider-MA pairings—supporting other reports that “non…”
ResultChandrasekaran, R., & Moustakas, E. (2025) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocaf218 · Cited by 13 · see citing works
Corby, S., Whittaker, K., Ash, J. S., Mohan, V., Becton, J., Solberg, N., Bergstrom, R., Orwoll, B., Hoekstra, C., & Gold, J. A. (2021) · BMC Medical Informatics and Decision Making · doi:10.1186/s12911-021-01560-4 · Cited by 13 · see citing works
Electronic Documentation in Pediatrics: The Rationale and Functionality Requirements
O’Donnell, H. C., Suresh, S., Webber, E. C., Alexander, G. M., Chung, S. L., Hamling, A. M., Kirkendall, E. S., Mann, A. M., Sadeghian, R., Shelov, E. D., et al. (2020) · PEDIATRICS · doi:10.1542/peds.2020-1684 · Cited by 11 · see citing works
Clinical scribes and their association with patient experience in the otolaryngology clinic
Rohlfing, M. L., Keefe, K. R., Komshian, S. R., Valentine, A. D., Noordzij, J. P., Levi, J. R., & Brook, C. D. (2019) · The Laryngoscope · doi:10.1002/lary.28075 · Cited by 11 · see citing works
“There has beenmixed evidence on the timeliness of note and chart completion in the setting of outpatient scribe utilization.(13,17) Several studies have reported an increase in time spent in direct patient care when scribes were present.”
BackgroundResultThe Impact of Medical Scribes on Patient Satisfaction in an Academic Otolaryngology Clinic
Keefe, K. R., Levi, J. R., & Brook, C. D. (2019) · Annals of Otology Rhinology & Laryngology · doi:10.1177/0003489419884337 · Cited by 11 · see citing works
“Self-developed survey (5 Press Ganey items) No difference Gidwani et al.(9) Primary care clinic Physician satisfaction Self-developed survey Increased”
MethodAlbrecht, M., Shanks, D., Shah, T., Hudson, T., Thompson, J., Filardi, T., Wright, K., Ator, G., & Smith, T. R. (2024) · doi:10.1101/2024.08.12.24311883 · Cited by 11 · see citing works
Chart Completion Time of Attending Physicians While Using Medical Scribes.
Florig, S. T., Corby, S., Rosson, N. T., Devara, T., Weiskopf, N. G., Gold, J. A., & Mohan, V. (2021) · PubMed Central · Cited by 10 · see citing works
Frequency and Severity of Moral Distress in Nephrology Fellows: A National Survey
Saeed, F., Duberstein, P. R., Epstein, R. M., Lang, V. J., & Liebman, S. E. (2021) · American Journal of Nephrology · doi:10.1159/000516575 · Cited by 10 · see citing works
Ong, S. Y., Jeffery, M. M., Williams, B., O’Connell, R. T., Goldstein, R. L., & Melnick, E. R. (2021) · NEJM Catalyst · doi:10.1056/cat.21.0294 · Cited by 10 · see citing works
Cauley, A., Green, A. R., & Gardiner, P. M. (2022) · Journal of Integrative and Complementary Medicine · doi:10.1089/jicm.2021.0401 · Cited by 9 · see citing works
Senken, B., Welch, J. L., Sarmiento, E. J., Weinstein, E., Cushman, E. L., & Kelker, H. P. (2024) · Journal of the American College of Emergency Physicians Open · doi:10.1002/emp2.13315 · Cited by 9 · see citing works
“2,6,12,22,23 By acknowledging the complexity in defining provider wellbeing, we chose to focus on the intersection of wellness and the clinical work environment to identify factors that impact shift satisfaction by role.”
BackgroundImpact of Scribe Intervention on Documentation in an Outpatient Pediatric Primary Care Practice
Jhaveri, P., Abdulahad, D., Fogel, B. N., Chuang, C. H., Lehman, E. B., Chawla, L., Foley, K. A., Phillips, T. A., & Levi, B. H. (2021) · Academic Pediatrics · doi:10.1016/j.acap.2021.05.004 · Cited by 9 · see citing works
Do Medical Scribes Help Primary Care Providers Respond More Quickly to Out-of-Visit Tasks?
Zallman, L., Altman, W., Chu, L., Touw, S., Rajagopal, K., Dolat, S., & Sayah, A. J. (2021) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2021.01.200330 · Cited by 9 · see citing works
“12,14 Our fi ndings suggest that this time saved due to scribes does not result in quicker responses to out-of-visit tasks.”
BackgroundInfluentialPiersa, A. P., Laiteerapong, N., Ham, S. A., del Castillo, F. F., Shah, S. D., Burnet, D. L., & Lee, W. W. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06710-y · Cited by 9 · see citing works
“As initiatives such as OpenNotes, which promotes note sharing with patients, gain popularity [49, 50], the quality and readability of EHR notes co-authored by scribes may reduce patient confusion and improve patient satisfaction with their notes [33, 41].”
BackgroundResultTranscription Accuracy of Automatic Speech Recognition for Orthodontic Clinical Records
O’Kane, R., Stonehouse‐Smith, D., Ota, L. C. U., Patel, R., Johnson, N., Slipper, C., Seehra, J., Papageorgiou, S. N., & Cobourne, M. T. (2025) · Journal of Dental Research · doi:10.1177/00220345251382452 · Cited by 8 · see citing works
“These interventions can reduce documentation burden, improve efficiency, and increase work satisfaction, but they require additional manpower in the form of a scribe (Gidwani et al. 2017; Mishra et al. 2018; Micek et al. 2022).”
Fogleman, B. M., Goldman, M., Holland, A. B., Dyess, G. A., & Patel, A. (2024) · Cureus · doi:10.7759/cureus.58032 · Cited by 12 · see citing works
“Increased provider and patient satisfaction and improved documentation efficiency [52].”
BackgroundImpact of Scribes on Medical Student Education:
Hafer, J., Wu, X., & Lin, S. (2018) · Family Medicine · doi:10.22454/fammed.2018.933777 · Cited by 8 · see citing works
Self-citation
- Authors
- Gidwani, R., Nguyen, C., Kofoed, A., Carragee, C., Rydel, T., Nelligan, I., Sattler, A., Mahoney, M., & Lin, S.
- Affiliations
- Stanford Medicine (US)
- Venue
- The Annals of Family Medicine
- Publisher
- Annals of Family Medicine
- Published
- 2017-09
- Volume
- 15
- Issue
- 5
- Pages
- 427-433
- ISSN
- 1544-1709 (ISSN-L)
- 1544-1717
- PMC
- PMC5593725
- OpenAlex
- W2754624876
- Cited by
- 202
- References
- 38
- Citations by year
- 2026: 11 · 2025: 22 · 2024: 24 · 2023: 12 · 2022: 16 · 2021: 31 · 2020: 35 · 2019: 30 · 2018: 18 · 2017: 2
- FWCI
- 31.91
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- The Annals of Family Medicine (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
- Keywords
- medical scribes, physician satisfaction, patient satisfaction, electronic health record documentation, general practice, physician burnout, health care efficiency
- MeSH terms
- Adult, Documentation, Family Practice, Female, Humans, Job Satisfaction, Male, Middle Aged, Physicians, Family, Patient Satisfaction, Efficiency, Organizational
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