Cited by 202Electronic Health Records SystemsNursing Roles and PracticesMedical Coding and Health Information

Impact of scribes on physician satisfaction, patient satisfaction, and charting efficiency: a randomized controlled trial

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Gidwani, Risha, Nguyen, Cathina, Kofoed, Alexis, Carragee, Catherine, Rydel, Tracy, Nelligan, Ian, Sattler, Amelia, Mahoney, Megan +1 more·2017·The Annals of Family Medicine

Abstract

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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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
Published
2017-09
Volume
15
Issue
5
Pages
427-433
ISSN
  • 1544-1709 (ISSN-L)
  • 1544-1717
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
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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