10 Reasons to Consider Becoming a Medical Scribe Ahead of Med School

Prospective medical school students will gain valuable experience that will help them while applying and in the classroom.


As a medical scribe, prospective students can learn how doctors build trust and interact with patients.(Gary John Norman/ Getty Images)

If you’re considering a career in medicine, working as a medical scribe is a best bet for familiarizing yourself with patient care. A medical scribe works directly with physicians, primarily focused on charting patient encounters in the electronic medical record. What’s more, scribe positions can be full or part time, making it a viable job choice for a student.

If this sounds appealing, consider the following 10 reasons why prospective medical school students should consider becoming a medical scribe.

1. You will shadow physicians. Most admissions committees expect students to have had shadowing experiences before they apply to medical school. One of the greatest benefits of shadowing is that the experience will help you see how physicians handle being busy and stressed.
2. You will learn a great deal about medicine. As a scribe, you will start to listen for the signs and symptoms that help a physician come to a diagnosis or a differential diagnosis list. Over time, you will be able to anticipate what some of these diagnoses may be.
4. You will learn a lot about teamwork. You’ll be able to observe the respect given to team members and watch them intuitively help one another.Many medical students have no idea what the roles of interdisciplinary providers are until they get to their third year. You will be better prepared to understand the role of a physician assistant or a nurse practitioner because you have seen them in action.
5. You will learn medical language. Over time, you will learn how to spell and pronounce the words, and what they mean. The more familiar you are with the terminology, the less you’ll have to rely on rote memorization after you enter medical school. Humans more easily remember things through experience than simply by reading a text.
6. You will watch, hear and see how trust is developed. I think this is different than basic shadowing where the focus is on the physician. What I am talking about here is the dance between the patient and physician that generates caring and trust. For example, you might hear how the physician works to clearly understand what a patient said or you might see the doctor comfort a patient by touching the patient’s hand.
7. You will learn about the medical record. You will learn why the patient’s chief complaint is different from the history of present illness. You will understand the importance of the social history and mental status exam. The order will be more meaningful, and you will practice it so often that you could do it in your sleep.
8. You will learn about templates, checklists and smart phrases. All of these tools are to help physicians become more efficient, but clearly the tools aren’t enough because they hired you to help.
9. You’ll probably increase your typing speed and efficiency. Not only are these skills beneficial to you, but they’re important in terms of maintaining patient flow and reducing patient wait time.
10. You will get to listen to patients. This, in my opinion, is the most important reason. You will get to hear their story, their pain and their fears. You will learn to be in the moment and block out distractions, which is what all patients hope their doctors will do.
Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes.   Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes

KMGMA 2017

#MDSofKansas will once again be at the #KMGMA2017 Spring Conference (04/20/17) and we are looking forward to seeing YOU!  Please stop by our booth and check out some of the great giveaways, and learn what we’ve been up to!  We are saving many clinics and businesses lots of money on everyday fees.  If you would like to save money, too, stop by and ask us how!



Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing, Medical Transcription, Scribe Services, and AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes.   Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #MedicalTranscription #AzaleaHealthEHR #RevenueCycleManagement #MDSofKansas #MedicalBillingService #MedicalScribes

17 Scribe things to know!

As physicians look for ways to reduce the clerical load associated with EHR data entry, they are increasingly turning to medical scribes.

Scribes help physicians with EHR navigation, retrieval of diagnostic results, documentation and coding. This allows the physician to free up time for patient care.

Yet while the use of scribes is growing, the position remains minimally regulated. There are no requirements for certification, for instance. Any certification received by scribes is voluntary, and the minimum qualification to work as a scribe is a high school diploma.

Here are 17 things to know about scribes.

Basic duties and numbers

1. Scribes typically go with the provider into the exam room and document the patient’s encounter with the provider. The provider may also dictate the patient encounter to the scribe, and the scribe gathers data for the physician such as nursing notes, prior records, labs and radiology results, according to the American College of Emergency Physicians.

2. “Medical scribes do the bulk of documentation for the provider, says Michael Murphy, MD, cofounder and CEO of ScribeAmerica, which provides scribes to hospitals and medical practices. “They’re tracking down labs, they’re notifying of delays, they’re helping in scheduling appointments. They’re basically handling 80 to 90 percent of the ancillary duties for providers.”

3. The American College of Medical Scribe Specialists estimates 20,000 scribes were employed by the end of 2014, and it expects this number to grow to 100,000 scribes by 2020.

4. As of April 2015, at least 22 companies supplied scribes across 44 states, according to the Journal of the American Medical Association. The largest company is ScribeAmerica, with more than 5,000 scribes in more than 570 healthcare facilities across 44 states.


5. A study published last year by the National Center for Biotechnology Information found physician productivity in a cardiology clinic was 10 percent higher when scribes were used. The study compared the productivity during routine clinic visits of 10 cardiologists using scribes versus 15 cardiologists without scribes. According to the study, physicians with scribes saw 9.6 percent more patients per hour than physicians without scribes. Physician productivity in a cardiology clinic, overall, was 10 percent higher for physicians with scribes.

6. This same study showed physicians with scribes generated an additional revenue of $24,257 by producing clinical notes that were coded at a higher level. Total additional revenue generated was $1.4 million at a cost of roughly $99,000 for the employed scribes.

7. Additionally, another study showed correlation between a scribes system and thousands of dollars in savings per patient. The study compared standard visits (20-minute follow-up and 40-minute new patient) to a scribe system (15-minute follow-up and 30-minute new patient) in a cardiology clinic. Direct and indirect revenue combined resulted in $2,500 more per patient with the use of scribes.

8. While the use of scribes has resulted in increased productivity and a revenue boost, evidence also suggests scribes may improve clinician satisfaction, as well as patient-clinician interactions, according to a study published in the Journal of the American Board of Family Medicine.

The authors identified five peer-reviewed studies from 2000-2014 assessing the effect of medical scribes on healthcare productivity, quality and outcomes. Three studies assessed the use of scribes in an emergency department, one assessed the use of scribes in a cardiology clinic and one assessed the use of scribes in a urology clinic. Two of the studies reported scribes improved clinician satisfaction, and one study reported improved patient-clinician interactions.

9. Dr. Murphy says scribes are helping alleviate productivity challenges associated with EHRs, but they are also helping providers through the transition to ICD-10 —the 10th version of the World Health Organization’s medical classification system that took effect Oct. 1, 2015.


10. CMS does not provide official guidelines on the use of scribes, but has responded to direct inquiries about using scribes, according to the American College of Emergency Physicians.

11. CMS does not bar non-physician providers, such as physician assistants, nurse practitioners and clinical nurse specialists, from using scribes.

12. A scribe does not need to be employed by the hospital they work at, according to the American College of Emergency Physicians. Hospitals may use scribes to bridge volume gaps, enabling a smaller number of physicians to treat a greater volume of patients, says Dr. Murphy.

13. The provider must add and sign an addendum to the scribe’s note when the scribe makes an entry on a paper medical record and correction is needed, rather than cross out or alter what the scribe has written, according to the American College of Emergency Physicians.

14. The Joint Commission does not endorse or prohibit the use of scribes. The Joint Commission permits scribes to document the previously determined physician’s dictation and/or activities, but does not permit scribes to act independently, with the exception of obtaining past family social history and a review of systems, a technique providers use to get the patient’s medical history.

Education and training

15. As of January 2016, the average pay for a medical scribe is roughly $12 an hour, or $29,595 annually, according to PayScale. The Bureau of Labor Statistics does not provide salary information specific to medical scribes. However it does provide data for medical transcriptionists. According the bureau’s latest numbers available, from May 2014, the average pay for a medical transcriptionist is $17.11 an hour.

16. The general minimum qualification for medical scribes is a high school diploma, although some pre-med students work in medical scribe positions to gain experience from shadowing physicians, according to an article published by U.S. News & World Report.

17. Scribes are not required to go through a certification process. However, there are organizations, mostly scribe service vendors, that train and certify scribes, one of which is the American College of Medical Scribe Specialists.  Read more…

 Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes.   Call 866-777-7264 today, or visit our website for more information.   Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Vitamin K2: Heart and Bone Health

By Dr. Mercola

Most everyone, including many conventional physicians, have begun to appreciate the importance and value of vitamin D. Few, however, recognize the importance of vitamin K2, which is nearly as important as vitamin D.

Dr. Dennis Goodman,1 who was born in South Africa and trained at the University of Cape Town, has multiple board certifications in cardiology (and several subspecialties) and holistic integrative medicine.

After his internship at the Grootte Schuur Hospital—where Dr. Christian Barnard did the first heart transplant in 1967—he came to the US, where he did his cardiology fellowship at the at the Baylor College of Medicine in Houston, where Dr. Michael DeBakey performed the first bypass surgery.

“I was really very lucky to be in a situation where I had these two cardiac giants as mentors and teachers,” he says.

Dr. Goodman is also the chairman of the Department of Integrative Medicine at the New York University (NYU), and has authored the book, Vitamin K2: The Missing Nutrient for Heart and Bone Health. In it, he explains why vitamin K2 isevery bit as important as vitamin D.

“For 20 years I was putting stents in; running around day and night at the hospital. When I got called to the emergency room for someone having a heart attack, I was like a fireman putting out a fire in a house.

Sometimes, you were very lucky and could save the house from burning down, and sometimes not.

What I started to realize is that prevention is really the key for us to making the maximum impact. I’ve always been interested in the idea that everything we need to be healthy is provided by the Lord above –namely what’s out there for us to eat.

80 percent of these chronic diseases including atherosclerosis, heart attacks and strokes, diabetes, and obesity are preventable. So I got into the whole idea of learning integrative medicine,” he says.

He was the chief of cardiology at Scripps Memorial, and went on to Scripps Clinic for Integrative Medicine for many years.

“Obviously, when you understand holistic medicine, you understand that so much of what we’re doing, unfortunately, in traditional medicine is procedures, testing, and prescribing drugs, because that’s what we’re taught—and making diagnoses instead of taking care of people who basically may not have a disease, but are not healthy and well.”

As a cardiologist, it’s quite appropriate to delve into vitamin K2, as it has two crucial functions: one is in cardiovascular health and the other is in bone restoration.

It performs many other functions as well, but by helping remove calcium from the lining of the blood vessels, vitamin K2 helps prevent occlusions from atherosclerosis.

Vitamin K Basics

Vitamins K1 and K2 are part of a family, but they are very different in their activity and function. Vitamin K1, found in green leafy vegetables, is a fat-soluble vitamin involved in the production of coagulation factors, which are critical for stopping bleeding.

This is why when someone’s on a blood thinner such as warfarin, they need to be careful not to take too much vitamin K1, as it will antagonize the effect of drug. Vitamin K2 is very different. There’s a complex biochemistry that occurs with K2 involving two enzymes:

  • Matrix Gla-protein (MGP)
  • Osteocalcin

“Gla” is short for glutamic acid. Glutamic acid is imported into the cells in the wall of your arteries, where it binds to calcium and removes it from the lining of your blood vessels.

Once removed from your blood vessel lining, vitamin K2 then facilitates the intergration of that calcium into your bone matrix by handing it over to osteocalcin,. The osteocalcin then helps cement the calcium in place.

Vitamin K2 activates these two proteins. Without it, this transfer process of calcium from your arteries to your bone cannot occur, which raises your risk of arterial calcification.

“Vitamin K2 is like a light switch—it switches on MGP and osteocalcin, which takes calcium out of the arterial wall and keeps it in the bone.

There’s so much information showing this relationship between osteoporosis (not having enough calcium in your bones) and having an increased incidence of heart disease. What’s actually happening, I think, a lot of patients are vitamin K2-deficient,” Dr. Goodman says.

“So now, I tell all patients – especially when they have risk factors for calcification – ‘You’ve got to get vitamin K2 when you take your vitamin D, and your calcium, and magnesium.’ Because we need to make sure that the calcium is going where it’s supposed to go.”

Statins May Increase Arterial Calcification by Depleting Vitamin K2

Besides a vitamin K2-poor diet, certain drugs may affect your vitamin K2 status. Dr. Goodman cites a recent article2 in the Journal of the American College of Cardiology, which suggests statin drugs may increase calcification in the arteries.

Interestingly enough, another recent study3 published in the Expert Review of Clinical Pharmacology shows that statins deplete vitamin K2.

“For me, that is so huge because if that’s true, everybody that is put on a statin, you want to make sure they’re also taking vitamin K2,” Dr. Goodman says.

This is an important observation, considering one in four adults in the US over the age of 40 is on a statin drug. Not only do all of these people need to take a ubiquinol or coenzyme Q10, which is also depleted by the drug, it’s quite likely they also need vitamin K2 to avoid cardiovascular harm.

Sources of Vitamin K2

Vitamin K2 is produced by certain bacteria, so the primary food source of vitamin K2 is fermented foods such as natto, a fermented soy product typically sold in Asian grocery stores. Fermented vegetables can be a great source of vitamin K if you ferment your own using a specially-designed starter culture. My Kinetic Culture is high in strains that make vitamin K2. If you would like to learn more about making your own fermented vegetables with a starter culture, you can watch the video and read more on this page.

Please note that not every strain of bacteria makes K2, so not all fermented foods will contain it. For example, most yogurts have almost no vitamin K2. Certain types of cheeses, such as Gouda, Brie, and Edam, are high in K2, while others are not. It really depends on the specific bacteria. Still, it’s quite difficult to get enough vitamin K2 from your diet—especially if you do not eat K2-rich fermented foods—so taking a supplement may be a wise move for most people.

How Can You Tell if You’re Deficient in Vitamin K2?

The major problem we face when it comes to optimizing vitamin K2 is that, unlike vitamin D, there’s no easy way to screen or test for vitamin K2 sufficiency. Vitamin K2 cannot at present be measured directly, so it’s measured through an indirect assessment of undercarboxylated osteocalcin. This test is still not commercially available, however. “That’s our problem. If that was available, we could start testing and showing people that their levels are low,” Dr. Goodman says.

Without testing, we’re left with looking at various lifestyle factors that predispose you to deficiency. As a general rule, if you have any of the following health conditions, you’re likely deficient in vitamin K2:

That said, it’s believed that the vast majority of people are in fact deficient these days and would benefit from more K2. One reason for this is very few (Americans in particular) eat enough vitamin K2-rich foods. So, if you do not have any of the health conditions listed, but do NOT regularly eat high amounts of the following foods, then your likelihood of being vitamin K2 deficient is still very high:

  • Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria
  • Certain cheeses such as Brie and Gouda (these two are particularly high in K2, containing about 75 mcg per ounce)
  • Grass-fed organic animal products (i.e. egg yolks, butter, dairy)

Different Kinds of Vitamin K2

The vitamin K puzzle is even more complex than differentiating between K1 and K2. There are also several different forms of vitamin K2. The two primary ones—and the only ones available in supplement form—are menaquinone-4 (MK-4) and menaquinone-7 (MK-7). MK-4 has a very short biological half-life—about one hour—making it a poor candidate as a dietary supplement. MK-7 stays in your body longer; its half-life is three days, meaning you have a much better chance of building up a consistent blood level, compared to MK-4.

In supplement form, the MK-4 products are actually synthetic. They are not derived from natural food products containing MK-4. The MK-7– long-chain, natural bacterial-derived vitamin K2– on the other hand comes from a fermentation process, which offers a number of health advantages.

Research4 has shown MK-7 also helps prevent inflammation by inhibiting pro-inflammatory markers produced by white blood cells called monocytes. MK-7 is extracted from the Japanese fermented soy product natto, and since it’s longer lasting, you only need to take it once a day. With an MK-4 supplement, you need to take it three times a day. The duration of action is also much longer with MK-7.

As for a clinically useful dosage, some studies have shown as little as 45 micrograms per day is sufficient. Dr. Goodman recommends taking 180 micrograms per day, making sure the K2 is in the form of MK-7. If you’re eating natto, all you need is about one teaspoon.

That said, vitamin K2 is non-toxic, so you don’t need to worry about overdosing if you get more. Do keep in mind that vitamin K2 may not necessarily make you “feel better” per se. Its internal workings are such that you’re not likely to feel the difference physically. Compliance can therefore be a problem, as people are more likely to take something that has a noticeable effect. This may not happen with vitamin K2, but that certainly does not mean it’s not doing anything! Last but not least, remember to always take your vitamin K supplement with fat since it is fat-soluble and won’t be absorbed without it.  Read More

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice


Health & You: Chemotherapy and Swimming


Chemotherapy is a cancer treatment that uses chemicals to blast cells. It’s not a blast of radiation, but a chemical treatment that targets cancer cells.

Chemotherapeutic agents kill cells that quickly divide – such as cancer cells. How do infections and chemotherapy and swimming all relate?

  1. Chemotherapy
  2. Chemotherapy and Infection Risk
  3. Chemotherapy and Swimming


For over 50 years, chemotherapy or ‘chemical therapy’ has been a part of cancer treatment. Chemotherapy injections or pills can be used by itself or in addition to surgery or targeted radiation treatment. Surgery and radiation destroy the cancer cells in a given region, while chemotherapy works well throughout the body.

Cancer cells multiply at a quicker rate than normal cells; therefore chemotherapy is made to target multiplying cells. The more they divide, the stronger the effectiveness of the drug will be.

With chemotherapy comes the side effect of normal cells being destroyed as well. These cells can be found in the hair, mouth and intestines. Side effects of chemotherapy include exhaustion, mouth sores, nausea, hair loss and brittle nails.

Additionally, the immune system can become weakened which allows for more infections. Because of these risks and side effects that accompany chemotherapy, many patients can be devastated with the option of chemotherapy.

Cancer treatment in many cases requires the use and access of veins for different options for treatments – including chemotherapy, blood transfusions, antibiotics and intravenous fluids, or IV fluids. To make procedures and treatments such as these easier, doctors might recommend using a catheter or port, however these present another infection risk.

blue-crossCancer and Infection Risk

Infection occurs when germs are allowed to enter an moist opening on the body, multiplying and mutating. This is common with those who suffer from cancer, as the immune system is in a weakened state. Fortunately, there are many ways to prevent and treat possible infections.

Catheters are long plastic tubes that deliver treatments and drugs that can manage side effects and symptoms of cancer directly into a vein. Washing hands before you touch the catheter helps prevent infection. Germs from dirty hands can lead to germs getting into your system, which is worse when the immune system is weakened.

Other helpful tips include changing the bandages when necessary – as germs can build up on an old bandage. Prevent air from getting in the catheter by making sure the clamps are tight when the tube isn’t in use. Avoid breaks or cuts in the catheter, and keep the catheter from being underwater.

After a chemotherapy treatment is when one is most vulnerable to infectious disease. Viral infections like influenza or the common cold are easily transferred from person-to-person in crowded areas. Some ways to help prevent infection include washing hands often and avoid touching hands to mouth or eyes.

Mouth care is also important; keep the mouth clean by brushing teeth twice a day; use mouth rinses without alcohol, and do not use floss. Food safety is important as well – and it is even more vital during chemotherapy to remember tips you follow as usual such as washing hands before preparing and consuming food, cooking food well, keeping raw foods away from ready-to-eat food, wash vegetables and fruits, and keep cold food cold.

On a related note, those at highest risk for infection shouldn’t drink water that is not properly treated. Boiling water for a full minute kills cryptosporidium and other waterborne organisms.

Pay attention to white blood cell counts during cancer treatment. Your health care professional should let you know when you receive a treatment that will lower your white blood cell count, and you should ask when white blood counts are going to be at their low point, when your body will be less likely to fight off infection.

blue-crossChemotherapy and Swimming

The American Cancer Society’s message regarding exercise is clear – moderate exercise during treatment is beneficial. Chemotherapy’s side effects can reduce the motivation to exercise for some patients, though it is important to keep as active as possible. Why? Exercise can actually increase effectiveness of cancer treatment, boosting odds of survival. There are other advantages to exercise – a 1999 study showed that there was a significant decrease in fatigue among chemotherapy patients, and that there was an indication of less fear, anxiety and other psychological distress overall.

Swimming can cause accidental ingestion of water and can therefore increase the chances of obtaining cryptosporidium or other waterborne pathogens. It is important to make sure to avoid situations where you find yourself inhaling environmental spores found in and around moist, dark areas such as rotting leaves and compost piles. Public hot tubs and spas are not recommended because there are some bacteria that can survive in the warmer water. However, if the hot tub is disinfected properly, there is little to no risk.

Swimming pools and hot tubs are not the only risk – swimming in lakes, rivers and oceans can bring on recreational water illnesses. These can be spread from swallowing, inhaling and contacting contaminated waters with open eyes, or open cuts or sores. The most common recreational water illness is diarrhea. Other illnesses from contaminated water include gastrointestinal, skin and mild respiratory infections.

Pools and hot tubs that are disinfected properly can be a safer swimming experience, especially low-use residential pools – but pH and disinfectant levels should be checked on a frequent basis for disease-causing germ control, and the water should be over-filtered, with long daily filter runs.

In many cases, chemotherapy patients are fitted with a port-o-cath for injections. Cover a catheter or central line with a suitable water barrier like a Tegaderm and tape over the area fully before swimming, and change bandages after each swim.

The take-home from this is to be sure to bring up these points with your doctor. Ask about your specific case, and if swimming and/or hot tubs should definitely avoided altogether. All cancer cases and infection susceptibility vary so it is important to communicate at various stages with your doctor about when swimming during chemotherapy is beneficial or best avoided – for you.

Get your Swim On, America

Dr. Pool


“Catheters and Ports in Cancer Treatment.” Cancer.Net. N.p., n.d. Web.

Patural, Amy. “Chemotherapy 101 – Cancer Treatment.” EverydayHealth.com. N.p., 16 Feb. 2010. Web.

“Infection.” – Managing Side Effects. N.p., n.d. Web.

Facey, Dorian. “Exercise During Chemotherapy.” LIVESTRONG.COM, 21 Oct. 2013. Web.

Millehan, Jan. “Swimming & Chemotherapy.” LIVESTRONG.COM, 19 Feb. 2014.Web.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement


A Visual Guide to Medical Coding




As of October 1, 2015, there will be more than 144,000 codes that may be applied to patient “stories”

Medical coders provide a critical link between health care providers who are busy caring for patients, and patient insurance companies. Ensuring patient care “stories” are passed to insurance providers in ways they will honor.



Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement

MDS Education Website

Salary Information
Salary Information

Did you know we have a site specifically for our education programs?  It is a little more personal, and completely geared to answer all your questions about Medical Scribe Specialists and Medical Transcription, or Healthcare Documentation, education and careers.   We are answering questions about wages, job demands and anything you can think of!  Check it out today by visiting our newly designed website.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, AzaleaHealth EHR, and REAL-TIME solutions.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.

More docs get EHR help

” Medical scribes move beyond the emergency room”  This is a great article written by Joseph Conn.  

More docs get EHR help

Medical scribes move beyond the emergency room

By Joseph Conn

Posted: August 24, 2013 – 12:01 am ET

Hospitalist Marek Filipiuk is working the room like a master of the bedside manner. His smiling audience is a hospitalized 70-year-old female patient who’d been admitted through the emergency department the night before with respiratory problems.

An electronic health-record system is documenting the encounter, but the doctor never touches a computer.

Dr. Filipiuk is free to focus on questioning his patient and listening to her without distraction, because his hands and mind are free from typing into the EHR. Matt Restko, a medical scribe who is positioned across the room, laptop perched on a window ledge, is doing the computer entry work for him.

Filipiuk is a member of Best Practices Inpatient Care, a 65-provider hospitalist group in Long Grove, Ill. He is rounding this day at Advocate Good Shepherd Hospital near the Chicago suburb of Barrington, Ill., part of the nine-hospital Advocate Health Care system based in Downers Grove, Ill. Filipiuk’s group uses scribes at two Advocate hospitals. Restko, 27, is a University of Iowa graduate with a degree in biochemistry. He’s an employee of ScribeAmerica, Aventura, Fla., a provider of scribe services that has contracted with Filipiuk’s group.

Their collaboration exemplifies the migration of scribes from their initial beachhead in hospital emergency departments into hospital medical wards and office-based physician practices. The movement has been fueled in part by $15.5 billion in federal payments under the American Recovery and Reinvestment Act that have motivated more than 4,000 hospitals and 300,000 physicians to use EHRs.


Scott Hagood is vice president of marketing at Fort Worth, Texas-based PhysAssist Scribes, which provides and trains scribes for 109 sites, mostly emergency physician groups. He says his firm now is getting three or four times as many requests for scribes from clinic-based physicians as from emergency medicine groups. But the limited supply of qualified scribes and clinic physicians’ preference for working with the same scribe rather than a pool of them constrain growth. He says that to work effectively with scribes, clinic-based physicians have to develop a practice style similar to emergency physicians so they are comfortable working with several different scribes, who often are in school and aren’t available for regular, full-time hours.

Physicians say they like to use scribes to handle EHR data entry because doctors find EHRs slow and clunky to use, interfering with their interactions with patients. Those complaints have hardly lessened in the several years since EHRs have come into broad use. A June customer survey report by health IT market researcher KLAS Enterprises on EHR “usability” found that customer ratings of usability for nine leading EHR systems on six common EHR tasks ranged from 55% to 85%. For one thing, many doctors are slow typists.

“I hunt and peck,” says Dr. Michael Merry, an internist/pediatrician with FHN, a group practice based in Freeport, Ill., and chairman of its physicians’ EHR committee. After FHN adopted an EHR last summer, his productivity dropped to 20 to 24 patients a day with the EHR, from 25 to 30 with paper records. He started using a scribe in January and says he’s nearly returned to his pre-EHR productivity rate. Merry uses Physicians Angels, a Toledo, Ohio-based company that connects physicians with “virtual scribes”—remotely located either in India or other parts of the U.S.—using Voice over Internet Protocol.

“If used properly, I think it’s a very reasonable way to continue to be productive and not be impaired,” Merry says.

Data on scribe use are scant. The costs of scribes range from $10 to $20 an hour, according to a 2011 white paper by the American College of Emergency Physicians. The ACEP paper estimated, based on interviews with scribe service providers, that 1,000 hospitals and 400 physician groups are using them.

Dr. Michael Murphy, co-founder and CEO of ScribeAmerica, estimates the top four national companies employ about 4,700 scribes, with another 1,000 scribes working for startups and regional players. Most of them work in about 500 hospitals that use scribes, and most of those are in EDs. But Murphy predicts that growth in other hospital and outpatient areas will be huge. The company has 15 inpatient sites now that are not part of an emergency department, but “we’re anticipating it will be our largest line of services, and surpass the emergency departments in the next couple of years,” he says.

Some physician groups and hospitals say using scribes in EDs improves physician productivity enough to offset their costs. The ACEP study found a return on investment greater than 100%. The jury is still out, however, on whether scribes can boost physician productivity enough to offset their cost in clinical realms outside EDs.

The Vancouver (Wash.) Clinic says it found scribes to be well worth the price for outpatient work. The 230-provider, multispecialty group practice is moving forward with a plan to provide scribes to another six physicians this year, and 12 or so in 2014. The clinic ran a pair of successful pilots from October 2011 through January that eventually included 19 physicians, and 18 are now using scribes.

Tom Sanchez, the clinic’s chief operating officer, says the group pays its scribes, supplied by Scribes STAT, in Portland, Ore., “upwards of $20 an hour.” But he figures the group’s return on that investment is 15% to 20%.

Dr. Marcia Sparling, the clinic’s medical director for operations and IT, said the group had its physicians with scribes add one patient-contact hour to their workdays. Even so, scribe-assisted docs still managed to cut the total length of their workdays by 1.3 hours, on average, all due to a reduction in the participating doctors’ record-keeping chores. As a bonus, patients liked having the scribes around, according to the group’s survey of patients.

“There was some concern with providers that this would be disruptive to the doctor-patient relationship,” Sparling says. But “patients actually thought the scribe made the encounter better.” Nearly one-fourth said it was better, and three-quarters said it was the same. Asked whether the doctors listened better with a scribe, 32% said it was better.

Dr. Oliver Jenkins, an otolaryngologist with the multispecialty Toledo (Ohio) Clinic, says using a scribe has returned him to his level of productivity before his group starting using an EHR. Jenkins has worked with scribes for about 4½ years through Physicians Angels. On a typical “good day” at the clinic, he sees 25 to 30 patients while talking to a scribe in India. “All you need is a data connection and anyplace in the world becomes home,” he says.

EHR suppliers push back against the idea that scribes will always be needed to overcome the perceived clunkiness of their products, arguing that an evolution in the way EHRs are used will make scribes obsolete. “Some physicians say it’s clunky and others say it’s the best thing that we’ve ever used,” says Dr. Sam Butler, the physician leader at Verona, Wis.-based Epic Systems Corp. “I look at it as a toolbox. Traditional dictation, voice recognition, scribes, all of those should be used matched to physicians.”

Back at Advocate Good Shepherd, just before entering the patient’s room, Restko and Filipiuk huddle for five minutes at the nearby nurse’s station. They prepare for the encounter by reviewing her records from the ED visit the night before, and other records, diagnoses, medications, listed in the system. Then Filipiuk announces, “Let’s go see the patient.”


The patient readily consents to having Restko, introduced as a documentation specialist, accompany Filipiuk during the exam. Under the doctor’s conversational prodding, she explains she had been experiencing trouble breathing, and her family doctor thought it might be pneumonia. She’d taken a round of antibiotics, but when she started feeling dizzy, her husband took her to the emergency room.

He asks the patient how she feels. Aside from a cough she can’t shake, she says she feels fine and is eager to go home. He tells her the CT scan she’d had last night indicated the pneumonia was gone and there was no indication of any blood clot causing the cough.

Filipiuk occasionally glances over his shoulder to send a silent signal to Restko, who’s unobtrusively flying through the EHR template, keeping pace with the exam. Filipiuk checks his patient’s breathing with a stethoscope. “So,” he says, “there is bilateral wheezing. No crackling. Skin is cool.” Restko types. Filipiuk thinks a bit, then subtly signals to Restko to get ready for the assessment and plan.

“The coughing is the issue,” he says, looking directly at his patient. “It keeps you up at night. Here’s the plan. I don’t think you need any more antibiotics.” He tells her he wants to prescribe something “to relax your pipes.” But he promises to confirm everything with her after he checks with the pulmonologist who previously saw her.

Filipiuk, who has been working with Restko since March, says he initially had reservations about scribes. “My first impression was I felt I had someone else to worry about,” he said. But after three or four weeks, his relationship with the scribes became “more steady,” he said. “My productivity and efficiency is better than it used to be,” he says.

For Restko, who plans to attend medical school, working as a scribe “enhances my desire to become a doctor,” he says. “I can’t imagine a better way to get exposure” to what a physician actually does.

Filipiuk’s hospitalist group serves one Michigan hospital and six more in the Chicago area. Dr. Jeffry Kreamer, the group’s CEO, says it launched the scribe program last year after he saw how well scribes worked in the ED of one of the hospitals his group staffs.

“I want my doctors to be in the moment,” he explains. They “can see more patients. They’re fresher. It also makes them happier. They’re less exhausted at the end of the day and they’re more fulfilled.”

And their EHR record-keeping is better, too, he says. Nurses and fellow physicians appreciate the increased clarity of the notes, Kreamer says. “I’m always looking for a way to do what we do better,” he says. “This is better.”



Why are doctors so upset? Are the EMR vendors just saying whatever they need to say?

Another Study Highlights Physician EMR Unhappiness

2013-03-15 17:28:54

The evidence keeps coming in, over and over, like waves pounding on a beach.  Many physicians aren’t happy with their EMRs, and the number of discontented doctors seems to be growing — with an undetermined but sizable number seeming likely to switch this year.

This time the evidence comes courtesy of the American College of Physicians and EMR selection site AmericanEHR Partners. A new study by the pair reports that physician satisfaction with EMRs dropped 12 percentage points between 2010 and 2012, and that the number who are “very dissatisfied” grew by 10 percentage points, FierceEMR reports.

These numbers, which were drawn from 4,279 responses to multiple surveys between March 2010 and December 2012, are a particularly strong reflection of the mood among smaller practices. Seventy-one percent of doctors/practices responding to the survey were in practices with 10 physicians or fewer, the ACP said.

These physicians seem downright upset with their current vendors. In fact, 39 percent of clinicians said they wouldn’t recommend their current EMR to a colleague, up sharply from the 24 percent who said the same in 2010.

According to the ACP, physicians feel their EMR is failing them in several key areas:

*  Improving care:  Doctors who were “very satisfied” with their EMR’s ability to improve care fell by 6 percent from 2010, while the “very dissatisfied” climbed 10 percent, with surgical specialists the least satisfied specialty.

Decreasing workload:  ACP found that 34 percent of users were “very dissatisfied” with their ability to decrease workload, up from just 19 percent in 2010.

Return to pre-EMR productivity:  The number of respondents who had not returned normal productivity after their EMR install was 32 percent in 2012, up from 20 percent in 2010.

Ease of use: Dissatisfaction with EMR ease of use climbed to 37 percent in 2012, up from 23 percent in 2012, while satisfaction dropped from 61 to 48 percent.

That we’re seeing something of an EMR backlash seems obvious here. The question is, will unhappy physicians switch futilely and end up just as unhappy, or are they going to actually improve their experience?

MDS’ Wichita State University Coop Student … Sydney Blanton!

Entrepreneurship and Management Experience Combined

Sydney Blanton’s experience atMDS of Kansas, a 22-year-old Kansas grown, document service business specializing in healthcare documentation, has been beneficial since the beginning. “Since day one, I have been helping with the marketing and growth of the business through forming and organizing potential client lists, brainstorming and working with direct mailers and newsletters, making cold calls, and working on the business Facebook and Twitter page,” said Sydney, a senior at WSU majoring in entrepreneurship and management.

This experience has giving her the opportunity see both the management and entrepreneurship side of starting and running a successful business. “I see that running your own business requires a strong, motivated, unique person with the drive and energy to see it grow. You need a strong talented team with their own unique experiences and talents to bring to the table. I have learned a lot about what kind of work environment I would like to be a part of,” said Sydney.

This co-op experience has solidified Sydney’s choice of study while at WSU, and she has her eyes set for the future. “Majoring in entrepreneurship and management was the best choice for me. I have had the opportunity to gain experience that will help me transition from college into a career that love,” said Sydney.


KBOR Approves MDS Scribe Program

Medical Assistants and Medical Transcriptionists, the time is right and the outlook is good!   Kansas Board of Regents stamped their blessing on the Accelerated Medical Scribe programs at MDS of Kansas December 2012.   This comes on the heels of approval from the American College of Clinical Information Managers, ACCIM.    Remember, ACCIM is the only governing body that has set a certification process.

If you are looking for an interesting career in healthcare with good pay, benefits and high industry demand, you are needed!

Calling on  Medical Transcriptionists, Medical Assistants, or various other allied health professions … classes starting in February and we already have strong interests from our medical friends in the community!

Medical Transcription Lawsuit Exposes Inherent Dangers To “Care-Then-Document” Model

This is a MUST read …

This case exposes the liability of documenting after the physician patient encounter, which is the historical practice of medical transcription companies.”

“Real time, onsite medical scribe documentation, alongside the physician, adds to increased operational productivity and patient safety protocols within the EHR environment.”

continue reading … 


MDS proudly announces approval from the American College of Clinical Information Managers, ACCIM, for our Medical Scribe (CIM) accelerated programs!  ACCIM is the only governing body that has set a certification process.   Our programs have been submitted to Kansas Board of Regents and we anxiously await approval to add these 2 new programs to our current MLS/MT.    The time is right … the outlook is good!

Medical Scribe Study Finds Scribe Use May Extend Physician Careers 85%

“With respect to productivity (agree or strongly agree), 64.2% felt that they had higher relative value units and 79.4% were able to treat more patients per hour with scribe utilization. The majority of respondents (74.8%) felt that scribes were very or extremely beneficial when transitioning to use of an EMR. Respondents who were previously using an EMR without scribes indicated that there was a large positive impact of scribe utilization on EMR experience with respect to relieving the stress of documentation (87.4%), being able to “focus on being a physician” (78.8%), quality of life (77.9%) and patient care (77.3%).”