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Can Scribes Fit in Your Practice?

Understand the dynamics, efficiency and profitability of using scribes.

Richard S. Kattouf, O.D., D.O.S.

Q As an avid reader of management articles, it's evident that the concept of scribes is not universal. In your opinion, are scribes a good fit for the optometric practice?

Dr. E. Dickinson
via e-mail

A: The question of scribes and delegation is a good one. Part of the answer depends upon how much you have delegated to the present point in your career. I'll discuss other considerations here.

Through the past 10 years, about half my clients have been ophthalmologists. It is common for these M.D.s, who delegate to the highest levels in the ophthalmic industry, to work out of four or more exam rooms. I've found that as the M.D. spends a short time with each patient and socializes with them little (if at all), the scribe is a great advantage.

O.D.s are more social due to the fact that most private practices see entire families for 30 years. It is almost as if the O.D. is part of the family. However, it raises a question: What can the scribe accomplish while you discuss the patient's children, colleges they attend or sporting events in which they participate? The dynamics, affordability, efficiency, productivity and profitability, then, are very different when comparing O.D.s and M.D.s.

A positive note

The following are some of the positive aspects of using scribes.

► Scribes enable you to examine more patients per day without extending the hours of the workday. Keep in mind the average unit sale per patient is $300. If the use of a scribe enables one more patient visit per day, then sales increase $75,000 annually, ($300 x 5 days = $1,500 per week x 50 weeks). Using a scribe becomes a no-brainer.
► Some O.D.s assign scribes to follow a patient throughout the data entry, exam, optical and contact lens fitting. This is a great strategy if it results in more patient visits (as above) or an increase in the unit sale per patient. An increase in unit sale per patient of $50 is huge.
► The positive “connection” between the scribe and the patient can be a compelling public relations tool for your practice.

Challenges

Using scribes in an optometric practice includes several challenges. For example:

► This employee must be cross trained in all departments. Their computer skills must be above average. The hourly rate for this type of skill level is no less than $15 per hour, or $30,000 per year. A good benchmark is that the scribe must generate three times his/her compensation. In this example, the employee must generate $90,000 of collected income.
► In the optometric practice, the doctor usually spends several minutes on small talk. This socialization time is not functional for the scribe or the organization.
► If the O.D. is interrupted (by a phone call, for example), the scribe is in limbo—again not efficient, productive time.
► If the scribe becomes involved with a patient or a situation, he/she may not be able to connect with the O.D. at the beginning of the next exam.
► A scribe's absence can throw off scheduling.

If you have delegated to the maximum level, this would be a good time to “trial” the scribe concept. If you struggle for consistent patient volume, your concentration should be in other management areas of the practice. OM