Do your scribes suck? Do just mine suck? Do I suck? Am I doing it wrong? You tell me.

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
jw3600 said:
You take issue with me advocating for trying not to use broad steroypes?
Click to expand...
No, I'm just saying that you don't get to tell people to leave. Different strokes/different folks, variety, that sort of thing. You don't speak for me.
Members don't see this ad.
 
  • Like
Reactions: 1 user
Apollyon said:
No, I'm just saying that you don't get to tell people to leave. Different strokes/different folks, variety, that sort of thing. You don't speak for me.
Click to expand...
Gotcha. That's fair. I didn't actually mean leave. More of sarcastic quip.
 
  • Like
Reactions: 1 user
It's whatever. Crotchety old men will continue to be so even though their generation is the one that raised all of these people as kids, handed out participation trophies, generally set this generation up for failure, let alone the complete rape of social security, the market, etc. to ensure millenials would have to work harder and be smarter to sniff at being able to earn and save enough money to ever own a home. The current old generation is the first one in the US which will have a BETTER life than their kids, and the "snowflake mentality" is certainly not the main factor at blame for that.

And doctors in that generation are the ones who unleashed the pandora's box of midlevels practicing medicine and deflating salaries on all doctors in the future because of their greed. Which can now never be stopped, and the motto is "I got mine, sucks to be you"

So screw it, blame everybody in the whole damn generation for the crimes of those in it.
 
  • Like
Reactions: 5 users
Members don't see this ad :)
A+ for epic derail from scribe suckage to generational wars. I had to catch myself up in here.

I'm just glad Gen X'ers like myself aren't the red headed step children anymore. I remember when everyone love to talk about how worthless we were going to turn out. I'm glad we have a new, even more worthless, helpless and pitiful generation to laugh at so we can build bigger and better inferiority complexes. LOL

As an aside and perhaps more topic related... I feel you guys with the scribe suckage. I just throw hissy fits, send them home early, email their managers until they find me ones that don't suck. They will keep the same 1 or 2 rock star scribes with me at all times to pacify me.
 
  • Like
Reactions: 1 users
RustedFox said:
This is what my scribes have been relegated to.

I worked with the lead scribe trainer the other night. Had to ask her to just close the chart and let me finish it myself, because despite me saying clearly: "Just type exactly what I say: capital letters and periods and all"... she just couldn't do it without going into the shorthand nonsense that never turns out close to right.

I said to her: "Listen. I just had three shifts at (other job site). The worst of those scribes are better than the best of our scribes here. Period. Your workflow... is not working. It HAS to change; or we're going to drown come tourist/snowbird season."

I was told later that she cried and called me a "meanie". My department assistant director "counseled me on constructive criticism".

I had no choice but to reply with a firm but polite rebuttal:

"Listen; this is millennial snowflake nonsense. If what you're doing isn't working, and you don't know it... then you'll never change and get better."

I was interrupted with "but education and guidance is..... whatever"

"Yep. You know where that approach has gotten us? Right here; with scribes that are barely functional and act like *we're* the problem because we're not sensitive to their needs. What's better yet is that our scribe trainer wants to go to medical/PA school. Really? Well... buckle-up, buttercup. You're going to get your arse chewed out plenty in clinicals/residency. There's no "time-outs" and "safe spaces" there."

Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week.

Stop the world. I want to get off.
Click to expand...

Thanks for the story. I know a good amount of physicians that talk to their scribes like that and call them out if they are clearly messing up.

However, if you see them working harder or doing better in the future make sure to comment and say that you notice the improvement, that usually goes a long way. You can be as "mean" as you want to people but as long as you acknowledge good work (when it comes) then people won't take it so personally.
 
To be fair, the comparison being made between a scribe and an actual medical student or resident is a bit unfair. Most of the people I knew that scribed never actually made it into medical school. Those in medical school and residency suck it up and get better, because we have to, just as was said. People with the attitude of your scribe tend to not get into medical school in the first place.
 
To further hammer it home, they could have taken your feedback to heart, got better at their job, and probably gotten a good letter of recommendation from you based on their growth. This is what the successful person would do.
 
Groove said:
A+ for epic derail from scribe suckage to generational wars. I had to catch myself up in here.

I'm just glad Gen X'ers like myself aren't the red headed step children anymore. I remember when everyone love to talk about how worthless we were going to turn out. I'm glad we have a new, even more worthless, helpless and pitiful generation to laugh at so we can build bigger and better inferiority complexes. LOL

As an aside and perhaps more topic related... I feel you guys with the scribe suckage. I just throw hissy fits, send them home early, email their managers until they find me ones that don't suck. They will keep the same 1 or 2 rock star scribes with me at all times to pacify me.
Click to expand...

Shocking
 
  • Like
Reactions: 1 user
When are we going to get back on topic about how much some scribes suck? There are a couple at my shop who make me cringe whenever I see them show up to work. I know I'm going to end up staying late to correct charts that say "no rash" on the patients who got admitted for cellulitis.
 
RustedFox said:
Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week.

Stop the world. I want to get off.
Click to expand...

LOL
 
Well did you talk to them about it?


Sent from my iPhone using Tapatalk
 
Members don't see this ad :)
deuist said:
When are we going to get back on topic about how much some scribes suck? There are a couple at my shop who make me cringe whenever I see them show up to work. I know I'm going to end up staying late to correct charts that say "no rash" on the patients who got admitted for cellulitis.
Click to expand...

It was an easy transition to make. My scribes suck. I told them that they suck. Instead of them acknowledging that I am their boss, and might know what I'm talking about... my head Pokemon trainer decided to tell me that I was the one that sucked. This is a particularly millennial attitude. Millennials got butthurt, many of them medical students or early rezzies, who have no idea what they're doing, but think that they're the best thing since Osler because of all the participation ribbons that they have *won* since pre-kindergarten. Nevermind that they can't diagnose a kidney stone. Their resume speaks for itself. It's we *old people* that have got it all wrong.
 
RustedFox,

I think in general, blaming "millennials" for this type of behavior is a poor excuse. As I read through your posts on this subject, all I see is the stereotypical anger each preceding generation throws on down the line. The old adage of "I walked 5 miles...both...ways..." Even when people agree that yes- you've had some bad scribes, but they've had very good experiences with them, you seem to ignore it. Several people have also pointed out that it may be unclear expectations or other factors in your interactions that are resulting in this, and yet- you continue to ignore them.

Even if your stereotypes proved to be true, it would be a reflection of the societal & family structures that the preceding generation provided. Children and young adult rarely have autonomy/control over the educational and workplace dynamics that exist.

I think it's sad that see this cliched generational mud-sliding frustration come down, even in semi-anonymous forums. You've put all of these millennials in the "butthurt," category (your words), while also throwing in the overplayed transgender slur of "Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week."

I get it. You've had some bad scribe interactions, and one (who called you a "meanie,") cried after you questioned her competence. I wonder more so if the criticism was delivered poorly, or if perhaps it had simply come from an older (and formerly idolized) physician whose sense of humor isn't shared by every person in the room (or generation).

I generally don't write a lot on SDN, but I've enjoyed things you've written in the past and was disappointed by your overly dismissive and belittling stereotypes. Certainly, education is a combination of tough love and support- but I'm surprised to find that you picture yourself as wise judge, prosecutor, and jury of the millennial generation's perceived poor work ethic and "snowflake," attitude.

If your attitude shown here reflects your "real life," behavior- I'm disappointed. For every one young resident/medical student/pre-med that finds personal growth in your midst, I bet several are likely avoiding your presence. Perhaps maybe you'll deem them weak millennials and therefore not worthy of your attention, but in essence- they'll just be looking for a mentor that teaches with respect, enthusiasm, and specific criticism that doesn't demean their generation or sociopolitical backgrounds.

All the best,

-wtffng
 
Last edited:
  • Like
Reactions: 13 users
Wtffng said:
RustedFox,

I think in general, blaming "millennials" for this type of behavior is a poor excuse. As I read through your posts on this subject, all I see is the stereotypical anger each preceding generation throws on down the line. The old adage of "I walked 5 miles...both...ways..." Even when people agree that yes- you've had some bad scribes, but they've had very good experiences with them, you seem to ignore it. Several people have also pointed out that it may be unclear expectations or other factors in your interactions that are resulting in this, and yet- you continue to ignore them.

Even if your stereotypes proved to be true, it would be a reflection of the societal & family structures that the preceding generation provided. Children and young adult rarely have autonomy/control over the educational and workplace dynamics that exist.

I think it's sad that see this cliched generational mud-sliding frustration come down, even in semi-anonymous forums. You've put all of these millennials in the "butthurt," category (your words), while also throwing in the overplayed transgender slur of "Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week."

I get it. You've had some bad scribe interactions, and one (who called you a "meanie,") cried after you questioned her competence. I wonder more so if the criticism was delivered poorly, or if perhaps it had simply come from an older (and formerly idolized) physician whose sense of humor isn't shared by every person in the room (or generation).

I generally don't write a lot on SDN, but I've enjoyed things you've written in the past and was disappointed by your overly dismissive and belittling stereotypes. Certainly, education is a combination of tough love and support- but I'm surprised to find that you picture yourself as wise judge, prosecutor, and jury of the millennial generation's perceived poor work ethic and "snowflake," attitude.

If your attitude shown here reflects your "real life," behavior- I'm disappointed. For every one young resident/medical student/pre-med that finds personal growth in your midst, I bet several are likely avoiding your presence. Perhaps maybe you'll deem them weak millennials and therefore not worthy of your attention, but in essence- they'll just be looking for a mentor that teaches with respect, enthusiasm, and specific criticism that doesn't demean their generation or sociopolitical backgrounds.

All the best,

-wtffng
Click to expand...

Need to print this for my refrigerator.
 
  • Like
Reactions: 1 user
RustedFox said:
I can be wrong in my line of thinking, but recently I've been concluding that using a scribe actually slows me down.

1. I enter room with scribe. Most of the time, they have a workstation on wheels and they stand there with the charting program (Cerner) open on one half of the screen, and (of all things) Notepad open on the other. They make notes on the notepad, and try to synthesize a HPI after the initial encounter.

Criticism: Over half of the time, I end up deleting their entire HPI and dictating it myself using DragonSpeak. Their HPI often lacks duration, direction, or some other quality that makes it difficult to understand just what is going on with the patient. This becomes even more time-consuming with the histrionics and the "pan-positive" ROS patients.

2. For physical exam findings, I have tried stating what I want out loud to the scribe when in the room. I don't understand why they do this, but most of the time they put a shorthand version of what I dictate in NOTEPAD, and then try and expand that into the PE section later on. The scribes lack the vocabulary and medical knowledge to do this reliably. For example. I will state aloud:

"Focused physical exam of the left lower extremity reveals no obvious deformity or fracture. Most importantly, the entire limb is pink, warm, and well-perfused - and the limb is without any threat to its neurovascular integrity. There is modest tenderness and fullness to the popliteal fossa, most clinically consistent with a Baker's cyst. There are no markings or discolorations to suggest underlying vascular pathology such as DVT or PVD."

Instead, this is actually what I got last night: "FOCUS EXAM: No FX. Entire limb is pink and profuse with no threat to NV exam Bakers cyst no marks or color for vasculapathy."

Criticism: I have tried on no fewer than twenty occasions (without exaggeration) to say directly to the scribes: "Listen, I just want you to be a microphone. I say it. You type it ... capital letters, periods, full sentences and all." I spoke my punctuation aloud to them in the exam room. They still go through their "Notepad -> Cerner" workflow. Then, I have to re-do it myself. DragonSpeak gets it right the first time, all the time. With autotexts and macros, my job is even easier. I type "GE", and I get my "This extremity is safe and stable" speech.

3. I have been told to use the scribes to help with workflow by asking them to remind me when "X" radiology study has returned, or when "Y" labs are back. With a ratio of 1 scribe to 2 or 3 providers... the scribe is more often off in another exam room rather than paying attention to the tracking board. This leaves me just doing it by myself anyways.


I can be wrong. I would love to find a good use for the scribes, but I'm really trending in the other direction now.
Click to expand...
Scribes are usually premeds.
Premeds usually suck and have little commitment to the job, as it's just a resume booster for med school.
Ergo, scribes usually suck.
 
  • Like
Reactions: 1 user
GeneralVeers said:
47% of all U.S. high school kids are getting an "A" average. This is proof of the snowflake/special mentality. They are not set up to handle real-world failure or criticism.
Click to expand...

How do you go from Point A to Point B? Do you really think that the only reason for systemic grade inflation is "snowflake/special mentality"?
 
Angry Birds said:
How do you go from Point A to Point B? Do you really think that the only reason for systemic grade inflation is "snowflake/special mentality"?
Click to expand...
Um, if they don't get As either they or their helicopter parents will destroy the school.
 
Angry Birds said:
How do you go from Point A to Point B? Do you really think that the only reason for systemic grade inflation is "snowflake/special mentality"?
Click to expand...

If you go 18 years with nothing but affirmation from authority figures, it will likely have adverse side effects. Correlation is not causation, however it is an interesting fact.
 
I see this hasn't died while I was away on vacation.

Wtffng said:
RustedFox,

I think in general, blaming "millennials" for this type of behavior is a poor excuse. As I read through your posts on this subject, all I see is the stereotypical anger each preceding generation throws on down the line. The old adage of "I walked 5 miles...both...ways..." Even when people agree that yes- you've had some bad scribes, but they've had very good experiences with them, you seem to ignore it. Several people have also pointed out that it may be unclear expectations or other factors in your interactions that are resulting in this, and yet- you continue to ignore them.

Perhaps you haven't read the entire thread, or are just being very selective in your rhetoric. The scribes across the board at my primary job site... suck. Many posters agreed, given the data I provided. Some claimed that my expectations were too high. I get that; after all, the thread title that I've written leaves room for me to invite criticism. Some time passed. I worked a few shifts at job site "B". The scribes there were light-years better. I bring this fact to light to the person who is in-charge of scribe quality at job site "A", and rather than recognizing their position, accepting the criticism, and wanting to get better... they cried and blameshifted. They don't have to take my word for it; but if they're in for a rude awakening in graduate school or the "real world" beyond. I haven't ignored anything.

Even if your stereotypes proved to be true, it would be a reflection of the societal & family structures that the preceding generation provided. Children and young adult rarely have autonomy/control over the educational and workplace dynamics that exist.

Stereotypes exist for a reason; its because there is a common kernel of truth in there that is generally recognized.

I think it's sad that see this cliched generational mud-sliding frustration come down, even in semi-anonymous forums. You've put all of these millennials in the "butthurt," category (your words), while also throwing in the overplayed transgender slur of "Seriously. This country is going to hell in a handbasket in the name of not hurting anyone's feelings. Meanwhile, there are 12 new genders this week."

You think its sad? Okay. What's sadder are the examples that Veers/McNinja/et.al provide, as well as the fact that the whole web has identified these traits as "millennial" because they're so common and prevalent in the said generation. Its not just me, you see. I was born in the last year of "Gen X", and some historians will call me a "millennial". I've got one foot in both camps. The criticisms leveled are pretty accurate from my viewpoint; so many of my cohort (siblings, even!) are struggling with adult life because they were underprepared and now are regressing to their snowflake safe-places. Its sad. Also sad is the fact that millions of our tax dollars are being wasted trying insane court cases and building separate bathrooms for people who can't figure out where to take a pee. It's a bathroom, not a place to address your feelings and achieve self-realization. Take a pee and get back to doing something else.

I get it. You've had some bad scribe interactions, and one (who called you a "meanie,") cried after you questioned her competence. I wonder more so if the criticism was delivered poorly, or if perhaps it had simply come from an older (and formerly idolized) physician whose sense of humor isn't shared by every person in the room (or generation).

I don't think you get it; at all. On multiple occasions, I have stated that I have tried constructive criticism, appeals to their strengths, modeling, whatever approach you want with our scribes. It has failed every time. I haven't even gone for the stick instead of the carrot, yet - as I have no power or authority to punish. I simply pointed out that they are being outclassed (outscribed?) and outperformed by others of their ilk and generation (a millennial receiving praise from me!? - boom goes your argument!), and look what happened... the snowflake melted because he/she was told (for once) that they weren't the *best*. What's more frustrating is that this person is in charge of training the other scribes and maintaining quality control. "Sorry - you're not the very best; like no one ever was. Now get a grip and get better."

I generally don't write a lot on SDN, but I've enjoyed things you've written in the past and was disappointed by your overly dismissive and belittling stereotypes. Certainly, education is a combination of tough love and support- but I'm surprised to find that you picture yourself as wise judge, prosecutor, and jury of the millennial generation's perceived poor work ethic and "snowflake," attitude.

The adage is generally quoted as "judge, jury, and executioner", just so you know. I have to be the judge here; I'm the one pointing out the problem. The jury is all of us who contribute to the thread. I get my vote. You have stated yours. I cannot be executioner, as I have no authority to punish. If it were up to me (and my medical director), we would fire our present lot of scribes outright at this point. Again, its not just me who has this opinion. You might just learn something if you listen. I was once in your position. I had bad interactions with my attendings sometimes as a student. I didn't throw a fit and demand a safe space. They were "right". I got better. The choice is yours.

If your attitude shown here reflects your "real life," behavior- I'm disappointed. For every one young resident/medical student/pre-med that finds personal growth in your midst, I bet several are likely avoiding your presence. Perhaps maybe you'll deem them weak millennials and therefore not worthy of your attention, but in essence- they'll just be looking for a mentor that teaches with respect, enthusiasm, and specific criticism that doesn't demean their generation or sociopolitical backgrounds.

Again; I don't think you've read the thread. On no occasion have I ever directly demeaned someone's generation or sociopolitical background. I criticized a scribe for not taking instruction and for not producing a passable chart; not because they were of a certain generation or political party. I made the association between the predictable outcome and the snowflake attitude of the generation on two occasions: the discussion with my assistant director, and on this thread. That you have transferred the criticism to yourself and others at large is very telling; you're tripping all over yourself on your way to being offended. Now... where have I heard that before?

All the best,

Thanks!

-wtffng
Click to expand...
 
RustedFox said:
I read your study. It argues just as much against, as for your point.
But don't let that get in the way of constructing your narrative.
Click to expand...

No, it certainly does not. Simply stating that does not make it true.

Also, I do not have a narrative here. You do.

Now why don't you go and make some other poor pre-med cry.
 
  • Like
Reactions: 1 user
Angry Birds said:
No, it certainly does not. Simply stating that does not make it true.

Also, I do not have a narrative here. You do.

Now why don't you go and make some other poor pre-med cry.
Click to expand...

K. I'm not going to dissect the piece of literature with you.
If you have no narrative, then why bring up articles which do or do not support it?

I'll make as many people cry as I need to if it breaks the unique snowflakes of their attitude. Its a shame their parents didn't do that job already. Might have helped them not raise "Generation Me".
 
UPDATE:


Decision made by primaryJob site to discontinue scribe program because 5/6 of our full-time docs have come forward and said "these scribes suck; we don't need to spend more time correcting their errors when we can just do it right the first time ourselves."
 
  • Like
Reactions: 1 user
sooo, are they getting a replacement scribe company, or letting you guys go solo?
 
It would drive me nuts to spend all that extra time importing labs, EKGs, CT results, other results, other crap, and this and that. I think they are invaluable and pay for themselves. Plus a few of them are hot and are eye candy. In any event, hope you’re happy whether u use them or not. I think they are worth their cost.
 
Yeah, TH/HCA has no plans to bring back our scribes either. Can't say I miss them that much as I agree w/ RF's original post. It's also interesting that multiple former scribes who weighed in now prefer not to use scribes themselves. But reading this old thread is making me think that maybe I was too hard on my scribes and I would've had a better time if I lowered my expectations and just let them click the clickyboxes and do the HPI/MDM myself. Of course, if we just invested in Epic instead of Meditech, I could just set up macros to do the equivalent of clicking clickyboxes and wouldn't even need scribes for this. Does Epic really cost more than MT+scribes?

And re a prior TH thread, I stand corrected: admin at TH told me they will not pay for time spent charting after shift. Guess I'll just have to... suck it up and learn to chart faster and sloppier.
 
DK0828 said:
I'm not yet a med student, starting next year but have previous experience as a spec ops medic. Hence why I was here (dreaming/planning my future in EM). In regard to the generational fight and to give outside perspective, I thought I'd add my two cents. Not as a veteran but as a cop, my current job.

Right now, there is something of a transition from the old guard to the millennial generation (my generation). During the training period of new officers, they ought to take criticism and do some self-improvement. As RF stated. Unfortunately, any criticism that is leveled (constructive or otherwise) is devastating. Some will just sit quietly in the cruiser for the rest of the shift, refusing further interaction. Some cry and others quit. There is such a shortage that they cannot be fired. The solution? They created a class for supervisors and trainees on how to interact with millennials. Things like first tell them what they are doing right, then in a calm neutral voice explain to them how what they did wasn't completely wrong.

I'd prefer "don't f***ing infringe on their constitutional rights again, trainee." Instead of being coddled, but to each their own.
Click to expand...

Sad but true. Played golf with a buddy of mine a month or so ago. His real estate firm had to have a similar in-service about "how to deal with the millennial". One of the noobs actually had his mommy call in to contribute during the forum.

I mean, come on. Time to grow up.
 
  • Like
Reactions: 1 user
I don't have scribes at my current jobs and, honestly, it's so much better then when I had them. It's faster for me to do an average note than it is to read over and correct all the notes of the average scribe who is typically a 007 in the medical-legal sense. So many of their charts would have been clean kills in the hands of a plantiff's attorney if I didn't go over them with a fine tooth comb. It was exhausting.
 
  • Like
Reactions: 1 users
Part of the problem is the use of Scribe America who frankly sucks. At that size you cant control your quality and it is unlikely anyone will listen to a 25 year old boss. You need that heirarchy. that being said some are terrible. But lets be serious can you not say the same thing about residents? One of my co-residents was the worse doctor I was ever around. I mean clinically was a ******, had 0 interpersonal skills and couldnt take criticism/advice on how to improve. Mind you I am no millenial.

While I agree there is an issue with this generation this is common and constant. Everyone looks around and says how crappy it is now and great it was before. Consider the differences.
 
UPDATE: Our scribes sucked so much that they are being discontinued altogether as of August 1st. Up until now, the MLPs wanted to keep the scribes, so they were allowed to do so. Even the MLPs came forward and said: "No. They suck; and no amount of 'coaching' makes them serviceable."
 
RF, sorry to hear your scribes were terrible. It sounds like a tough work environment with both low quality scribes and midlevels. Both of those extenders can be extremely helpful/useful when correctly deployed. I can’t imagine trying to run our ED without either but both our scribes and our midlevels are high functioning. I hope there is a light at the end of the tunnel for you soon.
 
Hercules said:
RF, sorry to hear your scribes were terrible. It sounds like a tough work environment with both low quality scribes and midlevels. Both of those extenders can be extremely helpful/useful when correctly deployed. I can’t imagine trying to run our ED without either but both our scribes and our midlevels are high functioning. I hope there is a light at the end of the tunnel for you soon.
Click to expand...

Thanks.

I worked a shift at a different job site two days ago.
No MLProblems whatsoever. Highly functioning.
No scribes there, either - but when we had them, they were good.
The problem with that site? HCA.
 
  • Like
Reactions: 1 user
For the record I like RF's posts a lot more in the recent months but I 100% stand by every post I made regarding the millennial bashing 2 years ago.

He was being an ass.

Now I'm a senior resident in EM. I'm probably one of the harder working, stronger residents. And yes, I am a millennial.
The point is that there are lazy incompetent schmucks from every generation.
I work with/consult many ridiculously lazy boomer attendings every day and it is infuriating.
Same experiences and emotions have been prevalent with millennials and guess who now?? Yup the new scapegoat: Gen Z.

Point is. Give someone a fair assessment based on their work ethic and skill set.
Not their race, gender, hair or birth date.

PS. There are rarely scribes at some of my hospitals and some of them are dumb as a box of rocks. I really empathize with this thread now.
 
  • Like
Reactions: 1 user
jw3600 said:
For the record I like RF's posts a lot more in the recent months but I 100% stand by every post I made regarding the millennial bashing 2 years ago.

He was being an ass.

Now I'm a senior resident in EM. I'm probably one of the harder working, stronger residents. And yes, I am a millennial.
The point is that there are lazy incompetent schmucks from every generation.
Click to expand...
Don't take it personally when someone bashes a younger generation. Every generation does it. My generation is "Gen-X" and the Baby Boomers bashed us as being lazy, useless "slackers." Now, the Baby Boomers have gone quiet as they rely on those "lazy useless" Gen-X slackers to pay for their social security and Medicare, while we fix all the stuff they --cked up. Amazing how that came full circle.

Now, Gen-X-ers bash Millennials as pathetic, easily triggered, snowflakes. Trust me, when the Gen-X-ers are old and washed up and the Millenials are middle-aged and have finally gotten their s--t together (a process every generation has to go through) Millenials will be bashing the generation of their children, claiming they don't know their head from their wenis.

The criticism means about as much as Angry Man croaking, "Get off my lawn, damn kids!"
 
  • Like
Reactions: 1 users
On scribes:

I've always opted to do my own documentation and here's why. I was always taught that the quality of the medical documentation you create is as important as your treatment you perform and the decisions you make. This applies to any medical-legal case you may face, Medical Board complaints or future care of a patient by yourself or others if critical history is needed. That's WAY too important a task to outsource to someone other than yourself without a medical degree, or even someone with one.

The response is always, "Yeah, but you get to review and revise the chart before it's signed." If I have to do that, then I'm not getting my money's worth paying for a scribe and I might as well do it myself. I simply don't trust anyone with less training than me, to do things that I might need to depend on to defend myself and career in court, or before a Medical Board.
 
  • Like
Reactions: 5 users
Birdstrike said:
On scribes:

I've always opted to do my own documentation and here's why. I was always taught that the quality of the medical documentation you create is as important as your treatment you perform and the decisions you make. This applies to any medical-legal case you may face, Medical Board complaints or future care of a patient by yourself or others if critical history is needed. That's WAY too important a task to outsource to someone other than yourself without a medical degree, or even someone with one.

The response is always, "Yeah, but you get to review and revise the chart before it's signed." If I have to do that, then I'm not getting my money's worth paying for a scribe and I might as well do it myself. I simply don't trust anyone with less training than me, to do things that I might need to depend on to defend myself and career in court, or before a Medical Board.
Click to expand...

I kind of have the same view, but a different approach.

Documentation is very important.

Most of the time we all can tell if the patient we see is a low-risk patient or a high-risk patient. Someone who comes in with knee pain for 5 months is a low risk patient. Someone who comes in with epistaxis and a platelet count of 20 is high risk. The first is going home. The second is being admitted. So....not a great example. But whatevs...I'm on vacation writing this and thusly not of 100% sound mind.

The point is that...as long as the exam more or less fits my MDM...I'm ok with it. Scribes save me a lot of time and hassle. They might get a few things wrong here and there...but I consider the following critically important to a file (in order of importance): MDM, exam, HPI. And these are what I look at in a chart. I don't spend time on Social History...because if I'm going to get screwed over social history then it will happen to me or with a scribe. So I scan the HPI (with not a complete eye to thoroughness...because the MDM is more important than the HPI),...PE and then MDM. The MDM interprets the case. If a patient has 9 complaints...then in the MDM I say "the pertinent complaint is chest pain...the other things are not contributory as they are chronic or not emergency medical conditions."


I was in a deposition a few months ago and my exam said something like
Neck: supple, patient was in a cervical collar brace and I didn't attempt to range his neck."
and my MDM said stuff like "I didn't range his neck and ordered appropriate trauma imaging"

it was a little embarrassing but didn't seem to be a hangup. I told him the truth. I use a macro and forgot to delete that part ("supple")
 
Responses in italics.

For the record I like RF's posts a lot more in the recent months but I 100% stand by every post I made regarding the millennial bashing 2 years ago.

Thanks. Good post, even if we don't agree. Maybe this touch of adversarialness will do us all some good.

He was being an ass.

I do that often. Sometimes intentionally. My wife lets me know every time I am an ass.

Now I'm a senior resident in EM. I'm probably one of the harder working, stronger residents. And yes, I am a millennial.
The point is that there are lazy incompetent schmucks from every generation.

Good on you. Brace yourself for attendinghood. It does get a lot better, though.

I work with/consult many ridiculously lazy boomer attendings every day and it is infuriating.
Same experiences and emotions have been prevalent with millennials and guess who now?? Yup the new scapegoat: Gen Z.

Gen-Z, Millennials, whatever. Certain things come to define generations. I am actually a "millennial" when you go by my birthdate/graduation date. The point is: Millennials (in general; not in specific) entrench a certain attitude. It's an attitude that was well-exemplified by my posts. In days gone by, that attitude was generally discouraged through a set of forces. Now, its being encouraged because of a different set of forces. This attitude is generally difficult to work with for so many reasons. It sounds to me like you were "born too late". Don't go trying to save the whole millennial set by your own example; it will be easier for you if you stand on your individuality.

Point is. Give someone a fair assessment based on their work ethic and skill set. Not their race, gender, hair or birth date.

Agree ad infinitum. I work with some boomers that are absolutely worthless as physicians. We just "fired" one. If he asks me for a reference, I can't check the box that says "I would allow this person to treat a family member." Thanks for the "false equivalence fallacy" though; its one of my favorite logical fallacies. You may as well have called me a Nazi because I don't like the millennial attitude.

PS. There are rarely scribes at some of my hospitals and some of them are dumb as a box of rocks. I really empathize with this thread now.

Scribes can be great. NONE of the scribes at my "main gig" were even passable, let alone great. At my HCA gig, the scribes were GREAT, but now they're gone because *HCA*. My original point remains... when I can autotext and smartphrase thru a chart in less than the time it takes me to speak out loud... then the scribe is obsolete, and only serves to screw things up.
 
  • Like
Reactions: 1 user
I've been trying to not work with our scribes. I was asked to do my best to figure out how to work with them. The best way is to tell them what goes in the note and immediately tell them what is wrong with what they documented. Immediately.
 
I'm happy to report that I don't know any of the generation names (Gen-X, Millenial, Baby Boomers, Gen-Y, Gen-Z, Booty-Rap Generation, Ghetto-Rap Generation, etc...) and I will never look them up

I will never look up the definitions

I will always look oddly at people who say the Ghetto-Rap Generation, Curly-Cue Pubic Hair Generation, or Millenial Generation don't know what's going on...

I think these generation names are stupid. Just say 80's. 90's. and uh.....um....uh....other decades.
 
Its almost August. For me this means my good scribes are all heading off to medical schools and advanced degrees. This leaves me with only the bottom of the barrel scribes and hours checking my charts
 
  • Like
Reactions: 1 user
I've gone without scribes for last 2 months and am already back in my rhythm pre-scribe from years ago in my last shop. I don't miss 'em at all. I seem to go just as fast, if not faster and I know EXACTLY what's in my notes. No more reading a consult note the following day that goes "Reviewed ER records..." only to pull up my note and have the most disjointed HPI and horribly misspelled PE with new medical terms that looks like a MS1 wrote it... So embarrassing. Now my notes and exams look perfect and I don't have to proof read anymore.

The only thing I miss is having a glorified fetch servant. "Fetch me room 9's EKG!" "Fetch the nurse for room 38 and ask her to get my trop results!", "Fetch my coffee!", you get the picture... I have to scurry around a bit more but for an extra $15/hr...it's worth it.
 
You must log in or register to reply here.
Next unread thread

Similar threads

M
There’s no specialty with the knowledge base/skill set that EM has and that kinda sucks
2
Replies
52
Views
4K
Nocturnist
N
bravotwozero
System downtime sucks donkey balls
Replies
6
Views
1K
Dred Pirate
Dred Pirate
M
Virtual/AI scribes
Replies
3
Views
731
BoardingDoc
BoardingDoc
Throwaway20205
Am I the dingus?
Replies
40
Views
3K
thegenius
thegenius
M
I just wish there were better fellowships/exit strategies from EM
2 3 4 5
Replies
246
Views
15K
TooMuchResearch
T
Top