If you're a health care leader, trying to improve efficiency of your hospital or practice, how would you like to find a way to have each doctor see five to eight additional patients a day and add an additional $100,000 a year per physician to the bottom line?

If that idea appeals to you, then maybe it's time to put medical scribes into your workflow to take some of the increased "paperwork" burden of EHRs off the shoulders of busy physicians.

"Scribes can add $2500–$12,000 per patient in direct and indirect revenue to your practice or facility, depending on the specialty," noted ScribeAmerica co-founder Dr. Michael Murphy in Medical Scribe Journal. "Even for a primary care physician, this can mean an extra $105,000 a year for the practice. Rather than being a line item expense, medical scribes are actually a boost to the bottom line for hospitals."

In fact, a recent study, published in ClinicoEconomics and Outcomes Research, noted that scribes can shave nine minutes per patient off physician's data entry, which is not, after all, quality patient-doctor time.

In fact, patients may often like scribe-assisted care, noted Murphy, citing the following patient report from an article by Victoria Wilcox: "In my one scribe-assisted visit, the doctor looked me in the eye as we talked. That helped me trust her, even though we had just met. Our face-to-face conversation sure beat visits I’ve had with my primary care doctor. She spends most of our time together pecking away at the computer, her back facing mine."

But the use of scribes is not without concerns. At present, there are 15,000 in use, with estimates that this will soar to 100,000 by 2020, according to ScribeAmerica, which is the largest player in the scribe space. At present there is no license needed to become a scribe, although about 30 percent of those working in the field today are licensed on a voluntary basis through The American College of Scribe Specialists.

“This is literally an exploding industry, filling a perceived gap, but there is no regulation or oversight at all,” George Gellert, the regional chief medical informatics officer at Christus Santa Rosa Health System in San Antonio, which uses scribes, told The Atlantic magazine.

There are two basic types of risk when using scribes, which health care professionals need to take into account.

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