It’s no surprise that since the onset of COVID-19, physician office visits dropped dramatically. Pent up demand for in-person checkups, screenings, and routine care is at an all-time high. Add to that the increasing administrative tasks, ever changing billing requirements, regulations and protocols. Physicians are at risk of reaching a breaking point. With the advent of mass COVID vaccinations, healthcare industry experts predict 2021 will be the year of “return-to-normal” — but “normal” still shouldn’t include the burden of EHR documentation. When looking for resources to help relieve the burden, medical scribes can help alleviate this clerical workload. Now more than ever, medical scribe costs are worth the investment.
There are many factors to take into account on the return on investment (ROI) of medical scribes for physicians. Below is the breakdown of each component that could factor in, dependent on the physician’s location and specialty.
To focus on the ROI of medical scribe use, we can note the efficiency by throughput, increase of patient load, and reduced time spent on the computer between patients, after-hours, and weekends.
Physicians in ambulatory settings spend an average of 73% of their day on administrative, non-clinical tasks. In addition, after-hour documenting has become an unfortunate “common” occurrence with many physicians, so far to even rephrase the term as “pajama time.” A recent study concluded that family physicians alone spend 86 minutes of “pajama time” each night. 
Finding a solution to removing these stressors will help overall efficiency and also reduce physician burnout. If practice managers and hospital leaders partner with a high-quality scribe company, “pajama time” can be a thing of the past, drastically reducing a physician’s time spent on the computer. This reduction will free the physician’s time to be able to increase productivity.
A study focusing on physician productivity in a cardiology clinic showed a ~10 % increase with the use of scribes. The productivity resulted in 84 additional new and 423 additional follow-up patients seen in just 1 year. The scribes also resulted in the generation of 3,029 additional wRVUs and net profit of $1,274,106 after the removal of the medical scribe costs.
For another medical group, after piloting scribes with 4 physicians, reported an annualized $400,465 net profit.  
30% of the time physicians leave their position at a practice/hospital. The most common reason physicians cite for leaving is due to practice issues. Physicians often leave due to disappointment over “broken promises” about patient volume and administrative support. 
Each year it seems like there are new factors driving up physician burnout. Just last year, the AMA came out with 12 factors that push physician burnout to the edge. A whopping 8 of the 12 were associated with EHR documentation. 
A 2019 study confirmed factors of this as it concluded that 70% of the physicians reported at least one measure of health IT-related stress. 
Luckily, medical scribes can be a solution to increase physician satisfaction. In 2017, the first randomized control trial of scribes was completed and the results showed that scribes produced significant improvements in overall physician satisfaction, satisfaction with chart quality and accuracy and charting efficiency without detracting from patient satisfaction. In the conclusion, the study also noted that scribes appeared to be a promising strategy to improve healthcare efficiency and reduce physician burnout. 
The Cost of Recruiting a New Physician due to Turnover
General turnover has and will continue to occur over time but due to physician burnout, the number of physicians that are deciding on early retirement or moving to a new faculty is increasing at an alarming rate. A recent longitudinal cohort study found that prevalence of burnout, engagement, and turnover were high within primary care settings:
- 53% of both clinicians and staff reported burnout. 
- Only 32% of clinicians and 35% of staff reported high engagement. 
- 30% of clinicians and 41% of staff no longer worked in primary care in the same system 2-3 years later. 
A 2018 healthcare task force report noted that burnout can cost hospitals and health systems alone as much as $1.7 billion annually. Burnout-related physician turnover costs up to $17 billion annually. 
Results from another study in 2018 showed that 28% of physicians reported the intent to leave their current position within the next two years. 
Notably, among the 15 hardest positions to fill in healthcare, 13 of them are all physician roles from ER physicians to Otolaryngologists. 
The overall calculation of the cost of physician turnover/recruiting is not an exact science but there are a number of key components:
When hospitals and practices have to recruit a new physician, they have to stay comparable to the current market. If the market has risen since the previous physician, then the cost of the new salary will come into play. When it comes to salary, medical scribe costs are significantly lower.
2. Recruiting costs
These can include sign-on bonuses, relocation allowances, income guarantees, and loan forgiveness.
Depending on the vacancy of the position, the cost will increase dramatically as well. For example, a 6-month vacancy plus the recruiting costs can cost a hospital $798,661. Compare that to a 12-month vacancy with recruiting costs, which can total $1,287,153. 
3. Lost revenue
Primary care physicians can generate over $1 million for a hospital annually. Certain specialties can generate several times that amount. That revenue is lost while the position remains open. 
4. Lost referrals
Revenue can be lost when patients find out that the physician they were looking to see has left the practice or hospital.
5. Onboarding costs
Administrative tasks done by your medical office staff such as onboarding, credentialing and training a new physician can add up to around $200,000 to $300,000, according to Echo, a HealthStream Company who offers credentialing and analytics. 
You can avoid these costs by partnering with a scribe company. Improving physician satisfaction, documentation quality, and efficiency will lower the chances of turnover and costs associated with it.
The physician is the most expensive “employee” within a medical practice. It is estimated that a doctor’s cost per minute is $4 or $240 per hour.  Clearly, it would appear more cost-efficient to utilize a medical scribe to document. A medical scribe costs around $20-$25 an hour.
In addition, allowing a scribe to document charts and remove the added burden of documenting in the EHR system allows the physicians to see more patients, improve face-to-face time with them, and increase physician satisfaction. Medical scribes are truly a business necessity than a business luxury.
Written by: Nicole Bramblett, MHA https://www.ama-assn.org/practice-management/digital/family-doctors-spend-86-minutes-pajama-time-ehrs-nightly  https://www.advisory.com/daily-briefing/2019/02/04/medical-scribes  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598196/  https://blog.psionline.com/talent/bid/112226/the-shocking-cost-of-physician-turnover  https://www.ama-assn.org/practice-management/physician-health/12-factors-drive-physician-burnout  https://www.aafp.org/news/practice-professional-issues/20190116ehrstudy.html  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5593725/#:~:text=We%20found%20that%20scribes%20produced,efficiency%20and%20reduce%20physician%20burnout  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6342603/  https://www.healthcaredive.com/news/physician-burnout-costs-industry-46b-annually/555631/#:~:text=Burnout%2Drelated%20physician%20turnover%20costs,system%20%2414%20billion%20each%20year.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258170/  https://www.dailypay.com/blog/employee-turnover-rates-in-the-healthcare-industry/  https://member.aappr.org/general/custom.asp?page=696  https://blog.psionline.com/talent/bid/112226/the-shocking-cost-of-physician-turnover  https://www.nejmcareercenter.org/minisites/rpt/the-high-costs-of-hiring-the-wrong-physician/  https://hbr.org/2013/11/the-strategy-that-will-fix-healthcare