PERSPECTIVE
A SCRIBE’S STORY By Ben Saul, Harish Thoppe, and Larry Kravitz, MD
It is hard to lay bare your personal medical practice to the eyes of another professional. As I have told every medical student on rotation with me, “You will learn from me how to practice medicine right, but you will also quietly learn how to practice medicine wrong, seeing things you will know you never want to repeat.” We are imperfect. When we are teaching medical students, we showcase our successes, but we relinquish any hope of hiding our professional flaws. You must make your own peace with that in order to teach. You must trust in the benevolence of students to see that you stepped up to the plate and volunteered to try to raise their medical skills. Medical students shadow and practice, practice and shadow. They come and go, usually for four short weeks within a family medicine rotation. But scribes come and stay; they are the ultimate shadows. Muted by the nature of their mission. Silent witness to the inner clinical sanctum. We take them on to share the exhausting intensity of our trusting patients with their challenging mortal illnesses and aging. A
IN THEIR WORDS: It is true that the bond between scribe and physician is undeniably strong. As a scribe, I gained a physician mentor and a good friend. I often felt that when we entered an exam room our brains merged so I could think and understand as he did. Family medicine can be arduous, but it makes up for this by its deeply personal qualities. I was perpetually amazed by the scope and breadth of knowledge family physicians were able to provide to their patients, possessing the ability to change the hat they wore to meet the needs of the patient at hand. While now I am only in my first year of medical school, I understand the importance of developing the skill and understanding to diagnose and manage a patient. However, after working with a physician for more than a year as a medical scribe, I now under-
bond develops with your scribe, often unspoken, yet undeniably strong. I have had scribes in my family practice for six years now, each one for about a year. Four are currently in medical school, and for one deserving scribe, we are hopefully waiting on his acceptance. Most scribes are in a gap year awaiting medical school, and hiring one is more than hiring an employee; you are entrusted with hiring an apprentice. In the year you have these future doctors, in a sense, you are grooming them for medical school; and you are imprinting on them a path, a template, for their entire physician career. They are the unassigned medical students, but the ones whose future careers you may influence more than any of the students you ever see on family medicine rotations. I want to tell their story, because scribes in family medicine are different than ER scribes, surgical scribes, or orthopedic scribes. Because family medicine is not just clinical, it’s personal. But I cannot tell their story. They have to tell it themselves.
stand medical education is much more about intangible skills. These are the things that cannot be taught from “UpToDate” or “Gray’s Anatomy.” How we understand and connect with patients is what makes a great physician, and I am grateful for beginning that education with a family physician. Young and budding physicians are undifferentiated, and I believe any physician who takes a scribe will contribute much more to medicine than they anticipated. As pre-med and medical students, we often focus too much on one thing; what do I want to be? Perhaps it’s a cardiologist, a general internist, a family medicine physician, or an orthopedic surgeon. While these thoughts are certainly important to ponder, they could never paint the whole picture. I believe the more important and meaningful question to ask oneself when considering a career as a physician is
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