For example, one ED group may elect to have scribes hired only for the 10 a.m. to 10 p.m. shift on weekdays, while another group may elect to hire full 24/7 coverage for their emergency department. These physician groups will negotiate contract prices with the medical scribe company, which can vary widely based on numerous factors including number of emergency departments covered, quantity of scribe coverage per emergency department, personnel training quality, etc. Some larger emergency medicine groups have developed their own in-house scribe programs rather than contract with an outside company.

Scribes themselves typically earn an estimated $9-$25/hour (depending on the business arrangement). The medical scribe profession will likely evolve over time as scribe programs mature and as demand goes up (or down, depending on the national health care climate), and scribes will likely find many different employment options. Some may offer benefits, while others may be more akin to independent contract arrangements. No literature is available on the current state of total average scribe program costs, but this will likely be an area of active research in ED operations.

At busy sites with increasing volume, the capacity increase can allow the scribe program to pay for itself.

I’m an ED Director – Should I Invest In a Scribe Program?

The answer is, “It depends.” There are costs and benefits to employing scribes in an emergency department. Each group has to make an assessment if the costs outweigh the benefits of scribe programs. The authors believe that costs are outweighed by the benefits, but some are nonmonetary benefits that can be difficult to measure objectively.

Costs of Implementing a Scribe Program

The costs of implementing a scribe program can be categorized as direct and indirect costs.

Among direct costs, the biggest cost in employing medical scribes is the personnel cost in wages and training (including likely turnover, given that many scribes are premedical students who will eventually move on to pursue other career options). Scribes are typically paid $8-$10/hour without benefits, though scribe companies bill emergency medicine groups in the range of $25/hour for full-service scribe programs.

Furthermore, there are costs associated with equipment and tech support needed by scribes in EMR systems (Meyer, H. “The Doctor (and His Scribe) Will See You Now.” Dec. 2010. H&HN [hhnmag.com]). For example, you will likely need enough tablet computers to have one per shift plus two backups (in case of technical difficulties) and uniform costs (which are often covered by scribe companies).