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Utilizing a Physician Scribe in a Pediatric Plastic Surgical Practice: A Time-driven Activity-based Costing Study.

Jonathan Cho¹, Karl Sanchez¹, Oren Ganor¹

¹Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, Mass.

Plastic and Reconstructive Surgery. Global Open

|November 28, 2019

Summary

Utilizing a physician scribe in pediatric plastic surgery clinics can reduce costs. This method saves $13.82 per appointment by substituting physician time with a more cost-effective resource.

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Area of Science:

Health Economics
Medical Practice Management
Pediatric Plastic Surgery

Background:

Routine pediatric plastic surgery visits incur specific costs.
Evaluating cost-efficiency in clinical settings is crucial for resource allocation.

Purpose of the Study:

To compare the costs of pediatric plastic surgery clinic visits with and without a physician scribe.
To apply time-driven activity-based costing (TDABC) methodology for cost analysis.

Main Methods:

A 10-month study at a tertiary care facility involving pediatric plastic surgery patients with diagnoses of skin lacerations, lesions, and plagiocephaly.
Two plastic surgeons participated, alternating between seeing patients with and without a scribe.
Physician and scribe time, including visit duration and note completion, was meticulously recorded and analyzed using TDABC.

Main Results:

Visits with a physician scribe averaged 12.83 minutes, with the scribe contributing 4.97 minutes and the physician 0.92 minutes.
Visits without a scribe averaged 12.01 minutes.
A cost saving of $13.82 per appointment was observed when a physician scribe was utilized.

Conclusions:

Time-driven activity-based costing confirms that physician scribes reduce the cost per office visit.
The use of physician scribes optimizes resource allocation by substituting higher-cost physician time with lower-cost scribe time.