Oregon Live, September 29, 2010

The demand for scribes has expanded as hospitals and the federal government push electronic record-keeping. To encourage it, last year Congress provided up to $27 billion over 10 years, and those who don't go electronic will receive lower payments from Medicare.

But it's estimated that at least initially, doctors lose about 30 percent productivity because of the greater time to fill out electronic records compared with paper ones. Dr. Robert Vissers sees that drop up close.

"You spend more time in front of the computer than with the patient," says Vissers, medical director of Legacy Emanuel Medical Center's emergency department.

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