Meet The Disruptors: Dr. Elliott Trotter Of ScribeNest On The Five Things You Need To Shake Up Your Industry

Authority Magazine Editorial Staff
Authority Magazine
Published in
10 min readJun 25, 2023

A People Centered Focus — A customer-centric mindset is crucial for successful industry disruption. Understanding the needs, desires, and pain points of customers is essential for designing solutions that truly resonate. Disruptors must conduct extensive market research, engage in active listening, and foster a deep empathy for their target audience. By putting the customer at the center of their strategy, disruptors can create offerings that deliver superior value and challenge established players in the industry.

As a part of our series about business leaders who are shaking things up in their industry, I had the pleasure of interviewing Dr. Elliott Trotter.

Dr. Trotter is a pioneer in the field of emergency medicine, having developed several key innovations that have improved patient care and physician efficiency. He is the originator of the modern medical scribe, a vital physician extender role he developed in 1995 to help physicians manage the original E and M charting guidelines. Dr. Trotter’s medical scribes have proven essential to hundreds of emergency medicine physicians to help them off load tedious computer data entry tasks and focus on patient care.

Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”? What led you to this particular career path?

As an emergency medicine physician I’ve always held a fascination with efficiency. In the fast paced world of the emergency department, higher efficiency translates directly into better patient care. Faster evaluation and treatment of emergency patients increases the overall capacity of your department to serve patients and lowers the likelihood that a patient will come to harm as a result of delayed treatment. Consequently, in the mid-90’s I started to experiment with approaches to improve my overall efficiency as an emergency physician. There were gains to be made in optimizing our scheduling to ensure we had enough docs in the department to quickly meet need, and in staggering caseloads so docs were tasked with the most difficult cases at the beginning of their shift tapering down to fast and easy cases at the end of their shifts. But even before the healthcare industry began its journey from paper based operations to digital solutions, it became clear that one of the biggest bottlenecks to our efficiency was the burden of clinical documentation. So, I began to work on that problem. I started by optimizing our documentation tools to facilitate fast and accurate recording of the relevant information, but that only got us so far. Then I enlisted the help of pre-med students to shadow me in the department and perform clinical documentation for me, with a little guidance of course. And in that moment the medical scribe was born. Soon it became clear that scribes could not only help alleviate the burden of documentation, but that they could help with a host of other important tasks from data retrieval to improving patient flow. It was then that I began to see huge gains in efficiency. I immediately saw that scribes could play a vital role in emergency department efficiency, and that their role would likely become even more impactful as physicians transitioned from familiar paper methodologies to digital ones with the introduction of electronic medical records. And so it was out of these efforts that ScribeNest was born.

Can you tell our readers what it is about the work you’re doing that’s disruptive?

At ScribeNest we recruit and train medical scribes to work alongside emergency medicine physicians, providing documentation and data retrieval support while helping their physician focus on patient throughput. At first glance this may not seem especially disruptive in the age of digital healthcare, but our scribes have been able to increase the capacity of a given doc to see in some cases up to three times as many patients per shift, with overall better patient outcomes. And because a scribe allows their physician to focus on what they’re trained for — direct patient care — we’ve been able to reduce physician burnout by offloading the tedious, time consuming and often frustrating administrative tasks that go with the job. And we can accomplish these gains at relatively low cost.

The benefits of our approach don’t stop there, however. The students working as medical scribes get far more out of the role than just a wage. Working as a medical scribe prepares pre-health students with a fantastic working knowledge of producing clinical documentation and with mastery of the complexities of an electronic health record. And beyond these practical skills, medical scribes develop a mentored relationship with their physicians that serves them throughout their medical careers. Our scribes go on to have better acceptance rates into medical school, having gained a wealth of knowledge in their roles and guidance from those already in the careers they desire. I sleep great at night knowing we’re truly creating win/win scenarios that benefit the scribes, their doctors and the patients they treat.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

I’ve learned that our ventures success relies on two core strengths. The first is simply a deep understanding of our customer and their needs. Our executive team is largely comprised of emergency medicine physicians who work with scribes themselves and are also embedded in our training development. This understanding is translated to our customer as improved efficiency and quality of the service we provide.

Our second core strength is an understanding that the role of a scribe is a demanding one, and as such we have an obligation to our scribes to help ensure their long-term success on the job. We do this by providing our scribes with the very best training so that they are comfortable and proficient at their work. But we also work to ensure their wellbeing with reasonable scheduling, fair pay and agile responsiveness to their concerns. With these supports in place, it’s satisfying to watch our scribes master their craft and then leverage what they’ve learned further on in their medical careers.

We all need a little help along the journey. Who have been some of your mentors? Can you share a story about how they made an impact?

Dr. Compton Broders is the mentor’s mentor in emergency medicine. He once gave me a rubber mallet as a gift/award. He said it was to remind me that “every time the solution seems obvious, it still requires a lot of gentle assurance to persuade others to adopt your new vision. A lot of gentle taps with a soft hammer.” As I built ScribeNest, I always remembered his advice as we recruited our team and communicated our vision to our customers.

In today’s parlance, being disruptive is usually a positive adjective. But is disrupting always good? When do we say the converse, that a system or structure has ‘withstood the test of time’? Can you articulate to our readers when disrupting an industry is positive, and when disrupting an industry is ‘not so positive’? Can you share some examples of what you mean?

The rise of disruptive technologies and groundbreaking business models has undeniably reshaped numerous sectors, captivating our imagination with promises of a brighter future. However, in the pursuit of groundbreaking advancements, we often overlook the potential drawbacks and unintended consequences that come hand in hand with industry disruption. In healthcare, the transition away from analogue to digital approaches has allowed care providers far better access to relevant patient information, reduced patient care errors and allowed healthcare leadership far better insight into their operations and overall effectiveness. But at the same time healthcare technologies have introduced a barrier between the patient and their doctor created by the need to endlessly interact with an electronic health record at the cost of time at the bedside. So we see that in the end digital disruption in the healthcare space has very much been a double edged sword — facilitating better information flow and fewer patient care errors on the one hand but reducing the critical human element of patient care and increasing the risk of provider burnout on the other.

Can you please share 5 ideas one needs to shake up their industry?

1 . An Innovative Vision — In our technology focused age it’s easy to fall into the trap that the next big thing must come from the latest software and hardware. But to truly innovate you need the ability to think beyond these tools to address the pain points and inefficiencies in an industry. In the case of ScribeNest, we were able to see that the answers to the modern physician’s work challenges were to be found not in the next best digital tool, but in the refinement of the physician’s role in the care team away from data entry. To address this, we had to create a new role on the team that allows providers to maximize their productivity and reduce on the job frustration.

2 . An Understanding of Industry Technologies — Technology is often the catalyst for industry disruption. Embracing digital transformation allows for the optimization of processes, the enhancement of customer experiences, and the introduction of new ways of doing business. As a disruptor you must stay ahead of the technological curve, continuously exploring and adopting innovative tools and platforms to gain a competitive edge. But at the same time need to have a keen understanding of the limitations of these technologies, so you can take advantage of opportunities afforded by new workflows and approaches outside of the technologies themselves. It was that kind of thinking that created medical scribes in an industry that was overly focused on pushing technological answers to challenges in patient flow.

3 . A People Centered Focus — A customer-centric mindset is crucial for successful industry disruption. Understanding the needs, desires, and pain points of customers is essential for designing solutions that truly resonate. Disruptors must conduct extensive market research, engage in active listening, and foster a deep empathy for their target audience. By putting the customer at the center of their strategy, disruptors can create offerings that deliver superior value and challenge established players in the industry.

I had a distinct advantage in this area while developing ScribeNest. As an emergency physician myself, I was the customer I was trying to satisfy. It was my intimate knowledge of the problems I had to solve and the environment I had to solve them in that allowed me to see beyond the out of the box solutions that were failing in the industry.

4 . A Flexible Mindset

Disrupting an industry requires the ability to respond swiftly to changing market dynamics and evolving customer demands. Agile organizations can adapt their strategies, products, and operations in real-time, ensuring they remain at the forefront of innovation. Embracing a culture of flexibility, continuous learning, and experimentation allows disruptors to seize opportunities and overcome challenges. The ability to pivot quickly and embrace change is a defining factor in successfully disrupting an industry.

A flexible mindset allowed ScribeNest to see an opportunity to change staffing approaches at a time when the industry was extremely focused on hardware and software to fulfil a need. And we keenly believe that a flexible mindset will be needed for us to continue to thrive as artificial intelligence brings a host of new tools and approaches to patient care in the future.

5 . Collaboration Building

Disruptors recognize the power of collaboration and ecosystem building. Industry disruption rarely occurs in isolation; it often involves forming strategic partnerships, alliances, or ecosystems that amplify impact. By joining forces with complementary organizations, disruptors can leverage shared resources, access new markets, and gain credibility. In the case of ScribeNest we discovered that fostering a collaborative relationship between our customers and their scribes created enormous value for both. By providing mentorship and training to their scribes our customers not only develop a highly skilled assistant, but they often end up recruiting former scribes back into their emergency departments to meet their needs for new highly skilled staff on an ongoing basis. And in return our scribes get not only a fun and exciting job to supplement their studies, but a host of contacts and useful skills that greatly help them in the industry of their choice. Further collaborations can be enormously helpful as well. By working with our local collages and universities, ScribeNest has fostered great relationships that greatly enhance our ability to recruit new scribes into the industry.

We are sure you aren’t done. How are you going to shake things up next?

Now we are keenly interested in the impact AI will have on data processing and clinical documentation strategies. While these technologies hold significant promise, the critical need for accuracy and understanding of the information utilized in healthcare makes it difficult to envision these systems functioning autonomously to create clinical documentation soon. That said however we can see a role for AI to augment the capacity of our scribes to assist their physicians. So, we’re working to explore how we can utilize AI to make our scribes faster and more efficient without the potential harm to patient safety that could arise from AI misinterpreting the patient information it’s working with. It’s an exciting new area of development.

Do you have a book, podcast, or talk that’s had a deep impact on your thinking? Can you share a story with us? Can you explain why it was so resonant with you?

“Gifts of Imperfection” by Brené Brown. It was shared by a mentee of mine as a guide to recover from her burn out, and I recommend it to all in healthcare to prevent or help recover from that moral injury. In summary, even doctors who are expected to be perfect all the time make mistakes just like the rest of us. We all need to embrace our imperfection.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“Pay it Forward.” We need to remember that we have all been made better by those who came before us, and as a form of gratitude we need fulfil our obligation to pass our knowledge and skills onto the next generation. I tell my colleagues that you need to show people they are “GEMs”. Gratitude. Educate. Mentor. Every day.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

As I worked to engineer the modern scribe, I never imagined the snowball effect the work would have on the practice of emergency medicine. Literally tens of thousands of students in healthcare professions, millions of millions of patients. It is my wish that in a similar light, we can all pass our gifts and blessings forward even if at first it seems we’re working on a small thing.

How can our readers follow you online?

You can follow ScribeNest on Facebook, Instagram and at our website ScribeNest.com.

This was very inspiring. Thank you so much for joining us!

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Authority Magazine
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Published in Authority Magazine

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