the decision about whether to commence a scribe program at a clinic, practice or facility, is usually either decided based on economic information, the impact on physicians or a combination of both. gains for the facility can be realised by increasing physician productivity (patients per doctor per unit of time), increasing patient throughput (cost of opening treatment spaces and staffing them, compared to the number of patients that occupy that space per unit of time) and the per-patient revenue (which varies markedly depending on the health system and facility). costs for the facility include start-up (implementation), training scribes (if undertaken in-house) and operational costs (scribe labor, support/management staff labor and equipment updates/replacement). economic information regarding the impact of a scribe program has been summarised in a systematic review undertaken by heaton et al. the cost of training program and training scribes in-house has been reported and there is a multicentre randomised study evaluating the impact of scribes on emergency physician productivity and patient throughput which demonstrates increased physician productivity and reduced patient length of stay in emergency rooms.