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Pay for acute care versus ER/progress notes

Posted By: dtmt on 2006-03-28
In Reply to:

My company has been out of work quite a lot lately and their only explanation is you know how it is during the off-season but the off-season now has been pretty much all of this year. My question is are MTs now all paid the same way for notes as opposed to reports. I distinctly remember that MTs who did progress notes and ER notes were generally paid differently because the notes were so short it was next to impossible to get an adequate line count. I feel like I am getting shafted because I am reduced to doing progress notes on a daily basis and I am generally spending 10 hours a day just to make my 1100 lines. Keep in mind that these are still ESL doctors who either don't know or don't care about putting in demographics so that too still has to be looked up and in the end I may get 5 lines per report. I understand that things do change but if its gotten to this point then maybe I need to be the one to make the change.

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I do 100+ acute care (op notes, ER) per day, apx 5-6 hrs of dictation. nm
I am acute care with them. I do op notes almost exclusively, except when sm
there are none. This past pay period (15 days), I did just over 15,000 lines. All were op notes except for 4 consults.

I work in Meditech and love it, although this is not the popular opinion. I use an expander, know my doctors, and really find that it is easy to use.

I know there is an ExText account looking for acute care MTs. A friend of mine works on it. She says that there are some very intense operative notes as they do a lot of cardiac cath procedures, but she gets really good lines and likes the platform.

The thing that I like best is that there is a lot of work and I am busy for the full 8 hours that I work. I like to sit down, work for 4 hours, take 1/2 hour break and work another 4 hours. I have to be that disciplined or I would be working day and night to get my lines. I can be the Queen of Procrastination (the nickname my sisters gave me years ago), so having a set schedule works for me. My lead tells me I can have flexible hours, but I can't do that as I will put it off until the end of the end and then be in a panic. The account I am on has enough work on a steady basis to support this; I have tried too many other companies where they promise a lot of work, but it does not happen that way. I have been with KS for 2-1/2 years.

Acute care is very different than clinic notes

I have been an MT for 20 years.  I have hired and trained MTs for a service.  There is a HUGE difference between clinic notes and acute care.  The poster who says she made the switch and didn't have problems is lucky and is probably a very good MT, who had a good base of knowledge to start with.  It can be done, but not in every case. 

Some MTs who work on clinic notes work for the same set of dictators every day typing about colds and aches and pains.  Dictators tend to say the same things over and over.  Most clinic notes are only a 2 or 3 paragraphs.  They work for the same set of dictators for years and even have their stuff canned, just pull it in and make the changes.

You put that same MT on an acute care account for a large teaching hospital and they may have a nervous breakdown, I've seen the meltdown, it's not pretty.  On an acute care account like that you may have all the specialities and subspecialties, probably 30-40 or maybe more, adults and peds, with all the dictators, anywhere from 5 to ??  And residents, let's not forget them.  And all the work types.  They are dictating DS, H&Ps, consults, ORs, clinic visits, progress notes, etc.  They are dictating about new procedures and medications that may not even be in reference books yet or that are experimental.  Some of those reports are 20-30 minutes long, 7 or 8 pages.

I'm not knocking the clinic MTs, but don't just assume because one does clinic notes, they can jump into acute care.  That would be very misleading and a total injustice to a newbie who read that and got into an acute care position, possibly setting themselves up for failure. 


Was told recently that they do 70% clinic notes and 30% acute care, very few Ops. Don't know
Acute care versus pathology

I did pathology transcription for 13 years and have been doing acute care for 8 years now.  Pathology can be very detailed, especially in the hospital surgical setting where you have a lot of surgeons performing every type of surgery imaginable.  The specimens run the entire anatomical gamut.  If you are going to be doing pathology in a laboratory setting, such as LabCorp, your work will be repetitious and you should be able to use many macros. Also remember, in pathology you will have no meds and no equipment to research.  In the hospital surgical setting, you would have more detailed anatomy dictation than a typical hospital OP note, but you will not have this in the typical laboratory setting.  Pathology reports are also completed in stages that are dictated days apart, and that is the biggest difference between them and medical records type work, in my opinion.  If you have been successful in doing acute care for any length of time, you will be able to do pathology and do it very well.  My concern would be that you would become bored with the work.  In a lab setting you will probably be doing lots and lots of prostate and skin biopsies, and biopsies taken from EGDs and colonoscopies.  Best of luck in whatever you decide to do.  :)

acute care versus clinic
You are so right. Same here. Started in acute care about 15 years ago back when they had tapes. arrrgh! I started out weekends in radiology which was for 5 docs and then when I graduated college went to HIM to do acute care. Started with maybe 30 doctors and doing all kinds of reports and hospital grew to 250 doctors minimum before I left there a couple of years ago. Now I am so thankful for the experience because I am very flexible with what I can do and that makes a better candidate on an interview. Best of luck to you and do stick with it if you can. Actually, I think its great if you are only missing it by less than 100 lines a day. Some advice, though, make you your own 'normals' and maybe save them in folders in Word or something if you can. Even if the dictation isn't the same every time, you can read through while the person is dictating and change what needs to be changed. Op notes are notoriously repetitive for surgeons, barring complications, so that is why it is important to proof as they dictate. Hope this helps bump up that production.
Acute Care versus Pathology.... After 28 years as an

acute care medical transcriptionist, and working from home the past 7 years, I have decided to go back out in the workforce.   I have an interview on Monday with LabCorp as pathology transcriptionist.   After almost 30 years in the medical transcription profession, and at age 50, I am facing no retirement benefits, no health insurance, no sick time or holiday or vacation time.   I know it's a little late to wake up and smell the coffee, but I figure in the next 15 years, I may have a little retirement to look forward to.      Anyone working for LabCorp know anything about the benefits?

Acute care versus clinic work...sm

Which do you feel you can get a better line count on and would you take a slight pay cut to do just clinic work?  Most acute care accounts have such difficult dictators and such I was wondering if it would just be better to go to a good clinic account even if it meant less per line.  Opinions? 

Clinic work versus acute care?
Anybody have any input as to the money to be made doing clinic work versus acute care?
Multi clinic versus acute care

I was wondering if it is possible to make a good line count with a multi-speciality clinic.  I was offered a PT position; one with acute care and one with a multi-clinic.  Just wondering what you all thought.

I beg to differ. Acute Care versus Clinic
You may have the same terminology in clinic as with Acute care, but I promise you, you will have terminology in Acute Care that you will never see in clinic. The terminology in Acute care is more extensive than in clinic. I have done the both, but I specialize in Acute Care with Ops. I've been in the business 30 years. Multispeciality clinic is quicker and easier terminology, therefore the pay is less.
progress notes
My company, XXX, has been out of work quite a lot lately and their only explanation is you know how it is during the off-season but the off-season now has been pretty much all of this year. My question is are MTs now all paid the same way for notes as opposed to reports. I distinctly remember that MTs who did progress notes and ER notes were generally paid differently because the notes were so short it was next to impossible to get an adequate line count. I feel like I am getting shafted because I am reduced to doing progress notes on a daily basis and I am generally spending 10 hours a day just to make my 1100 lines. Keep in mind that these are still ESL doctors who either don't know or don't care about putting in demographics so that too still has to be looked up and in the end I may get 5 lines per report. I understand that things do change but if its gotten to this point then maybe I need to be the one to make the change.
My account has all progress notes.
everything was straightforward.  I thought I was doing everything right but then I was notified I'm doing certain things incorrectly.  One day last week I asked someone in the office how to do something and got an answer but then I got more corrections telling me this way was wrong.  It's a little confusing and I hope it's just the new account adjustment.  Like I said I'll wait a full 90 days before making any definite decision.  What account are you on?  
Do you recommend starting with clinic notes or acute care when just starting in the MT field?
!I realize this question may be better suited for the new MT board, but this board is my favorite)

I am considering accepting an acute care position, even though I am just out of MT school. However, I don't want the learning curve to be so steep that I fail before I even begin. I would also like to have a smaller pool of dictators to transcribe from as opposed to many.

Also, are there more ESLs in acute care versus clinic/dr office work?

What has your experience been? Would you do it differently?

Thanks for any insight!
MDI versus MedScribe versus SoftScript versus Transsolutions versus TransHealth. SM

I'm getting ready to start applying and these are the companies that I'm looking at.  So give me the low-down.  Good, bad, India?

Here are my criteria:

9 cpl or better

Does NOT send work to India

Good accounts with at least 50/50 of ESL versus American dictators

Consistent work flow - no downtime or time spent waiting for work

Upper management should be professional, positive, and encouraging.

Pay for lines WITH spaces.

Is there such a job out there or am I just dreaming?  If there are other companies other than the ones I listed that would fit the bill, please feel free to let me know. I tested with TransHealth and I felt like I tanked.  It was a hard test and I had to use the mouse to stop and start the dictation as it was online test and you couldn't download the voice files.  So that made it a lot more difficult.  One of the dictators was cutting himself off through the report and I had to leave some blanks.  I'm very frustrated with this whole process of looking and testing.  Are all the tests like that?  Or are there companies that allow you download the test files and transcribe them using your pedal and software?  Ugh!  I am just so frustrated and discouraged.

Thanks for any helpf.

Acute care

Acute care is (sm)
typically the basic four: history and physicals, operative reports, consults and discharge summaries. It's hospital work typically done in the medical records department of a hospital.

That's going to be your hurdle because it sounds like you don't have the acute care experience. Once you have 2-3 years of that, you've got it made. Getting your foot in is the hard part.

I'm not a recruiter. Is there a local hospital you can work at? That's sometimes the way to get the experience when you have some medical transcription but not acute care.

Good luck!
Yes, acute care
I have 5 major accounts I get backlogs for and they are all empty, completely!!!! It has been this way since the beginning of December and before that so light that if you got 300-500 lines you were very lucky and had to work morning to evening for it. If you talk to the owner, she will just say she is going to hire more, the work will be there, it is slow deal with it, etc. I can't believe we are not being taken care of.
Acute care, ER
They wanted to pay 7.5 cents for 150 lines an hour, and then anything over 165 was on a tier plan.
Acute care

I started out right out of school working for a national doing acute care for a large hospital.  Let me tell you, it was very scary for me.  But, I look back on it now, and I am glad that I had that experience because I learned a lot right from the very beginning.  I have transcribed every type of report in every specialty.  Acute care can be very difficult, but what I like about it is the variety.  For me, it never gets boring.  I am still working for the same company I started out with (along with another) and I am still very happy.

Since you already have quite a bit of experience, you will have a somewhat easier time than I did, but it will still be difficult.  In the beginning you will have to spend a lot of time looking things up and doing research and your production will probably not be that great.  In the long run though, I think you will enjoy it, I know I do.  But, you may also find it is not for you.  You just won't know until you try. 

Probably the hardest thing about working for a large hospital is getting used to the large variety of dictators.  At this point in time, I have approximately 30 doctors that I transcribe for that I would consider my regular docs.  Then, there is a very large pool of approximately 200 doctors, any of whom I may get on any given day.  Rarely a day goes by that I don't get a doctor that is new to me.  But, that is also something about the job that I enjoy because that keeps it from getting old and boring for me.

I have created tons of normals and expansions and that has helped me beyond belief.  I know that is no big secret for someone who has experience such as you.  My advice would be to give it a shot and see how it goes.  It could be the best decision you ever made.  And if you find out you don't like it, at least you will know that for the future.

Best of luck to you!

They said maybe I could do some acute care if
the Rad work is low...but they're starting me out on about 3 or 4 Rad accounts so I doubt if I will do any acute care for a while....I know there are people who do acute care for them who say they don't run out of work..I'm not worried...just anxious to get trained!!! (which starts tomorrow)! 
Acute care..nm
No more acute care for me
I do not particularly enjoy acute care either. I really want to get back to typing clinic, but all the jobs I see posted lately are for acute care/basic four. Where do you find clinic work these days? I stay away from companies who use Emdat too. Just hate that system.
Acute care
I work there
Sorry, acute care...nm
Is there any way you can get on acute care?
acute care
Two other people that I know had the same problem this year, they had no work available to train on.
The Big 4 Acute Care
Please pardon my ignorance, but what are the big 4?  I do surgeries, H&P's, and ER.  Is inpatient care the 4th?  Thanks for any input!
6.5 cpl is for acute care.
While 6-8 is the average for a new MT, I think 6.5 is extremely low for acute care. This is why I left Spheris. I now make 7 cpl for clinic notes and make a lot more money and have a whole lot less stress.
I do acute care/B4 and some ER at KS
and was looking to do basic 4/acute care with MDI. Do you really have to pay a lot in back in taxes when you are an IC? I have never done this before as I have always been employee status at every other company I have worked for, so I don't even know how much ICs generally have to pay in taxes. Thanks for the advice! I will definitely keep that in mind when deciding which road to take!
Acute care

acute care

Ya know, I started out with no experience in a hospital setting also about 15 years ago. It definitely is a learning curve. I stuck it out and it took me about a year to get up to making $9.00 an hour including ESL docs which you will get everywhere! My advice, unless you want to do clinic or one specialty, stick with it, it's a lot of learning, like a new language, but you will get it and then have a lot of opportunities open up after that.
GOOD LUCK!! Hang in there!
Acute care NM
acute care
I used to work clinic, now acute care. In clinic, sometimes most of my day would be 4 line reports. I had to set up each one. Avg. was 20 lines though. In acute care, avg report is probably 50+. Not so much setup time. In the long run, you want to narrow down your # of doctors if possible. That's who I see making the most money.
Yes I think they are all acute care but sm
Usually after we get the accounts, the radiology departments and such also use our services.
acute care
I prefer acute care. You can make lots of normals for physical exams and OP notes. Acute care reports tend to be longer so I can get a rhythm going, not having to change reports and look for patient info every minute or so.

It has been my experience that I do tend to make more doing OP notes exclusively. Some MTSO will not pay the Transcriptionist for normals that come from the client, though I'm sure they are charging the client when they are used. That is one question I am sure to ask these days. Found that out the hard way.
CA, acute care, 75% ESL nt
No, acute care...nm
Acute care - HP, DS, Con, Op, maybe some sm
specialty worktypes like sleep studies, diagnostic reports (EKGs, EEGs), depending on your hospital. Level 3 MTs are ER, radiology and basic clinic work.
Acute Care
Dumb question: Acute care does not include ER reports, does it? I do not like typing ER and that seems to be all I type. I was hired for acute care.
IC ... acute care hospital
If this is for the acute care position - sm
I wouldn't bother - it's a horrible dictating hospital, the cherry pickers are rampant, and honestly, more often than not there is no work!  I've gotten e-mails from them saying they're expecting a lot of work on such-and-such a date and could I please set aside extra time for them.  They even offer to pay incentives, but then when that date comes and I've blown off all my other work and I'm ready to type, there's NO WORK.  Regarding paychecks, I didn't like the fact that they didn't provide a line count to me.  They have their own line counting software and it never jived with mine.  I think they now have direct deposit, so I guess that would be a plus.  And they had also promised to reimburse me "x" amount a month for long distance, but I had absolutely no way of knowing if I ever received this because I would just receive one big check every month and never saw a line count to go with it, so I'm very suspicious if this was ever included.   I only know about this one account, but it definitely wasn't worth my time and I definitely could not rely on it to be a steady job.
Are you acute care or Radiology?
The difference being that Radiology usually has a faster TAT. I think most companies will be flexible. I know a few give you a 12-hour window to get your time in.
Why can they not bring on acute care MTs?
Cannot get them or do not want them?
Not sure if there are Rad openings. I do acute care...
OPs, DS, HP, and CS.  Been here since September and have never been happier with a job.  Website is www.mditrans.com. 
I think acute care is a great way to go
You will gain a lot of experience, just try your best not to get frustrated and don't give up, it does get easier. As far as ESL's go, I think that just depends on where you work, you may have more in acute care, you may not. I wish you the best!
Actually I have done acute care for many years but
I'm an MT with 23 years of acute care

they told me to call them.  I called and Heather was busy at the time and told me she'd call me RIGHT back.  She never called and I never checked back; I accepted a job with another company that DID call me back.  I was very interested in DSG but since they weren't excited enough about ME to call me back, I figured I'd go with one who was.

With all the acute care experience I have (as a hospital employee, as an MTSO myself, and as an IC for other companies), I am used to companies falling all over themselves trying to hire me, trying to convince me to work for them, etc.  I guess they didn't recognize how VALUABLE I am! 

45-50 reports acute care

not sure about clinic work.

Was that for acute care or clinic? nm
I have 10 years + acute care, maybe that is why? nm