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That is your opinion,not mine. So we will have to agree to disagree.

Posted By: ETMT on 2007-03-01
In Reply to: They are such a horrible company they can't keep - yea and you know why


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Have to agree and disagree (sm)
I thought their pay was comparable to nationals rather than low; but I did hate their program, it was very, very slow and complicated.  Screens keep changing and freezing up.  No one could help me.  Most of the people were friendly and nice, just seemed disorganized.  Didn't stay very long.
Ah, well, will have to agree to disagree (sm)
I have read the blog before and my take on it is the same as other marketing blogs I've read; it's not a diary, it's a marketing tool. It's to generate excitement and sell product. I just don't agree that the clues in a blog like that are keys to the person's personal life because it's a blog with a specific purpose.

You're right though about closing the issue and moving on. Time will tell in all things, I do agree with that.
I agree and disagree
While I agree that there should be some sort of compensation for those wretched dictators, I also like to think that doctors like this, who are beyond the capabilities of ASR, are what are going to keep me employed and that remind the clients that having a 'humane factor' preparing a report can make a big difference.
I disagree and agree..
there is no perfect place, but there are way more unhappy with MQ than happy. Their numbers have dropped in the thousands in the last couple years. Not to mention their significant turnaround in PSs, which is a big sign things are *not right* there. Many who have started in the last couple years are happy simply because they don't know any better. Anybody who has worked there for quite a long time has lost money over the years. They may still have more positive things than negative to say about MQ, but they have lost money...which never makes anyone happy.
I agree to disagree - my experience ...SM
I'm from the NE, living in SE so I have a totally opposite experience than you seem to have.  It's cool, no problem here! :)  It probably differs depending on what part of the country one is from. :)
Really? Oh no, starting a job soon that uses that. Anyone else out there agree/disagree?
Glad you agree but disagree on one thing sm
This is far from a socialist country. Oh trust me, I have many lawyers in my family and you can sue a company who won't hire you if you have disability. These companies are treading a thin wire.

How would someone like it even if they simply had an abortion on their record and a company didn't like that!

I agree to disagree with you. In many fields wages

have not really changed that much over the last 10 to 15 years, however, in my case, as well as many, MANY others, the wages in this field have changed drastically.  They are still changing as evident on the job board most days.  While I have been a MT for over 20 years, fifteen years ago I was making 15 cpl and today I am at 8 cpl.  I feel like I have every right to be angry about this and had you taken a cut in pay as such you would be angry as well. 

As far as VR, I have no experience with it and hope that I never do but I am not stupid enough to believe that it will not ever happen. 

As far as our jobs being sent to India, if you cannot get pissed off as a MT about this and seriously have no fear that your job will be sent there, then at least as an American and a patient in the healthcare system, you should be pissed that patient's personal information is being sent to another country, as well as fellow Americans are losing their jobs.  All, IMHO. 

Nope. I'm thru with this thread. I made my point. We all just need to agree to disagree with b
I agree - mine used to be on Yahoo IM all the time (sm)
my supervisor AND team lead, plus a couple QA people....now, NONE of them are on or at least they are not showing....guess they are hiding from all the questions.
Don't have mine yet either...agree with above post about company going downhill..sm
A constant lack of work since November.  One day we are working and then the next day we are told to sign off because of no work and to not sign in until they tell us. In total since November I have missed 17 days due to no work.  That is a lot of money for me.  Hard to get another job because I need my insurance.
Agree with this. Some lucky ones have great accts. Mine were awful, so I left. nm
I totally agree, your story is mine and lots, and lots of others, please
believe me when I say Keystrokes has been honest like we used to have in this profession. If I can help one Transcriptionist avoid what we have, this will all be worth it. I worked parttime for Keystrokes at the time I was fulltime with ____ and quit, 2 years later I begged them to take me back after once again my paycheck was cut in half, and they did with open arms. I don't mean to run down anyone but a lot of these transcription companies are getting obscenely rich while paying below minimum wage to transcriptionists, playing with dictation and after working for a couple of them you know who is honest and who is not. Sorry I came down so hard but the reality is there are single mothers out there that I bet cry themselves to sleep not able to give their children a decent life because it is easier to steal from us. When companies have millions of dollar to pay for other transcription companies, open transcription schools in other countries, ect., ect., you know there is a lot of money in it. That is all I am saying.
I bet you 1 million $$ you won't find one on mine. Mine is
2 years old and it does not have a 9-pin serial port, nor does it have a game port.   I have used both ports on other computers so I know what both ports look like.  I also have a company provided computer and it does have the ports on it. 
Hear, hear! Read My Opinion's opinion.
Regarding Wondering's question, the company I work for is investing strongly in upgrading its MTs' and editors' skill levels (exactly what this says about need for us for ten years down the road I can't say). This morning I found an e-mail saying they would pay every one of us to attend an on-line class on making Expander macros to increase our productivity. Amazingly, I have to assume many employees were choosing not to attend the unpaid ones they had been offering...
I disagree with you......sm
I've been working with them since July and have not had any problems with communication or having work available, and I'm an employee. 
Have to disagree

I am a hospital employee.  I like the platform, it is basically word.  I am making more lines here than I ever have anywhere else.  I only work on one account.  The equipment is fine, brand new Dell with flat screen.  No problems in particular with supervisors or QA.  Hospital can be picky about things, but it is the hospital, not DK.  Benefits are great through the hospital, very affordable.  

DK is no worse than anywhere else, you just have to find what is best for you.  They are working fine for me  

I disagree with you. sm

I have to say that the reason companies are offshoring is not completely their fault.  US MTs, over the  years, have gotten to where they want to make more and more money so that they have to produce less and less work every day. 

Any talented MT should be able to produce 1500 lines (accurately) in an 8-hour period.  At a rate of 0.075 cpl, this would total $112.50, which works out to 14.00 per hour.  If you want to earn more than that, you work extra to do so.  There are people coming out of college with degrees that do not start out at a wage like that and don't make that until they have many, many years experience in their field.  This would be though in an average area.

By asking for exorbitant wages, which you could also earn by increasing your line count and working just a bit harder, we are forcing companies to have to look at offshoring more and more work.  Yes they work cheaper over there.  However, they also don't mind working harder and doing everything possible to increase their line count.

Another issue bringing our wages down is the fact that now an Editor is used.  This has come about simply because the MTs that are coming into this business are not adequately trained.  Therefore, an extra cost associated with the higher wages.  The same editor can be used but editing India work and the company will make a better profit and turnaround times are much better.

I do feel that MTSOs should look at the cost of living of different areas and also pay MTs accordingly as any other job would.  For instance, an secretary in some parts of Texas start out at 6.50 per hour; however, a secretary in New York may start at 17 or more per hour.  This is an issue that has never been addressed by an MTSO and I am sure never will be.

Over the last several years, many schools have developed that teach MT.  However, they are not producing quality MTs.  To make it in this business and earn the big bucks, you have to have speed and accuracy.  You have to be able to remember medical terms.  Most of all, however, if you cannot produce 200-250 lines per hour minimum, you might should consider a new job.  This is a production job and if you can't produce, it is not the job for you. 

For those of you experiencing out of work problems, easy solution... find another company to work for/with.  There are too many out there, so don't waste precious time.  Find one.



Well, I disagree with YOU !
Here is your statement -Over the last several years, many schools have developed that teach MT. However, they are not producing quality MTs. To make it in this business and earn the big bucks, you have to have speed and accuracy. You have to be able to remember medical terms. Most of all, however, if you cannot produce 200-250 lines per hour minimum, you might should consider a new job. This is a production job and if you can't produce, it is not the job for you.

Now, I am taking issue with this type of noncaring type attitude to those of us who are 50 and older, have a lot of physical problems, but you know what, I might not produce 220 lines/hour, but I do type 70-90 wpm, but I find I can only type for four hours, then have to stop, and then restart later on to finish up. Up to now, I have found employers out there who do understand this, and as long as I get my quota in for the day, they and I do not see anything wrong with doing the work this way. Well, you had your say, now, I had mine. Why don't YOU get to work, and stop chewing-out us other hard-working MTs, and there are quite a few of us left! I stack my medical terminology memory next to a doctor's, so there you have it, and I just could not sit by and read your comments without having some of my own to stick up for those us in my situation.
I disagree with you.

I disagree with you on a number of points.


First of all, as was pointed out by another poster, 1500 lines in 8 hours depends totally on the accounts and dictators you transcribe.  I have an (occasional) account where I can transcribe 400-500 lines an hour, and that, obviously, is due to the template.  I have another account on another job where I can only transcribe 120-140 lines an hour.  That isnít due to my failings but due to the slowness of the company-provided computer and their platform.  When transcribing another dictator, I can usually transcribe 250-275 LPH.  The main reason I can do this is because I get this dictator all the time, have had the opportunity to become accustomed to his style of dictation and can make shortcuts based on his particular consistent phrasing of sentences.  If a person transcribes for more than 100 different dictators, the Transcriptionist never has the opportunity to become familiar with the dictator.  There are many variables in how many lines someone can transcribe per hour, and they donít always involve the skill level or competency of the transcriptionist.


I also take issue with the fact that people coming out of college with degrees earning less.  Who cares?  Why should MTs who have been in this business for 20-30 years suffer just because kids who graduate from college make less money?  Iím sure most of these seasoned MTs would tell you that they made much more money 10 or even 15 years ago than they do today.  They are hanging in there with a deteriorating industry, just trying to make a living wage.


I especially disagree with paying transcriptionists different rates based on where they live.  Often that is the only recourse for those of us who have the ability to relocate to economically impoverished areas, just to keep up with steadily declining wages in the MT industry because we love this kind of work.


Although I agree that speed used to be a very important of a transcriptionistís job, I also believe that with the evolution of VR, the need for typing speed in a transcriptionist is obviously going to diminish since it is no longer required.  Combine that lack of skill with the new graduates you mention who are basically clueless, and a whole new generation of incompetence is being created, leaving the more experienced, seasoned MTs out in the cold.


I personally am going to remain with the smaller companies, as I believe when it is all said and done, they are the ones that truly care about quality, and they may be the only ones left after all the big nationals outsource themselves into extinction through their new quantity versus quality standards.  They are also the ones who are less likely to cut the throats of their loyal, highly-skilled employees.



Just because an MT is a production worker doesn't mean we never deserve a raise.  Basically, you expect the MT to do more, more, more, and never make anything more per hour, which isn't right or fair in general, and especially with the way the cost of living constantly goes up, health insurance, etc...

As far as editors go, editors have always been a part of the MT world as long as I can remember.  They aren't anything new.  I'm sure it's much easier for an Editor to edit jobs done by U.S. MTs than people in India who can't even speak English...That's just common sense.  Alot of their reports need to be totally redone because the quality is so bad, yet you'll send work to them??? LOL!!!

Amazing how you only harp on quality, speed and accuracy when it comes to U.S MTs; none of which you're getting from any MT in India, but you're okay with that because it's filling up your pockets. 

Soon, U.S. medical records will have to remain in the U.S., which is the way it should be.  You'll see.

I have to disagree (sm)

I used to be an MTSO.  There is a very fine line to walk between overstaffing and adequate staffing.  With the TATs being what they are today, it is even worse.  You have to keep the clients happy or they will go elsewhere.  I don't believe that is a problem at TT like it is at many other companies.  I also never ran out of work during slow times, just adjusted my schedule.


SirPercy - please don't denigrate yourself with such names.  No one is garbage, maybe a little trashy, but certainly not garbage.  I just left D and L typing a few weeks back.  They were fab-u-lous. Challenging (in a good way -- not too hard to comprehend) work, wonderful software, very nice staff. Always was paid as promised, on time. I didn't want to leave, but had other committments. I give them 5 stars.


I have to disagree with you.....sm
on that explanation.  I do NOT work for Keystrokes, but I did try them out very briefly awhile back and they put me on an account that had horrid ESL dictators that I could not even begin to understand.  I tried telling them in a round about way, but they never would give me anything different and there was NO WAY I could have stayed there with that mess.  If they had anything better than that, I wouldn't know, but I have heard that most of the accounts or horrible.  Besides that, they weren't too bad, but nothing out of the norm. Not every company is good for every person. 
I disagree.
Great company small company to work with. Plenty of work and payroll is DD and always on time. There are a lot of ESLs, but if you're an MLS that's great. Let's face it their here and they're not going anywhere. Their only downfall is that are no benefits so if you need paid vacations and insurance don't go there. They do not treat you like you don't exist. You are in constant communication through IM which stays up all day and there's always phone or email if needed. As for previous post you do look up a lot of addresses, however those are provided for you for each account. If you do not have it you don't search you leave a blank. No guessing. No internet searching. Can't find a word - they don't dock you for blanks. They would rather you leave a blank than guess. Daily feedback. You can have DSL to work with them, you dowload several voice files at a time and then can up load at same time or individually so second line would probably help but not necessary. They do not have much in the way of flexible hours, pretty much wanting you to work 8 hours straight but what job doesn't. They are not strict though, very easy to work with. As I said though if you are needing insurance coverage and vacation/sick time they currently do not offer, although have been working changing this.
I disagree
We work long hours (often longer than reported) on a job that is physically demanding (people don't realize how much so until they do it a few years and people who have never done it have absolutely no clue). You cannot socialize at all when you work, your right foot, both hands, ears and eyes are 100% on task for many hours. Because we work from home I think most people don't realize how hard we do work. In fact, most of us work harder from home. Yet, we get vacation time that is like a carrot dangling in front of a horse to get and you'd better be careful how you use it, unrealistic demands that we would have told any hospital to shove it (well, most hospitals don't treat their employees like that to begin with). We work holidays, weekends, nights, days, you name it. Our work is changed and thus our incomes, we're asked to be on call without pay. I could go on but I won't.

No, it's not that attitude that is harming the MT field. It's the attitude toward the MT field that is harming the MT field. It's become a nuthouse.

I disagree

I'm sorry, but I think we most certainly are different from assembly line workers or a pharmacy tech, etc.  Our job involves a whole lot more than those professions and I feel proud that it does.  I would say an experienced multi-specialty MT might be on the level of having a bachelor's, and what would be wrong with that?  How many of you with years of experience can diagnose a patient after hearing the H&P and know not only what meds to prescribe but their proper dosage along with a treatment plan?    

We still do patient care but in a different way.  We work with the written record as opposed to hands-on patient care.  Why should this mean we don't need as much knowledge?   We're the patient's safety net, as I recently heard a medical professional say.  Especially with the EMR and electronic signatures, we've got to be darn sure all the bases are covered and covered correctly.  The next time that patient is treated, what we have transcribed will be what the treating physician refers to.  How else can we know what the mumblers, speed demons, ESLs are saying if we don't know what they are supposed to be saying!  This is where the years of experience really pay off.

I think you're selling yourself and this profession short to compare it to those others.   To do our job well and make the most money, we can't spend time looking things up.  We have to KNOW it.  We have to know anatomy and physiology, disease pathology, pharmacology, procedures, maneuvers, signs, surgical equipment, the world of nuclear medicine, etc.  not to mention knowing how to make the best use of our computer's software, and the Internet, and tricks of the trade with our platforms, and skills with the English language such that we can edit where necessary all the while following account specifics which change depending on which account you are on.   Yee gads, it's amazing what we do!   If this weren't the case, why would the companies be so insistent on wanting people with years and years of experience?  They don't want errors and they want high production from us.  That's why newbies have such a hard time finding employment -- they don't know enough yet.  It takes years, as you all know, to incorporate the booklearning with excellence in the job performance.   It all has to come together and this takes time and effort on our part and the end result (our pay) should be worth the effort just like with any other job. 


I, too, disagree.
I feel obligated to use my expert grammatical and punctuation skills to make my work look professional. Typing verbatim makes the following look bad: the dictator, my company, and me! Of course, we would never change the meaning of the sentence - goes without saying. I have a problem with making everyone look dumb, though.
I disagree, as well..sm
medical transcription is SO different from anything you described, such as court reporter or closed captioning writer. When I was in MT school, we were TAUGHT to make the doctors dictations more correct with respect to grammer, punctuation, spelling, etc. This verbatim junk just came out recently as a way of cutting lines for the Transcriptionist and is sooo wrong. but as the other poster stated, we can all disagree and each to their own opinions.
some will disagree...but SM
many companies will offer their top quality MTs an abundance of work on a continual basis, but often offer less work for the less talented MT. I'm not saying one is harder working than the other, but as a previous MTSO, it does not take long to figure out which MTs will produce the quality work that requires little to no editing, making the service operate overall more efficiently. I will be the first to admit when I operated a small service of 5-10 MTs over ten years ago, the top quality producers (not quantity) received more work than the less skilled. Both had the proper education and training, some are just naturally better MTs than others. I would imagine this is how many large companies operate (not saying all). So when you don't have adequate work and you feel you are a top-notch MT, either move on. On the other hand, consider your work and don't always be quick to blame the company you work for.
I disagree with you
I have a great background with ESLs but seems like I got a good bit of them. I couldn't make a decent line count with short reports and these dictators. Sadly this happens everywhere especially where work is farmed out from the hospital. Do you think they are gonna assign you the butter reports. Heck no, they assign out the ones they cannot do or don't want to do. Its no different anywhere else. If you wanna survive in this business these days you have to learn to do these and then find a place that pays you what you want and has the right balance of reports to add up to the check you want.
Disagree. sm
Well, I just don't know about you guys.  The level-1 acute care center I work for is up and running 24/7.  Hope no one I care about is at your facility on the weekends, waiting for discharge , consult ,  transfer, surgery, whatever.   P.S.  Been chugging along here 20 years, not a prima donna.
I disagree. RC starts at 5 cents a line. MedEDocs starts at 7.5. BIG difference.
I disagree
The company should mail the paperwork to the employee and provide an overnight or 2 day prepaid means for the employee to return the paperwork. Some people cannot afford to pay $25 for a fax machine. BTW, the cheapest I've seen is $50.

I feel that an employee should NEVER have to spend a dime in order to obtain a job.

If you interviewed at a local hospital for an inhouse job and they asked you to do something that required you to spend $50 before you could take the job, what would your response be???? This situation is no different.

It is not a matter of complaining, it is a matter of not being able to afford to purchase a fax or pay $25 to have papers faxed back to an employer. There are plenty of companies who overnight the paperwork and provide a means for the employee to overnight it back. I have worked for 3 such companies.

To the person who stated that if you work from home, you should have a fax machine: These people are MTs. It should not be assumed by an employer that all MTs have fax machines at home as a fax is not pertinent to their jobs.
Sorry would disagree there - sm
I'd always choose working for a smaller company over a larger one. But it's harder to find them these days.

I think with offshoring being as prevalent as it is even with the McTranscription companies, it's getting increasingly difficult for small companies to compete at all for anything but clinic work, and even that's getting harder because small companies might not be able to handle the McDoctors megagroups that are everywhere these days.

And as far as smaller ones becoming larger ones, I don't believe it happens; the playing field simply changes beyond a certain growth level with the technology and staffing requirements of larger groups. I've seen that happen several times. And then the successful smaller company is often approached by another one, maybe a little larger, and a purchase comes about, and, well, the smaller company is no more, really.
I disagree . . .
with all due respect. I know for a fact that many, many doctors outsource willing to India. In fact, many here in Ventura County, California, encourage it and recommend it to their peers. We are way past the period of getting attention from the doctors. They don't care. If it means cheaper labor, so be it, for them. Where the power lies is within the people. If the public were to strongly voice their objection, write their congressmen, the AMA,consumer rights,legislation, then perhaps there would be some attention paid. Unfortunately, inertia has a hold of the public now. People do not speak up loud and clear and voice their opinions and objects to the powers that be. America has fallen into complacency. People are too busy and stressed out to find the time to protest and spend on advocacy.
Not really...have to disagree with you
It is an odd spelling, easily made a typo,or maybe just so excited to say what she thought was the best co. to work for accidentally misspelled.  There are many possibilities here.  Don't know why you made a big deal over it though.  Have to agree with the other posters, basically someone touched a nerve with you.  You are the only complainer.  Now that is very odd.  My hand is down, sorry annabanana, don't agree with you.  She's happy.  Obviously your not!!!
I disagree
I just tested in the past couple of weeks. My experience was different. I was given 48 hours to test. All testing materials were accessed via a website. No tests were emailed to me. The grammar and medical portions are timed and taken via the website. You only get one shot at these tests. The transcription portion of the test is also accessed via the website. You are emailed a password to access the site. It is stressed in that email that you must complete testing in 48 hours. You do not have to do it all at once, as long as you complete within 48 hours. Good luck!
I disagree.
I have only been working in this field for just under 1 year (graduated last January and started working FT in April). I easily make $15-18 an hour. I have even made over $20 an hour on a few good days. I am not glued to my chair for a straight 8-10 hours. I do take bathroom breaks and eat lunch, but when I am working, I am only working. I treat this as I would a brick & mortar job. When I am working I do not surf the net, answer the phone, or chat with the family. I also look for ways to increase my productivity every day. I have taken the time to create templates for each of my docs for each type of report they dictate. I have spent a lot of time adding to my expander. My Expander has increased my productivity by at least 50%. This has been time-consuming, but these things have helped tremendously. I am still consistently seeing my line counts go up each month. There is money to be made as an MT. I am sorry that for whatever reason it is not working out for you.
I disagree. sm
very flexible, great pay, user friendly platform, plenty of work, acct specs are a bit much but that is being addressed, no slow issues any longer, wonderful benefits, best boss (mine anyway). Perhaps the other poster was not happy at Webmedx but I am. I have been here since 2003 and am not going anywhere. They really value their people. No off shoring either.
If the industry stepped up and brought some professionalism, mature management, ethical pay structure might be nice, etc etc etc, the offshore thing would be appealing, but IMO the industry has a very low self esteem and has a hx of being a doormat rather than a leader.
Disagree.. What he needs to know is only..sm

IF she can accept to job under his terms (salary, schedule, etc.) and she can start work.  It's not his business if she has given a 2-week, a 1-week, or 1-day notice or given any notice at all.  Employers in ANY field do not routinely ask such a question (unless they want to make sure they'll be the only game in town.)  They'll almost always ask you when you can start, and the decision to give the old company 2-weeks' notice is up to you; if you've been treated right, 2-week notice is fair, if treated badly, no notice would not both my conscience. The other poster is right, given the horrible way MTSOs exploit MTs, keep you old job until you know the new one works out.  They have left us in such a financial bind, for the most part, that most of us cannot affort the luxury of quitting, job-hunt, and then wait weeks to get paid.  

Disagree 100%.
No one makes you work under these conditions. No one makes you work in this industry.

It is 100% voluntary. It is 100% based on your direct choice.

Who gives a rip how men see female MTs? What in the world does that have to do with anything?

There is no exploitation of women at all because women are not a helpless group. They make their own choices.

CHILDREN -- Now CHILDREN can be exploited because they cannot make choices for themselves and cannot have control of their own little lives. The ELDERLY, the DISABLED - these groups can be exploited.

I have to DISAGREE
I am a QA and work for a small company of about 75 MTs.  The MTs that I work with are wonderful.  They are very kind and receptive to any QA feedback.  They are also very appreciative.  I personally enjoy my job and have great satisfaction in knowing I am able to help someone.  I am blessed to work at such a great company.  Yes, I do work on production but the focus is on quality, so I just commit to doing my job to the best of my ability.  So...there are good QA jobs out there, just keep looking. HAPPY NEW YEAR!
Just disagree with you
There are unions here, does everyone have to belong? Nope. If I work as independent, 9-5 and make 5 cents a line- does that play into your job? If I work restricted hours and have so much line count a day- does this mean all people are going to have to become employees. I donít think your reasoning above means much of anything. Just tells me what the employers are NOT supposed to do, speaks nothing of my job as compared to yours. So surprising how others worry so much about how a person does their job.
I disagree with you.
Most of the companies who pay QA by the line also expect you to provide feedback to their MTs. Providing feedback can be very time consuming. While you spend time typing up emails with feedback, you are not being paid for that time.

I would take an hourly job any day before I will accept a by the line QA position..especially at the 3.5 to 4 cpl rate that most companies pay. If a company wants to pay me .05 cents per line, then I would consider it. Otherwise, no way.

Also, if a company who pays by the line does not require feedback be sent to the MTs, then I would also consider it.
I disagree
I think the MTSO should tell the MT if the account is no longer with the company. They don't have to tell any gory details, but she does deserve to be informed.

I think the MTSOs often like that MTs are isolated from each other and from management. It's easier to get people to put up with baloney that way, because no one knows for sure what is going on.

I think a good company should want to keep everyone informed, and I think things would ultimately run better that way (even when giving out negative news).
I disagree...sm
A nasty QA person can certainly drive away even a good MT by just being inconsequent and irritating.
It is known that QAs deem themselves as 'know it alls', even when they are wrong and whould never admit to make a mistake.
I disagree.

but carry the same terminology.  Even a neurologist will comment on an orthopedic issue or a hematology issue in a consult (clinic), so I don't think you're accurate there.

Acute care should pay more based solely on the fact that you can get numerous dictators, but the specialty terminology is the same from a medical perspective. 

With 20 years in this field, it can be done.  I had radiology experience (6 years), jumped right in to doing card caths, pacer inserts, and cholecystectomies.  So, don't go there, okay?  Don't want to be unkind, but the terminology is all the same.

Having radiology experience will prepare you for clinic work, but acute care, trauma, of course depends on the facility. I do acute care and it's a LOT more difficult than clinic notes and more difficult terminology. Have 37 years experience backing me up. Get paid more for doing ESLs & acute care, OPs, etc.
I disagree.
I've been doing this 28 years and I find the ESL has been less over the years. The second or third generations are becoming doctors. I have the foreign-sounding names but they are American accents. I think things have gotten easier.

Again, the doctors are bringing in the money. No one is going to tell them to clean up their act.

We go through this every other week on this board about the dictators. It's just the way it is. Need to get over it and go on to something else.