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

Posted By: about Rad. nm on 2005-08-24
In Reply to: Do they have Radiology? - nm


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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. 


I spoke with recruiter 3-4 wks ago and was told mixed acute care & clinic, no ops exclusively. Low
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!
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.

Pay for acute care versus ER/progress notes

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.

Was that for acute care or clinic? nm
Are they looking for Acute Care or Clinic?

There are a few posts already about Axolotl if you want to do a search.  A lot of negative lately.  Clinic work is not bad but the pay is average.  Acute Care is terrible.  90% ESL on some accounts and every account has conflicting Account Specifics so you really have to pay attention to which account you are on. (for example, if the dictator says 50 cc - you type on one account 50 cc, but on another 50 mL), and QA will nail you on that if you do it wrong.   Work comes in by TAT, so you may switch every other job between 2 or 3 accounts all day or get a string of the same horrible ESL dictator in a row.  No flexibility.  They are a small company with only enough MTs to cover incoming jobs.  You tell them what hours you are going to work and you have to be there at that specific time.  Really depends on what you are looking for in a new job.  Ask lots of questions.  Let us know how it goes. 

Clinic should pay 8 cpl and acute care 9 cpl
Clinic notes can be just as difficult as acute care.  You can run up against difficult dictators and varying templates.  Acute care reports can be longer, but not anymore difficult especially if you know the specialty.  I say 7 cpl for clinic is way too low.  Acute care should pay more in that you will most likely have a variety of dictators and specialties whereas with clinic you tend to get the same dictators and shorter reports, but not always.    JMO. 
Acute care or clinic? - nm
Clinic and some acute care
I work on clinic, but I also work in acute care too.  The work is not an over abundance, but it's enough to keep me going.  I hate to hear you are having such problems.  At my last job I had a humdinger of an account and just could not make my lines.  It's so frustrating, but hang in there.  Maybe things will change soon. 
both acute care and clinic
-- not sure about ER. No benefits, not quite an IC, actually SE (statutory) status/no benefits. They have a couple systems in place, my work is done over the I/N; some positions require unlimited LD.
They have acute care, ER and multispecialty clinic,
225+ acute care 300+ clinic - I avg'd almost 400/hr this week - sm
It is easier to get more on clinics because your expansions can be much more specific than on acute care. I have over 40,000 entries now, so most things I don't have to type straight. If you have specific questions, feel free to email
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.
Does MDI-MD have clinic accounts or only acute care? nm
is that clinic work or acute care if I may ask?
I prefer acute care and am really not interested in clinic but was told I have to do it
Acute care is quite a bit harder than clinic.
Definitely. Never a good idea to lie. You won't find anyone at most big companies to ask beginner questions to, on ops or otherwise.
Also acute care here and maybe the clinic people
should have learned how to branch out to acute rather than losing jobs to EMR if that is the case.
Can you give us the name of the company and if it's clinic or acute care? Thx. nm
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.

Acute care and clinic work are two completely different
things. Anyone can switch from acute care to clinic, but if all you've done are a few clinics, then you only have experience in a few specialties & acute care requires experience in ALL specialties. Big difference.
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.
Both their acute care and clinic starting offers are more than that.
Are there companies out there that have clinic work? Tired of acute care..
I have both hospital and clinic experience, but I am tired of working for large hospitals where you cannot get familiar with the accounts or the dictators.  I work part-time for an orthopedic surgeon and I love doing it as I can breeze through it because I have learned his style, voice etc.. It is getting so frustrating every day doing different doctors who either cannot speak English or choose to speed talk and ramble on so fast.  Do they think we are miracle workers?? I guess you could say I want an easy account, which by now, I have figured out, does not exist OR does it?? HELP.. any ideas besides getting out of this profession
It depends if clinic or acute care, years of experience, can you do
ESLs.   They pay about the same as most companies. 
Clinic or acute care? I am looking to work 5-6 hours a day during the morning and early SM
afternoon hours.  Which type of work is more appropriate for this kind of schedule, clinic or acute care? I really do have some time constraints outside of these hours as well as on weekends, so I need to find something where I can concentrate on working during those daytime hours.  I am a newer Transcriptionist (at this point looking for IC), and I am hoping to find a place to stay for a long time.   Any advice appreciated.   Thanks
How are the MW accts that use the ExText? Good sound? Lots of work? Acute care or clinic? Thx. nm
9 cpl as an IC doing clinic notes vs. 8 cpl is
still quite a bit of difference, especially 8 cpl as an IC at Softscript...
9 cents for clinic notes
Clinic notes 6.65 then 7 when off proofing within 90 days
It was supposed to be 7.5 cents if off proofing within 30 days, but they never did a QA assessment, so got 7 cents after calling and asking for an assessment.
Yes clinic notes go to Cameo India
I have very few applicants who can even do easy clinic notes,
Hiring is can be a total nightmare.
Also the Clinic work SOAP notes
Clinic notes. SOAP is the format,





Clinic notes or physical therapy?


Does anyone have suggestions for companies that hire for physical therapy or just general transcription/clinic work?  I've tested at several companies and did not score high enough apparently to do acute care, even though I did not leave so many blanks, I thought.  My problem was with the actual transcription; passed the other part of tests.  Really discouraged right now.  TIA--


ExCUUSSE me... she said 7.5cpl for clinic notes,
NOT op-notes. Most places consider clinic notes easier and pay less for them. So if that is the case, the op-notes SHOULD pay more at that job.
Clinic notes very rarely delve into
specifics like acute care does. There is a difference.
Anyone recently with Axolotl? How difficult is Lotus Notes to use? nm
i would definitely start out with clinic notes first to get a good base.
You need to try to get as much learning as you can in an unrushed way. When you do acute care notes, you are having all medical specialties pushed on you all at once.
are clinic notes productive... 2 and 3 line reports?
Can you turn them around pretty fast or do they slow you down?
I went from clinic to acute

I worked for about 10 years as an IC for clinc work, then lost my account (like you).  I got a job in house at my local hospital and also applied with a national for PT work at home with a teaching hospital.  Things were slow going at first, having to look a lot of things up, etc.  I left the in house job after a couple years to be at home full time again.  Being in house helped a lot because of having the other girls to help and I also learned the ins and outs of HIM dept.  Poster below is correct about teaching hospitals being difficult.  But if you are going to learn acute, you have to do them.  I find the work very interesting.  I now work at home as a full time employee for a teaching hospital and couldn't be happier.

See what companies will test you for acute care even though you don't have experience.  I passed my test by a national.  The test took me a while, looking things up, etc, but it was worth it.  Just remember things will be slow for a while.  I only did about 150 lines an hour in the beginning (now I am at 300+).        


clinic is not like ER, pays less than acute, you may have a few ESL in any clinic company, and is different from acute in that you have all different specialties who have different word lists, from ENT to dermatology to pediatrics, etc., and once you learn them, make macros or normals, you can make more LPH.
Clinic or acute?
Do any of you happen to work on the clinic side? Just wondering. Thanks.
they have mostly acute but some clinic
clinic or acute
The ad says that they are looking for acute cardiology. I am thinking this is a hospital account. I could be wrong. It does not specifically state clinic though.
is this acute or clinic work? nm

100+ clinic and 50+ acute - really depends on
pay depends on if you are acute or clinic...
I was told acute care starts at 8, but clinic is less than 8 cents, but that is normal just about everywhere.