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Do you recommend starting with clinic notes or acute care when just starting in the MT field?

Posted By: curious on 2005-12-02
In Reply to:

!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!

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Both their acute care and clinic starting offers are more than that.
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
I work for a major national and starting rate is no where near 9 cpl for acute care. (nm)
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.
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
I spoke with recruiter 3-4 wks ago and was told mixed acute care & clinic, no ops exclusively. Low
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...
I got 10 for 10 yrs exp and just starting with them
Could you have misunderstood maybe?
Thanks !!! I was starting to wonder....
and just this morning, I got an email about a new dictator for my account..
Starting soon
I'm starting there soon. Just wondered as I have noticed it down this week. Thanks.
Starting soon.
From what they explained to me, it is quality and affordable, Blue Cross Blue Shield.
Starting out definitely no more than in the SM
mid 20s and that's if you are typing all the time.  I have been doing this for 15 years and yes, I use expanders, etc. but I have never made more than $37,000 gross in any year (and some of my jobs were hourly PLUS incentive).  My income has declined every year since 2000--the Social Security yearly statement attests to that.
Anyone starting with CIT? Do we know who they are? nm
If you are first starting out...
and need really good experience, Medquist is a good starting point. MedQuist is not the company for you if you want to make over 25K a year.
Maybe it is D&L starting over!!
Do you know when it will be starting?
all starting to come together now...
Good news; I've got my software installed, a primary and a secondary account assigned and am fixing to start training. When it started to pull together, it has happened fast. So far, so good.
starting over - help
never thought i would come back to full-time MT - spent the last 10 years raising my daughter and working part-time in various places that we have lived. My husband is in construction, and we just aren't making it any more. The only thing i know how to do is transcribe, so I am looking to come back.

I quit in 1998 - i worked for ddi for 7 years - after Rick Cammeron sold the company to MQ, it got awful, so i stopped. I really don't want to work for MQ again (they were really nasty to us). I did everything for ddi - lots of ops and consults, and cardiology (for Good Sam in LA - great account)

What are my options? who are the best companies to work for? what about speech recognition - can you make any money at it? I have heard some people say they can't make anything becasue they are getting 20% taken off their line rates -others say that they are making money at 50% off.

I don't know anything about the recognition stuff - can someone help me? I am interested because i might not have to type as much - i am willing and able to work hard, but when i quit, my hands were bothering me a lot - i have been transcribing part-time for doctors with no trouble - but only for a few hours a day - don't know that i could handle 8+ hours a day.

I have so many questions. At ddi, we were all independent contractors - i liked that, but then we didn't need insurance. seems like a lot of companies offer employment with insurance. what do they pay? i have heard from a lot of people that the pay is less than 10 years ago. how could that be? don't these companies know that everything costs more?

anyway, any advice would be SO helpful. I have to do this, we are running out of money, and i don't want to get s.....ed by some awful company that promises everything and you end up with all ESL and no work.

thanks everybody.
I will be starting 7/1
Have you started yet? Let me know how it goes. I've been out of the MT field for almost five years. I'm going to start practicing my old dictation tapes to get back in the swing of things. I hope everything works out and I like it. :)
Starting Over, thanks!

I've got about the same amount of experience as you have.  I know what you mean about working at home and trying to take care of yourself, too, sometimes hard to balance everything, but for right now, even though I miss the social aspects at times, think this is what I still need for right now.  Just need to a 'little'  more exercise time somewhere, or in other words make it a priority!! to fit it in.  Thanks for the encouragement!  Good luck to you

just starting
with MDI and am really looking forward to it...just being able to talk with someone who is on planet earth was soooo refereshing! i guess we have to be able to weed out the crap when listening to others...i'm happily heading in!
They are getting it, starting 6/1. sm
I called and asked after I saw this. The papers are being signed today and a letter going out.
Their pay is not low. For a while, they were starting sm
everyone at 8 cpl for 90 days to see if it works out for both people. As a Lead MT for them, I see a lot of people who test well and have great resumes but either do not do what they are scheduled to do, have incredibly low volume or horrible quality. This way, it is an evaluation period for both sides.

I do know that they will start higher than that and have been thinking of a few other ideas for that evaluation period.

One thing that I find funny is that for a while, there was a $300 sign-on bonus and a few other things in place related to volume and quality that would give more, but not many people bothered to do the math and see that if they can produce 1200 lines a day with good quality, it came out to 0.09-0.10 per line for that period and beyond.

I have been with them for 5 years this June. I have never made less than $45,000 in a year and that was only one year when I took time off for surgery and my daughter's wedding; the other years I have made over $55,000.

More important is that 0.08 per line with a lot of work is better than 0.10 with nothing available. JMO.

Will someone please let me know the starting pay
for Voice Systems, LLC?  Also, if anyone has any current information on the company, such as pay on time, direct deposit, ESLs, platform and anything else you can share, please do.  Thanks!
9 cents for clinic notes
Oh, sure, 260 lines just starting on DQS.