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Can some explain the grammar rule for comma use in --sm

Posted By: Debra on 2008-03-24
In Reply to:

in the following sentences?

1.  Stable, broad-based posterior disc bulge effacing the ventral aspect of the thecal sac with resultant mild to moderate bilateral neural foraminal narrowing.  Stable associated mild facet arthropathy.  --comma after small

2.  This is felt to most likely represent nonspecific demyelination, and multiple sclerosis cannot be excluded.  --comma after and

Was counted off for these by QA as 'necessary commas' but do not know why.

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....if you will. It's the rule book of grammar, file set up, etc. that many places
Replace semicolon with comma, remove comma
I say no comma...sm
I seem to recall learning that no comma was necessary when the 2 adjectives described different things. Since pleasant describes her personality and elderly describes general age, no comma necessary. If it said "A pleasant, jovial lady" then you'd use the commas since both describe personality. I think it's easiest to do as someone said above and ask yourself if you would or could put an "and" between them, or if you feel a pause is necessary in the sentence to separate thoughts. Although you possibly could put an "and" there, most people wouldn't say "pleasant and elderly" and I don't feel a pause is warranted there, so I think it's fine without it.
In #2, it's because "multiple slcerosis cannot be exluded" is a whole sentence. Not sure about the first one.
comma before which?
Could someone please clarify for me when I need to use a comma before which? I looked it up in BOS but I need someone to explain it to me in plain English. Also, does anyone know if there is a feature in AutoCorrect to change 1 space between sentences into 2? TIA!
no comma after domed,
WAS and Dr. Smith's, (comma)
just my 2 cents, but I think it's right.
comma usage
QA is correct; the commas do belong there, and it would be wrong to omit them. The first comma is a series of adjectives; the other comma is to separate two conjoined sentences.
I would put a comma but definitely not a semicolon.

Omit comma in your example.

Response to comma
Bless you. .I thought I was missing a "mandatory" BOS style change or something.  Thank you so much!!!
do you have a comma key on your keyboard?......nm
I agree - comma if it's informal nd first name is used
and colon if they use the last name. (Dear Dr. Martin: or Dear John,). That's what I've always been told.
a comma doesn't belong there!
im glad you haven't done it after!!! :)
My best one says inverted comma for quotation marks.
very bad syntax and is your keyboard missing the comma key?...m
when to put a comma before 'which', in plain English... ...
Some nonessential clauses begin with who, whom, which or that and include a verb.
Put a comma before those.

Example: The house, which is a very old house, is situated on 45-92 Grand Street.

Consider the commas as 'hooks.' The clause 'which is a very old house' could be 'unhooked' and dropped out of the sentence because it is not necessary to identify where the house is situated. It is merely extra information and not essential to the basic meaning of the sentence.

In all other cases do NOT put a comma.
Acc to my experience there are more cases that do NOT require a comma before 'which.' Also, the trend nowadays is to minimize the usage of commas and hyphens.

when to put a comma before 'which', in plain English... ...
Some nonessential clauses begin with who, whom, which or that and include a verb.
Put a comma before those.

Example: The house, which is a very old house, is situated on 45-92 Grand Street.

Consider the commas as 'hooks.' The clause 'which is a very old house' could be 'unhooked' and dropped out of the sentence because it is not necessary to identify where the house is situated. It is merely extra information and not essential to the basic meaning of the sentence.

In all other cases do NOT put a comma.
Acc to my experience there are more cases that do NOT require a comma before 'which.' Also, the trend nowadays is to minimize the usage of commas and hyphens.

I'd lose the comma after the male and replace with "who is".
Otherwise, the sentence is fragmented.  Do you have carte blanche to edit for clarity and style purposes?
I feel left out! Nobody picked on my errant comma that shoulda been a semi colon.
What a win-win situation!

I wish the animal shelters took better care of our pets (since they are a part of the government and all). I don't know why those shelters smell so bad; the shelter in my county stinks so bad that you are constantly aware of it. Taking care of displaced or hurt animals should be a big part of their job, and they could take measures to ensure the animals don't get sick. I understand all about their being overworked, but then someone should report to the higher ups what is needed, and then there should be no problem meeting those needs.

In a neighboring county where I live, the public went toe-to-toe with the director over the animal division; demanding answers about the operations and procedures. (That director said he needed a new building, but the public thought the changes should be made in their operations and procedures.

When I want a dog, I always adopt (so far over the years I've adopted 2 beagles).

Nice post!
First rule of being an MT

That's what I was taught.  Everyone is in the same boat and has to take the bad with the good.  Refusing to do the hard stuff makes it worse for the other MTs on that account, and they will not appreciate it.  Until the problem doctors go poof and disappear, nobody has the right to say they can shove all the bad jobs onto the next MT because THEY are here to make money (everyone is, and someone has to type it).  And there is such a thing as Karma - one day you might log on to find ALL the work is the dictator you dread, because all the MTs that came on before you felt entitled to leave the crap work for YOU.  You really won't make any money on that shift, as opposed to doing a few bad jobs each shift.  So type them as you get them, like the rest of us. 

If everyone got together and went to management about the problem guy, that's one thing (and yes, we all feel this way about at least one doctor).  Deciding you don't have to do it because you don't want to is quite another, and often grounds for disciplinary action.  Work is often just that, hard work, and with time and practice it becomes easier.  Nobody promised you a rose garden, challenges are what this job entails.

MY first rule, before being MT. is I have to
The first rule of being self-employed is that

you set your own line rate.  However, we all know that NONE of the MTSOs hiring IC MTs allow us to set our own rate.  They "offer" a rate, and we accept if it's OK.

I worked for a real cheapo doctor when I first started out.  He paid hourly and kept riding my backside to type faster because he only wanted to pay for the actual time dictated instead of the time it took to transcribe.  More than once I told him that it takes an average of 3:1 typing to talking ratio to get it done.  It worked out to be $.03 per line.  I dropped him like a bad habit.  He bounced through a few other transcriptionists who all quit on him before he wound up having to pay to outsource to a service.

as a general rule...

I use an "f" after any abbreviation that I want to expand.  I just use the standard abbreviation plus f, so I do not forget what they are.  My ShortHand is full of things like this.

ex: cbcf  tcpf  tshf

Works for me!


date rule
Thanks. My mind just blanked and I couldn't remember. It seems like it has changed so often over the years!
I have been an MT for 33 years and the rule has always been...sm
to use mg when preceeded by a number.
and there are so many exceptions to all those rule! lol
that's the english language for ya! I really don't know.
My rule for semicolons
is that if the two statements support each other and each statement could be a separate sentence, I use a semicolon. Example: He underwent an ultrasound in March 1999; AT THAT time he was noted to have BPH. The sentence you asked about should be done like 'NM'says: He underwent an ultrasound in March 1999, at which time he was noted to have BPH.
Thought that was already a rule
Hmm...I thought that that was already in effect, that no US Govt transcription contracts could go overseas/be outsourced - at least the V.A. has that standard in place...
I was always told as a general rule
it was double.  Most of the time, however, I think it is slightly over that.
Rule Books and AAMT
AAMT sure brought this profession to the forefront. However, when they started publishing their own Bible (BOS) there are a lot of grammatical errors in there. Also, the styles they use are not accepted in this part of the country and will be considered "errors" by the client, hospital or clinician who do not want their reports set up in this manner. It is wrong to test people on a style that is not accepted in their part of the country. You are only forcing people to learn a "new style" which the facility in your area will consider completely wrong. Then the private company will comply with that particular hospital and change the set-up. Sadly, the person who took the test and did not use the BOS has a lousy score and is not considered for the job although s/he meets the set-up criteria for hospitals in the area where they live. Go figure, spend all that money for the book, or just test and get 100 per cent and then study the style of the facility who is paying for the work and then be 100 per cent right. Don't judge all tests by style, wait and see what the hospital is paying you wants for the style. You are putting the cart before the horse. Been in long enough to know that the BOS is absolutely not the "Bible" and the testing companies should take this into consideration. You could study this book until you're blind and then have to "unlearn" it to comply with the paying $$$ facility who is the ultimate "boss" of how the work will be turned in and accepted. Kabish? If I turn in a discharge summary in my local hospital according to the BOS style, I would be considered a total idiot. If I used the local hospital style for testing nationally, I would probably rate a 65% on what the hospital would consider 100% correct for style and grammar. Can't win.
It's the AAMT new BOS rule on numbers.
you two are the exception to the mommy rule(sm)
Most MT mommies got into this business solely for the purpose of staying at home and making a little extra cash on the side.  They try to juggle the kids and MT and the diaper changes always come before that STAT report.  And, yeah, I know what I'm talking about because I used to work in the hospital and that was always the way with the at-home mommy MTs.  There was always an excuse as to why they couldn't do this or couldn't do that.
Well, my husband and I rule the menu here.
We're sure not going to let the kids do it, otherwise it would be pizza, tacos, and hot dogs daily and everyone would keel over from clogged arteries at the age of 30!  Beside, like Kikki said, it's not good to let the kids call the shots.  That's why the good Lord made parents! 
No one said the kids should rule the menu
But if you love your kids then you understand that they are people too, with their own tastebuds. Just because they might have a suggestion doesn't automatically make it JUNK. Just different.

Trust me, my kids know who the boss is. Geez!!!!!
My rule of thumb is a $100 minimum
Of course, closer relatives and friends receive more, but always at least $100 for graduations, wedding gifts, etc. when someone is an acquaintance.
General rule is 3-5% a year. sm
If you currently get 8 cpl, ask for a raise up to 8.25 or 8.5 cpl, that almost covers cost of living and inflation.

Generic numbers here to show the math based on the 8 cpl with the raises:
200 lph at 8.00 cpl = $16 hourly/$33,280 yearly
200 lph at 8.25 cpl = $16.50 hourly/$34,320 yearly
200 lph at 8.50 cpl = $17.00 hourly/$35,360 yearly

When you ask for a raise, provide them with verifiable data to prove you DESERVE a raise. Say you are 99% accurate, remind them. If you type 250 lph or more, remind them. If you work OT on days off, remind them. If you come at them with your homework done and good reason to give you more, they will be more apt to say yes. (I have never been turned down for a raise, once even got more than I actually was looking for because I didn't specify how much of a raise I was wanting.)

Please cite the HIPAA rule. Thanks
The HIPAA Privacy Rule...(sm)

...requires a covered entity to make "reasonable efforts to limit use, disclosure of, and requests for PHI to the minimum necessary to accomplish the intended purpose."  The only AHA-approved HIPAA training program, HIPAA Academy, specifically states in its training materials that HIPAA intends that personal information be limited to document headers unless absolutely required   I will quote page 4-56:

"In practice, we expect the minimum-necessary requirement to lead to compartmentalization of the medical record so that one portion of the record (the body of the report) may be readily disclosed for one purpose without compromising the privacy of the entire record."

By limiting PHI to headers, reports can easily be redacted of personal information; when the PHI is scattered throughout the reports, this information cannot be redacted.


First rule of computers: Whenever anything goes wrong...


That will take care of about 95% of problems.

If you have two identical toolbars, then you may need to go to View, then Toolbars, and then Customize (way down at the bottom of the list). On the Toolbars tab, see what is checked.

If both Standard and Formatting are checked, this is where you may have your duplicate. Try unchecking either one of those and see if that puts your toolbar back the way you want it.

If that doesn't work, come back and we'll try again!

My company has a 2-minute rule
We are supposed to spend around 2 minutes looking for something.  If we can't find anything, we blank it; my boss says that's what they pay their QA for.
I like your company...good rule/sm
Some places make you feel like if you don't search and search then you are inadequate. But I don't get paid to research, I get paid to type. I will research a reasonable amount of time and that is it.
HIPAA Privacy Rule
Guide for HIPAA PRivacy Rule
Covers for Stedman's books are designed by the graphic artist who works with them.
OLD typing rule I have in my head, whether it is accurate I do not know, hence I said IF---nm
You are the exception, not the rule, when it comes to kids w/o fathers.
My family now has a hard and fast rule... (lm)
Nobody who is incapacitated/confused/at all unaware is EVER alone in the hospital.

Family comes from all over if we have to, but that's what you do. Family takes care of each other no matter the inconvenience, and having good friends, good neighbors, and a good church helps, too.

We learned that after my father suffered a head injury and was confused and combative and kept trying to get out of his bed, pull out his IV, etc. Someone from the family was with him most all of the time. Family only left when someone from the church or a friend or a neighbor came to stay. (The church had people sign up to come stay with him so that we could get a break, and neighbors would just show up and say "go get something to eat. NOW! ". God bless them all...)

Thank God, my father made an almost complete recovery. He has some personality changes and hearing loss, but nothing we all can't handle. I would NEVER leave a loved one alone in the hospital unless they were FULLY alert and oriented.
Rule of thumb - THERE'S NO FREE LUNCH
If you don't want to do much, don't expect to make much. That's just the way it is.
Rule of thumb in the NE is October & April when

the time changes. Daylight Savings starts in April and Standard Time in October. It always works for me. Change all the clocks and change all the batteries.

For those who haven't done so yet, though, better get changing.

Personally, I like the new rule. I think it looks terrible to type

The patient has had intermittent diarrhea for four to five days.

Instead of:

The patient has had intermittent diarrhea for 4-5 days. Do much easier to 'quickly read' the number of days as 4-5.