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Doctors don't care what's in BOS

Posted By: the client writes the check! on 2009-03-28
In Reply to: long time MTs opinion on BOS sm - MT 30+ years and running

I agree, its crap.


And I'm willing to bet the price of the latest version of the Book of Shite that not a single client has even heard of it or gives a fig what's in it.  Most clients have a pretty good idea of how they want their reports to look, and will insist on it no matter what the supposed industry standard is.




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Some doctors simply do not care.....sm
I was talking to my mother's surgeon at one of her checkups about outsourcing, and he said their hospital outsources all the x-rays to Australia, because while we sleep, they are transcribing, and the work is back the next day for them. He just smirked and could care less this is taking jobs away from us. As long as it isn't taking his job, it means nothing to him. He's attitude really sickened me.
Maybe doctors don't, but most acute care facilities do.
x
I think doctors in general just don't care about their dictations... sm

I know there are some who are really great and are careful or even just considerate.  But I think for the most part they just think it's a pain to do and want to rush through it and get it done... let the lowly MT deal with whatever garbage comes out the other end.  Maybe I'm a bit bitter, but at this point that's how it feels.


 


Disclaimer: No need to critique spelling, grammar, or punctuation within my posting... this isn't work, it's a message board.


The changes are in the medical care area. Doctors want to make
They are cutting costs where ever they can. It makes sense to cut costs. But, human error can occur in a place where lawsuits are allowed. I think we will be a safety net for awhile, until a cap is placed on the amount of awards, anyway. I do EMR also. But, they still do dictation a little bit just so they remember who the patient is and can keep the referring physicians well informed.

I just got an account that I under bidded on. My competition one of the nationls (states with an S) but they wanted the work done close to home. Radiology.
Kinship care versus foster care/adoption
Having been placed in a position where I now have custody of my 3 YO granddaughter and going through the legal system, I sought an online network of relative caregivers for children. I would encourage you, especially since you are in Georgia, that if you take any children into foster care with the idea of adopting them, there is federal law that requires the state to take certain actions in a specific time frame. When a child is removed from it's bio parent(s), the state is required to investigate any possible relatives who can take the child before foster care is considered, but even before that, reunification with the parents is the priority. Once a child enters the system and is in the system for 15 out of any 22 months, the state is required to find permanent placement for the child.

The problem with this is that there are case workers who may favor a foster family and do not seek out relative care. I have a good friend in Georgia who had to fight all the way to the state level to get custody of her grandson after the child was placed from the hospital into a foster care home with the promise that the foster parents would be allowed to adopt. She has now adopted her grandson, but it was a long, hard battle to get the state to admit their own interests were placed above those of the child and/or family.

If you get a child placed through the state, please make certain there is not a relative who wants that child before you get your hopes up. The courts are now favoring return of children to relatives even after a child has spent years with a foster family who hoped to adopt them.

States get bonus federal funds by complying with the time lines and being able to close the case, so some states place children in foster care because it is easier than trying to locate relatives.

Didn't mean to go off on a tangent, but I can't imagine my sweet bella going to someone outside her family.
If it was a clinic, it might have been urgent care, but it was NOT acute care. sm
Acute care refers to work in an acute care setting, a hospital, doing at least History and Physicals, Discharge Summaries, Consultations, Surgery notes, Emergency Department notes, and much more, including GI procedures, Cardiology procedures, Neurological procedures, Pulmonary Function Studies.  It goes on and on and it means and acute care hospital setting, not a clinic.
I always figure if they don't care about their dictation, they probably don't care about their
nm
Dont care how many languages you took. Care
x
oh, so if I don't care about my job, I "should" care
you come off as narcissistic.
Only 30 doctors?
Your line count sound great anyway! Maybe some day I will get there. I will keep working on the expander thing. But only 30 doctors? I am sure we work for the same national. I have only two accounts, but have 97 doctors! I have been meaning to ask my friend who works for the same company if she has as many. She has 4 or 5 accounts, but I don't know how many doctors. Sometimes, when I see the 'no jobs' screen, I am tempted to call and ask for another account, but I never do since I am afraid of what I will get. One of my accounts is my 'dream account' because there are few doctors, and they are WONDERFUL. The other account has about 90 doctors and I never know what I am going to get!
Doctors
I used to type for a doc who said sh*t at least once in every sentence. He always told "the typist" to delete that but it was a laugh just listening to him!
You may be right that most doctors
do not read their reports, but a lot of other people do, including coders, nurses, insurance companies, attorneys, and possibly even the patients themselves.        
CERTAIN DOCTORS.

I work for a small MTSO, and I have been asked to work on a certain doctor.  It happened to me because I was getting his work done on time and how he wanted it done.  So, yes there are good reasons for this to happen. 


Thanks!


So....how do you think these doctors who
And some of them KNOW about offshoring (lots of them do), feel about people going overseas for their medical care?  How does it feel?  Not so much fun, huh?
One of my doctors...
is wonderful about saying A-B-duction or A-D-duction instead of assuming I will know. He's got a slight accent, too, so I really appreciate it
Doctors as MTs
I can't help but wonder why someone would go to med school, then decide to become an MT. Even in India, I would think an MD does better financially than an MT -- which is why I bet while they may be good MTs, they must have been inferior MDs. JMHO.
Do you ever wonder how much doctors would
keep patients if they talk to them the same way they dictate? I have transcribed some doctors that I wouldn't go to (no matter how "good" they are) simply because of their dictation. If they talk as fast, slurred, etc. to patients as they do when dictating, no wonder people are sick.
Doctors
Does anyone know where doctors post that they need a transcriptionist?  I have looked through many websites but only find companies and not doctors.
doctors-ha
I am frustrated beyond belief at doctors who do not keep up with dictation then the office blames the Transcriptionist for being behind.  Dictating a week's worth on Sunday afternoon does not mean they will get all the dictation returned on Monday!  And of course they are asking for "stat" reports on one particular patient, then claim they have "missing" dictation.  Well I don't get paid for my time going through and finding one in particular.  I've been an MT for 15 years, but never have I been so frustrated as this afternoon when this whole situation came up for the upteenth time in the month of May.  Sheesh.........why don't they talk to the doctor about keeping up?!  gggrrrrrrrrrrrrrrrrr     Sorry, just had to vent..... but I was wondering if anyone has a spare tazer I could borrow.
doctors
Isn't it sickening?! Funny how they think they know everything and are always right, then can't even dictate all of one day on that day or can't remember what patients they've dictated on and blame us for losing them! It's actually the doc who has the problem, but they can't/won't see that. If I didn't need the money so bad, I would certainly quit this guy. He's a major royal pain in the buttocks!

Maybe it's just normal "rigors of transcription", but this has been a consistent problem for months and months and especially for the last couple of weeks. Maybe his allergies are frying his brain! Whatever it is, the staff has the same problem!
They are now quoting me what my contract says and claiming I'm not fulfilling that contract!

gggggrrrrrrrrrrrrr
Getting new doctors
I was wondering if any of you can give me some idea on how to get new docs. The last two accounts that I had I just fell into them. My friend was working for an office when they needed a transcriber. And the second were my ob that I had been seeing when I was pregnant with my twins. Unfortunately, I lost the first account to a lady who was going digital and she was was to come in and cover for me while I was out on maternity leave. And now the ob docs changed over the a new system. They are actually using a piece of paper that they check off everything and if there is something abnormal they make a note of it directly on the paper. I had been transcribing for six docs, but now I am only doing 1 and he is probably going to be retiring soon. I don't know what kind of information I would put on a flyer, or should I send out a letter to doctor's offices. Any help would be greatly appreciated. I have never done hospital dictation, so I am strictly looking for office work.

Thank you in advance,

Cheryl
Doctors
Thanks.  I did work for a doctor who stated that doctors are always looking for transcriptionists, but I could never find where they advertise.  The doctor I got was from word of mouth, but he recently moved out of state so I am looking to do work for another doctor.
doctors lie

What do ya'll think about doctors who lie in their dictation.  I have come across this twice within the year - so I am sure it happens quite often.  Once was my own personal MR - doctor came in and told me I had a coronary spasm but when I got my records there was no mention of a coronary spasm or anything else having to do with coronary - he basically said he didn't know what the problem was - other than my blood pressure was 220/114 - which I had to take my own medicine in the bathroom to get it to come down -


 


then - a friend of mine had a bariatric procedure and developed a stricture - he then had an egd under conscious sedation (he is 21 years old) and he became combative on the table.  The doctor came into the RR and told us all about how he had been up and down on the table and how he was not able to do a dilation because of this - then when we got his records - the report said that he had used 3 different balloons and dilated the stricture successfully.  However, my friend was not able to keep anything down - so the doctor went in and did the egd again under general - and could not even find the anastamosis site - he was sent to a specialist who did an egd using dye and fluoroscopy.  Another stricture is forming and the specialist is going to place a stent which is not approved for bariatric patients - it is something they place in people who have esophageal cancer which allows them to eat until they die since the cure rate for esophageal cancer is so low.  I wouldn't let them touch me again - but this is a young kid and he doesn't know any better.  I might also add that the anesthesiologist and the nurse that was in the room on the first EGD came to the RR and told us how bad the situation had gotten before the doctor gave up.


long story long - do ya'll think this is common?  can we no longer trust doctors with our lives?  I realize they are scared of malpractice suits - but, as with my friend, we know that the doctor messed up his tissues - and the specialist told us how bad the tissue looked - like it had been "stabbed through with a knife, inflamed and beginning to scar up".  But do you think that they lie in all of their reports where something goes wrong - or that they color the situation so that they come out smelling like a rose?


doctors
I like www.healthcarehiring.com/

Can look up doctors, clinics, and other things by state.
Doctors --sm
are so used to dictating certain ways that he may not even know he said the word comma. I have a doc that uses "comma" for every punctuation, including period at the end of a sentence. My transcription training drilled it into my head to use as few commas as possible and we were graded on that, dinged if we had too many. I transcribe what I feel to be right, not what the doctor dictates as far as punctuation goes. JMO
I take this seriously; however I know doctors
My mother's surgeon is one of them. Sometime during one of his visits, mother's medical records were brought up and somewhere in the conversation transcription. Well, he said all the x-rays were transcribed by a facility in Australia and he thought it was wonderful because they were ready the next day since their day is our night, etc. He just had a big 'old smile on his face. When I asked him didn't he realized HIPAA rules could not be enforced, he just shrugged as if it were no big deal. This is a guy that has been around a long time and he doesn't even care about patient records, and this would go for ALL the other doctors in his group practice as well. The x-rays are sent by a local hospital, so if the doctors don't care, and I know the hospital knows where the records are, I find it hard to believe most don't know what's going on with our records.

The bottom line......MONEY.........and not the patient.

I take this seriously; however I know doctors
My mother's surgeon is one of them. Sometime during one of his visits, mother's medical records were brought up and somewhere in the conversation transcription. Well, he said all the x-rays were transcribed by a facility in Australia and he thought it was wonderful because they were ready the next day since their day is our night, etc. He just had a big 'old smile on his face. When I asked him didn't he realized HIPAA rules could not be enforced, he just shrugged as if it were no big deal. This is a guy that has been around a long time and he doesn't even care about patient records, and this would go for ALL the other doctors in his group practice as well. The x-rays are sent by a local hospital, so if the doctors don't care, and I know the hospital knows where the records are, I find it hard to believe most don't know what's going on with our records.

The bottom line......MONEY.........and not the patient.

my doctors!
or the nurses or whoever else, but as i just said this IS being implemented April 1st!

dont think it will happen super quick for everyone, this is an eventual process, how can you deny that?
Doctors will not like to have to
put all that data into a computer. They are doctors not data managers. That work will pile up on them and because of their busy schedules and become a real pain.

They will always in the end have to dictate/narrate some sort of personal profile on the patient that does not include vital signs,lab values and imaging results.
No, because the doctors will not want
to listen through an entire dictation of sometimes meaningless stuff to find out what they need.
if the doctors in the USA really REALLY sm
knew why their work is of such bad quality, they would bring their transcription back into the US and hire EXPERIENCED US MTs to do it. I see it happening already, albeit very slowly!
Doctors
are the worst at spelling. I have one doc that consistently spells words wrong. I spell them correctly and leave a note letting him know. He continues to spell them wrong (the same meds). I think he just cannot admit that he is wrong(-:
Where have all the doctors gone?
Gone for AMA meeting every one...ohh when will they ever learn? When will THEY ever learn?

Okay, joking aside. The AMA is meeting in Chicago. Obama is addressing this convention to push his new health plan, something the AMA doesn't support. They are afraid, as are we all, that this will "save" money by cutting compensation to doctors and hospitals. They seem to have record numbers in attendance to show their numbers and power.

So, this might be why work is low all around right now. Bully for them! If they can stop Obama on this, I'll be low on work for a bit and I don't mind in the least. I don't believe that nationalized health is the answer for this country.

GO AMA
Doctors have bad days too!
Guess SHE was having a bad day. Once during the dictation, she screamed it ou because she could not find the medication list!  This foreigner had no trouble learning that word, obviously!
Cheap doctors
I remember one specialist many years back who complained when the hospital I worked for put in a new dictation system which required pushing the buttons on the phone to put in patient ID, etc.  He came to the department in person, ranting and raving because "now he would have to pay to have a push button phone installed" in his office.  This same doc came in the department on a Sunday afternoon and was using the hospital department copy machine to copy EACH AND EVERY PAGE his JAMA because he had DROPPED IT IN HIS POOL at home.  Can you say, "cheep, cheep, cheep"???? 
They sound just like my doctors! (sm)

Something more fulfilling, most definitely.  At least I won't feel like a doormat.  I am starting to think I am really being stupid to make sacrifices like this.


After all, this is just a job.  We all need to have a life, not be irritated all the time. 


One transcriptionist, three doctors--HELP

I work from home as an independent MT and presently, I am working for three doctors.  Anyone else out there working for a few doctors.  I am beginning to think it is impossible for one person to do this, as I am working 7 days a week, long hours.  Any advice would be greatly appreciated!!! 


Doctors are definitely their own breed.
I used to type for a doctor who I swear had his own dictionary. He was always making up words and also using really big words that nobody ever uses. I guess it made him feel smarter and above us lowly transcriptionist. He was a very nice guy. He just insisted on using words that were not words. When you typed him, you worked for every single line you got. Your situation is exactly why I hate verbatim accounts. We had one doc that wanted us to type his reports exactly as he dictated them. He never once used a verb. Terrible-looking report, but docs get what docs want.
That is true for SOME doctors but not all - PLUS (SM)
think about it - we need doctors and they are the ones who have gone to college and earned the degree so of course they should benefit. If they weren't going to make more $ at it then who would go through all of those years of school and sacrifice to do it???? You also have to calculate in their expenses for help, the patients who never pay, the ones with insurance who don't have to pay much, their employees, their equipment, their office expense, college loans, malpractice insurance, which is sky high, plus all those hours that they are on call EVERYDAY that they don't get paid for. I worked in the office for a doctor and did hsi transcription and he was in private business and barely made as much as I did doing transcription. He charged high too but after all the expenses he just didn't see as much as everyone thought he did. There are others that are definitely benefiting more but not always how it appears on the outside and I say that for the most part they have earned it and deserve to make more after all of those years in school than someone like me who went to school for 9 months to get my transcription certificate.
I have a couple of ESL doctors who say

"full stop" instead of saying period at the end of a sentence.  The first time I had one I didn't know what he was saying because he wasn't clear.  After QA told me what he was saying I could hear it, but still drinks me crazy.


I also have an ESL doctor who says "paragraft" instead of paragraph.


 


Most doctors do not abide by. . .

the BOS.  It was created by AAMT, who is the only entitiy to profess its acceptability as the standard in MT.  It has been a moneymaker for them.  Period.


Actually, only the AMA Style Guide is the "official" standard for any/all medical writing, including transcription.  There is a new version of it coming out soon as well. 


RE: Most doctors do not abide by. . .
You did not answer the original question. Your personal feelings were not asked for in this instance.
Some American doctors . . .
aren't that much better. Example - patient lives several thousand feet in the air - translation - the patient lives in the mountains. I kid you not.
Doctors are SO inconsiderate
Just need a moment to vent...why are doctors SO inconsiderate??? This one doctor, which I happen to have been working on ALL morning, is so inconsiderate. She mumbles, shuffles papers with the phone in her hand, and generally just cannot be still while she's dictating...and to top that off, she will not dictate in any reasonable order. She never indicates when she's changing from history to physical to assessment to plan....UUUHHH...I am literally !!!
Doctors Cursing

I've had plenty of doctors curse during their dictations.  The first time I had to ask whether to transcribe it or not - the answer was no - I have taken it to be no from that point on unless it is a direct quote from a patient - which happens a lot if you transcribe psychiatry - anything goes there. 


 


Stiffed by Doctors. What would you do?

How many independent contractors here ever been stiffed by a doctors' office when you didn't have a written agreement?  Just did business on a handshake?  What did you do to collect payment or did you ever collect payment?  I'm being stiffed and know I won't take this sitting down.  I worked too long, way too hard.  Invoice is teetering 7K.  Any help/advice would be very much appreciated. Thank you.


What to charge doctors.
About 10 years ago transcription services were charging 15-16 cents a line. This was in PA. If you are going to pay your employees 8-9 cents a line this could work out, as you should plan to keep 50% in order to pay for your expenses. Cost per page - services were charging the hospitals avg. of $4.00 a full page, $2.50 half a page.
Let your doctors worry about this....
You'd be an utter fool to buy sticky paper for them.  It is far to expensive, and they would not pay you enough per line to charge for your work plus the sticky paper.  Remember, doctors make about 30 times-plus what you do.  If they want to use sticky paper, don't be "used." Let them buy it, or you buy it and add the cost of it to their invoice, plus your time and travel costs involved.  If you keep buying things for them, next they'll expect you to buy their other office supplies, computers and digital recorders!  You're running a business, not a year-round Christmas party.
Don't know of a website, but new doctors
usally had an ad in our local Sunday paper.  It will probably run for a month or more.   
Happily just five doctors- NM
NM
Gifts to doctors
St. Jude's Childrens Hospital sends a nice card if you donate money in their name. I think it would make the doctor feel wonderful and you are doing a great thing, everyone benefits. That's what I think is a great gift for someone who is a professional. Look them up on the Web.