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Serving Over 20,000 US Medical Transcriptionists

First time on verbatim - must VENT!

Posted By: NoNameMT on 2007-10-10
In Reply to:

Disclaimer: I'm not perfect, never will claim to be...


Now that I've said that...I'm on my first-ever verbatim account, and the QA is making me nuts!


I have more than 20 years as an MT and have been on numerous accounts.  I consider my skills solid, and I've never been on QA more than 3 days on a new account. 


The QA folks are nice and they do a good job.  But the details involved in this account are beyond anything that makes sense to me.  I really don't know if I want to be on an account where I have to sweat each and every character placed on the page.


I'm only in my third day, and I'll give it a couple more.  But if the feedback continues to be along the vein it is now and I can't make some headway, I think I'll have ot throw in the towel.


The last year has been tough for me in this industry; I feel like I've been through the wringer, and just want to find my niche. 


I'm feeling tired and frustrated and insecure about my skills.  And I think verbatim is for the birds!!    Thanks for listening.


 




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Need to vent... (If you have time to kill, check it out!)

I am so frustrated right now I could just scream!  If nobody even makes it to the end of this I will understand, but I'm just livid. 


First of all, I was due my paycheck on the 15th.  I work for a small MTSO, and our checks are frequently late at the end of the month.  (The checks due the last day of the month usually get paid sometime during the first week.  I'm used to that now.) But the paycheck on the 15th is consistently on time.  Our mortgage is due on the 1st with a grace until the 15th.  With the terrible economy and struggling like we tend to do, we usually pay on the 15th.  We save half our checks from the 1st week of the month then pay the mortgage when we both get paid on the 15th so that we don't have to take the huge mortgage hit out of one paycheck but rather spread it out over two.  (Hope that makes sense.)  Well, I was told on Monday that we would PROBABLY be paid by FRIDAY, but that it's not for sure.  Since I won't have my check, and we will be paying after the 15th, we will get a $75 late fee on our mortgage.  Is it too much to expect to be paid ON TIME? 


It gets better.  The very next day after this news, my MTSO emailed me saying that a client was missing 5 patient reports.  She kind of went "high and right" on me saying that she didn't have them, the client didn't have them, I didn't send them, where are they, etc.  I was calm, knowing that I didn't make that mistake.  I went back and found the files.  I sent the files.  I then went back and searched my email until I found the email that contained the missing files.  I forwarded the email in its entirety, complete with headers showing the time and date it was sent, and put in the email what basically amounted to, "The original email contained 20 files, 7 of which were for other clients and 13 of which were from XYZ Ortho.  Since the other clients never complained of missing files, and since XYZ Ortho isn't complaining about the other 8 files, I am confident that you sent the files on to XYZ Ortho and they just lost them."  (Which this client has done over the last four years, losing files that have been sent and then blaming us.) I finished with, "I have forwarded the original email so that you can use this to show the client that the problem is not with their Transcriptionist - don't let them blame us!"


I graciously did not point out what I really wanted to point out, which was that I sent my boss the files like I do every morning.  If the client lost their files, there is still no reason why my boss shouldn't have been able to pull them up from her computer!   


The next day, however, I get a pissy email saying "I never got your original email.  I searched my computer and I searched my computer and the files are not there.  You will have to get a more reliable ISP, because I'm not getting your email.... " She went on to blame me for the problem in SPITE of the fact that I already pointed out that the problem could not possibly have been with me.


Now I'm really cheesed, because either she's just plain dense or she thinks I'm just plain dense.  I wrote back reiterating that I just forwarded her the original email.  She's only missing FIVE files.  The original email contained TWENTY files for DIFFERENT clients (including one that is VERY picky about getting their files back in less than 24 hours -- if they hadn't gotten their files I would have heard about it weeks ago! ).  I told her that why she can't find the five missing files on her computer or in her email is obviously a problem on HER end, but considering that my other clients aren't missing anything and the problem client is only missing a few of the files, the problem clearly is not with me.  I sent the files.  The files were recieved.  What happened next, either with her or with the client, is not something I can control. 


The next day I get an email that said, "Found the problem.  Thanks."


WHAT?  She accuses me of losing files, not sending files, put it on me and then when it's pointed out that she's the one who did something wrong there's no "Sorry I blamed you, it was my fault."  I'm telling you, I am HOT. 


This on top of the fact that I'm not getting paid is the reason why I am currently interviewing for a work-primarily-from-home analyst position with a local company.  I really expect professionalism, and this isn't it! 


If you've made it this far, you deserve a hug.    Thanks for listening!   


 


 


 


 


 


Verbatim is verbatim, but I defintely to the little things to make the doc look better such as..sm
an eye problem instead of a eye problem.  I definitely wouldn't change too much.  Stick with what they say and only make changes when you absolutely think it is necessary.  I took a test last night and have an interview today and this is what I did.  FYI, I do clinic work.
Verbatim = verbatim......flag it...NM
x
Verbatim for ESL too?
Geez, if that were the case on my account (not MQ), you wouldn't believe the crap I'd be putting out - "59 years old pt, denies of chest pain, comes to ER for short of breath," and I could go on and on.
Verbatim
I still don't understand, for example I have a doc who does about 20 lengthy bypass operations a week.  I have a 4-page "standard", that I just immediately pull up.  He never dictates it the same way twice, I just simply pull up my standard, put ears on, follow along and delete, insert, change and so on as he dictates, and that is as good as verbatim.
Since I am on verbatim also, I use whatever s/he says..
Jim for James etc....however, if the doc is clearly off track, he starts calling Mary by the name of Frank for instance (it has happened) then I flag it.
verbatim
The docs at a big teaching hospital I formerly worked for did not put punctuation marks after the word HOWEVER.  That's the way they wanted it and we were marked down if we added the comma.
verbatim, really?
Of course verbatim means typing EVERY SINGLE word they say, even when it's a side conversation, a snide comment, etc.  One thing I do that may not help them at all but makes me feel that I've at least let them know that I know - I enclose such words in quote marks to set them off from the real words.
Verbatim
As a private IC there was a prominent heart surgeon from Iran whose dictation I "cleaned up" constantly or he would have been the laughing stock of the community. Sometimes you have to "save face" for the client. If I worked for a national and they QA'd me from saving someone from a drastic error, I would immediately "quit." Another ESL went to hospital admin to tell them I was "his friend," I did not change the meaning but there were several instances when I had to make sense of things for him to cover the hospital's reputation. I was taught never to "change the meaning" and to put certain language "in quotes" although as an IC, I would always call the client first and they usually thanked me. When you work for another service, you can't do this, so it makes it very difficult.I guess you have to go with who pays you, but I would never, never type a senseless sentence.Good luck to those who have "bad QA assessments." They should know better.
verbatim
it's stupid and dangerous to type verbatim. Some hospitals stupidly insist on it cuz they believe we can't think for ourselves. They say "We've always done it that way."  Well God forbid you should TRY TO IMPROVE.  they say "well, you don't KNOW what he meant."  My answer to that is "well, YOU may not know, but I do!"  They just don't want to be bothered with having to actually think about it. Any decent trx with many years' experience and worth her salt GENERALLY knows what the doc really means but can't spit out, for one reason or another. I'm married to a doc - I know. But he DOES want us to leave blanks if we DON'T KNOW - better that than making something up, which he does see all the time from Spheris trxs. That's what happens when you hire people with one year of experience and don't monitor them closely, of which Spheris is guilty. And leaving a message for them on ESA doesn't work, cuz the doc won't see it till he goes to sign if off, and by that time, he has no earthly idea what he said. Nor does he care!
IF they got verbatim EXACTLY what they said,
they'd probably be in total shock at how ridiculous they actually sound when they dictate. Don't you just want to give them what they give you sometimes?
Verbatim
The problem is with the client profile. It should not ever have the word "verbatim" in it because the word by definition means "word for word" and we all know all of us from time to time and doctors especially speak garbage and have to be cleaned up. If with followed the client profile and transcribed "verbatim," screams would echo across the country. So I am all for removing that word from all the client profiles unless they truly want reports transcribed verbatim, word for word. We could do that, but it would not be much of a record.
verbatim, no BOS sm
Who are they? I would love to throw the BOS out the window, please e-mail me. Sick of all the new rules which don't amount to a hill of beans anyway at most times.
verbatim
I must be getting old. I'm finding it more and more difficult to "follow directions" as I age regarding this subject. I can't believe these younger physicians don't want us to fix the glaring errors. The real trouble is there's no one who will be the intermediary between the transriber and the doc, maybe, like back in the day. Way too many cooks stirring the broth and complicating what used to be a common-sense and less complicated situation, transcribing, that is.
i do verbatim too, but still BOS has
many points of reference that are helpful. I am one that hated the idea of a BOS, but when i finally succumbed, found there was a lot of useful info in it. Its not a bad idea to have a common reference point.
They may want verbatim, but if they are in
an acute care facility BOS overrides what they want.  JCAHO can give/withhold accreditation based on the medical records and they say follow BOS.  It isn't that is is an issue of style as much as it is a patient safety issue. 
Verbatim
The hospital I work for now is a verbatim account, but we were told to spell out everything in DX, Impression, etc. I spelled out a lab abbrev and it looked so weird, but QA/Trainer told me to spell it out. Very contradictory so if it ever comes back as getting "dinged" for it I am going to tell QA who told me and they better not takes points off my audit.
verbatim is hard for me too
It is very hard for me to deliberately type wrong words, phrases, etc. It makes me think someday someone is going to read that document and say "gads where did they get that transcrptionist!" not knowing we have to type it as dictated.
verbatim accounts
I thought the idea was to correct their poor dictation in most circumstances...I'm wondering why any client would prefer it verbatim, for legal reasons?
that is verbatim. QAs are only human too. nm
 
you could fix it if you wanted to or is it verbatim? nm
:
Well, now if it is a verbatim account and
the dictator said, "during this hospital stay" and the MT transcribed "during this hospitalization" -- that is wrong. It all depends on what the client profile outlines.
Seriously, do you *really* type verbatim? sm
I don't. I'm supposed to, but I've told my super that nothing with my initials on it will ever read like "Patient hand swollen." Yep, I take some liberties. I clean things up, I've added in words, taken some out, rearranged words. I think count-wise it comes out even because I'm not padding and I remove words probably about as often as I add them.

If you are on a verbatim account, are you really typing "Obese patient older than says age, no toxic"?
Only typed verbatim twice
once for a Russian infectious disease MD. After one week of strict verbatim reports, evidently she got a talking to by the senior partner and her style became acceptable.

The hospital is one of the larget and most respected hospitals in the US. All residents much pass a week-long course dedicated strictly to how to chart, how to document, how to dictate. Each resident must personally sign his/her own name daily on a log in sheet and anyone who misses a day does not get to start with the rest of peers. One day is devoted SOLEY to HOW TO DICTATE and accepting full legal responsibility for the dictation. They have to sign an agreement that the hospital will not provide legal support if their documentation falls short of their standards and the resident has to provide his/her own funding against any lawsuit. If they dictate a reversal of pulse rate/respiratory rate, I could switch them, but I had to send it to QA who attached a note to the dictator covering the MTSO from any repercution.

Best dictators I EVER had!
If these dictators actually got verbatim
reports, they would probably have a stroke and need immediate medical attention. It is scary to think that these people dictating take care of us and our families. I certainly hope they are better at treating than they are at dictating.
is this a verbatim account?....nm

How can verbatim=garbage?
We transcribe what professionals dictate.  These people went to college for a long, long time to learn their profession.  Who are we to say verbatim=garbage!!!  Become a physician, then talk that garbage!  Give me a break!  We average $25.00 an hour if we're lucky as transcriptionists, and these physicians are making much, much more than that because they went to school to be a physician and treat patients.  Come on!  Transcription is just that, typing what the doctors say verbatim, maybe correct a little inconsistency here and there (we're all human), but to say the physicians' statements are garbage is wrong, wrong, wrong!  If we were so bright, we wouldn't be typing, we'd be doctors!!!!!!!!!!!  Let's give credit where credit is due!  Bottom line is no doctors-no transcriptionists!  AAMT is just another company out there trying to turn a buck!  They don't know it all and neither do we for goodness sakes!  Do the best job you can because believe me if you are that important in the medical field (as a transcriptionist), you'd make what the doctors are making!!!!!  I'm sure I'll get blasted for this one!!!!  Oh well!
Oy. And I suppose it's verbatim.
So then you have to ask if you are supposed to leave the stoopid stuff in or take it out??


Hate verbatim, also, except
that *if* you get used to it, you really do not have to worry about THEIR errors...

that said, it forces you to NOT care about the quality/accuracy of the work and that sucks for those of us who take price in quality work.

I cannot wait until I can say adios to this work (or at least be able to go to part-time).
Verbatim dictation

The company I work types verbatim as well.  I would not have it any other way.  It is much better than trying to remember 50,000 rules by the BOS!!


Quality and verbatim

Even though you type verbatim does not mean you type all the mistakes the doctor's dictate.  I would NEVER type an error.  When in doubt, it is blanked and sent to QA.


The company I work for is known for their QUALITY and we type VERBATIM on all accounts except stated otherwise in account specifics. 


Verbatim means, according to
the dictionery, word for word exactly as given.  I think that means every single word even the little aside remarks, phone conversations, sort of almost corrections, EVERYTHING!!  I wonder how long they would accept that before changing their minds, or do they really prefer lousy  quality??
simply verbatim
Has anyone worked for this company? Just curious.
No. You said verbatim acct. Maybe that is why
x
Even on a verbatim account,
It sounds as if he was obviously having trouble organizing his thoughts. This is exactly why I no longer work on verbatim accounts. I like being able to use my brain and be trusted enough to make the necessary corrections.
That's why I LOVE MY JOB. VERBATIM!!
No stupid BOS rules to follow.  We type what is dictated unless there is a gross medical error and then we leave a blank and send back to facility!!  We also follow account specifics for each facility.
Is it a verbatim account?
I to am QA and the only way I would take the and out is if it a verbatim account and the doctor did not dictate it. I don't think QA changes things just to make a change. I know I don't.
Not all accounts are verbatim, some,
like mine we are to make phrases into complete sentences, but definitely do not add words just to up the count.
Flag it. Verbatim or not, you do not
knowingly put in wrong info.
Obviously you don't have a verbatim account.
The time when MTs were even permitted to translate jargon and expand abbreviations are behind us.
As long as your end result is verbatim, it should be up to you how you get there! nm
..
Hey, I forgot to add... I was on verbatim account

The poster below who said she shouts it back at the screen gave me a big laugh..Its seems funny.. if we say it, its okay, but don't let a doctor!  I think, "How dare her!" But, I did get a laugh out of it, even though I don't like that word!


Please read below for verbatim response from my son

After all of your wonderful input, I decided to ask my son if homeschooling would be an option that he would like to try. He did not say yes right off but asked me if I would give him time to think about it for a bit.


He then came back to me and told me that he would like to try it as it "might be helpful for the time being."


I asked him to tell me honestly about his day at school. He dictated, I transcribed. :)


This is what he had to say:


_____________________


"You have to get up way too early to go to the school where you sit around for a half hour and then go into a classroom for 1st period  (science) where your teacher is not prepared and doesn’t start for a good 15 minutes after the bell rings and then when he finally does start teaching, he doesn’t teach over the material that we learned. He doesn’t keep track of the homework, barely makes us pass it in and tries to give us projects about things he hasn’t taught us.


2nd period is study hall in the café with 150 people for 45 minutes where the students just talk and the monitors don’t care and the kids that want to get work done can’t because they can’t concentrate.


3rd period is health. We have all known this stuff since 4th grade and haven’t learned anything new.


4th period is math, the only class where we learn something new every day, but we don’t really learn, they just expect us to keep it in our head and then we have a test with only one day review.


5th Study hall again.


6th Lunch


7th Study hall again.


8th Latin. Latin is fun to learn, it’s a good thing. It would help if the teacher knew how to teach the material. He doesn’t even teach, he just says the words in Latin but, doesn’t give us any meaning and then wants us to translate it into English.


9th English. I really liked the English teacher I had, but she quit the first week of school. We have had 7 substitute teachers in a 6 week period and haven’t done anything in class, but just sit around while the substitute tries to gather herself.


10th World Geography. Only good thing that I have actually come across about the high school. The teacher knows how to teach. Best I’ve ever met, very attentive, very energetic and he gets the whole class into discussions.


My overall summary of the high school is that the education isn’t the greatest. The kids are horrible. They like to pick at people. There are all kinds of new kids (coming in from the towns that don’t have their own high school). Everyone is always grouchy. It’s not a really friendly environment at all.


The sophomores, juniors and seniors don’t set a good example. There are only about 10 kids out of sophomores, juniors and seniors that are actually respectable and the rest just talk about partying.


They have bad harrassment at the school with  threatening sexual and physical harrasment and threatening to harm families."


______________________________


In a nutshell, he basically said to me that he wants to get a good education and he honestly would like to be able to meet graduation requirements in less than 4 years because he knows he can do it in less than that, even if it means doubling up on stuff without having to sit around.


Depends on how picky they are (verbatim)....
I personally would prefer to type "cillin"-type medications or something like that. Maybe check with your QA point person. If you have never been told who he/she is (would not surprise me), his/her e-mail should be listed near the top of the client profile.
If you hate 'em, verbatim!
xx
I think your boss was saying transcribe verbatim,
as in p.r.n before the drug was dictated, and you changed the order. Not to be a witch, but the other poster is not correct - ibuprofen is not capped. You are right that PRN should be p.r.n. - it is a latin abbreviation, but MANY MTs cap stuff like that. One of my peeves...
If it is a verbatim report, she should leave it that way. nm
x
BUT - it's verbatim!?!? Just making a point.
x
I have to disagree, verbatim is not professional
and this is supposed to be a profession and yes that means you have to edit a little bit to make it a professional appearing document. Verbatim = garbage.
The account I do VR on is verbatim so can't fix sentences. nm
nm
...right, even if you're told to do verbatim. nm
s