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I'm an IC for a mid south rural hospital...

Posted By: tia on 2007-12-04
In Reply to: Opinions please! I have been asked by a small rural hospital to do their overflow. SM - MyOwnMT

Although I get paid per minute of dictation, I have done the math and I make 10-11 cents per line.  Patti is right, it doesn't matter per line or per minute.  Its what you make per hour.  I do radiology and the basic four every day with the same dictators with a new one thrown in every now and then and have been doing so for 13 years and make anywhere from $20-35 an hour working average 5-6 hours a day.  Did not ask for a rate increase until my 8th year in which they balked at and began looking elsewhere.  Two years later asked for another rate increase in which they readily agreed to but keep better track of what I do.  Better to start low and become valuable to them than start too high.

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IC working for a small rural hospital
I have worked for a small rural hospital as an IC for 9 years, this year I asked for a raise.  Hospital thought about going to a national until they found out how much they charged.  They contract their transcription themselves.
Opinions please! I have been asked by a small rural hospital to do their overflow. SM

It is clinic notes that are pretty easy to type.  Some of the work is digital and some is still on tapes.  They want me to come in and pick up tapes, and they want me to print and deliver reports when I pick up the tapes because they don't know much about setting up a remote printer.  I made an introductory offer of 12 cpl for the first month and then 15 cpl if we both feel like continuing to work together.  I felt that since I am going to be out the cost of gas and ink, my offer was more than reasonable.  Well, they countered with a flat 12 cpl period with a one year contract and then we reevaluate at that time.  While I was mulling that over, she called back and asked if I would be interested in doing some radiology for them in addition to the clinic work.  So basically this account will keep me very busy and is not going to be just overflow.

So now I'm back to thinking 15 cpl and because they balking, not offering the introductory rate anymore.

What does everyone think?

Depends on what kind of hospital? Large urban hospital or small community hospital? SM

Also, is it a large teaching hospital? If so you have to consider there will be A LOT of different residents dictating, usually a lot of ESLs at teaching hospitals, and the residents rotate out and new ones rotate in every summer. So you can't expect to get the same dictators and build up your macros because the dictators change all the time.

I would say 9 cpl would be a pretty good offer for a small to medium community hospital where you will be doing the same dictators on a daily basis.  But for bigger, urban or teaching hospitals I would want at least 12 to 15 cpl. 

I worked for a rural doc. So much fun! :)

We even had a patient in the waiting room one day that brought in a paper bag with baby chickens in it as it was too hot to leave them in the car.  Nobody in the waiting room gave it a second thought.

It was great fun to work there.  They called it a "medical center" but it was in an old house with less than state of the art equipment.  The country folk swore by "Doc" and "Doc" didn't think twice about going out at 3:00 a.m. to make a house call.

He never would have dreamed of asking for a co-pay up front and even let one farmer's wife pay with fresh baked pies.

They sure don't make them like they used to.

P.S.  We still had typewriters back in 1994.  :)

I have the same problem and we are not THAT rural....sm

It is very frustrating to feel so limited in your job choice b/c of something like that.  I have never really had any major problems with my dial-up and have been told by two different techs. that I have excellent connection speed considering it is dial-up.  Frustrating though....

rural hospitals
If this is an extra job I would certainly make it worth my while. I worked at small hosp. for 5 yrs that did not want to work us from home. Kept saying they could not but I knew better. Eventually I went off on my own and have been home since. We had 3 FT. They hired 2 in my place and 1 PT for wknds. I type at night now to catch them up. They still had 1 PT and 4 FT, but I charge them 15 cpl. I clear in 5-8 hours what they all 4 do in 1 day, literally. Still did not want to put me or others at home. Want me to drive 45 miles 1 way to type, after I've pulled my reg. 8. Now what I do, whether they know it or not, I dial up on my C-phone into thier system and type at home, save it to disc (they monitor email + HIPPA) drive over for about an hour and transfer work into thier system. So if they have a phone in line you might check with them about on call stuff being typed at home, especially if this is stat work. It will certainly get back to them quicker. This is just fear of the unknown. This same hosp. has now, instead of firing those not doing work and hiring a good worker or paying them OT will pay me double the amount. They have also moved the weekend girl to FT and are letting a file clerk/PT IC do the weekend x-rays and still want me to help. That's 5 full time typist and 2 PT for a 43 bed hosp. Thier may reason was not to put thier network on home computers, which they all ready do. Won't give me network access but have given it to the weekend girl. Plus they are paying a consultant out the wazoo to tell them why this is not working!

If you are going to be on call, make sure you have set days or hours that you will be on call and that you are compensated. Don't let them just pay you for the work you do. Your time is worth money also. In other words don't sit home all day 3 nights a week waiting for a phone call and get paid for 1 hours. I have done this in the past where I worked and was on call on weekends for x-rays. There might be 1 or 21 or none. I got paid by the hour. If there were none I got paid for 1 hour for showing up. Ask an x-ray tech or someone who gets on call pay. They get a flat rate for being on call and then they get paid for the individual call.
Actually, I live in a rural community sm
and left a hospital where that was very good pay.  Starting wages for MT was $8.00 an hour with a 25 cent raise every year if you were lucky.  $11.50 would be like gold for the transcriptionists that work there.
Just moved to a rural area
Have a satellite dish, no cable.  The phone company out here does not provide ULD.  One job I would like you need ULD, and the other you need internet access, no satellites accepted.  Does anyone have any ideas?  Is there a way you can get even dialup without having to use long distance?
Rural America wages
Last year interviewed for two transcription jobs. Neurology office $13.50, hospital $16.00. (the most I have ever been offered) I was offered the neurology position, but declined and the hospital job was given to someone with less experience, i.e. less $$$, they were hoping to add an addition MT on, but did not. I have over 15 years multispeciality office transcription experience including running my own business for 10+ years. I basically learned on the job, sort of fell into transcribing 20 years ago. I am also a Certified Medical Assistant (silly me, actually went to school for that), I have worked in physicians office over the past 20 years part-time doing medical assisting and transcribing and worked my way up to $11.50/hr. Unfortunately in the office MAs are being replaced by regular high-school graduates, $7.00 per hour, etc, and of course they can do transcription too.. ha ha. Since I live in a rural area the opportunities are limited and each position would require a lengthy commute and with high gas prices that is just crazy, so I decided to go employee with national. Since I get paid by production I can make more $$$ that way overall but the cpl rate is not nearly what it should be, you just keep working harder for the $$$. I would not recommend anyone get into this field by choice as technology will eventually whittle us away to almost nothing. If you want medical, go for the top.. doctor, RN, nurse practitioner, PA, etc. Decent wage and some respect, too.
Rural doctor situation...

I hate going to the doctors office.  My daughter has had a sore throat for a week and went in to see doctor this morning, sat there for three hours.  We have gone through six different pediatricians/primary doctors in 11 years.  How are they suppose to know if there is something really wrong.   Doctor looked at her (daughter, 17)  throat and asked why she had not had her tonsils out.  Did not ask her history.  She has not had a throat infection in over 10 years.  As a toddler she had frequent throat infections and naturally large tonsils and doctors never once stated they should come out.  Now, she is worried.  She is a vocalist and does not want to that to effect her singing.  Anyway, I'm getting off the subject here.  We went in to see the doctor in clinic to find out he quit Friday and there is an interim doctor (who we've seen in ER and who has filled in for other M.D. in the past and like a lot better than current M.D.  Too bad he is not staying).  Is it that inconvenient for doctors to locate a practice in a rural area? Our area might not have much but we are only 30 minutes away from one medium city and 45 minutes away from a moderate one.  Our little town is now down to one doctor when at one time it had 4-5 family practices.  We have a hospital, but no doctors.  LOL.   

Thanks for letting me vent, but this is really getting riduculous.  The doctor today did inform me that he was trying to recruit either some doctors finishing their residency or maybe some middle aged doctor from the N.O. area that would like to start over.  We have great facilities, just no doctors.

I give, where in rural Georgia
are you talking about? I think I could put up hearing that more than I can with what I hear out of the Atlanta stations, at least it is not butchering the English language - just maybe their own language like I had mine from moving from Tenn. I understand that nexted above- I have heard that and even worse. I have a daughter-in-law who is parapro right outside of Atlanta (Jonesboro) and supposedly they are not to correct children when they speak incorrectly- she says heck with that and does. Can we say ebonics?
I'm not in a rural area. I'm in a big city and everything is SM
outsourced. My beloved company, run by a very decent man, was bought out by Edix. I thought they were bad until Spheris took them over. God help us.

Then there is the large community hospital, who has a "sweetheart deal" with another outsource company. You would not believe the garbage that goes on in this field.
Regarding unlocked doors, rural or not
My sister once left this true-crime book at my house and I read it, I guess because I wanted to have nightmares for a week.  It was about serial rapists (WHY does she read this stuff?)  Anyway.... one thing I noticed was that almost ALL of these perps walked into people's houses thru their unlocked doors, usually in the middle of the day.  Sure your husband may be right about if someone wants in they'll get it, but just like anyone else, criminals prefer to do things the easy way.  Why help them? 
In 1995 I was making 12 cpl for a small, rural

Changes were gradual.  First, we were allowed to start working at home at 12 cpl, instead of the hourly wage.  We still were employees and had the same benefits.  This saved the hospital money in overhead and we were all happy.  Then they started using outsourcing services for holidays and weekends.  Gradually, the whole MT dept was phased out and we had the option of going with the service handling the hospital transcription or finding another job.  The service kept us at this rate of pay for a short time and then gradually started implementing "incentive bonuses" and lowering the line rate of pay.  It evolved over the years to what it is today.  Starting line rates were lower and incentive bonuses done away with.  Health insurance is contingent on production, but their platforms crash regularly (as do many, many others) and we either have to work extra to make up the loss or just eat the financial loss altogether.  The services overhire to make sure that their TAT is met, which means unstable availability of work, which in turn affects production, in turn affecting benefits. 

The logic today behind all the changes is the "lack of experienced MTs in the U.S.", thus the need to hire people outside the country, who have even LESS experience with the English language and slang medical terms, at half the price of hiring American MTs.  The MT field in general has to be able to compete and so must lower their rates to keep clients from going offshore at half price.  And now with the advent of VR, the MTSOs using it try to justify the cut in line rate to the fact that we're no longer "typing", we're "just editing."  It's been a gradual evolution, but not in a positive direction.

And in all of this, AAMT has not come to the aid of the transcriptionist.  It has furthered the promotion of offshoring and has developed ways to enhance the MTs adjustment to VR instead of enhancing the MTs value and amount of worked involved in VR.  When the AAMT doesn't step up for the very ones it says it represents, why would the ones using the services respect, understand, or value the MT either?  

It is pretty rural where I am too, but the sprawl is coming - sm
My friends in the area (been here 8 years now) are people from the old school my kids went to, now a couple parents at the new PS they are going to and my neighbors. I am lucky in that I live on a private road with 14 houses on it. It is our own little world/community and we all get together now and then and have about 2 big parties a year (Daytona and 4th of July). I am close friends with one neighbor. I don't really have a "best" friend here (they are back home where I grew up in PA who I see 3-4 x a year) that I go shopping, etc. with, though Mary and I do things now and then with our kids. See if you can get friendly with your neighbors, good to have a local support system in place if you need it. Maybe a local library or club. Our area is slowly building up, have a supermarket now 5 minutes away versus 30, a local library, 2 dance studios, martial arts, a couple restaurants, Curves, movie store, etc. Try to get involved in some local club or activity, great way to meet people, or voluteer down at your local elementary school 1 day a week or something, they can always use some help. I keep very busy with work, Curves, taking the kids to dance (there are adult classes too), library trips in the summer, etc. I am pretty social though I don't mind being by myself either; so I try to keep a happy medium, but getting out and involved in something is the key to meeting new people. Give it a shot.
Do you think a company pays less for rural pay than city?
Does not make sense to me.
I am am in a rural area with lots of trees - sm
so when I had Bluesky (or what ever the name it) come out they said too many trees for the satellite. My one neighbor just got Directv high speed.....she also has lots of trees. So I may be looking into that (have Directv now just not the internet hookup). But I currently use a Sierra Wireless Aircard 875U. Unlimited and costs me $67 a month. It is through AT&T but I know Verizon has it too, as well as Sprint. You need to make sure it works where you are first though, but their websites can help you there. I love it. Not as fast as DSL but a huge step up from dial-up. I have it set up to use on my desktop, laptop, my backup desktop, and my daughter's computer. The only thing I have with it is it does not work everywhere...when I try to use it on my laptop...unlike the commercial where they show the guy in the middle of Africa or wherever he is. But I have been very happy with it.
I worked in a rural physician's practice for years.
He eventually ended up joining a group.  He still has his office in the same place, but is financially part of that group.  Unless they join some sort of group/organization so that they can get group rates on lab, insurance, etc., it is really hard for them to survive.  The community lost its hospital several years ago.  You said your community has a hospital, but is it a full-service one?  Our next nearest town with a hospital is about 35 minutes away.  Now the 2 hospitals in that town each have satellite physician clinics in our little town.  When I was working for this physician, we had a total of 4 doctors in town.  Now, through these satellite clinics, we have a good number.  Before this physician joined this group he recruited numerous physicians over the years.  Unfortunately, he was not able to assure them enough of a salary and benefits to keep them.  There is simply not enough money coming into these small clinics.  They have to satisfy Medicare and insurance regulations, just like the big clinics.  The recruited physicians all eventually left for greener pastures after being actively recruited by other facilities.  One physician I remember tripled his salary when he left there. 
just some information for MTs in rural areas where high speed is not available

Hi all,

Was just on the Sprint website a little bit ago and checking out wireless cards for my laptop since I will be moving to an area that doesn't even have landline service available yet.  Sprint is now offering a wireless card that is a USB card and apparently will work with both a laptop and a desktop as long as you have an available USB port on your computer.  Might be something to think about


Yep, I agree 100%. I live in such a rural area, though, that my neighbors, the natives, think I'm
NUTS cause I keep my dogs in the house, and actually still walk them on a leash in my yard.  We all have about 2 - 5 acres minimum each of woods in our neighborhood, and no real dog laws at all! Dogs run at large 24/7, which is no picnic for me with my dogs on leash, either!  And they ALL keep them outdoors, tied up with the chain and the smelly old dog house.  I think they just look at dogs strictly as deterents? Not sure really, come to think of it! Cause even if they were getting robbed, Fido couldn't get off the 6 foot chain! Oh well!  I used to be sad all the time for the plot of the dogs here, but I can't save them all! Only my guys!
You must live in a metro area because rural areas pay even less per hour.

Of course you can buy a big house for 130,000 in a smaller town and the same amount won't buy you a pot to pee in, in a place like San Diego or the D.C. area.  It's all relative.

The phone line has to support DSL signals. Most rural lines don't due to distance from central of
I live in a small rural area and they housed some evacuees at a nearby military base
crime went UP in our little community that previously HAD a ~very low~ crime rate. It is a FACT. I'm not saying all NO residents are like that, but MANY seem to be.

My mom was raised in conditions like this poster describes. Mom's parents died when she was 7 (father) and 9 (mother). Her teenage sister (newlywed) raised her and 4 other siblings. They had next to nothing. Not ONE of them turned to a life of crime. Not ONE even graduated high school but they still made good lives for themselves. Life was rough for them, but they didn't blame it on everyone else and cry around about what the president should be doing for them. It is all about RESPONSIBILITY and taking what life throws your way. IMO.
south where
Church retreats, bus tours. Casinos. (Tournaments for pinochle)....
where in the south are you?
some schools here started today, but mine started LAST Monday! It's kind of a relief, but I miss 'em already! Have a good first day of school!
And here in the south we would say...
Bless your heart, in other words you don't know any better and I feel sorry for the venom you are spewing out. You must really be one angry person! You assume this and that about the job I am doing. I format no work, keep no records, no copies. There are a lot of people out there who read these posts and it seems like you have just called a whole host of them unprofessional with the term "any professional peers" not beubg worried about their jobs. I think most of the people worrying might object to that. Just go back under your rock and I hope things pick up for you. Again, bless your heart.
I live in the south.
I was raised to be prejudiced.  As I became an adult I learned better.  Now I have mixed children on both sides of my family.  I really hurts me to see these children, who I love dearly mistreated.  Although the crime in the Holloway case may be a racial issue, I do not see that the media sensation is.  She was an American tourist in a foreign country.  People are interested.  That sells newspapers, magazines and time on TV news.  That says a lot about the American people.  Missing children and teenagers in the U.S. are, for lack of a better term, "old news".  Not to say that a parent of a poor missing child in this country is not just as devastated, I am saying that this is the way we have become. 
South Florida, been there
eight years, IC until this May, now Employee
Hey, I WAS born in the south and I don't get it either.
But then again, I guess south Florida is not considered "The South," right?

I live in conservative N FL now and well, it's different..

You and msbeanctr are right on target and very eloquet.
have you ever lived in the south?
If not, then don't make negative comments about people you know nothing about.
I did South Beach also -
and lost the tummy area first.  I was absolutely amazed how I was never hungry and didn't crave chips, ice cream and chocolate!  I found it time consuming preparing the meals, but the results were worth it.
Goin South
That line was the funniest in the movie! (That and "Where's my bride?!" when he meets the 80-year-old who saved him from hanging.) Now I have to get out my old VHS tape & watch it again! LOL
Transcription South Inc
All these days I was told that TSI is a "do not outsource company" but I was shocked to find this claim on the net by an unknown Indian company in their site "SSAPL, parent company of ISPL has recently acquired Transcription South Inc.(TSI), in Florida which is now a sister concern of ISPL and has been serving hospitals from Tallahassee to Miami for over twenty five years." (infovisionsoftware.net) Can anybody shed some light on it
Do you either live in the south or
where brought up the south?
Transcription South
I worked for them 6 years ago. The owners are nice people. The wife is a MT. They were partners with Dictaphone at the time and had some problems with the work and the relationship with them and did not have enough work, so I went elsewhere. Don't know what they are like to work for now, but the owners are really nice people.
It is pointing south, but ...
it has to be aimed directly at a particular satellite. There is evidently an arc of them to the south, but we are aimed at one that one of the techs admitted they were having problems with.

I am a little south of Atlanta
probably about 20 miles or so, used to live right in Atlanta but the living where I am very, very reasonable now. What part of NC to be so expensive?
I'm in the south and it is hot and humid
which makes me puffy.  If I eat anything with more than a sprinkling of salt I swell up.  I use No Salt, but if I have prepared food with a high salt content it bothers me.  Sitting on my butt or hours at a time will do it.  Increase your fluid content.  I occasionally take Lasix and I have issues with potassium loss if I take too much Lasix, but I've never had issues with dry skin/mouth.  Try propping one foot up while typing and after a while switch feet.  If you're overweight that will contribute to.  My feet used to swell so much I could barely get my tennis shoes on, would have to loosen the strings so much that there was barel enough to time them.  After a day off from work or getting out and walking I was having to tie my shoes tight again.  I have lost 40 pounds and now my feet/ankles only well if I have too much sodium.  
That's what ours cost a year ago! Where in the South are you?

I wonder why it's so much there than everywhere else.



It was not about the south, but the people on that board. get over yourself.
Not necessarily. She was in the south where christianity came first
in the white man and black man's eyes no matter the color of skin. Was racism wrong?  Darn tootin.  But, had Rosa Parks been aetheist, buddhist, mormon or any other religion she would have gotten NOWHERE.
Yes, happening right where I live. I am in South
Jersey, and a local hospital here, along with ortho surgeons, has been using these nasty parts - supposedly unaware of their origin. Lots of local folk have been called in and given the news...Met a lady in a doctor's office the other day who has been sick for a long time - high fevers, shaking chills - goes to ID specialist, but still don't know what she has, but now they know the source - rotten cadaveric spine implants. In NJ, the source of all this mess is a funeral home up in North Jersey. I believe we are not to post identifying info - especially in NJ - I watch too much Sopranos, but the hospital is in South Jersey - the recipient - and the source was a funeral home in North Jersey. A Google search should give all details! Ya just never know...
South Beach Diet
I have had this same problem! I gain too much weight with each pregnancy, then when I finally get it off I have ended up prego again. HA. Well, it won't happen that way again. Anyhow, I did the South Beach Diet between my last 2 kids and lost 54 pounds in just a couple of months (a little over 4). I actually lost my weight in this area first. I am just starting it up again for the same reason, and because I know it works--I have done it before. The first 2 weeks are kind of hard to stick to (at least for me as all my teeth are sweet teeth), but it goes by fast actually and you won't believe when you step on the scale and each day your weight is down and you drop clothing sizes. Just typing this is enough motivation again for me to do it. I didn't exercise the last time and the weight just melted off, so I don't know about any exercises. Good luck to you! :)
South Beach Diet
When I did it the last time they only had the blue book out, now they have cookbooks too and the foods at the store so it will be even easier to stick to. I just bought a treadmill and am sad to say after 15 minutes I am dying! HA.

I have even seen the South Beach books on ebay for cheap. :)
south beach d question
would someone tell me please a few examples of 'good' carbs and 'bad' carbs, and/or what causes them to be good or bad?  Thanks.
Going to be hot in the South. Too hot to cook. We're having


Love Goin South! Not many
people have seen or even heard of that movie, but I think it has got to be one of the funniest, well-written, movies EVER!!  I have the VHS and have just recently recorded it to DVD so I NEVER lose it.. "I can do this all day long, I mean ALL day long!"    Sometimes I think this line while I'm working!  lol
South Beach Diet sm
beel ala orange with brown rice and broccoli, carrots, and bamboo shoots...only thing is, they forgot the brown rice...I am still hungry. yarrr.
Sorry but truck driving is going south also
Also had hubby as truck driver, as well as done team driving --the rates there are going down as many are coming over the borders and able to drive for less.  So that profession has dropped 50% as well or at least held its own over the past ten years which is not a progression at all.  Even owner-operators are seeing a decline.  So it is hitting everywhere. 
I am so against ebonics and I live in the south
Here close to Atlanta it is ridiculous to hear all the time. It is so different from what you describe above. I would rather had a very fast, slurring of words physician speaking than to hear a professional using English wrong. I actually was having a very big problem with it before moving from Atlanta and hearing it day in and day out on the news channels. I really had to tune it out, that is how bad it was. I did not allow it spoken in my home, ever and by the way, it was being offered in the lower grades in school. Some blacks, as in my post above, consider speaking without ebonics, speaking white. What a shame!
I just know people move to the south a
lot and especially my town because the conditions are so much better here- not for the lower wages- that would be idiotic. As far as the wages here, my husband is in the union so we do not know about lower wages. I saw nothing in my post back to you that would set you off, though. People who donít know about southern living often just make assumptions. Oh, I do have a cousin who is in Boston now, professor at Berkley that is moving south when he retires next year, the cost of living is more reasonable and something he can afford rather than be overpriced for what, a little lean to shack there. Those are his words, by the way.