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I do reports all the time where patients have asthma, COPD, emphysema, and

Posted By: me on 2005-12-14
In Reply to: It won't take cancer to quit smoking. Try - Very Old MT

even cancer and continue to smoke.  In our local paper they are following a woman in her battle with cancer.  She continues to smoke, as does her husband.  They were broke before the cancer diagnosis, having to borrow daughter's babysitting money to pay bills.  Just think how much money they've blown on cigarettes.

I've even known one man with a trach who smoked through his trach.  


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Just wondering, for you MTSOs, about how many patients/reports per day...

For, say, an orthopedic surgeon, or  a family practice doctor.  Or, maybe, how many minutes of transcription on average per day. 


The clock does play into how much time is spent with patients
The way the CPT codes bill insurance have guidelines for the physicians built into them that give amounts of time spent with the patient (in addition to certain information covered in the ROS/PE), especially in consultations (whether inpatient or out), hospital discharge codes and critical care time (inpatient or out).

Yes, that computer is in fact billing the insurance company because it not only saves not having to pay an MT, it bypasses a billing clerk (eliminating that salary), and if the doctor's office space is paid for by a hospital, that file is sent to the hospital's database where a *scrubber* compares what the MD submits versus coding guidelines. If it is an independent office, the MD can upload all that day's billing before he walks out the door and leave it unattended to update patient accounts and reconcile the days money intake.

In a nut shell, your doctor is no longer just practicing medicine. Your MD is doing the documentation and billing and saving money on two warm bodies.

I understand your concern as I see it more and more in today's medical care, but yes, this is the way things are going. I am fortunate that my MD has been very computer literate for a long time, so the amount of time he spends with his laptop is minimal. Once he enters the info, he kicks his shoes back and we chat and get into a deeper discussion both professionally and personally (we've known each other a long time). Give your MD a chance to play catch up to what he or she is doing with that computer and you should see a more relaxed physician soon.

Good luck.
Doctors patrolling themselves? What a joke! They barely have time to see ALL their patients....

Doctors today are totally incompetent for the most part.  YOU cannot worry about it when it comes to transcribing their gawd awful reports.  THAT is between the patient and the doc.  Just knock the report out as fast as you can and make sure it's accurate and then after that, forget about it. 

The docs make the big bucks - you don't!  Let THEM worry about things that will eventually catch up with them, one of which is called the Karma bug, and that little bug ALWAYS bites those who don't deal fairly right in the butt!  And big time, too!  

Well, if you have COPD, inhalers will help. sm
It is a steroid, so be careful. It can make you very hyper and cause your blood pressure to rise, as well as slow healing of any cuts or wounds.

My son has asthma and uses rescue inhalers prn. My dad has COPD and used albuterol 3x daily.
The last time I did reports per page...
was about 3 to 4 years ago, and I was getting $2.50 per page then.  I did about 10 pages an hour, so I was making $25 an hour.
I shouldn't have RETYPE the reports all the time because the MT
doesn't do their job. They don't read over their work. They add and leave out words. They misspell words as if they don't have any spellchecker whatsoever. They completely SKIP dictations in the middle of a 30 min tape. NO IT IS NOT MY JOB TO TYPE IT. IT IS MY JOB TO EDIT IT. I would rather spend my day EDITING because I am an editor.
Find my reports changed all the time.
In ChartScript you can view and edit previous reports.   Anyway, I have found tons of my work which I know is not the way I typed it.   I just let it go and so far have they have not said anything.  If, however, I was told about these mistakes I would say something even though I know QA would be right.  Agree, they think they know it all and some really don't know jack.
Long reports, dead air time

Does anyone have any good tricks for dealing with the long reports with huge segments of "nothing"?  On top of that, the people I am dealing with are ESLs so that's slowing me down enough already.

At this point, all I do is speed up and fast forward but am wondering if there are other ways to compensate for this issue.

Seems like someone would teach them how to pause when they stop dictating! 

Do the majority of MTs reread or relisten to all the reports you do and how much time does this take
or I suppose rather which is more effective and takes less time. Do you do this for every report you do. Do the big nationals require this. I suppose it depends on your QA score if you need to do this.
well, it IS work related. I edit those reports all the time.
Unfortunately most docs don't care; they don't even read the reports most of the time.
It's OUR job to comply with quality standards.
Inhalers are used for a lot of reasons besides asthma.
My Dad is on one for his COPD.  My son was on one temporarily due to a severe viral lung infection.  I have to get one every summer and wear one of those white masks because of hypersensitivity to forest fire smoke with bronchitis.
Asthma Allergy specialty
I am working as an IC for a asthma/allergy specialist who has recently went into private practice.  In the 10 months that I have worked for her she has changed the format of her PE, new patient, D/C, well all of her forms, several times.  I have tried to explain to her that it is her practice and I will transcribe whatever information she feels is necessary to have in the permanent record (she does not do dictation, I transcribe from written report).  Can anyone give me an example of final transcription for an asthma/allergy specialist, and possibly an example of the forms used?  I would like to present these to her to compare so she can feel comfortable with what she is transcribing for the final record.  I would really appreciate any help I could get with this.  This is my first job and I want to keep this doctor satisified......Thanks!
If they don't read their reports how do they know what's wrong with patient next time he sees

Yer right... half the time the docs dont even read the reports. (nm)
Does she have a problem with going outside? Too hot - too cold? Child with asthma, (sm)
I would say it's time for a serious talk, about maybe some other living arrangements.
Allergy/Asthma Clinic Work
I am hoping someone can give me some insight on Allergy/Asthma Clinic work.  How difficult is it and is it something that can be transitioned into easily?  I have the opportunity to pick up some work but I've not done any Allergy/Asthma Clinic work.  My experience has mostly been in Radiology/Ortho work but I have also done OB/GYN, Family Practice and ER reports.  Thanks!
LOVE teaching hospitals and long-winded reports. Less ADT time which I'm not paid for.
Hate filling in ADT screens w/ searches just to do a one minute report.
If you submit your reports on time and correctly, you get paid correctly. Pay has been on sm
time for 2 years now. 1st and 15th for employees, 2nd and 16th for ICs. If it falls on a weekend or holiday, it posts the next business day.

By the way, there is no Sophie on radiology at Keystrokes. Must be a troll.
The MR reports were being filed. Referring physicians/medical care providers reports were not.
This is a hospital radiology department with in-house MTs and a clerk who is in charge of the report distribution.
we should just once, as patients (sm)
go to the dr's office and waste THEIR time!!! Let them know how it feels for a change. But then again, the doc wouldn't wait two seconds on a patient, now would they? Wow, whatta double standard!
On a really bad day, I feel like a vampire for making money off of other people's misfortunes.

Maybe sometimes we have too much time to think! I don't know.
Just because 2 patients have the
same dx does not mean they are treated the same and symtoms are the same in many dxs. Do you have your degree?
Well, too bad that they have 30 patients - sm

to see so they don't want to spell things out.  Do they cut corners on patient care, as well, when they have 30 patients to see - or is that reserved for us peon MTs?  So they're "frustrated" with 30 patients - well, cut your patient load!  We're not paid to "guess" or have to look up everything they don't feel like spelling, especially other doc's names.  Just won't do it. 

By the way, I wonder if they know how many documents we have to type a day (30 maybe?) to even eke out simple minimal wage - but that's OK, I suppose, compared to their 5 or 6-figure salaries.

Just give everybody the bum's rush because you have 30 patients.  Suppose we did the same? 

The two sentence normal reports will balance out the 3 page reports.
I am Wendy too
A party for our patients...
Every year, the staff in our clinic takes it on ourselves to throw a party for our patients. We all cook finger food, make snack trays, cookies, baked good, cheezes, bread, meat trays, the works. We have breakfast foods and lunch foods. We decorate tables in our lobby to spread this out on. We usually do this one day a week for the four weeks before Christmas so many patients will get to enjoy it. We have coffee, hot chocolate, orange juice, cokes and punch. We have fruits and dips....something for everyone, even diabetics. The patients are touched that we go to the trouble and we are touched by how much they love it! These patients have gone through enough suffering with their diseases and some are elderly and don't have family members. Some tell us this is their only Christmas!  We have been doing this several years now and the patients are beginning to tell us to be sure we appoint them to return on the days we are having our "Christmas spread." I just thought I'd share the Christmas party that means the most to me... and this is definitely it! Just the look on their faces as they are enjoying it is Christmas to me.
It is not our job to judges the patients sm
or why or where they seek treatment.  It is our job to transcribe the dictated reports.  If you don't like the healthcare system, then go out and change it.
Just how many lives do YOUR patients have?

Apparently mine have more than one because I have one dictator who likes to use the following phrase:  Patient was told that he might have death and loss of current life. 

Now we have to insist patients
being treated are actually examined before treatment is rendered?

Wasn't it bad enough medicine when ER docs would proclaim a diagnosis before exam, only to have to backpedal after taking a look?? I guess if they are going to do things in that order, doing physical exams is going to result in their looking stuupid, so their solution is not to do that part.

Big grrrr.
If the patients were aware of that, they could
Do any of you ever feel sad for the patients?
Maybe it is because I am on my period and am more emotional than usual, but today typing all these terminal cancer reports is making me want to cry.  I feel so sad for the patient and their families.  I just cannot imagine being told that I only have a few months left of my life.  And the doctors sound so cold about it.  I know they are very used to it....I just know that I could never be a doctor.  I could never get used to telling someone they are going to die.
A question regarding patients' rights
I was just wondering this. My mother was recently sent to a "liver specialist" who is local gastrointestinal doctor because of concern over persistently elevated liver function tests. He drew a LOT of blood work on her and only told her that it looks like she might have a fatty liver. He set her up to come back in six weeks to "get the results of her lab tests."  SIX WEEKS!  With her being  very concerned, of course, we immediately searched the net and found out that fatty liver occurs in patients 1). who drink alcohol (she never has), 2). Patients who are overweight (she is not) or 3). Patients with diabetes (she hasn't got that, either). It says that a liver biopsy is how they find this out. He never mentioned doing one of those. My question is.. would a physician want to wait 6 weeks to find out lab results? You know it doesn't take 6 weeks to get the results back, they probably had them back within a day or two. In the meantime, she is stressing big time about what could be wrong.
Not sure when doctors graduate their patients but
I have boys and we stopped when my oldest was 11 because they always made them strip down to their undies for checkups and checked their privates and I didn't feel that was necessary and my boys hated it. 
No thanks. Anorexic geriatrics patients don't do it for me.
Very true, but a list of patients?

An invoice by the patient?  Some clients need to do their own book keeping.  It is bad enough you have to worry about the content of the reports.  To have to retype a patient name into an invoice with the line count is utterly ridiculous especially as an IC.  IC's get taken advantage of.  As an IC, yes you should be charging for "everything".  If you're an employee, they can put it under "other duties as needed".  Business is business.  If it takes more time, that takes more money.  End of story.  Don't do nothing for nothing.  Your clients sure do not.  They go all this time with this Transcriptionist with her invoicing and then all of a sudden decide they want each patient name and line count?  Cut me a break.  You don't think there should be a charge for that?  You can work for free, but I certainly WILL NOT!  To make statements like be paid to walk to the computer is really being a bit of a smarty pants in my opinion.  Keep it to yourself if you want to work for free, most people don't!  Have a great day making nothing to do A LOT! 

I read it... does it mean US patients would have to travel - nm
A lot of physicians refer to their patients
as heterosexual or having same sex partners, it is very relevant in some aspects, as in exposure to AIDS/HIV, etc.
New Doctor, some patients already typed
I got a new doctor.  They girl who had been working for him left him in a big mess, undone dictations, etc.  The office gave me a flashdrive to do with about 30 patients on it over the holiday weekend.  Today they've told me ten patients had already been typed, how did I want to handle that?  It seems they don't want to pay me for these.  My husband says to bite the bullet and not charge them, since this is a new account and I'd like to keep it, is possible.  What do you think?  I know it's a land of confusion there from what is done to what is not done.  Thanks!
. Why should patient care suffer?! The patients haven't done anything wrong, even if management sucks. I thought that's what MTs were ultimately hired to benefit, the patients.
How does outsourcing dictation allow doctors to see more patients?
In an article in the MT News section, it states this.  Do they really need to see more patients?  Most of them herd them in and out like cows.
And that is because the GYN forgets to tell his patients that when changing pills you have to use an
alternate method of birth control for a month until the new level of hormones in the pills kick in, whether higher or lower.  That is how come so many get pregnant on the "pill."  The facts...my cousin is GYN and he tells all of his patients that.
these are the docs that I don't think care about their patients. my opinion. nm
We need actual examples of patients harmed by outsourcing
to take to the media. Then we could probably get enough interest for someone to do an expose on it.
I wasn't clear. I guess patients' names is what irks me the most. SM

and you know how famous they are for dictating "Krenazcyssky, Jane, that's J-A-N-E.

neat web site 'chemo angels'. Help cancer patients
My nurse said most patients make calls with their cell, no problem
Pt has had asthma her lifelong. Is lifelong correct?
Your English teacher does not do medical reports. This is for medical reports.
Not anymore. For some time now, I've been working 32 hours and am considered full time to receive
Working full time at home with small children is hard but part time works great
is almost impossible. You will either have to work when your spouse is home or for only a few hours during the day and then more when they are asleep. I work part time at home and my kids (2&5 now) have done very, very well. They are great kids, very well behaved, don't get into much. I stop working to check on them/give them some attention every hour or so while I work (5 hours each afternoon or so) and they get all my attention in the morning and at night. It has worked out beautifully for us.
Yeah, our choc. lab does that from time to time - makes it interesting!- nm