I have to agree. I would be uneasy having some ESLs as my physicians - sm
Posted By: ChuckM on 2009-03-27
In Reply to: has nothing to do with the race, but rather the communication gap when dealing with my own medical n - old and cranky
at times, too, for that same reason -- I've seen too many errors creep into the medical record because of the language barrier (though I would place equal, or greater, blame upon the MTs and/or QA who allowed it to happen through the "god help us, we can't have a blank so fill that blank with SOME kind of word, quickly!" mindset).
I once had an ESL psychiatrist who had a terribly thick accent. After doing hundreds of his reports I would still have a difficult time understanding him at times, yet when he was interviewing his patients and they didn't follow the conversation well he would often enter that into the record by saying that "the patient had a difficult time understanding this examiner and following the conversation" ... well, h--l, anyone would, doc.
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I so agree - ESLs once ya get 'em ya really
I happen to be very_good w/accents, also living in a very diverse area (and let's not forget, being an MT am we are also supposed to be excellent listeners)
what I think the OP doesn't get is ALL LANGUAGE commences in the heart - we are all the same - just *hearing* different words for much of what we all talk about on a daily level.....they say the similar things about similar issues ongoing in the world, and, instead of getting ALL freaked out when one *hears* an accent, my suggestion (unsolicited as it is) would be to try to become a better listener.
To the OP, about your hypothetical blurb telling them to *go back to their countries*...guess what? Your relatives came from elsewhere, unless you're native American....and somehow I doubt that you are;
Would you have liked your ancestors to be told similar, holding that same exact thought as you, about they should all go back to their own countries? hmmmmm?
Time to open the brains nice and wide to things that are different but ongoing all over the world 24/7/365....better late than never...I have some great ESL dictators and some not so great, but first and foremost have AMERICAN ANGLO mushmouths who just care less for the most part.....
Have a nice evening....
You are so right. Its up to the physicians and
also your local competition. Its all about offering the physicians something better than the competition - better rates, better TAT, and if your competitors are certified, you can bet that's part of their "sell"...But you could never predict the certified issue until you check the waters. Good luck to you! Its not that hard to pick up a local account or two. Enjoy!
Do you think ER physicians actually do as thorough
a physical exam as they dictate or do you think they fabricate a lot of the details of the physical exam?
Not all physicians are like that .....sm
I work for very generous, kind and caring orthopedic surgeons who see patients, with little to no income, and charge them nothing. They ask for no payment and nothing in return. These docs would give you the shirt off their back.
Not every physician cares only about money.
It is bad enough for the ESL physicians but
today I had an ESL PA dictating and when she dictates hypertension she says hypertensions, as in the patient has hypertensions and heart disease is diseases and lukemia is well you catch how it goes EXCEPT if you have the patient's wife, then she says the patient wife or the patient daughter. I am TICKED
Is it just me, or are physicians getting worse
with dictation. I transcribe several that use speaker phones to dictate. I think ER docs are the worst. Not only do they use the speaker phone, but that talk at a rate of about 150 miles per hour. Do they not realize (or maybe they just don't care) how difficult they are to transcribe. I really don't understand why the companies we work for allow this. 
I ask the physicians! Haven't had one yet
who didn't tell me what they were already being charged. You should be able to call the MT department at your hospital and ask around there too.
About incompetent physicians...
Yes, they are definitely out there and getting scarrier day by day. Actually, the great majority of them are quite pathetic.
local physicians
I was wondering if any one knows if local physicians would rather hire certified MT to do their work from home. I am thinking about supplementing my income with a national and wondering if this would be a good way to go. Any insight into this would be greatly appreciated !!
Prospecting physicians??
I currenlty have one account of my own and am an IC through a very small local transcription company. However, I want more of my own accounts. I have sent letters and am willing to do more. Does anyone have any idea on what it takes to "land" an account? Thanks so much for any ideas/help/suggestions!!
Physicians by State
www.healthcarehiring.com. Scroll down to the bottom and you'll find all of the states. This is a great site to search by state, and you can search by specialty even within that state. It is in alphabetical order, which is very, very helpful. I love this site myself and use it every day. 
Yep, been there,done that. Many physicians today
have gone to EMR. I talked with one not long ago who said I needed to find another line of work since EMR is replacing the MT. Even my own personal physician uses EMR.
We are either being replaced with technology (EMR or VR)or work is going offshore. Somehow for me, editing is really not something I am interested in, as I would rather transcribe.
Hopefully, others here will be able to direct you and encourage you, perhaps giving you ideas of how you can obtain clients. Much success in whatever path you choose.
We have many Muslim physicians in the US.
Would you be so quick to condemn someone who had a problem with "We took a moment to praise to Allah"? Would you be as tolerant as you claim to be in that situation?
The physicians used to have to be bribed
to come in and dictate charts, have seen for myself. I would love to know how it went from not wanting to dictate to suddenly everyone getting out their EMRs and typing away.
My take on how these physicians dictate
I question and I mean question about every day whether the person coming in as physician is really that. I have 1 that basically cannot string a sentence together, changes sentences 3, 4 or 5 times each sentence. I have physicians who pull the same stuff, going several paragraphs down and then asking you to add or delete something. I get really ticked when I hear all this and don’t hold my cool. The person in the room with me usually hears my ranting and raving. It is hard enough to get through the ESLs, mumbling, crunching, snorting, eating, sucking, sniffing, sorting papers and the list goes on without putting up with this. One change that was made at the hospital I work for was to tell dictators they could NOT use a cell phone to dictate. It worked. I only wish I were in charge so I could tell them more about how to dictate!
I've found that most physicians who
dictate at such a ridiculous pace are trying to make up for other deficiencies....you know like "male menopause" where the older guy goes out and buys an expensive sports car, etc., etc. Seems most of the speeders on my account are DOs, NOT MDs.....guess they feel inferior in some way. 
Physicians are willing to share their knowledge with (sm)
anyone who will listen. They love young bright eyed students. I expected the MT world to be just like medicine.
Why is cost the only issue? It is unprofessional to only think about money. What about pride in the profession and wanting to share knowledge? Isn't that how professions advance and grow?
I am surprised.
State Licensure for physicians
I use the State licensing agency for whatever state the physician is in. I just Google State License or Health State licenses and it brings that particular website up and then I do a search. Great Tool!
When do physicians give feedback to MTs?
x
I have heard American physicians say that. What is the
big deal? You know what they mean.
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.
physicians pinching pennies
while making over $100K a year (after insurance premiums), for a service that is tax deductable.... they really dont have a clue...
To my knowledge, you can't print the physicians'....sm
list and I doubt they are in there by specialty, too. You can print the contents of your ESP file if you save it to your desktop and then print it. Hope this helps.
There are no dictators, physicians, nurses, PAs or the like
who don’t dictate on the VR I use, wish I did not have the crap dictators as you call them but they are not left out on my end. I really, really hate it now when I do get a straight report to type I am so happy with the VR I do. I think before long most big places will go that route, little ones not so much as I think VR costs quite a bit.
A great site for referring physicians
that includes credentials and you can search by state is:
http://www.healthcarehiring.com/physician_pennsylvania.php
Down at the bottom you can change the state. I have used this site quite a bit.
Good gried!!! Plenty of physicians
mispronounce terminology, medications, etc. that they are not familiar with in their specialities. Get a life and find something worthwhile to gripe about. Did you understand what they meant? Apparently so, so just do the work.
Physicians and caring or lack thereof
recently I have experienced both sides of this aspect. In January I was hospitalized for asthma by my then family physician. I had been to him 3 times in the month before that with problems but he made no effort to adjust meds, etc. About a month later, he walks into his office and tells his staff today is your last day. I'm closing the office.
I got strep throat and went to a different doctor. She was absolutely the best. She looked at ME while she was in the room, not at the chart or her PDA in her hand (like the first doctor used to do). She talked to ME. Asked ME questions and answered any I had. asked about allergies (which I have many). The first doctor tried to give me medicine I was allergic to (and he had been told multiple times). Two weeks ago I was hospitalized through the emergency room with another asthma attack (brought on by the flu). My new doctor sat down beside me in the room. Talked to me. Got a very detailed history. Explained what tests she was going to do. Explained the results of what tests had already been done. Told me she was going to refer me to a pulmonologist to evaluate if my meds need tweaking. Even asked me which one I preferred based on how my insurance would pay. I have only seen her in the office twice and then while hospitalized and I already feel more at ease and reassured that 2 years of using the other doctor.
Also, at work this past week a patient was admitted after lunch. Because the patient had missed the noon meal, the PHYSICIAN went to the cafeteria and bought lunch for the patient and took it to him. Now THAT is a physician that cares about the welbeing of their patient!
I wish all doctors could be like these two - both of them female! Maybe it has something to do with our nurturing instincts! 
I'm sorry, but the physicians are supposed to review the medical records for
accuracy, then sign off on them. THEY are the people who went to medical school, did their internship, and actually saw the patients. THEY know what they were trying, often badly, to say. THEY are the ones making the big bucks. NOT US. We go to maybe a year-long correspondence school, make crappy money, and watch our butts spread wider every day while we TYPE, yes, I said TYPE, medical records for them. Anyone who thinks it's more than that is kidding themselves. And save your speeches on patient care and work ethics. I know all about that stuff. The harsh reality is that this job does not require a college education to get into, and your income is tied to your production level. The doctors don't care enough about the medical records to speak slowly, enunciate, and double check everything before signing off. How are we supposed to read their minds? Anyone in this field who knows more than grammar and medical terminology ought to be working as an RN or MD, because you'd be better at it than half the medical providers we type for.
switchboard.com is another good site for finding physicians
x
Many physicians in my area don't want to take Medicare, Medicaid, Tricare
or other insurances because the insurance companies require a huge buydown of charges and then disallow quite a bit for being "above the reasonable amount."
For example, I had double insurance of Blue Cross/Blue Shield and Tricare when I had surgery. The bills totaled $15,000. Blue Cross knocked $5,000 off the physician's $7,800 bill, paid him $600 and left Tricare and me to deal with the $1,200 balance. Tricare wouldn't pay because they disallowed the amount as unreasonable, the physician's office forced me to make payments on it, and I had to fight just so I didn't owe them another $1,200. It was ridiculous that I had double insurance coverage and wound up owing anything. Meanwhile, the doctor didn't even get paid that much, and he did my presurgery appointments, the actual surgery, two postsurgery appointments to remove hardware, plus coordinating everything between cardiology, radiology, anesthesia, laboratory, surgery, and having special equipment trucked in from out of state.
If I had not had insurance at all, I would have had to pay the entire amount. I think it's crazy that noninsureds have to pay the full amount but insurance companies can disallow or buy down the amounts due. Anyway, you hit a big rant of mine. Shortly after I lost my Blue Cross coverage, my son needed to be seen but we couldn't find a provider to even take Tricare at all. So much for my husband serving his country and being away from his family in the line of duty. The doctors get rich and refuse to treat military personnel who fight for their freedom. Talk about a total lack of appreciation.
Same situation here. When worked in-house or for physicians offices,
never as much as a single episode of no work available. Much to my dismay, I have found out that MTing from home for a nation is so unpredictable, in so far as what your paycheck is going to be every week or 2. They all say "there is plenty of work," which is probably factual. However, the nationals are primarily interested in pleasing the client with their promised swift turn-around-times. What they forget is that if it weren't for the MTs, there would be no turn-around-time whatsoever. It's really very discouraging and quite unfair. Most people try to adhere to their monthly budget, which is impossible when one never knows how much they are going to make from one week to the next. We ARE the providers, not peeons, and resent being treated as such.
Does anyone know where to find a listing of the V.A. Medical Center physicians?
Thanks for the help.
Medicare is offering free installation of EMR to physicians and hospitals.
http://www.medscape.com/px/instantpollservlet/result?PollID=1502
I also have two offices w/mult physicians on tapes, but going digital this month (sm)
at my encouragement. I am training them with a consulting fee by the hour. They were resistant, very old fashioned, but after multiple problems with a few docs dictating over each other's tapes, and the cost of gas, paper, and everything else... I encouraged this. In fact one service just added another physician and I told them I could not handle their transcription anymore, but they said whatever I can do to continue, so we are going digital and longer turn-around time. It will be a time saver and more cost effective for me right away. I will still be going in to the offices probably twice a month because I feel the personal touch is really important. I also work PT for a national, by my choice, as I feel it keeps me on my toes with different types of transcription. Also the national is a guaranteed paycheck via direct deposit every 2 weeks, whereas my own customers, thought good money, well sometimes they are late. 
They are physicians, not grammarians. I transcribe it so it is grammatically correct, but my accoun
I would rather do some ESLs that some of the
sloppy southern drawls that you cannot ever understand. Wish those people would learn that not everyone is in love with a southerner.
ESLs
What is an ESL ..... and I agree with you completely about the time spent on GRAMMAR!!!!
They can take the smallest so-called "errors" and put a black check by your name. We are medical transcriptionists, NOT English teaches.
Any GOOD MT has equally good grammar. Plus there should be less emphasis on grammar and more emphasis on the medical terminology. Do you REALLY think the doctor cares if a comma was put in or left out? NOT !!!!
I wasted a lot of time agonizing over GRAMMAR when I could have been getting in more lines and doing what is best for the patient .... accurate medical terminology.
Bad ESLs
Wouldn't it make sense for companies with bad ESLs, to hire US MTs who speak the dictator's mother language to do the transcription?
ESLs
If it makes you feel any better, I once worked part-time for a doctor in his office. I wanted to get back into a hospital setting so I gave him my notice. He couldn't understand what I loved about being an MT. He said, "At least I have the benefit of reading their lips." AND I was once transcribing for this absolutely miserable ESL one day, pretty much the way you described, and waiting for him to hang up. Instead he was chatting with someone when I heard "I don't know how they do it, but I give them a lot of credit." I had to rewind to make sure he was talking about transcription and he was. Not all of them are that sweet. I once had to show an English book and the BOS to an extremely arrogant ESL oncologist. I hope you had a little chuckle here and feel better!
ESls
That's why AAMT is no longer a valid entity for us. The standards have been lowered to accommodate the ESLS because they can't make a decent sentence and don't know how to convey what they did or did not do to the patient. How the hell are we supposed to read their minds???? Those who can speak English and demand verbatim get what they deserve. Just the other day, the doc gave a female who had a vasectomy. He was a verbatim ESL and he got exactly what he dictated. When enough of them get sued or reprimanded, maybe standards will return, but I have no doubt in my mind that ESLs have lowered the standards at the hospitals and that's why we no longer change the dictation to make it sound like they at least passed English class. When I started it was not verbatim. We edited to change context and not content. Hospitals should make it clear they either speak clearly, or write clearly, and failing both of those, they should hire a PA or someone who can dictate like it should be, and some of the PA's aren't much better.
ESLs sm
Once they know you're good at it, expect them to send you nothing but!
ESLs
Hey, we all were horrible at ESLs (and I have to be honest that I often still struggle myself), so don't feel bad about that is how it goes. :) Good luck to you.
Had it up to here with ESLs....
I used to be one of those conscientious MTs who went back and re-listened sometimes 2 and 3 times, because I hate to send blanks to QA. After this morning, NO MORE !!!! This particular ESL doesn't even say the complete word, only the first syllable which is mumbled and scrunched into the first syllable of the next word. From this moment on, I go through it once, proof it and off it goes. If it's shot full of holes, then so be it!!! I'm telling ya, Wal-Mart is looking better and better. UGH !!!!!
What about ESLs
who dictate 1, 2, 3, 4, 8, 10, etc.? These people are prescribing medications and they can't even COUNT in English? I can see messing up and missing a number, but totally messing up like that? On more than one report?
If only the ESLs would be more
organized, be briefer, and pay attention and use normal phrasing instead of these long, awkward sentences they put together. They are strangely worded whether they are routine or made up on the fly. If only they would notice which phrases we can't understand and study the non-ELS dictators' short reports. If they could keep their reports short, we could knock them out much faster and be done with them.
ESLs
Speed up the dictation and listen carefully..then repeat by slowing down the speed. Think in terms of how the ESLs would transpose certain leters. What nationality is the dictactor? Example: S might actually be a T. Hope this helps. Good luck!
ESLs
I can totally relate. I get SO fustrated with some of these ESL dictators because like you say they cannot speak decent English. And yes I wonder how do they understand their patients? If they can't speak English properly can they just understand it when spoken to them? I cannot believe they actually have MDs either. I swear sometimes I sit and just curse when trying to figure out what they are saying. I am glad I am not the only one. I just feel like saying if you can't even speak where I can understand what you are saying then you don't need to be a doctor. I know being a doctor entails much more than speaking properly but geez they are terrible.
I do a lot of ESLs too and I can actually take
an Asian with a very thick accent and do him without any blanks at all, but then I get the fast talking, slurring, nonenunciating American born doc and I have problems. Even if I had a copy of his physical exam that he says the same every time I still would not be able to hear it because it is so slurred.
I recently started a new account and I have doctors with 13 or more letters in their last name and I just take a deep breath and prepare to have a difficult report, but they have no accent at all and then I get a Dr. John Smith and his accent is so strong that I have a headache and am cross-eyed when I get through his dictation.
Like it or not the ESLs are here to stay and you can learn to do them or you will find your options limited, especially if you do acute care.
ESLs
Yeah she made the comment let his own people figure out what he is saying. She said this out of fustration. I for one know how fustrating it is when you are struggling to understand what a dictator is saying. You just get so fustrated. It is our job to transcribe no matter if it is an ESL or American, that is true. That doesn't mean we can't get fustrated when we have to struggle to transcribe what they say.
Also I think she meant the MTs in India are the ones doing it for 3-4 cpl. That's why alot of outsourcing goes over there because they work much cheaper. I guess what I am trying to say is I understand your point. It is our job. But I understand hers too. It is very fustrating. :)
ESLs
You know that is a great way to look at it. I hope I gain something for all the struggle I have to go through to understand them. At least I will have gained some experience.
Not only the ESLs
We're being awful hard on ESLs, and alot of the defense for them is they are no worse (or possibly better) than poor-speaking English speakers. The bottom line is that if you are speaking for other people, you should speak clearly, regardless of where you are from.
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