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Serving Over 20,000 US Medical Transcriptionists

I know you can learn accents

Posted By: Renee on 2008-01-19
In Reply to:

Ever wish you could take your post back after more thought?  I spent alot of time thinking about this topic of ESL/accent/ignorant dictators, and I guess I would like to clarify now.

I understand that if you listen to the same dictator or dialect repeatedly, you learn to understand it, and there are several that I have become quite familiar with.  But, my point was that for the $2.00 +/- per page that I get paid, I choose to listen to someone who is willing to take the time to speak with courtesy and clarity into the microphone.  I understand that at some point I may not have the choice, but while I do, I choose to work for someone who gives what they expect.  They expect clear reports, I expect clear dictation.  And they get paid ALOT more than I do to hold up their end of the bargain.

On the same token, for the hundreds of dollars that I pay out in medical expenses every year, I choose to give that money to someone I can understand and that I am relatively sure understands me, without the language barrier.  I don't want to chance a compromise in care because of a misunderstanding in communication; there are enough other things that can cause a compromise in care.

The medical language is hard enough when everyone is speaking the same language, with all the sound-alike words and similiar words, etc.  I don't want to confuse it even more with any extra variations.  I know it is here to stay, but I want to stay under my rock as long as I can.

Hope I haven't I haven't worsened my "foot-in-mouth" disease, or made anyone else even more upset...

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Accents - sm
Just wondering - do you southern MTs have as much trouble with northern accents as I do with southern accents?  They sure take some getting use to; no disrespect intended, but some words are pronouced so differently that I have to listen several times to get them.  I suppose I'll adjust eventually - I hope!! 
YES! we do, I'm from Texas.
to JWJ on accents
You are SO RIGHT. I do a LOT of ESLs and I rarely have problems just because of what you said - think with an accent and pay attention to where you are in the report. If you can't beat 'em - join 'em. When you are done, you can go back to your real thinking but in the meantime, think like them.
White males who make long, convoluted sentences with improper sentence structure.
southern accents
Being a Yankee who now lives in the south, I can relate! Had far more trouble with the southern dictators than with the foreign ones.
And yest, those British & Australian ones are sexy!
Spanish accents. sm
I worked on an account out of San Diego once, heavily thick Spanish (Mexican), brilliant docs, but very difficult.  I work on an account in FL now, still Spanish but Cuban and very, very different.  Those of you who say you don't do accents, try another field.  This job is all about dialects and learning and hanging in there.  If you are pompous enough to say, "you don't do this or that", bet your pay reflects it. 
Spanish accents. smC
Clarification:  You probably still make good $$$$ if you are the perpetual cherry picker.  I hate cherry pickers, that is cheating, lying and stealing.  Most managers even those Rhit sort of people, do not realize how much cherry picking hits those of us in the pocket who do any job assigned.  I hope all cherry pickers rot in hello.
No accents/ESL. PERIOD!

Okay, I have a confession... I cannot understand accents.  Period.  So, when going to see a new physician, etc., I make sure to ask right off the bat whether the doctor speaks clear English, and if the answer is no, then I tell them that I am sorry for wasting their time and I go to the next doctor.

Just the same, when I was being considered for the accounts I have now, I told the lady I work for that I cannot do heavy accents or ESL doctors.  I know - - could have kept me out of work, but you know what?  I don't need the money that bad, because I would just be spending it on psych meds because trying to do the work would make me crazy! 

I'd estimate about 200+ - all accents
worst accents

I agree with the person who said not really an accent.   Those who chew, yawn and dictate while falling asleep are the worst.   the only Hispanic I ever worked for was very precise and even said comma, period etc. his words were very distinct but some of his pronunciation was difficult but once becoming accustomed to that it was no problem. 


Vent on accents. SM
Why oh why does a doctor who has been in the United States practicing medicine for over 20 years continue to have the same thick accent and poor grasp of the English language, as well as inability to grasp proper grammar and punctuation. It's like they do not even attempt to lose the accent. I understand young foreign doctors who have not been here long and are struggling to deal with language barriers, their residency, etc., but these older docs who I know have been around for a long time, drive me insane. I would in no way, shape, or form see them for my medical care, if they have made no effort to improve communication with their U.S. patients. Hello, what country are we in here? Thanks for listening to my vent.
vent on accents
I think most of the larger Medical Schools do offer the remedial courses, at least the 2 I worked for did, in fact, it was required for all foreign docs at first. Just wish that all ESL docs would take advantage of it.
I prefer non-Southern accents

I'm from the south but lived out of the area for several years.  My favorite accents are Northeast and MidWest.  For a while I did MT for a hospital in rural Alabama where a resident from Cuba was working.  He had acquired a number of southern altruisms that cracked me up with his thick Hispanic accent.  I'll never forget when he treated an elderly woman who had received a rattlesnack bite to her foot through her "teenie shoes."  (if I hadn't been from the south, I wouldn't have known he was referring to "tennis shoes!")

Once my dryer needed servicing and the repair man came out.  After talking for a while I asked if he was from somewhere near southern Russia because of his accent.  He got so excited that someone knew the geographic area of his origin!  He was from a tiny little country bordering southern Russia!  (one of my neurologists was from Russia).  I love to try to place someone's accents


I have a bad time with southern accents too
Their words just sort of fall into one another and it seems like they put emphasis on the wrong part of the word, so I need to concentrate with them.  The worst however is the Chinese accent by far.  Especially when they do try to slow down and enunciate, it makes it worse.
middle eastern accents
I had one yesterday for that sang and hummed most of the report. He dictated in a sing-song voice that made me think he was casting some sort of spell. In between words and sentences he would say, ahhhh, ummmmmmm, and then speed ahead with the sing-song again. And it was all in a middle-eastern accent. It was an extra long report and awful. I was so jittery by the time I finally finished.
anyone else think British accents are sometimes difficult?

There are few doctors with British or Australian accents compared to Indian, Middle Eastern, Hispanic, East Asian etc....but perhaps because I don't hear them as often I am sometimes really thrown off by them..  not ESL! But I find myself relistening before I get some of the words.   Also difficult are some of the other European dictators...do not get as many of those either. Used to get a guy - I looked him up on the hospital web site - it said he spoke about 6 different European languages - he had a very unusual accent.

No, not for me! I love European accents
and do well with them. However, the middle eastern accents throw me. There's something about the tone or pitch that I simply can't hear. Maybe I have a deaf spot or something. It's caused problems at jobs because MT employers think I'm "refusing" to do those work types when it's actually a hearing problem. Some of the Hispanics are the same way. I can do Asian, French, German, Scandinavian, east coast, American Indian, southern, British, whatever, just not east Indian/Arabic accents.
I have as much trouble with southern (USA) accents (sm)
as I do with most ESLs!
My mom is from the south. Thanks to that I have no problem with southern accents. nm
Hope you're good with accents! sm

All customer service is outside of the US and I had a really tough time communicating with them.  Also if you choose to discontinue early there's a whopping $90 fee that's buried in the fine print.

I used Vonage with broadband satellite for 2 months and it disconnected frequently on me....my satellite has been stable for years with multiple platforms so I suspect Vonage is just not suited for satellite.  Just a heads up!

Accents (Kim Komando's Cool Site of the Day), 8/10

Always something interesting in Kim's world:


What's the worst part of it? Accents, research, TAT, etc.? Hope
No, not at all, plenty of people with accents, not all sound dopey.
Then again, maybe it's all the pot he smokes, kills a lot of brain cells, ya know?
learn something new every day - thanks
See - learn something new every day. Thanks. I just knew about some laws passed locally last year on a city/county basis.
Did you learn
on the job, or were you taught by a friend, or self-taught?

Most of those tests nowadays are geared toward grads of official MT programs.
Learn something new every day don't
you.   A consult is similar in format to an H&P, but 2 different things - for example, an elderly patient with diabetes breaks a hip and needs surgery.   Most likely they are admitted to ortho, but need an endocrine of internal medicine consult to determine if diabetes is stable enough for surgery and no other medical problems that might be a contraindication to surgery, or need treatment prior to surgery. 
You will never learn to do them...
unless you tackle them head on. You do what you can with the report, and you do what you can with the next report. You cannot avoid difficult dictations. If you don't learn to do them, you will never make any money and will probably get into trouble for abandoning too many reports.
Why would anyone want to learn it???
Learn something new every day...sm

Outlook and outlook express are two different things I guess.  I never knew this, but that's what I am being told.  Outlook has a calendar option but outlook express does not.  Very interesting indeed.  Let me know if you all hear anything different from this. 

Thanks for all your help.  I have decided to try the yahoo calendar for free and see how that works.  So far, it's perfect!  Thanks for the info everyone! 

thats it! You have to learn the sm
hard way to understand. For my own personal experience, I have gone through a horrible illness and I know more than ever the importance of medical records that are perfect. I have seen some really bad stuff out there in medical records, my own included that not only is a disgrace but downright dangerous! I have always done my job with the idea that there is a patient behind all of this and they deserve the best we can give them. With all the ruckus about the state of our health care system these days, why would any MT not understand that this is not about us and lines typed and cpl etc. ITS ABOUT THE PATIENTS!!!!!!!!! you are right, the money comes later. Its a career long learning experience, one that I hope never ends on the learning part. Sounds to me like you have also been through enough life to understand all of this. The younger ones won't get it until they have been at this for many years. The only problem is, with some of the attitudes of "I won't do this and I won't do that" they won't be in the business years from now!
Learn from history

and think very carefully about this person and his sob story. Boo hoo! 

His child is cruel toward animals, chances are this child is being mistreated in some way by someone. This is a red flag that something in not right in this child's life regarding the adults. Children are NOT naturally violent--it is learned behavior.

Be friendly, but takes things very, very slow and think of the safety of yourself, your children, and your pet (s). Better safe than sorry.

newbie trying to learn

I have recently finished an online medical transcription course.  I have been reading the posting on this website and I'm very intrigued by some of the information.   Not to sound stupid, but what are word expanders, auto correct, and shorthand?  I have macros on my computer, but I never used them.  I am trying to find my first medical transcription job, but it is very difficult as a newbie.  I would love to be a productive, accurate medical transcriptionist, but it seems that no one wants to give the newbies a chance.  Any thoughts of how to get started?  thanks!

It is your job to learn the ESLs and if you can't/won't then you need to
find a new job because you are in the wrong one.
However, once you learn it, it's great!
I averaged $21-23 an hour doing radiology, about $15-17 doing acute care. If I were to go back into transcription, it would be doing radiology.
Thanks, i'd be interested to learn more

welcome; love IT and sure you will too when you learn it. nm
It depends on what you need to learn. Sm
Right now I have a gal starting Sep. 1 who has absolutely no med. training whatsoever so we are starting from scratch. She is paying for textbooks, cd's, materials, etc. I am having her pay as she goes along. I am not making any profit on any materials, but when she gets to the transcription part, I will have to start charging minimally for my time. Not sure yet how to go about that.

The second gal has some formal training and needs dictation practice and I am actually in the process of working with a company getting copies of microcasette tapes with approximately 800 minutes of dictation on them and will give those to my students.

I have a few accts. myself so when my students show that they are ready to tackle digital dictation, I may consider "hiring" them in the future. Right now, our goal is to get them trained and ready with my help, and to be able to pass a co. test.

I don't know where that box is to place my email address is and I don't want to post it in this spot. I will try to get my email available for anyone seriously considering getting into the field and being trained with an experienced MT who is willing to mentor them along the way to meeting their career goals.
It was very frustrating to learn but

after 3 months, I have grown to like it.... well maybe I have grown not to dislike it so much.  I would still rather work in MS Word.  It is NOT the best platform out there to be certain.  The spell check is awful and I copy everything into a Word document to double check.  You cannot copy back into Emdat though.  If there are any changes to make you must type them.  For some reason if you copy from Word, although it looks okay to you, on the physician's end it is wrong.

It is nice not to have to worry about the line count.  It is VERY nice not to have to save each patient separately.  It is nice to have the patients name available (although that is not always the case).  Overall, I give it a C. 

Hope this helped.

I had to learn the same program sm
Whether it is worth it - is only a question you can answer.

Personally, the platform is so easy; however, I do not get the high line counts I am used to even with their expander. I am so used to working in a Word-based platform with over 5000 auto-correct entries. For me, the transition was not worth it. I could only average 240 lines per hour compared to my usual 350 - 400 lph.

You have to realize, every one is different with different needs and wants.

The packet of policies you mention really is no big deal. Just print them out and read them over and within a week you won't even look at them again. Starting any job is overwhelming at first, but then it becomes routine.

I would suggest you give it a shot. You have nothing to lose and everything to gain.

As for the ESL account, I have no idea which one that would be - mine is a good mix of all.
Thank you! Learn something new everyday!
I like it. Once you learn it, it is easy.
Is this so you dont have to LEARN which is which?
If so, no, theres no way.

If you need a shortcut, just put the nongenerics in your Expander as capped. Put your others in like ddiphenhydramine and it will catch on spellcheck and you will know it is generic.
Yes. Use MT while you learn something else. It's never too late. nm
Was very difficult to learn and there are
still some things I cannot get the hang of. But, it is the only Expander I am permitted to use so had to bite the bullet after resisting for a few months. Takes about three months go use it effectively. Try using it for a few hours every day. When you get frustrated, close it and type everything out. On short-fuse days, skip it altogether. Over a few months, with this method, you will begin to develop speed and each new problem will be solved one by one so your line count will not get suffer greatly. Using IT requires doing a massive amount of reading initially. But, I have to say, I love it now (and am still learning how to use it six months into using it).
That rate is better than most. You do learn

the ESLs.  You just have to "train" your ears.  I remember my first day on my current account.  I had all ESLs and I had so many blanks and was so stressed, but now I would rather do these ESLs than some of my American docs.  I still have times when I will have a blank with these docs but it is rare.    When you get corrections back print them and keep a file for future reference and if you can relisten to the report once you get corrections and see if you can hear what they are saying this time. 

Took me about a week to learn it. I sm
forced myself to do it the IT way (using their marker keys), and started out using it 1 hour a day. I purchased mine at fitaly.com for full price. I have seen it used on ebay & here on the equipment board.
because in med school they learn to be even
cockier and they also learn how to dictate even faster. They also learn to pretend that everyone's physical exam is exactly the same no matter what their problem really is and, by the way, the Transcriptionist should know what that physical exam entails from the very first report. So, they all decided to save their money and just be a P.A. instead of an M.D.
yep, for some it's a big deal so learn it *LOL*

The patient will be seen for followup in a week.

Followup one week.

The patient came in for follow up of her acne. (I believe this can be hyphenated to follow-up.) 

The patient will be seen for followup care in a month. (This, too, some MTs hyphenate to follow-up but I do not.)

The BOS has this very issue - Book of Style by the AAMT 2nd edition  - discussed in it. 


Where did you learn all these tricks?
I have the program and have really not got into it too much yet, but the manual leaves a lot to be desired. It is very highly recommended so I intend to keep on trying. I bought it about a year and a half ago, and admit I finally gave up and put it on the back burner, but I really want to learn how to use it. I will add, though, that I have had a lot of trouble learning the tricks with Word, since I am on my own and having to teach myself.
Is it easy to learn?
It will help you learn MD names and
I think help you get a realistic idea of your nursing career. I don't have kids though. I hope you have a good support system.

Good luck to you.