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I prefer ESLs

Posted By: Tired&CrankyMT on 2008-01-08
In Reply to: ESLs -- How do they understand - Blondee

I personally prefer an ESL to a native English speaker any day of the week.  At least I know with an ESL, I am dealing with a tougher ear level, a level not many folks can do or are willing to do, and 99% of the time, they happen to be the best dictators out there, they don't rush their dictation or speak half-thoughts/utter a sound that means 10 words, they do their best to speak clearly...all I need to do is learn their accent and clean up their grammar. 

I have only 1 current ESL who speed talks with a thick accent...Just 1 of out say 50+ that I handle between 5 acute care accounts.  I handle a lot more ESLs than that due to the logistics of 3 accounts being major city hospitals, but I didn't want it to seem an inflated, BS number. 

In the long run, my willingness and desire to deal with ESLs allows me to build my ear skills further.  When it comes time to job hunt, that little line on my resume, Heavy ESL experience gets my foot in the door to show what I am able to hear and do, making me a bit more marketable.  Don't get me wrong, MOST ESLs I can handle.  Russian accent still leaves me saying WHAT?!?!  but hey, at least I am willing to try to step up to that battle to conquer and learn them.

I worked for a company that NO ONE wanted to transcribe the 52 ESLs.  I kid you not.  The TAT on those files was disgusting.  MTs would actually refuse to transcribe them.  I took them on, they became my primary workload, my preferred work.  I'd log in for the day, my supervisor would ask me what I wanted for "breakfast" as she read me off the list of who she had.  I had the freedom to choose back then, and let me tell you, it was CAKE, I was loving it and laughing all the way to the bank.  My queue for the day was set with just about 120 minutes of assorted accents, my daily line requirement, as a part timer, exceeded the full-time requirement.  I never ran out of work, I never NEEDED to worked late, never felt pressured, and didn't have to worry about leaving a blank, for it became clear to my supervisor/QA/team leader, as well as the CMT/owner, that if I couldn't get that blank, there was no way they could either.   I took care of my supervisor/QA/team leader and she took care of me, we were in a win-win situation.  But, that job is gone now, as the company folded and closed its doors.  My comfort zone is gone.

Currently, I work for 2 nationals.  They do not filter and distribute files broken down between ESL and native English speakers.  I pull my daily workloads from a pool, so I never know who I will end up with.  It's in my own best interest NOT to shy away from an accent.

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How would you prefer - sm
Wondering if you have any suggestions for a better way? What would make it easier for you?

and why.


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I much prefer sm
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I just prefer it.
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I prefer my ESL
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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.
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? 

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!
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!
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
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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!
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. 

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. :)
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.
I have had a real difficult time with some ESLs too. But I was on an account where basically I could do them or not work. So I pretty much had to just do it. It got a little better the more I would hear the accents. And I mean a little. Do they provide you with samples for these ESLs? That often helps alot. Good luck!
I totally agree with you. It is just as important to know how to speak it as write it if not more so in medicine. There is no excuse. It doesn't matter what nationality -- Latino, Indian, European, or Asian. It makes no difference. They should learn the language fluently to practice medicine. An accent is one thing. But just flat out not being able to communicate clearly. There is no excuse. And no you don't see ESL lawyers. At least I haven't. I am sure you will get some posts telling you you are racist or a bigot. But it won't be from me. And by no means do I have a problem with ESLs who are fluent speaking in English.
I have one who says "please use inverted commas," which means (to you and me) quotation marks.
I have also heard them refer to blood pressure as 120 by 80 for example. I don't know.
You know you are just preaching to the choir.  So what if they say 120 by 80.  You are a professional.  You should know what to put down.  If you want to gripe about something, make it something that matters. 
If ESLs want our $, should be able to
A lot of ESLs
I was told that they have a lot of ESLs so if you are ok with them you will probably like them. 
You said VR does not get ESLs
but the platform I work on does them better probably than I could. I am totally amazed it can but it does.
Well, fortunately for me, ESLs were my specialty because of my strong background in foreign languages, so I loved them when I was working. BUT I've known many excellent MTs, including my own sister, who had an extremely hard time with them and would literally weep, wail and gnash their teeth! And you're right, on some accounts, the great majority of dictators are (or were) ESLs. Why, I don't know. I retired at about the time when everything was starting to be sent offshore, a few years ago. I'm glad I was able to retire before our whole profession had gone down the tubes.
Well, fortunately for me, ESLs were my specialty because of my strong background in foreign languages, so I loved them when I was working. BUT I've known many excellent MTs, including my own sister, who had an extremely hard time with them and would literally weep, wail and gnash their teeth! And you're right, on some accounts, the great majority of dictators are (or were) ESLs. Why, I don't know. I retired at about the time when everything was starting to be sent offshore, a few years ago. I'm glad I was able to retire before our whole profession had gone down the tubes.
Probably best for ESLs.
Or really anybody who can type better than they can dictate.

My PCP has a point-and-click system and during my visits the PCP spends most of the time typing comments into the space provided. I have a feeling that a lot of providers may quickly grow weary/frustrated with the constant typing/spelling/grammar when they should be seeing patients. I'd hate to see what their medical records look like.
I have had my share of hard ESL doctors, but by far the worst dictators are English and just go too darn fast or speak sloppy.
I prefer In-Hock Rd.
I certainly prefer Word but......
I have become accustomed to it. It is not too difficult to learn and overall I don't feel a bad program. I have used DQS as well and I think Emdat's InScribe offers more options from what I see.

My biggest complaint is the spellcheck. I copy/paste and save all my reports in Word and spellcheck in Word as it catches errors that InScribe's spellcheck does not.

Also, I do not use their Expander - I use Instant Text which I love.
I have done both and prefer IC because I can write
everything off. You have to be very diligent about receipts and setting aside tax money though.

The only real difference in pay between the two is 7.25% for social security (self employment. You have to put aside the taxes rather than have the company pay them for you but either way, that tax money comes out of your check not the company's pocket.
I also prefer in-house

... but I am doing radiology.  I worked at home doing hospital work for 4-5 years, and it wasn't interesting enough.  There wasn't enough variety for me.  I could see problems that I would be sooooo good at fixing if I was working in-house, but there was no way for me to have an impact on quality issues working at home.  I now get to improve the referrer database, look at the future schedule to look for missing referrer names, work with schedulers, techs and radiologists, and just do lots of little things that really add polish to our business, and are very satisfying to me. 

To each her own. 

I prefer VR, MTg for 28 years....nm

thanks but prefer programs not from...

She does prefer that I type in EMR
but said she we would discuss what would work best for both of us. Thanks for the info, that was the kind of thing I needed to know.
I prefer the CD. I can travel with my
job and used a laptop.  I am able to have all my references available because I have them on the computer.  Stedman's only allows 2 downloads though, so if you are one who may have lots of computer issues where you will need to reload your computer a coupld of times a year or if you  might want to resell then CDs wouldn't be the way to go.  The books you can find used on the classified board.

You can use www.drugs.com as a drug reference.

There aren't a separate set of books for clinic work, but I would recommend a book called Sloane's Medical Word Book by Ellen Drake.  It is a large book with all the specialities and while obviously not as thorough as the Stedman's books, the terminology used in clinic work isn't as technical as acute care and will probably be good enough for you.   I haven't looked at Stedman's lately but they may have a similar book. 
prefer books

I prefer reference books, as all my work stays in one spot in my office.  Have tried the CDs in the past but didn't care for them.  I can understand wanting the convenience of having everything on a laptop since it sounds like you move around frequently.  Guess it depends on the work sutation.