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I used to have to type DSs (discharge and death summaries.)

Posted By: Sad, huh? on 2007-11-03
In Reply to: Sad dictation this morning - PAMT~MDM

It was tough, especially the young mothers or children.


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I do OP notes and discharge summaries and type about 500 lph
x
Discharge Summaries

Hello, can anyone help me?  I have done medical transcription for three years at an acute care clinic.  The doctor I worked for bought me text books and tested me until I had sufficient knowledge in the subject, and I became his medical transcriptionist. 


I am now trying to find a job doing MT work at home, and I am currently taking an online test for a company.  My question is, if a specific format is not indicated, which format do I use as a default, for


discharge summaries, acute care, operative, and radiology.


any help would be appreciated.


amber


 


Discharge Summaries (sm)

Do any of you do all discharge summaries?  If so, can you build up speed if given the appropriate time to learn the account?


Discharge summaries
Not a mental block. Just a REALLY slow work type for me too. Hate them too, but as perverse as MQ is, I get them all day long!!
Ask to start out on discharge summaries. I'm sure you can
NM
Discharge summaries are the pits. Consults and H&Ps might get better, maybe not.

absolutely love discharge summaries nm
nm
Are acute care discharge summaries (sm)
Considering job for small hospital doing DS.  Rating 1-10, difficult being 10, easy to learn.   What is line count compared to clinic work.
H&P, Consults, OP reports & Discharge Summaries. nm
x
Hospital work - history and physicals, op notes, discharge summaries,
s
death summaries
I've typed several that have left me sobbing, spilling tears on my keyboard quite literally, over the line: The patient passed away peacefully with his entire family at the bedside. After I would dry my tears and wipe off my keyboard, I would wonder why that statement was deemed medically pertinent?
You will starve to death with only crap to type, trust me. They did it to me.

A steady diet of difficult doctors and bad reports = no lines an hour.


No lines an hour = Broke city.


If you took a cent a line pay cut and only did ER work you'd make more money!


Discharge summary TAT?
What is the minimum and maximum TAT for discharge summaries have you had?
Breast discharge
I saw my doctor today for breast discharge, amber colored, from several ducts in the right breast. I am having a mammogram Friday. My doc did not feel any lumps. I am very nervous.

Has anyone had an experience similar to this and have some possibly reassuring words for me?

Thanking you all in advance.
how about 54 discharge meds??
That's got to be a record, at least from my end -- i was thankful when he dictated that reader was referred to chart for most of them -- wow.  how can a body handle all that really??
Basic 4 = op notes, consults, H&Ps, Disch. Summaries.
Most services want at least 2 years of experience and a high score on a screening test. Consider your options carefully and read the archives regarding pros and cons of working for services. A few are great; most are not.
I have an account where former MTs dictate dishcarge summaries for docs. sm
Believe it or not, they are the WORST dictators!! For people who should know the terminology and pronunciation of medical words and meds, they sound like first-graders trying to sound out every other word. I absolutely hate doing their charts. They are both American, but they're worse than ESLs for even basic medical words.
You can *what if* yourself to death--sm
it sounds to me like your decision is already made.. gor for it! Giving up *free time* is never easy, but we need to earn a living too. Good luck to you!
EMR is NOT the death of MT
Even if the entire world went to EMR (which I doubt we'll ever see in our lifetime) it doesn't mean the death of the MT nor does it mean we will all have to go to VR. I transcribe for an office in NY that uses EMR, and once our reports are sent in, they go into a holding bin for the doctors to review and sign of on.Then the reports go directly into the patient's EMR. The only difference is no paper. We still get the same amount of work for the same amount of pay. There is absolutely no change to my routine. On the other hand I have an account out of AR that will probably never ever ever go to EMR unless the doctors are faced with losing their licenses or they retire (a good 20 years or more)
That just irks me to death.
I worked for a national that had two QA people on my account.  The one QA person did it one way, and the other one did it another way.  One pushed for combining forms, the other one said NO.  I never knew who was working from one day to the next.  I finally sent an email to both QA people, the account manager and the owner of the company with quotes from each of their corrections contradicting each other.  I asked which way I should do it because I couldn't do it both ways.  It took forever to sort out.
Income Tax after Death

I have a friend whose mother passed away in March of this year.  She was an IC and thus earned income right up until the time of her death.  Is her daughter now responsible for filing an income tax return and/or paying taxes on this income?  I know an accountant for her would be handy in this situation, but I thought I might get some opinions here as well.  Thanks!!


RE: Taxes after death
My mom died last year and the accountant did work up her taxes and they were paid by me. The money, of course, came from her account.
death toll
That is 53 confirmed deaths so far....Lord knows what the count will be when the water subsides, so it may be close to comparison with the Tsunami, I pray not.
Yes and lover her to death!
$50 a week. We have about 2500 sq ft and she cleans the whole house. I can't believe it took me as long as it did to hire someone.
I'm tested to death, too
If you create a folder on your desktop called "Sound Files" - then when you are downloading an mp3 file or whatever - right click and do "save to target" - then browse your desktop until you see sound files folder and make sure that is in the box. Then, the files will download to that folder. Then, when you double click on Express Scribe, up on the top you will see "Load" - click on this and then browse for your sound files folder. Highlight those you want to download into express scribe and then down at the bottom, hit ok or load (can't remember which it is). They will then be loaded into express scribe, ready to go.
Death summary on someone who...
had died for the same disease as my dad, lymphoma. The summary went through the last month of her life and the hospital stay. At that time, my dad was not in the hospital, but was showing these same signs. So, I knew what was forthcoming for him. And, needless to say, it happened the same way with very few changes. Talk about a tear jerker and a tough one to type.
Death in family
As the "executrix" in my family it was my duty to be sure everyone was treated fairly. Some things were taken by family members without waiting and rather than get upset about it, I let it go. I just made sure the written wishes in the "will" were carried out. Some did take things that should have been given to others, but I knew better than to bring it up,since it would only make for family problems ad infinatum. You don't know if there was something about the jacket that made this person feel her father's presence, not thinking of where it really "belongs." I agree that it should go back to you but in my experience, they might say, "it was a gift" and never be on good terms with you again. Let it go, believe me, this is what this wonderful man would have wanted you to do. It's hard, it's difficult, but "letting go" will give you more freedom. Perhaps at a later point you could mention how much the jacket meant to your son and how you are glad it was not given to a stranger. Perhaps she'll come to her senses. She's in too much pain right now to think straight. Wait a week or two and don't cause a permanent rift. You'll be proud of yourself later. It's material. Bad feelings go on forever. Somehow "grace" is always the best under pressure. Sorry for your loss.
Death in family
Quickly - ask for it. Otherwise, it might be sold in a yard sale. I know that when my father-in-law died, my mother-in-law's mother and sister came in and cleaned out the house - within 3 weeks you would have never known that he had lived there. They took and sold everything that they wanted, left my mother-in-law with a few pictures and her own memories. Thankfully, her mother died this year - she and the sister were real vultures. Hope this helps, but whatever you do, fight or no fight - get it back - you will be glad that you did and so will your son.
scared to death...what to do

Okay, now that I have job offers, I have to figure out what to do.


Right now:  I am employed on site as an admin asst with great insurance, good pay, people I like, and job security.  The downside is missing my family--I only see them about four hours in the evenings and most of that is bathtime, cooking supper, you get the picture.  I also have quite a drive to work and parking is HORRIBLE.  I feel I work LONG weeks and then have little to show in the way of my emotional outlook and cash left over after buying gas, etc. 


What could be:  I have job offers to come back home and type full time.  I would be here to see my children and be close to their schools if something happened.  Also, my husband has built me a gorgeous office by closing in a porch, so there's a big three-paned picture window that overlooks my garden.  I can envision myself at home, but there's a tremendous amount of fear that's holding me back. I am AFRAID because I remember how long it took to get lines in every day.  I worry about the security of benefits, PTO, and just the job itself.  I don't want to be sitting in this office 7 days a week from 6 a.m. to 7 p.m.  I hope I'm more capable than that, but sometimes it's not the MT, it's the conditions, and if I give up my other job... 


I guess I am just venting and worrying and wondering.  After a two-year break, can I come back home and be productive and accountable as an MT?  Can I count on the industry?    I really wanted to come home, but now I'm afraid.


TIA for any and all suggestions!


BORED TO DEATH
Does anyone else get sick and tired of doing the same work, same doctors, same everything day in and day out?  I am bored to death with this job!  I like the job just not the same stuff.  I think I need a change!!!! 
Death summary

Dr. dictates:


Reason for Death:  Incompatibility with life.



The VR is what bored me to death..sm
I would actually get to the point where I could feel my head nodding...80% of what I got was VR....I was beginning to feel retarded.  The only straight transcription that was sent to me were the worst dictators, cause the company knew I would do it, take my time, research, relisten, etc.  I've always felt more alive transcribing than editing.   Cat
Sick to death of this!

Now, I'm sure that this has been covered again and again, but I am so upset that I just have to say something!  I am so SICK and TIRED of every single job listing saying, "New graduates need not apply," etc.  It's like a slap in the face...you're not good enough, we just know it, don't even THINK about submitting you resume to us you subhuman.  I have worked at previous jobs in which I was as good after two months of experience as some who had been working there 3 or more years.  (I'm sure everyone has had this feeling.  I'm not trying to insinuate that I'm a genius or anything.)  Why can't anyone just give me a chance?  How do they know that I'm not good enough?!?!?  Meanwhile, I've invested a moderate amount of money and a huge amount of time into this for what???  Anyway, that's my rant.  Thanks for listening and sorry for the negativity.


Once had a supervisor who nitpicked me to death, my first job,
took it and took it, until FINALLY one day, she told me that "mcg" was not abbreviation for micrograms....that's when I QUIT and went home!
So the solution is clubbing 50,000 to death?
Pleeeeeeeeeeeeeeeeeze. I'm sorry, but that's just an ignorant comment.
blue screen of death

I'm not sure if he went back to myspace a second time, I'll have to ask him.  Thanks for all the help.  I got it at Best Buy so I think I'll take it back there and see what they have to say also. I just don't want him away at college and have the darn thing crashing all the time.  It's not like you can just keep buying new ones at that price!



DRG'S - DEATH OF BIG BUCKS FOR DOCTORS
I still remember when DRGs came into healthcare - before that - you could just go to the hospital and get yourself admitted - relax for a few days or a week - have nice nurses to wait on you hand and foot, and then leave - with the insurance company picking up the tab.  Oh, they would give you some aspirin or tylenol - something to charge for and do a complete routine lab panel on you at each admission, but you didn't have to have anything really wrong with you in order to get in.  Then came the DRGs, insurance coding and the end of the primadonna transcriptionists - This also ended the big bucks to the physician's (for the most part).  Some still make a lot - but it is due more to savvy investments than it is from healthcare.  Google DRGs if you want to find out more, especially those of you who are new transcriptionists.  Our days of the "big bucks" is over, as well.  I have seen about a 50% decline in pay from when I started working 15 years ago.  Most of that within the past 5 years.
It may die a slow death. Agree with having more than one
nm
I agree - slow death
I don't think it's on its way out just yet, but the type of work is changing and with VR and EMR, who knows how long we will be typing. I do agree, also, ongoing for coding. I think the more diverse you make yourself, the better off you will be. Never put all your eggs in one basket. Good luck!
Years ago I did a death summary by a GI doc.
I don't think GI docs are used to having patient's die and I don't know if it was his first patient to die not, but he was crying so hard at the end of thedictation it was hard for him to dictate.  I think he was in his second year of practice, so around 30.  I can't remember he if made a statement or not, but I'll always remember him crying. 
And you'll almost never get just Op notes. Probably get mixed acute care - op notes, discharge su
s
they always have and always will have hurricaine parties and joke about death.
I grew up in hurricaine country - there are folks who would much rather die at home.  I do not understand it, but I know that its true. 
Probably starved to death on what thisperson made.
x
(((RadGuy))) Death is never easy to accept........
But it does sound like he enjoyed a very full life and that is some consolation, I hope.

RIP, teach.
death in the family brings strife
Why is it that when a family member dies it brings strife among people who are supposed to love each other? My father-in-law passed away recently. My son plays baseball at his high school and  my husband and I had bought his father a jacket for Christmas one year that had the school logo and his name. He came to all of our son's games with that coat on. My problem is that my husband's sister took it without asking if we wanted it. We were planning on keeping it for our son to remember his grandfather and all the games he came to see. Any advice? Let it go? or ask for the coat back? I guess I am more upset that she didn't even ask (we did get it for him for Christmas as a gift) than anything else.
I'm scared to death for my 29 yo beloved neice!

Her insurance will not pay for a first, baseline mammogram even though strongly ordered (and fought I might add) by her ob/gyn because of some cystic type lumps in her breast, so we (uncles, aunts and her dad) are paying for it and she goes tomorrow. 


Now, her insurance co, BS, has all the info and would rather "deal with it" if she has an issue later on?  We did a family tree of sorts when she went to this new ob/gyn and it looks more like a family time bomb!


Paternal side: 1 cousin and 2 second cousins diagnosed with breast CA in their early 30's, grandmother had it, great aunt died from it, great grandmother died from breast and cervical CA, great great aunt died from breast CA and uterine CA.  I am her only paternal relative not diagnosed and the rest were before the age of 50 & I have mine yearly (also having mine with her tomorrow) just because of my side of the family but hers gets multiplied!


Maternal side: Her mother was diagnosed at 39, fought for 5 years and died 3 years ago from breast CA.  One cousin (26) with fibercystic disease is closely watched, and went into POF, premature ovarian failure at 24 causing infertility.  Aunt won her battle with breast CA only to lose it to ovarian CA at 42. Two other aunts went into premature menopause in their 30's (which the doc said is a red flag to watch) Then her grandmother died from it, great aunt died from breast and brain CA, great great grandmother died from breast CA.


After the mammogram, her ob/gyn wants to seriously talk about elective mastectomy's with reconstructive surgery to just not even give this God awful disease a chance to hit her because of having 13 relatives total diagnosed.  After watching the devastation in her mom and aunts, she has no problem with surgery but the uphill battle will be the insurance company.


She's still my baby and it just scares me to no end the inheritance she's been cursed with!


 


My female doctor annoys me to death...
She will be maybe... a minute into dictation... and start a convo with someone else in the room for about 4 minutes... start again, but wait!! loses her place..and skips to a completely different section.  I would say about 90% of her reports are always incomplete.  She will just hang up the phone a lot of the times.
My sister and mom both drank themselves to death this year. sm
They were 45 and 24 years old. Alcohol is poison. I do not touch that garbage and wish prohibition days were still here so my family was still alive.
"The Death" of Medical Transcription
I have to agree with you wholeheartedly. I think it is a shame what has happened to our profession.

It seems that people with 25-30+ years of experience are either transcription service owners or instructors in medical transcription. Very few transcriptionists with
a lot of experience are doing "sweat shop" transcription.

I feel sorry for those students who are being misguided that they will become transcriptionists and be able to work at home and make a lot of money. I am afraid they are going to be in for a big surprise!

I do not understand how medical documentation ever transpired into a production-oriented job. Production WILL have priority over quality when it comes to a paycheck. Why bother looking up terms in reference books or on the internet? That takes a lot of time and can affect an MT's paycheck.

I compare a medical Transcriptionist to a robot -God forbid you go to the bathroom and stop production!

Perhaps a Walmart greeter would be a more pleasant and less stressful work environment!
Control-shift sux. Death throes? sm
I wouldn't disagree with your statement, OTMT, about the "dead profession". At least, there used to be so much more dignity and professional pride in being a good transcriptionist. Especially if you were a (shhhh!) CMT or a massive but accurate producer. Now we're treated like factory girls, but even factory girls deserve dignity, respect, and a fair wage for doing their job right. Please excuse the negativity, but I was out there a very long time and know what it was like before the downward spiral began.
I think Taylor did a much better job last night than a lot of the guys. I love Ace to death but was
not that impressed by his song.  I think Will is gone, he's good, he just out of his league with guys that sing for a living.  He always reminds me of someone who is just standing up singing at the 4-H talent show, hasn't had time to develop his voice or true showmanship.  I think Gedeon did a wonderful job last night, too.