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When ESL docs use interpreters...

Posted By: I soooo understand....(small message) on 2006-05-23
In Reply to: Totally understand! - sm

I just laugh when I hear an ESL doc on my account needs an interpreter to explain the risks and benefits of the procedure...LOL!

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Actually, simultaneous interpreters
don't make big bucks. I am proficient in three Slavic languages. I thought the U.N. would be a perfect fit, but when I heard what the U.N. paid, I kept looking. Simultaneous interpreting is VERY stressful and requires a lot of rather expensive training. The U.N. doesn't pay enough to make it worthwhile. They think the "prestige" of working for the U.N. should make up for the difference. Yeah, right. Freelance and contract work pays a LOT more.
ESL Docs

That is SO true!!!!  There is definitely a problem with dictating the appropriate gender when it comes to ESL docs. They tend to go back and forth umpteen times during one dictation, so you really have to pay attention.  Verb tense can also get very confusing.

I agree that sometimes slowing down and concentrating can actually increase productivity. Even though I feel like I'm transcribing like a tortoise, I'm really getting more done than I think when I slow down and allow myself to think.

Just hang in there with QA. They are just doing their job and you need to take a good look at what they are telling you and concentrate on that issue. It's really hard not to take it personally, that's for sure, but it's gonna make you a better Transcriptionist in the long run. On the other hand, if you feel they are truly wrong about an important issue, then challenge them!!  But you'd better have major references to back up your challenge.

Ellen S.



ESL docs
are you on VR yet? you can choose to have a 20% cut on your baseline rate and get the "better" dictators ?? or you can choose to keep your MT 100% baseline rate and probably get all of the ESL docs -- what a choice - not fair, huh??
This is almost as bad as the docs
I got three of them yesterday...three different docs. I think this is soooo rude! I'm almost to the point where I'm going to refuse to attempt to do them. Surprisingly, it's always a female doc who is dictating either a GYN or breast cancer related report.

I can picture a couple of these ladies hopping on a Harley Davidson riding home from work.
I think they should ask all ER docs

if they even know the English language to begin with, 'cause if they do, they don't practice it.

I know everyone knows that a lot of docs don't

read the reports after we have transcribed them, but I just had a doc on my account dictate that he wanted the line "Dictated but not read" added to ALL of his reports from now on.  He was mad because he said he requested this to be done a few weeks ago and has been "keeping track" and it hasn't been getting done.


All of my PAs were better than the docs before

I switched companies and along with my new account came all new PAs (and might I add, quite a few of them) who all make me miserable. They botch the dictations beyond belief and I am left to fix the sentences which look like riddles and are actually confusing after they get done with it.

Change thoughts in the middle of a sentence...start talking and forget where they left off so I am sitting there for another 2 minutes waiting through the ummms and ahhhs and the start of sentences "the patient umm.... ahhh" and I'm waiting for them to say something and they just hang up.

Mine are good for this too... they will dictate an incomplete report and then a few dictations after they will start finishing incomplete dictations, adding in something they forgot to say, or they will say CC a copy to: Dr. ____  on a 4 second report and not say whose report it goes on. This would be easy to figure out if they didnt have 40 dictations and at least 5 hang-ups with about 8 of those 40 dictations being something they want added on to some nameless patient's report.

Had I not switched jobs, I would have had a hard time believing any PA was hard to transcribe...just because I had a good bit of them on my other account and they were all PERFECT speakers.

Now when I see that I have to transcribe a PA-- 


ESL docs
Hey there,
Hang with it a little while longer. You'll probably find that it gets easier. Those ESL doctors do say the same thing over and over again and it takes practice to get it. Try listening a few seconds longer than the phrase you aren't getting because sometimes that helps. I agree that samples help an awful lot so be sure to request as many as you can. Good luck! You can do it!
I would always rather have my ESL docs over the sm
English as first language docs, who speed talk, slur words, and don't seem to care about the patients.  I am usually very impressed with the patient care given, and the understanding of the human issues, by the ESL docs.  I think the problem with the original poster is she needs to learn to transcribe these docs, with all the suggestions, especially getting samples, mentioned above.  She doesn't really seem that concerned with patient care, but her inability to transcribe difficult dictators.  It is, quite simply, the nature of the business.  The easy docs go on voice recognition, and the transcriptionists transcribe the difficult dictators.
I tell ALL my docs that I'm an MT...
...and I transcribe and read my own reports (I work for a large healthcare co).  Hubby signed a HIPAA form for me to transcribe and read his reports, too.   Now the docs are more careful 
how many docs know?

When I mention to physicians that if they send their work out it might be sent overseas they are appalled!  Sometimes they say things like, "So that's why there were so many mistakes."  Companies don't always tell them where the work is being done or by whom. 

I still fault them for trying to save money at our expense, but in a certain sense some of them are being taken advantage of as well.  Perhaps our "enemies" could turn out to be our best allies should a good case make it to Court TV. 

We need to educate the physicians as well as the public. 

Or I like when they make up their own spelling of words, especially meds.
sorry made a mistake above...I meant the docs take me to the bathroom with them LOL!!!
Let's face it ladies and gents - doctors have absolutely NO respect for what we do for them so they can make $$$$$$$$$$$$$$....
My ER docs do it alot

I guess it gives them the right to charge PREMIUM prices,  although I

think ER prices are quite pricey enough.  My friends trip through the ER

the other night was a cool $10,000 and all she got was an aspirin.  (she thought

she was having a heart attack and it was GERD.  But to rule it out they gave her

the works; CT scan, CXR, blood work, cardiac enzymes......and on top of that came the doctors (including the cardiologist, oh my) bill.



of course, I know 'bout as much as the docs do...sm

yeah, and that's why I'm here typing and they're out on their yacht somewhere, right?    But I do try to diagnose, even did this when I worked for a doc in the back office.  And sometimes I was actually right!

Cheap docs

They absolutely don't care about quality or any of that jazz, which is why I have always wondered why we as an industry keep beating each other up over issues that doctors couldn't care less about. Not that I think we should all just transcribe any old way we want, but it seems like we act like the slaves out in the mud pit slapping each other around about how much or how little straw to use for the bricks while the slavedriver sits on the side line with the whip completely content with end product either way.

I suppose the answer most would give is that we should take pride in the quality of our work whether they (the doctors) do or not, but I can't get passed the notion that these are the same individuals that the powers that be seem so intent on pleasing and are also the same individuals who would see us all in the soup lines tomorrow looking for the next homeless shelter to sleep in if they had their way. They (the medical profession) will not think twice about putting all transcriptionists out of business at their first opportunity, and yet we as an industry continue to bow to their ridiculous and uninformed demands concerning how to do what we do or their complaints about how much we charge or that we shouldn't charge for line count generated by short forms or macros, etc. They have no clue how many times their butts get saved by transcriptionists on a daily basis.

I've never met a transcriptionist who wouldn't readily agree with the notion that we are part of the health care team, and yet many of us continue to act like we still work for the doctors instead of the patient. Oh well, go figure.

Just venting as well.

also, most docs won't do certain tests (sm)

without your consent, if they are not considered standard and will probably have to be paid for by the patient out of pocket, unless the patient agrees to pay either up front or if the charge is denied.  At least that's been my experience! Good luck, I hate insurance companies, too!

Isn't she cute? 

Do your docs talk 2U?

I have one doctor who, when she wants to correct something or other always says "This is an aside to the typist." ARGH. I feel like I'm in a Shakespeare play or something - don't those have a lot of "asides"? I always want to scream at her "Don't you know I'm not a TYPIST?? I'M A MEDICAL TRANSCRIPTIONIST, DAMN IT!!!!" Of course she's 80 or something so I shall forever be "the typist" to her.

I have a resident who always says "For transcriptionist, would you...." to get my attention - but when he was new I thought he was saying "Poor transcriptionist..." I always nodded my head in sad agreement until I realized what he was actually saying....

And then there's the doc who loves to complain about his job to me, sometimes in great detail - "Here I sit, waiting for some x-rays to come in so I can make a buck" and "I cannot believe this hospital."

They crack me up!

docs talk to me
I always get one who says, "uh, secretary, please correct..." and then I have one who always says "oh, operator, could you kindly...." Does he think that because he dictates into a phone it's a telephone operator on the other end or what?
Docs don't have those guidelines because... sm
they realize how stupid they sound and look.  They learn the language of medicine and stick with it.  They don't bow to some silly-*ssed organization's whims. 
Hoo yah. I hear ya. Then you have the docs that. . .

think for some reason you know exactly what they are going to dictate for ROS so they just basically babble right through it and take a big deep breath at the end.

Or the one like I had today that sounded completely wasted off his butt and even with the speed up or down it still sounded like a drunken drawl. It was ridiculous. It was also dicatated later on Thanksgiving night, so who knows? Maybe doc had a few too many rounds of Thanksgiving cheer and then thought, "Ow thith, I thstill gottsa do my dictatheen."

Report them to your supervisor. It's worked for me in a few cases. It's up to them to pass the word along that the dictator needs to slow down.

I had one guy that I do locally on tapes that suddenly decided that he was going to take his machine and dictate on his way home in the car.  I don't think so pal. I called my local boss and said I wasn't going to do it. His tapes have been clear as a bell ever since because he's doing them in the office again.

that won't do nothing but give you a bad name and p*** off the docs...sm
that is definitely NOT the professional way to handle this. Give a little bit more time to get the check, ask for more details (in a neutral tone of voice) about when the check was sent, the number of the check, etc. Document the answers. Then consider filing a claim in small claims court. Sometimes it's a scam but sometimes it's a cash flow problem.
Chiropractors and other alt med docs?
Does anyone know of a good site for this? I usually use WebMD or AMA but chiros and the sort are not listed, and I can't find a good resource for them.
contacting the docs re. this sm
What she did does seem cruel to you and perhaps she is cruel, but those accounts are absolutely hers to deal with and I think it is wrong for the subcontractor to contact the contractor's clients, totally wrong. I do feel for you. As an IC and MTSO, I have been "kicked to the curb" for cheaper price undercuts by "so-called" friends, etc. You must let it go and move on, perhaps contact your local church if you need help with food, utilities, etc. I do feel very badly for you, but I think to contact her clients would be "tacky" and make you look bad. Perhaps one day you will own your own accounts and see what I'm saying is true. Good luck to you, I am sure you are very hurt, I have been there as well. Not much you can do but log it into your "experience" book. Stay well, things will get better. Sometimes change forces progress, I hope so for your sake. With all my best wishes to you.
Hopefully docs will realize
that their time is better spent seeing more patients than doing data entry..glad that your docs realized this. I had one lone hold-out who refuses to do the clerical entry... but doesn't dictate either... still writes ShortHand notes in charts....Ugh!
Lots of ESL docs
Have worked for prison system in Tx. They hire lots of ESL docs but work is not hard as they outsource serious cases to general hospitals. As regards pre-employment testing all I did was a typing test and gave my references.
Ask the docs what they are paying now and go from there. nm
foreign docs
And why do a lot of those same ones who speak such poor English also make no sense in putting together their sentences?  I have several that sound like they are clenching their teeth together and straining to get the words out which makes it even worse.  I know exactly what you mean.  Their oughta be a LAW! 
inconsiderate docs
I had one doc who gave me a bad checs. So, I found another account to make up for his lack of funds, but I picked up his work as usual. I did the last two tapes he gave me, but I didn't give him the work and I returned blank disks to him. His OM hated him, so she called me when she had a deposit and I met her at the bank with the checks and a bill for the new work. She gave me a new check, we took care of business, I got my all my money, and he got his work. I then notified him that I would not do his work for him any longer since he tried to stiff me for several hundred $. Boy was he mad. Tsk, tsk, tsk.
Wow, there are some rude docs out there!

I guess I am very lucky to have such appreciative doctors.  They tell me thank you for the wonderful work about everytime I see them.  I dont get a Christmas gift from everyone of them, but out of my 7, I usually get 3/4.

Sorry you all have to deal with such unappreciative and lousy dictators

Rude docs
Judy, I have 6 docs like that.  First of all, I insisted on a sample for each of them.  That helped a little.  When blanks were happening in a place I knew I would be getting over and over, I would email or call to force them to find out what he was saying and let me know for the next time.  Believe or not, every day gets a little easier.  I've had them for almost 9 years now and get 99% of what they say.  It's rude and disrespectful, but just depends on how badly you need the account.  You will get it eventually.  Every new dictator is tough at first. 
fast docs
Why don't you get with the office manager and get copies of their standards and then all they have to do is say "use my usual or make changes". Mine were too happy to do this because they HATE dictating as much as we hate hearing them like that. And, I still got my line pain in spite of using normals.
That's funny because my docs are
just the opposite. slow as molasses through the h&p and then speed up to warp speed through the diagnosis. I don't understand it, but you are right, it can be annoying.
Some docs are - I know an oncologist
making around a 1/2 million a year - not too shabby!
The docs might be making a little more because
patients now than they did in the past. Go into any office and you will see they are way overbooked. A rheumatologist I used to see saw 50 patients a day. He said it was to cover Medicare and public aid losses. That doesn't mean they are making money hand over fist, just seeing more patients to cover the hospital losses.
Docs I know have been doing that for years - sm
its a CYA and its nothing new unfortunately.
How about the docs that use the tapes sm
to dictate, then use the call in system, put the phone by the recorder and re-record the whole stinking tape via the call in. To me, that is the worst. It turns out to be 30-40 minutes of dictation and they sound like they are dictating from the grave. Yuk.
If the docs dictated like that, they would never get anything done, lol
longwinded docs
I type for an American doc that will dictate a 30 minute report which should really yield some lines as he speaks so clearly, but he hums and flips through pages for 20 minutes of that report, and chats with others about their family, etc.
Yes, have done my own...avoid going to docs where I know...sm
the MT.  I would not want anyone I know doing mine. 
RE: so many docs/specialties
The national I contract with has me on one account in one specialty. I was doing another specialty as a second, but there wasn't enough work. Is there any way you can request doing just one practice or specialty, or am I misunderstanding how other companies do things? This is the first MT job I've had, so I'm not familiar with the norms of the field. I can imagine if each doctor has different formatting how it would further complicate things, too.
Hundreds of docs
Me, too!  I just want to cry when people talk about being able to set up templates because I may not get the same doc again for weeks, if not months, let alone skipping from immunology to hepatology to dermatology to cardiology to neurology (pant pant pant, too much skipping) and then to several other specialities as well.  Jack of all specialities, master of none.  Sigh.
ESL docs and newbie me

I'm working my first MT job and the docs are all Indian ESL's.  One doc is fine when dictating stuff like height and weight, but as soon as he comes to drug names or procedures (he's an anesthesiologist) he talks rapid fire and his accent is incomprehensible.  I'm afraid I will lose this job because I cannot get his accent.  He says inviolabile for available. Oxnin for Oxycontin.  Menfarm for Metformin.  I almost cry when I get muy corrected copy back see the mistakes I've made. 

I've spent hours on two or three words and figure that I am averaging about $1.50 an hour at this point. My son makes more working at Arby's.  Is there any hope?  Should I plow my way through it or ask the MT company for a different doctor?

All my docs supply their own
paper, letterhead, envelopes, etc.  I did have one doc that wanted sticky paper, but the office supplied it to me at no charge.  I would give them a copy of the receipt when you purchase it.  Attach it to the bill with a small charge for having to go and buy it for them.  Could you perhaps speak to the office manager who could maybe have their person who purchases supplies order it for you? 
But if people let their docs know THEY don't want it - sm
I DOES add up to money. That's what we're talking about here. If patients change care providers because they don't want their SS#'s and personal data sent to god-knows-where, then the docs can push their medical institutions to be more diligent about who does their MT work. Paying a little more up front is a LOT less expensive than paying thru the nose to defend themselves in a lawsuit (or to lose one.) And medical institutions can be more adamant than ever to the MTSOs they hire that they don't want one shred of info. being offshored. And some institutions are already getting the picture that they can up their transcription quality by hiring their own MTs, and cut the costs by having them work frome home. It's the best of both worlds. But again, the BIG problem is that the average Joe Citizen walking around, who goes to the doctor and has a medical record, hasn't a clue that it is even typed by another person other than their doctor! When I tell people what being an MT means, they are usually surprised. One person I told actually thought the docs HAND-WROTE all their own patient records. And the same Joe Citizen who is currently up in arms about other issues in this country (a good example right now is the pet-food contamination disaster), I believe they have the potential to put pressure on the government about offshoring private American medical information. There are probably other offshoots of this that could become motivated to join in as well, if the risks to the public are similar. Maybe it's time to start asking our personal healthcare providers to start furnishing us with WRITTEN PROOF that our records and personal data are not leaving U.S. soil.
So did you change docs because of it? nm
Obviously I can't speak for ALL ER docs
and perhaps your son's exam was as dictated, but I know from personal experience that they often "fill in" stuff on the reports. 
sometimes the docs specifically say they--sm
won't pay for *normals* or pretyped template phrases. If he/they have not already stated this, then charge the same. If they realize after the fact that this is the case, be honest and tell them that it was never stated not to include template normals and then negotiate a price. If, as the other poster stated, you have to print these out, it is still costing you the same, so I would charge for it. Perhaps, if you want to be above board, ask him prior to beginning with the new templates, what his intentions are. Sometimes they *forget* to say whether it is paid for, or not. I hope you get what you want out of it. good luck.
Really Smart Docs
From OB ultrasound report: "The fetus is single."

Good for that fetus! No fetus should marry before being born.
Docs are kept in the dark
When I told my Doc I was leaving the hospital he asked why and I told him. I also informed him of what was really happening with the transcription department and he had no idea at all. All of the Docs are up in arms about the work, but were not told that for awhile it was going offshore, and that we had a lousy supervisor who could care less, but sure covered her rear to her supervisor to make sure she looked good and left us to hang ourselves. She would not support us, but just screamed at us over nothing. My Doc was set straight, and I told him they need to be aware of what was going on and offer help.