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dictating while seeing a patient

Posted By: Cindy on 2007-11-13
In Reply to: dictating while talking to patient - SA

I must be weird because I never had a problem with the doctor dictating while seeing his patients. I worked in a busy clinic where one of the doctors pumped her breasts while dictating, one would eat hard candy and comment about the patients under his breath, one would tell dumb jokes in the middle of his dictations. We (the transcriptionists) got even with them one year at Christmas by publishing a little booklet of all their bloopers. We even got our raises that year!!!

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dictating while talking to patient
I like peds transcription..have not done as much as I would have liked.  I have had some doctors who do dictate at home with their children around ("Be quiet! Daddy's dictating...go see Mommy..sshh")  Used to type on an account that had a cardiologist who always dictated his reports while interviewing the patient ("you have the chest pain how often...(patient talking)....") Annoying...all in a day's work.
Putting patient versus The patient (sm)
When did this "rule" come about? I've been an MT/Editor/medeical records tech/ART for 30 years - Never, ever was I told to put that. You cannot make the sentence be "The patient sent to Radiology" but you can put "Patient sent to Radiology."

Thats just insane.
If they are dictating what you do with it,
Furthermore, whose to say they won't take it back!!!!???!!!
someone dictating for him
here is one for the books - have a sub-intern dictating for attending - dictates the following - "Dr. _____ states that the patient has a history of "what did he say "quinaquina" failure.. I am not sure if that is the correct spelling."

well he would not - it is chronic renal failure. Now why is he even trying????? - thankfully at the end of the report the attending who apparently was sitting next to him by this point, corrected him when he dictated it again. I give up.
that might be why the doc is dictating sm
all this old stuff. Doc may have gotten caught and fined for not having charts up-to-date. I a hospital, docs get their hospital privileges suspended if the charts are not caught up
They said Drs. not dictating on this account
I tried re-dictating to Dragon...
I bought the latest best version, souped it up with KnowBrainer and devoted 3 solid months to training it to my voice and building a huge vocabulary. I could still type circles around it. Editing is extremely bulky and slow. Also don't think you can have your docs dictate a page and then train Dragon to do their speech direct. First of all, they will expect you do to charge less since "the computer" is doing all your work. Second, you will be spending tons of time doing further tweaking and training to get Dragon anywhere near up to par to actually get any production out of it. All of which is not only frustrating as h---, but you don't get paid for it. Now, don't take this to mean that VR won't take over transcription. Big companies use a different platform with the Dragon engine - one in which they have spent a lot of time figuring out how to make it quick and easy to edit...oh, the end is in sight, all right...
Dictating while being tickled
I have one MD who on three occasions has dictated while being tickled! I can't help but laugh along, but it sure makes me wonder who the heck is in there tickling him!
Dictating and driving
Can you hear me now?? I have a physician who dictates while he drives,and by the way, his dictation goes in and out so unable to get really what he is saying.
Is this a child dictating?
I once had a doc say "I asked the patient to pee in a cup". I forget what I changed it to but I cannot stand the word "pee" and refused to use that. It is so vulgar (of course got the approval from my supe first on the change).
Child dictating
Both my Ped doctors say poop and pee. Is this going to be the industry norm? Maybe we won't have rhinorrhea any more, just snotty noses, and a few owies, ouchies, and boo boo's. lol
Transcriptionist dictating into VR
I read an article about this years ago.  A local Transcriptionist would listen to a report and dictate it into a VR program she had on her computer so all she had to do was edit rather than type because she had carpal tunnel so bad.  It worked well enough for her that she could remain employed.  I didn't know her or have a chance to meet her, unfortunately, but she inspired me to take the VR class through Office Careers at the local junior college.  Like most people in the class, I found out pretty quick that I didn't have the voice for the software.  It just didn't work well.  Plus you have to retrain it any time you get a cold, allergies are acting up, yell yourself hoarse at her kid's football game, etc., because your voice quality has changed and the program doesn't recognize you as you anymore.  At the time, she was working with reports on tape and whatever word processing program was popular at the time (WordStar, WordPerfect, Word).  I'm not sure if you can use VR on your computer (or the one supplied by your employer) with the Internet platforms that provide the voice files now.  It would probably be an added complication your company's technical department wouldn't want to deal with unless they were forced to as a "reasonable accommodation" under the Americans with Disabilities Act.
People dictating
That is as annoying as the dictators trying to say a last name that is 13 letters long, can't even pronounce it, but they continue to use it throughout the report....they can't just say "the patient."   Geez!
Really does not have to do with the doctors dictating
because I have found eScription for so reason seems to hear the ESLs much better than the English speaking dictators a lot of times. Having said that, I think the system you are using has volumes to do with it from what I read on these posts. Which system do you use, if you donít mind me asking?
Doctor not dictating. sm
I obtained a client in December. He says he is slow in dictating, but he nor his partner have not dictated all month. I tried to inquire, but he insinuated that my feelings are hurt and that if I didn't like it maybe we should end our working relationship.

I found this odd behavior, especially since he sought me out. Should I drop him and his partner, since they are not dictating? How long do I wait before I drop him?
Actually, if he hates dictating sm

and he is NOT alone in this, you could suggest his coming up with normals for stuff he says all the time and then dictate around those.  This is a joint effort with the physician because he will have to sign them and have what he wants in them.  You don't negotiate a lower fee for this either, btw, since it takes time to drop them in and to come up with them in the first place. 

If he has some F/Us for say a total knee, then he could have a total knee note like:  Pt is ____ days postop. I removed the staples from the ____ knee.  Pt is to return in ____ weeks' time for followup. 

WIth the above, you would drop in the canned text and he could dictate Ms. Josy Blow is 10 days out, had staples, return in 2.  Or just 10, right, 2 on his end.  I have normals provided by the company I work for, then I have many of my own.  Some are a full note because they rarely vary.  Some are parts of notes.  Some are just shells with headers.  ANYTHING not to have to type it all! While you have no problems typing them for him, he doesn't like to dictate so yes, you can help him solve his problem AND cut down your work and worry.

Don't interrupt the doc while he's dictating!

I'm doing this GE doctor and there's a nurse or OR tech who keeps asking him questions.  Then he can't remember if he's dictating a colonoscopy or an EGD!!!  He loses his place and has to start all over again!

I'm pulling my hair out with all the "uhhhhh, uhhhhhs" and then I have to listen to him get short with her and her get snippy with him and then he can't remember if he took biopsies or not, if he's in the colon or the stomach.  He is clueless!  Just let him get his rhythm going and leave the man alone!


Okay, I've had my rant for the day!

Believe it or not, I once had one dictating on a small
roaring up and down sand dunes in a DUNE-BUGGY. I had thought it was actually being dictated on a roller-coaster, because that's what it sounded like. When I complained to the boss, he said he'd look into it, and called the hospital. The next day he comes back and said, "No - you were wrong. He wasn't on a roller-coaster, only a dune-buggy."

"ONLY" a dune-buggy?
Re-dictating a sentence in a different way, only - sm
not letting the MT know, and the sentence sounds like an extension of the first sentence. You don't figure it out til you get to the bottom of the report under Impressions, and then you have to go back and find that sentence and listen to it again. This always seems to happen in the middle of a 45 min. long mega-report, too.
I had the guy who was dictating in his sleep,
and he was ESL to boot. He dictated the physical exam 3 different times, and it was different each time. The patient's race also changed from white to black in the course of the report, and there were 3 different contradictory findings in one part of the exam.

I sent the whole mess to QA; they put blanks in the spots that needed them--and sent it on through to the client, discrepancies and duplicates and all. So I got paid for all the typing I did. I did not get paid for the head-shaped hole in the wall, though....

But if what they are dictating doesn't even exist.... ? nm
Then the dictating physician needs to spell it out instead
of expecting us to be psychic. I used to waste so much time at my old job trying to find the proper addresses for these yahoo CC physicians. In the meantime, the dictating physician mispronounced, didn't spell, and didn't even give a clue where the other doctor worked. I had to check the company physician list, the hospital physician directory, Anywho.com, then Google. And that was even if I could spell it properly! One physician in particular couldn't pronounce properly. He would put extra Ns and Rs throughout the name. How was I supposed to find it? And I got chewed out by QA for not being psychic enough to figure it out.
Dr. dictating just said happy Valentine's day!
Just makes me smile when the doctors remember to say something nice!
My favorite is dictating a whole list

and then going back and saying, "will you make so-and-so #1 instead of such-and-such."  Ugh!


OMG!!! Why do ESL's sit there not dictating for 5 minutes at a time????
Geez, as if they're not annoying enough when they actually ARE talking! 
Doctor is dictating while watching

All I can here is zoom, zooom, zoooom.  He paaaaaaaaaaaaaaauses for long stretches while he watches.  It's driving me crazy.  I keep getting report after report by him.



Try a doc that chaws tabakky while he's dictating
PLUS doesn't even have a nodding acquaintance with subject/verb agreement.
Why do doctors have to eat while they are dictating!!!!! so rude
MR has little to do with dictating and typing or editing, ...sm
it is point and click by the doctors on their little computer they carry from patient to patient in the hospitals or it is in the doctor's clinic.
When they try to keep what they're dictating a secret...
... from the people having the LOUD conversation right next to them. Guess they never figure out that they are also keeping it a big secret from ME. I keep waiting for them to yell SHADDUP! but for some reason they never do. Sometimes I am half tempted to just transcribe the background conversation instead......
I had a doctor using her breast pump while dictating. sm
Reminded me of my granddad's dairy.
Reminds me of my favorite dictating physician..
         Really miss transcribing his 8 page reports (no sarcasm implied) Have a great day everyone.
I would like to hear from anyone who uses Fusion dictating equipment...

Hospital just purchased Fusion dictating equipment.  We had been on a Lanier system for almost 15 years.  I've read some on the Fusion equipment and all it is suppose to do (even speech recognition).  does anyone use this equipment with the call in station?

I'd say dictating at half speed exonerated you
I could not STAND when they did that! (dictate at half speed distorts the voice or that was my experience anyway)

People dictating who cannot pronounce the words
and do you notice when they are reading others have reported, you can tell they are reading word by word by word and yet half are ones they cannot even pronounce and stumbling all around. Ye Gads!
Dictating on a speakerphone: One of my biggest pet peeves!!
It simply should not be allowed.  It is hard enough to understand a lot of these people, and then they sound like they're speaking from the bottom of a pit with the annoying mechanical, buzzing sound quality as they "push to talk".  Not to mention all the extraneous noises on top of that -- drives me nuts!!
Eating their lunch/dinner while dictating
I have a doctor from Croatia who is hard enough to understand with his "ah" and 'um" but when he's crunching carrots in the middle of it?  Forget it. 
they can have bad days, but they're still supposed to be professional while dictating. I'd co

To what do you attribute the fact dictators aren't dictating?

Does that mean people aren't sick or dictators on strike? 

I would never be too sure of any company not shipping out work.  I know of one that DENIED they would ever do anything so horrific and all the while shipped work offshore.  They said they needed to do this to compete but didn't want to own up to it. 

Trust no one but yourself.


Rad is dictating what is written on requisition for History is why I would have left it along.
It was very unprofessional for the dictating physician to include that statement.
I have never come across such a thing myself, but I wouldn't hesitate to type it.
MTSOs who work with call-in dictating systems. See inside.

If you work with a call in system, would you be willing to share if you like it/don't like it, how your transcriptionists acess their work (internet or through the call in system), where did you buy your system and is it efficient, etc.  Thanks.

I have one dictator who i helped set up her template as she was having difficulty dictating the fiel
now, she acknowledges me with every dictation and thanks me for my time and says cute funny things that do brighten my day. Some don't realize we are people working just like they are. I brought that to light and have had extremely good response. I changed my email recently and sent the office an email that as always to let me know if they needed anything. next dictation she says by the way i could use a sundae with whipped cream and cherries on top. i couldn't resist sending her an email with a picture of a sundae as she described. might would have had one delivered if local, but it is not.
and now it's OUR fault that the docs aren't more careful when they're dictating?
Hey, they're making 100 times what we do, so it's their responsibility to be aware of what they're saying, not ours.
I don't understand; how does "speaking reports" work? Isn't that called dictating?
I have a niece studing to be a PA. I told her to call me when she starts dictating sm
I told her to be sure to ENUNCIATE, spell difficult names. I hope that will give us one PA that will be clear. LOL
I think they are actually dictating to a transcription service (Baker Sten-Stel) via C-phone
then they e-mail back to the doctor's office for me to type. So maybe it will go back to them for QA. Why I don't know. This work cameto me from a temp service and they obviously did not know much. I will find out Monday morning. Thanks for your input. I will more than likely be on this site screaming for help. The AOL question was just in case I can get them to use my home office next time, because I just switched to DSL through AOL and I was hoping that would would work with Express Scribe, my footpedal and their software.
C-phone used to call in to dictating systems to receive work. A special phone. nm
Is the patient
patient name
It's surprising your company lets you put the name in the report.  The trend has been to use "the patient" instead of the name.
The patient is...
The patient is a 2-month-old elephant.

The patient is a 2-month-old infant.

Work from India.