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doctors who dictate badly

Posted By: MDIMT on 2006-06-19
In Reply to: MT pet peeves - peeved pet

I typed for a doctor who dictated once from the stands at a pro baseball game, once apparently at his kid's Sunday school 'cause they were all singing "Jesus Loves Me," and in the car on the way to Grandma's--both parents were dictating (both were doctors, my clients) with the kids carrying on about "When will we be there?"  and one of the parent yelling at them without, of course, turning off their recorder.  HIPAA would have had a ball with them!

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I don't believe it. I don't think even the doctors can DICTATE 700 LPH! sm
I think she's yankin' your chain.

She has to be using templates or something to get that.
Your doctors transcribe??!! Mine just dictate.
Most places are not allowed to tell the doctors how to dictate...
Does anybody else hate to transcribe doctors who dictate on speaker phone? nm
Yep, they dictate in noisy nursing stations, dictate in the ER, dictate in the OR when they are
cleaning up banging around and we are supposed to hear them. So much for HIPPA.
No need to feel badly for me - feel badly for an adult who has no control of his/her own life!
I hope these people didn't produce any daughters! Bad, bad example!
Why do you need to know so badly?
What does it matter where she's from?  Obviously, some people don't like to tell everything about themselves on the Internet because there are other people out there who stalk.  I speak from experience because someone was doing this at another MT website.
feeling badly

I feel kind of sick mentally, someone recently hurt me and in my childhood things happened so i've developed this habit of cutting myself or punching myself.  I just cannot handle my emotions sometimes they get so overwhelming, and truthfully it helps get my mind off of it, but then later I see what i've done to myself and I feel guilt and sick over the whole thing and the cycle starts again.  Just wondering if anyone has ever had the urge to do this? 

Just feeling badly today, I would post on the depressed board but no one ever goes there.  I don't feel like I  can talk to anyone in my life about my problems either, so I just needed to vent that out a little bit.

Please don't feel too badly - sm
I have been in this situation too and thankfully, I managed to get out a long time ago. Unfortunately, there are a lot of really mean people out there, who never stop to think about how their words might hurt another person. There is life after a bad and abusive marriage. Just try to ignore these mean comments here. You did what you had to do to help yourself and your children and you were only offering advice. Don't feel badly about that. I'm sure the OP knows whether or not what you did would work for her, and if she thought this would put her in grave danger, she probably wouldn't do it. Big hugs to you and the OP here.
I am so sorry. I feel so badly for you and your son,
and your other child :-( I have been with my husband several decades, and at least all is smooth now - I fought it out! But the first 5 years of our marriage were Hell - he drank - verbally abusive, etc. I actually left him - took the baby, her things, my typewriter, Dictaphone, and the TV. He knew it was over then! We separated about 6 months - I proved to him and myself that I could live happily on my own. He then agreed to counselling, and we have been happy ever since. But it was an enormous battle of wills, so to speak. Hope you are not offended, but I will be praying for all of you - your family. Please keep us posted if you can. Go with your heart - I know you know - your son deserves the BEST! I know when it came to my finally leaving my husband, it wasn't for me - my self-esteem was long gone, but it was for my daughter. She deserved better.  And she got it ultimately - he is a wonderful husband and father now, but it took me leaving him to snap him out of it. Know that you are not alone.
Yeah, but we need it so badly. nm
I feel so badly for both you and the OP sm
Just try to realize that the pain management professionals do not care if you get addicted. They don't even really care if you are in pain. Everything to them is the bottom line...$$$. You don't even have a name to them. Do you want them and these pills controlling your life for the rest of your life?? Personally, I want control of my own life. I don't want the poison that these pharmaceutical companies are pumping out daily in my system. The way I look at it is that if God wanted it there, he would have put it there. You CAN live without them....you just have to want to. You CAN.
Never been treated so badly in my life

Just signed on with a company, had 1 week of work, now I am on my second week with no work.  I am a single mother with children to feed...it's just not right. Searching for a new job and have 3 offers on the table already......

Noooooo! Don't!!! It burns so badly you will wish it had been where it was before! SM

I had the same thing happen to me. Called my doctor  and he said  well put it up front, same tissue. YOIKS!! I called him from my seat in a cold-water bath and told him to mark that suggestion out of his book.

treated badly and pentalized
Has anybody here had a company treat you badly because you want to work?  I was offered a full-time employee position.  I took it and then I was barely getting 200 lines a day.  I was also told I would have a back up account.  When I questioned what was going on, I was given the cold shoulder.  What's the deal? I want to work!  I am use to getting at least 1500 lines a day.
I so badly need a vacation. And one simply isn't in the budget.
But you know, having travelled far and wide with a man who could take me places, I did learn it isn't where you go, it is who you go with....

Yes, would love to meet, date, fall in love with and marry a rich fellow. Having a two income household would be a welcome change if the guy was the Mr. Right.
A lot of women are treated badly in general sm

not just in the Amish community.  How many women are abused daily, behind closed doors and in public.  I remember an incident when I was visiting Atlantic City.  Had just walked into the casino and there was this man, wife, and child in a stroller along with some other friends.  Don't know what their argument was about, but the man hauled off and smacked his wife across her face like it was nothing and the friends seemed so embarrassed.  The poor lady just shielded her face and cried.  The man acted as if he had done nothing wrong.  If this is the treatment he gives her in public, imagine what goes on behind closed doors.  I told my husband if you ever even think about it I will put your poor soul to rest.

We cannot generalize by culture because it is the world we live in.  To the Amish community I am sure they receive "normal treatment." 

The gist of it all is no one should have to suffer the pain these children nor their families have endured with these school shootings, molestations, and abuse.  If you are that miserable (they end up killing themselves anyway most of the time), why not just go ahead and take your own life and leave others alone. I pray for them all and hope that they can find peace in the midst of all this tragedy.

Don't feel too badly MQ folks. Another large SM

company soon to initiate docking for errors. Whether these errors exist or not.  These may be style guide errors.  It seems the latest version of said style guide contains a lot more pages than the original version which was, perhaps 80 pages long.

Yes, I'm quite sure these companies are only concerned about quality transcription and not the bottom line.


depends on how badly you need GOOD work
and whether you are one of those who spends every penny on payday or budgets.

25-40 bucks an hour suits me just fine, cake platform...

you must just like to complain

Re above message - just posted on technical board. Need help badly.
We all feel very badly about the situation from the hurricaine but it is a big deal with MTs losing
the people and the offices they are used to and the fact that work is very short with some of these regions after you get transferred because many new people are put onto the accounts so why wouldnt it be a big deal when your income and accounts are jeopardized. What else is there for MTs.
800 dictate can help you set it up.

Cannot dictate for MDs
You cannot dictate for a physician unless you have a PA or MD degree.  We volunteered at the last in-house position I held to dictate the discharge summaries instead of paying quite a bit for interns/residents to do the dictating and were told it is not legal.
If they dictate
your hours, you are not an IC and the IRS will sooner or later jump on it.  Do you file a schedule C with your income tax?  Be careful, because if you're not a real IC your deductions may not be allowed.  
I often dictate for a doc sm
that will send his patients to a therpaist named Candace Jones, but he always sends them to Candice Bergan.
If they dictate them, they want them on there.
There is an old adage - "He that writes like he speaks writes badly." nm
Doctors need to learn that they are creating a document that is going to be read by others.

I work for a hospital where the gastroenterologists compete to see who can dictate their endo in the fastest time. They deserve the blanks.
1-800-dictate (342-8283) [mq]
so, where do you get the information to dictate?
I mean, how much time do you spend on listening to a report and turning around and dictating into your machine.

Just curious...a male friend of mine suggested I do this years ago already.

He said, why not get a voice recog machine, and use it with your job.

Is this what you do, Snow Bunny? I am awful curious, because I was thinking of asking my employer, if they would pay for one of those machines so I can do my job better.

We could probably eliminate about half the MT work force...maybe that is what is happening already, why MQ is always out of work.

If that is the case, however, the only problem I have with that is that everyone should be able to have access to this technology, and it should be above-board from employer to employee...it should be like general knowledge that a company either uses this or allows this...

You have been doing this a long time and whether you know it or not are probably paving the way for the future.

I am the one who keeps trying to get everyone to check out what the MOHCA is doing...within a decade (my opinion) med records may not even need editors at all...

They are pushing for standardized text rather than free text, where a doctor does not even dictate anymore...will be a thing of the past.

My question is, then what?

they seem to be trained to dictate that way.
I worked at a hospital that had a podiatric residency program, and the residents were often required to do the dictation for operations performed by others.  Obviously the long format wasn't something the resident made up on his own, it was something they had been trained to do.  Other doctors tend to stumble into dictation without much in the way of instruction.
before they dictate....I presume...nm
Yeah, become a PA and dictate really WELL.

most surgeons dictate very well sm
That is one of the best things about ops.  When I say "dictate well" I mean that they normally know exactly what they are going to say and use the same phrases over and over, which means a better line count for you.  Plus, you are much more likely to get normals doing ops than you are consults and H&Ps (especially in acute care).  Instead of doing one of these docs who repeat everything, or change everything, or a resident who is all over the report back and forth.  That is what slows you down.  I absolutely love op notes; they keep you up-to-date on equipment, etc., and the line count is great, but most of them get farmed out to Spheris (gee, I wonder why?)  However, if you never type OP notes, they can be difficult at first. 
Will it is true that not just anyone can dictate
notes, you have have other degrees and dictate.   They have to be certified by the hospital to be able to dictate, at least at the hospital I work for.  With psych dictation I often have RNs that dictate.  I also have lots of NP that dictate.
LOL, did granny dictate????? NM
the doctor themselves dictate SS#
You are way off base here dear.
If this is your only job and the dictate when you work - sm
then by the IRS definition you are an employee, though it does not sound like you are having taxes taken out. I take care of this problem myself by having another IC job that all I have is a deadline and I must have my work in by then, they could care less when I do it, as long as it is done on time. I have another IC job, where they asked when I would be working, a schedule of sorts, sort of what you are doing, but I do not firmly stick to it. I think it is more to give them an idea of what days you plan to work and what time of day. They do not chew on me if I vary my schedule as long as I log in and do the work. They know as an IC they cannot dictate the hours I work. I don't/cannot write off my home office as it is in my bedroom, but I write off everything else I can. If you need clarification call the company you work for and tell them of your dilemma and how your tax person says the IRS considers you an employee and since they require "set" hours then they should start taking taxes out, etc. from your pay, and see how they backpedal on the set hours issue.
There are some accounts that do not dictate - sm
every day, very true, but some people also refuse to do anything but one thing. If they only want one doctor, then yes they can expect to run out of work. I work many different specialities and can type the majority of docs (and have). This LTS is in Richmond, VA; I have never heard of another but you never know.
I have several who regularly dictate sm
30 minute reports. Unfortunately, they only give me 100 lines. On the other hand, I have a female PA who dictates 4 minutes notes and that gives me 100 lines, too, because she dictates at the speed of sound. I have to slow her down to turtle speed to hear her correctly. I prefer to do the 30 minutes ones since they talk reaaaalllll slowwwww and I can run the voice file at chipmunk speed and zing through it.
Do counselors dictate? sm
I was going to send out another round of postcards to drum up business and was going to send to counselors but wasn't sure if they dictate like psychiatrists.  Maybe any of you know this?
As an IC the employer cannot dictate the
times you work. They can ask you when you will be working or you can tell them. If they have work available and you are not working, they can let you know so that if you want to work you can; but if there is no work available when you want to work, they do not have to supply any. You, as an IC, decide when you work.
Express Dictate


I currently use Express Scribe software for dictation. I was wondering if anyone has used the Express Dictate system. I am looking to expand and add more doctors and was wondering how this system worked.

Also, if you have any advice on a cheap start up not using tapes please let me know.



Thank God for some nurses who DO dictate...
for the docs who are horrible dictators. I do progress notes for an ICN nursery almost nightly. Thank GOD for those nurses. There are 2 docs right from the old country who can't string a sentence together in English though good docs they may be. We're talking 7-8 page very detailed reports on some of these babies. The other night, one of these gals dictated the first part, God love her, and actually handed the phone to the doc to give his 2 cents worth, awful dictator. Hey, the best thing some of these docs can do is let their PAC's do the dictating!!!
I had one dictate from the jon and flush over and over again sm
Through, get this FOUR DICTATIONS!!! The pregnant pauses, the bobbing of the roll as he pulled out paper, the echo of the small room followed by FLUSH!!!
Express Dictate
My doctors are considering using Express Dictate.  I did a search here to see if there were any comments one way or the other about this and if it was hard to set up and use, but I didn't really find anything recent or helpful.  We went from a Lanier Voicewriter to EMR, and now there is 1 doctor who doesn't want to use the EMR and a couple others who just want to do a little bit of dictation, so they are putting me on contract to do this.  I don't know much about how things like this work.  I have used Express Scribe to test for on-line companies, but I don't know anything about Express Dictate.  Any comments?
My take on how these physicians dictate
I question and I mean question about every day whether the person coming in as physician is really that. I have 1 that basically cannot string a sentence together, changes sentences 3, 4 or 5 times each sentence. I have physicians who pull the same stuff, going several paragraphs down and then asking you to add or delete something. I get really ticked when I hear all this and donít hold my cool. The person in the room with me usually hears my ranting and raving. It is hard enough to get through the ESLs, mumbling, crunching, snorting, eating, sucking, sniffing, sorting papers and the list goes on without putting up with this. One change that was made at the hospital I work for was to tell dictators they could NOT use a cell phone to dictate. It worked. I only wish I were in charge so I could tell them more about how to dictate!
Actually, they can dictate a schedule and even pay.
It's not a black and white line on those issues. It is very gray and very subjective.

A client/company can state when they want the work done (time frames) or even how much they are willing to pay and even other issues.

Our working at home blurs the line and casts so much problem in defining this accurately.

But yes, they can definitely define those factors.

If only they would dictate/speak - sm

as clearly as they did when going for their interview for medical school or hospital position.  If they spoke then they way they dictate now - they'd never have gotten into school or gotten their MD jobs -- so WE KNOW that THEY KNOW how to speak intelligibly when they want to; they just don't think we're worth the effort.

I appreciate and respect the ESL who puts forth an honest effort to be understood, over someone (usually English as FIRST language) slurring at 78 rpm, going through the HPI/PMH with ..ah, ... um ... (2 words) ... er ... (1 word) ....uh, ...(2 minutes pause) ... uh...uh... and then speed-racing through meds, labs, and whenever reading diagnostic reports verbatim .. so everyone knows that they know how to say those long words and which they wouldn't be able to come up with on their own.  My pet peeve??  We're BORN knowing how to spell any doc's name, just because THEY know how: i.e, ."CC to Dr. Kryswkowskizhausen and then spells J-O-N-E-S.

Called that great 800 dictate and the

guy who answered did not even know what I was talking about !!!!!

So where do I go now????

I don't see how any company can dictate what you send to QA
That is preposterous to think that you can have say how many to send to QA!! At any given time, ANY doctor can dictate something that you would question or something you have no idea what it is. Noise, ESLs, mumbling.. just to name a few factors involved. All that does is tend to make the MT quess in order to keep down a QA count. The company I work for has NO limits on what goes to QA. They would rather it go to QA than guess. Under no circumstance, would they say to NOT send something to QA. You can't control the doctors, PA-C, NP, etc. to make them dictated where all could understand every word!
Do you think any of these dictators ever LISTEN to themselves dictate.
Sometimes they're downright HORRIBLE!!!!