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Serving Over 20,000 US Medical Transcriptionists

these are the docs that I don't think care about their patients. my opinion. nm

Posted By: radeee on 2006-06-29
In Reply to: I just had a - Speed Demon

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Most of these docs realize it and the sad thing is that most do not care --
nm
Unfortunately most docs don't care; they don't even read the reports most of the time.
It's OUR job to comply with quality standards.
Opinion question... Radiology/Acute care, sm

I currently type on an acute care account (pd by the line).  We have an MD who consistently dictates his radiology reports on the acute care line.  I have been told to just go ahead and type them.  Am I loosing money in doing this?  Is radiology paid more than acute care? 


Thanks for your help!


k, that is your opinion, i stated mine. poor quality in my opinion shows bad work ethics if they do
;
we should just once, as patients (sm)
go to the dr's office and waste THEIR time!!! Let them know how it feels for a change. But then again, the doc wouldn't wait two seconds on a patient, now would they? Wow, whatta double standard!
Patients
On a really bad day, I feel like a vampire for making money off of other people's misfortunes.

Maybe sometimes we have too much time to think! I don't know.
Just because 2 patients have the
same dx does not mean they are treated the same and symtoms are the same in many dxs. Do you have your degree?
Well, too bad that they have 30 patients - sm

to see so they don't want to spell things out.  Do they cut corners on patient care, as well, when they have 30 patients to see - or is that reserved for us peon MTs?  So they're "frustrated" with 30 patients - well, cut your patient load!  We're not paid to "guess" or have to look up everything they don't feel like spelling, especially other doc's names.  Just won't do it. 


By the way, I wonder if they know how many documents we have to type a day (30 maybe?) to even eke out simple minimal wage - but that's OK, I suppose, compared to their 5 or 6-figure salaries.


Just give everybody the bum's rush because you have 30 patients.  Suppose we did the same? 


A party for our patients...
Every year, the staff in our clinic takes it on ourselves to throw a party for our patients. We all cook finger food, make snack trays, cookies, baked good, cheezes, bread, meat trays, the works. We have breakfast foods and lunch foods. We decorate tables in our lobby to spread this out on. We usually do this one day a week for the four weeks before Christmas so many patients will get to enjoy it. We have coffee, hot chocolate, orange juice, cokes and punch. We have fruits and dips....something for everyone, even diabetics. The patients are touched that we go to the trouble and we are touched by how much they love it! These patients have gone through enough suffering with their diseases and some are elderly and don't have family members. Some tell us this is their only Christmas!  We have been doing this several years now and the patients are beginning to tell us to be sure we appoint them to return on the days we are having our "Christmas spread." I just thought I'd share the Christmas party that means the most to me... and this is definitely it! Just the look on their faces as they are enjoying it is Christmas to me.
It is not our job to judges the patients sm
or why or where they seek treatment.  It is our job to transcribe the dictated reports.  If you don't like the healthcare system, then go out and change it.
Just how many lives do YOUR patients have?

Apparently mine have more than one because I have one dictator who likes to use the following phrase:  Patient was told that he might have death and loss of current life. 


Now we have to insist patients
being treated are actually examined before treatment is rendered?

Wasn't it bad enough medicine when ER docs would proclaim a diagnosis before exam, only to have to backpedal after taking a look?? I guess if they are going to do things in that order, doing physical exams is going to result in their looking stuupid, so their solution is not to do that part.

Big grrrr.
If the patients were aware of that, they could
nm
Do any of you ever feel sad for the patients?
Maybe it is because I am on my period and am more emotional than usual, but today typing all these terminal cancer reports is making me want to cry.  I feel so sad for the patient and their families.  I just cannot imagine being told that I only have a few months left of my life.  And the doctors sound so cold about it.  I know they are very used to it....I just know that I could never be a doctor.  I could never get used to telling someone they are going to die.
A question regarding patients' rights
I was just wondering this. My mother was recently sent to a "liver specialist" who is local gastrointestinal doctor because of concern over persistently elevated liver function tests. He drew a LOT of blood work on her and only told her that it looks like she might have a fatty liver. He set her up to come back in six weeks to "get the results of her lab tests."  SIX WEEKS!  With her being  very concerned, of course, we immediately searched the net and found out that fatty liver occurs in patients 1). who drink alcohol (she never has), 2). Patients who are overweight (she is not) or 3). Patients with diabetes (she hasn't got that, either). It says that a liver biopsy is how they find this out. He never mentioned doing one of those. My question is.. would a physician want to wait 6 weeks to find out lab results? You know it doesn't take 6 weeks to get the results back, they probably had them back within a day or two. In the meantime, she is stressing big time about what could be wrong.
Not sure when doctors graduate their patients but
I have boys and we stopped when my oldest was 11 because they always made them strip down to their undies for checkups and checked their privates and I didn't feel that was necessary and my boys hated it. 
No thanks. Anorexic geriatrics patients don't do it for me.
x
Very true, but a list of patients?

An invoice by the patient?  Some clients need to do their own book keeping.  It is bad enough you have to worry about the content of the reports.  To have to retype a patient name into an invoice with the line count is utterly ridiculous especially as an IC.  IC's get taken advantage of.  As an IC, yes you should be charging for "everything".  If you're an employee, they can put it under "other duties as needed".  Business is business.  If it takes more time, that takes more money.  End of story.  Don't do nothing for nothing.  Your clients sure do not.  They go all this time with this Transcriptionist with her invoicing and then all of a sudden decide they want each patient name and line count?  Cut me a break.  You don't think there should be a charge for that?  You can work for free, but I certainly WILL NOT!  To make statements like be paid to walk to the computer is really being a bit of a smarty pants in my opinion.  Keep it to yourself if you want to work for free, most people don't!  Have a great day making nothing to do A LOT! 


I read it... does it mean US patients would have to travel - nm
.
A lot of physicians refer to their patients
as heterosexual or having same sex partners, it is very relevant in some aspects, as in exposure to AIDS/HIV, etc.
New Doctor, some patients already typed
I got a new doctor.  They girl who had been working for him left him in a big mess, undone dictations, etc.  The office gave me a flashdrive to do with about 30 patients on it over the holiday weekend.  Today they've told me ten patients had already been typed, how did I want to handle that?  It seems they don't want to pay me for these.  My husband says to bite the bullet and not charge them, since this is a new account and I'd like to keep it, is possible.  What do you think?  I know it's a land of confusion there from what is done to what is not done.  Thanks!
It's called BEING FAIR TO PATIENTS
. Why should patient care suffer?! The patients haven't done anything wrong, even if management sucks. I thought that's what MTs were ultimately hired to benefit, the patients.
How does outsourcing dictation allow doctors to see more patients?
In an article in the MT News section, it states this.  Do they really need to see more patients?  Most of them herd them in and out like cows.
And that is because the GYN forgets to tell his patients that when changing pills you have to use an
alternate method of birth control for a month until the new level of hormones in the pills kick in, whether higher or lower.  That is how come so many get pregnant on the "pill."  The facts...my cousin is GYN and he tells all of his patients that.
Just wondering, for you MTSOs, about how many patients/reports per day...

For, say, an orthopedic surgeon, or  a family practice doctor.  Or, maybe, how many minutes of transcription on average per day. 


THANKS.


The clock does play into how much time is spent with patients
The way the CPT codes bill insurance have guidelines for the physicians built into them that give amounts of time spent with the patient (in addition to certain information covered in the ROS/PE), especially in consultations (whether inpatient or out), hospital discharge codes and critical care time (inpatient or out).

Yes, that computer is in fact billing the insurance company because it not only saves not having to pay an MT, it bypasses a billing clerk (eliminating that salary), and if the doctor's office space is paid for by a hospital, that file is sent to the hospital's database where a *scrubber* compares what the MD submits versus coding guidelines. If it is an independent office, the MD can upload all that day's billing before he walks out the door and leave it unattended to update patient accounts and reconcile the days money intake.

In a nut shell, your doctor is no longer just practicing medicine. Your MD is doing the documentation and billing and saving money on two warm bodies.

I understand your concern as I see it more and more in today's medical care, but yes, this is the way things are going. I am fortunate that my MD has been very computer literate for a long time, so the amount of time he spends with his laptop is minimal. Once he enters the info, he kicks his shoes back and we chat and get into a deeper discussion both professionally and personally (we've known each other a long time). Give your MD a chance to play catch up to what he or she is doing with that computer and you should see a more relaxed physician soon.

Good luck.
We need actual examples of patients harmed by outsourcing
to take to the media. Then we could probably get enough interest for someone to do an expose on it.
I do reports all the time where patients have asthma, COPD, emphysema, and

even cancer and continue to smoke.  In our local paper they are following a woman in her battle with cancer.  She continues to smoke, as does her husband.  They were broke before the cancer diagnosis, having to borrow daughter's babysitting money to pay bills.  Just think how much money they've blown on cigarettes.


I've even known one man with a trach who smoked through his trach.  


 


I wasn't clear. I guess patients' names is what irks me the most. SM

and you know how famous they are for dictating "Krenazcyssky, Jane, that's J-A-N-E.


neat web site 'chemo angels'. Help cancer patients
http://www.chemoangels.com/
Doctors patrolling themselves? What a joke! They barely have time to see ALL their patients....

Doctors today are totally incompetent for the most part.  YOU cannot worry about it when it comes to transcribing their gawd awful reports.  THAT is between the patient and the doc.  Just knock the report out as fast as you can and make sure it's accurate and then after that, forget about it. 


The docs make the big bucks - you don't!  Let THEM worry about things that will eventually catch up with them, one of which is called the Karma bug, and that little bug ALWAYS bites those who don't deal fairly right in the butt!  And big time, too!  


My nurse said most patients make calls with their cell, no problem
x
Kinship care versus foster care/adoption
Having been placed in a position where I now have custody of my 3 YO granddaughter and going through the legal system, I sought an online network of relative caregivers for children. I would encourage you, especially since you are in Georgia, that if you take any children into foster care with the idea of adopting them, there is federal law that requires the state to take certain actions in a specific time frame. When a child is removed from it's bio parent(s), the state is required to investigate any possible relatives who can take the child before foster care is considered, but even before that, reunification with the parents is the priority. Once a child enters the system and is in the system for 15 out of any 22 months, the state is required to find permanent placement for the child.

The problem with this is that there are case workers who may favor a foster family and do not seek out relative care. I have a good friend in Georgia who had to fight all the way to the state level to get custody of her grandson after the child was placed from the hospital into a foster care home with the promise that the foster parents would be allowed to adopt. She has now adopted her grandson, but it was a long, hard battle to get the state to admit their own interests were placed above those of the child and/or family.

If you get a child placed through the state, please make certain there is not a relative who wants that child before you get your hopes up. The courts are now favoring return of children to relatives even after a child has spent years with a foster family who hoped to adopt them.

States get bonus federal funds by complying with the time lines and being able to close the case, so some states place children in foster care because it is easier than trying to locate relatives.

Didn't mean to go off on a tangent, but I can't imagine my sweet bella going to someone outside her family.
If it was a clinic, it might have been urgent care, but it was NOT acute care. sm
Acute care refers to work in an acute care setting, a hospital, doing at least History and Physicals, Discharge Summaries, Consultations, Surgery notes, Emergency Department notes, and much more, including GI procedures, Cardiology procedures, Neurological procedures, Pulmonary Function Studies.  It goes on and on and it means and acute care hospital setting, not a clinic.
I always figure if they don't care about their dictation, they probably don't care about their
nm
Dont care how many languages you took. Care
x
oh, so if I don't care about my job, I "should" care
you come off as narcissistic.
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.


Amazing.


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. 


docs
Or I like when they make up their own spelling of words, especially meds.
docs
sorry made a mistake above...I meant the docs take me to the bathroom with them LOL!!!
docs
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.