A community of 30,000 US Transcriptionist serving Medical Transcription Industry


Posted: Mar 23, 2012

What is QA "nit-picking & over-editing?" Are the demands for perfection in what is now considered a low payscale & wage unrealistic and exploitive to workers? Looking for all feedback & thank you in advance for any input.  Laughing

This would be nit-picking - sm

[ In Reply To ..]
I got a fail on one from a QA who dinged me for the following:
1) ____ (full sentence); however,_____ (full sentence). She said my semicolon should have been a comma. Not my understanding of grammar rules but whatever.
2) A comma in a place where she didn't feel it was necessary.

My QA person is not anal about punctuation unless - it is REALLY bad guess I am

[ In Reply To ..]
Blessed. She is more concerned with things that affect patient care, using correct wording and grammer. Punctuation has to really be bad for her to mark you off on it.

She may give feedback on minor things, but she does not take points off.

The way I see it is as long as you are not screwing up lab values, medications, diagnosis and guessing at stuff then there shouldn't be a problem.

I can't believe how far some of the people take this QA stuff sometimes, it's terrible.

This would be nit-picking - lucy

[ In Reply To ..]
I agree totally with you! Where did that rule come from? I swear some of these people who do QA don't know what the heck they are doing! I definitely would fight that one!

If both make a full sentence, no comma - You are correct

[ In Reply To ..]
I am amazed at how many people don't get that semi-colon or period thing and use the comma when it comes to "however." If both "phrases" are full sentences, then it gets the semi-colon or period. Period.

The patient was feeling ill this morning. However, as the day went on, he got worse. (Or semi-colon, up for grabs sometimes.)

The patient was feeling ill this morning. He, however, got worse and worse as the day went on.

and this... - sm

[ In Reply To ..]
I am so tired of living under the threat of this 99% - I cannot take it anymore

Posted: Mar 23rd, 2012 - 4:39 pm

Either I am being targeted or I will agree I am on an account that perhaps requires regular audits, but I just cannot take it anymore. The last two audits I barely failed and I now I am assuming I will be terminated.

We are encouraged to speed up editing and in the process we are most assuredly missing incorrect ASR dictation, etc.

I mean no offense to any MTs who work for this company, but I daresay across the board this company does not produce MTs who continuously maintain 99%, it is impossible. Especially, as I go into the FTR reports and I see major mistakes that are made, some lazy, others who knows.

I would really like to hear from you MTs who have no problems with the ninja like auditing because you always maintain 99 to 100%. Then maybe I will accept that no matter I have been doing this for 20 years and have NEVER had a problem with my quality or EVER had a client have a problem with my reports, that I have just been lucky and able to skate by and I am an incompetent MT.

We had no say in what they decide constitutes critical, major, minimum error.

I am shaking so much right now. I hate what this profession has become. It was perfect, we are isolated and for the most part, women, a perfect combination to exploit.

QA - anon

[ In Reply To ..]
You are absolutely 100% correct. I could have written this post myself. You know what I think all this QA crap does? Makes us less confident and ruins our performance. I can't tell you how many times I have brought this up to management. I was a 99.9% quality, then came (kicking and screaming) to this company, lost 40% of my wages, work twice as much and now have to FIGHT to keep 99% because of the "ninja QAs." I actually have my own pet name for them. I literally have chest pain every day that goes away when I am not sitting in front of this computer. You are correct, exploitation of women, isolated, trapped. It's a sad realization.

MT job stress is worse than Air Traffic Controllers..... - sm

[ In Reply To ..]
I'm sure Air Traffic Controllers don't even feel the daily stress level an MT does...well..at least they're compensated substantially more and have medical benefits to medicate w/antacids unlike us sweatshop workers. Not even the physicians have such perfection levels placed upon them as they are "practicing medicine." Yet, we are held up and hung out to dry to the tune of an "expert practicing medicine standard" necessary to having their knowledge & experience PLUS then some to perfectly ascertain their speech into documentation at slave labor wages each and every document with our compensation on the line every single time.

''and this..'' - sm

[ In Reply To ..]
Your remarks are absolutely correct. To maintain 99%, close-to-perfection, standards, proofing of reports is required which obviously decreases the MT's production. This is just another way for the MTSO to exploit their most highly skilled segment (and also most easily exploitable, due to isolated female workers) of their work force.


[ In Reply To ..]
I have worked both sides of the coin. Personally, I find those that feel that QA is "nitpicking" do not care much for quality (for the most part). What some MTs don't realize is that as a QA we have a responsibility to the company and to the client to ensure the most accurate documents possible, ensuring that not only BOS is being maintained, but also the client's wishes (and sometimes the client wishes very odd things). But one follows the golden rule: Those who hold the gold - rule. But, think about it... what actually is an acceptable mistake? Wrong words typed or words omitted? Misspelled words? Poor grammar and punctuation? Not following the account specifications? Numbering lists incorrectly (one would be surprised how many people get confused with a list containing more than 3 items). Thus, if we are not "nitpickers" the files might as well be off-shored, and then why should MTSOs pay US MTs more when they can get the same garbage files with off-shoring and save $. Think about it....

What makes no sense to me is what is - going to happen SM

[ In Reply To ..]
when all the hospitals go to the EMR point and click or even front-end VR. The software will have to have a 99% accuracy, correct? It obviously doesn't now, it does not format itself correctly, so how is that supposed to work? Will the hospitals have to drop their demand of 99% accuracy? It seems to me something will have to change as they try their hardest to get rid of MTs so who will they blame? The docs?

QA may be worried the position is going away - MT4

[ In Reply To ..]
I think personally that QA often justifies their paycheck. If the MTs have to have 99% to 100% quality, where does that leave the QA? With M-Modal for example, first time right, there are no more QAs... as if too many reports from an MT go to QA in the company the MT's pay is severely reduced. So, now there are just Mentors who teach and really no QA position anymore. The MT is the QA and sends directly to the hospital. This way MTSOs pay even less wages to employees. I think it is a trend, and perhaps when existing QA nit picks about punctuation, they are really just showing that they are trying to do their job so their job does not disappear like the trend in the industry. This is just my theory.
to clarify, M*Modal does have what they call a - QA coach who
[ In Reply To ..]
performs audits for what ever team she is on. There is no "QA dept" though. They have what is called MMEs, Master Medical Editors who review reports and fill in blanks at 3cpl for any report sent to QA.

BUT there is no QA dept so to speak. MMEs have no authority to grade reports, their job is to review the report or fill in the blank and send it on its way.

Only the QA coach has that authority when she does audits. So unless you get a really bad QA coach, the nit-picking is minimal.

And you gotta figure, the QA coach is responsible for a whole team of MTs so the likelihood of being centered out is low unless you have been brought to their attention because of errors or complaints from the client.

Re: QA ''Nitpick'' - rita

[ In Reply To ..]
I have worked ''both sides of the coin'' also and would not, even in jest, proclaim myself a ''Nitpicker''. Your generalization that objections to the picking apart of MTs' work with hair-splitting nonsense and petty trivialities that in no way affect meaning are due to a lack of concern for ''quality'' is as ridiculous as your rationalization for paying Indian-scale wages in a country with the cost of living of the U.S. What is QA nitpicking?! You obviously have not been paying attention. The example above mentioning a QA's incorrect substitution of a semicolon is a classic example of a person who should not be in QA because she not only lacks knowledge but also does not possess the judgment necessary to discern between splitting hairs over trivialities and the valid correction of actual errors that affect meaning. The poster below may have hit the nail on the head with her comment about QAs attempting to justify their own positions and hanging on to their hourly-wage jobs for dear life by over-editing. What is ''nitpicking''? Well, another example might be if your post were being edited and you got dinged for beginning a sentence with the conjunction ''But''. Your remarks, as well as your moniker, are just plain silly.

Fabulous post! Produce quality work and you will NEVER be out of work! - luckyladyinca

[ In Reply To ..]
Excellent post! I have my own clients and interact with all staff and physicians, which is very informative. Trust me, pay attention to even the smallest of details, and you will have more work on your desk than you know what to do with and command a higher pay rate. You would be surprised how much they really do appreciate your attention to detail.

What planet did you last work on? Venus? - anon

[ In Reply To ..]
Pay attention to detail and you will have work? It is not all about any of that. Listen, every report can be picked apart. You can find things if you want to. Companies can take out words or put in words also, how would you know that. None of us remember everything we type. They have the edge, and if they don't like you, they can get rid of you any way they choose. Right now, there are plenty of people waiting in line and they don't have to care because the cost is cheaper and more beneficial to go overseas anyway. No incentive to keep any work here in the US. Who cares about healthcare anyway...we have not fixed the problem and keep arguing over it in Washington anyway.

if they are going to nit-pick then - they need to be right

[ In Reply To ..]
All too often I get feedback where the QA is wrong about grammar. I've started bringing things to their attention and now they don't bug me as much. It's great of them to put quality first, but they need to be make sure their corrections are right. It's not all of them, but I know one person in particular who should not be a QA.

Good example of OVER-EDITING & NIT-PICKING - sm

[ In Reply To ..]
The patient admits to having severe pain in the lower abdomen that has been going on for some time...

The patient admits to having severe pain in the lower abdomen and it has been going on for some time...

The patient admits to having severe pain in the lower abdomen. This has been going on for some time...

ABOVE is the same verbage that could be interpreted subjectively different depending on the "listening & critiquing ear" as to what was dictated but inevitably it's the MT's production which is affected as they will have this counted against them in an audit as omitted dictation, etc. This sort of over-editing has nothing to do with integrity of documentation. Instead it wastes time, production hours and demoralizes employee morale encouraging employment turn-over.

Nit-pick - Addison

[ In Reply To ..]
Sutures WERE removed today versus Sutures ARE removed today.

The patient will take THE medication for another week versus The pateint will take HER medication for another week.

nit-picking and over-editing - blondy

[ In Reply To ..]
I may be wrong, but I just went through that with a company I worked with for 6-1/2 years. Her 2 editors left a few months prior as she wanted them to also type. Her work slowed way down and became almost a blip. I am no longer there. "Suddenly" I couldn't type right. No matter what it was. I began working directly with the owner of this company as her 2 editors were gone. Then I had many, many days of no work at all as ALL of my work SUDDENLY had to go to QA. Pure and simple, she did not like me. Eventually, after 6-1/2 years, she said I was no longer any good, bye-bye! So, if you can, get out before they say bye-bye! Being an independent contractor sucks. You have no recourse.

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