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Compensation question - Carrie

Posted: Sep 21, 2013

I work from home for a small hospital. I pull up the patient's account and place the reports into it. Most of my doctors are so great and give me the account number or patient information. However, I have one doctor who is bad about not giving me any information to find the account. I spend more time trying to find his patient's accounts than actually transcribing his reports. I am wondering how I can ask for compensation for this. I make .15 cents per 65 characters. Does anyone make extra for doing extra tasks? I don't even really know how to go about addressing this. Thanks!

Contract employee - Carrie

[ In Reply To ..]
I should have mentioned that I am a contract MT for the hospital.

My advice - RHIA

[ In Reply To ..]
My advice is to ask your contract manager at that hospital to address the issue with the physician.

Don't approach it from the point of view that is annoying you, i.e., that you aren't being paid for it, but from a patient safety standpoint. You aren't certain that you can identify the correct patient, so you fear making an error.

If the doctors are supposed to be identifying the patient, they are supposed to do it. There is a reason for it. I would have no problem discussing it with them.

If they are reluctant to do that, then you can suggest that you make a list of the unknowns and have the hospital identify them. That will make them responsible, not you, and possibly get them to speak to the doctor.

With our system, you would be hard put to find a patient just with their name. We greatly fear misidentifying folks, too. I think your hospital should be the same.

When you talk to them, don't take "no" or waffling from a transcription clerk. Ask to speak to the HIM director if you have to.

Did your contract mention anything about identifying the patient? It should.

Long story but with an important point to consider - RadMT

[ In Reply To ..]
I worked for a mid-sized imaging facility that took both scheduled appointments and walk-ins. There were 2 MTs (myself included).

We had a doc who was notorious for just rattling off the patient name, with no other identifying information. It was annoying but we had daily printed schedules to refer to. This schedule, however, did not include walk-ins throughout the day.

Early one morning I transcribed an OB ultrasound for a patient (let's call her Jane Doe). Jane Doe was 16 weeks pregnant, healthy and viable pregnancy, all was good. I transcribed the report and uploaded it for the radiologist to electronically sign.

After lunch, I received a dictation to transcribe on Jane Doe. I remembered the Jane Doe report from early in the morning and thought perhaps this would be an addendum. Lo and behold THIS Jane Doe was 16 weeks pregnant with FETAL DEMISE. Either the first report was erroneous or he had just spat out the wrong patient name.

I went to look at the other schedule that was posted, the one that contained hand-written walk-ins, and there it was, about an hour after Jane Doe #1 had come in for her OB ultrasound, Jane Doe #2 had come in.

Now, here was quite a predicament. Which Jane Doe had been the one with the healthy IUP and which Jane Doe had the fetal demise? The radiologist was so disorganized he couldn't remember.

It took a couple of hours with our fingers crossed that a copy of the first report (which the radiologist had signed at lunch) hadn't already been faxed to the referring OB/GYN. Can you imagine the possible catastrophic possibilities, being Jane Doe #1 and thinking all was well with your baby, only to have to get a call that the report was in error and you've suffered a fetal demise?

And what if MT#2 had gotten the 2nd report to transcribe? She would have been completely unaware of the 1st Jane Doe report and had no idea that two pregnant women with the exact same name had come in just an hour apart that morning. The only reason it was caught was because I, by luck of the draw, happened to receive both reports.

It was a huge nightmare for all involved until we sorted it all out (the initial report hadn't gone anywhere yet, thankfully).

The potential liability made the radiologist get his act together and FINALLY listen to the MTs suggestions that he needed to dictate not just the patient name, but the date of birth, MR#, or other identifying information to avoid a dictation disaster in the future.

Yes, as the above poster poster has explained, approach the hospital that this for PATIENT SAFETY, not your personal annoyance. The repercussions of you choosing the wrong patient could be a complete nightmare for you. Better safe than sorry.

Sorry so long, but it was such a unique experience that there was really no way to pare it down.

good story. - nudder Rad MT NM

[ In Reply To ..]
`

And that is exactly why we do not upload based on name - or fax anything anywhere

[ In Reply To ..]
Among other things. :-)

RadMT, your first-hand experience with this should.... - Mom22dogs

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.....be part of the curriculum for every single medical school in this country! Get these MDs-to-be into the habit of clearly identifying the patient from the start!

Very good point!!! - reader

[ In Reply To ..]
This is a very good point. Now, I guess they have a lot of safeguards like scanning the bar code and things like that. I used to work in a radiology department and sometimes the radiologist would read a film and put the film in another patient's envelope. Much later, when nobody could find a film, I looked at the old schedule to see who came in that day and would go to the file room and find the missing films. Ya,these docs don't concentrate on their work all the time.

Good example of why MTSOs need to address this with their clients! (sm) - Rose

[ In Reply To ..]
In working for an MTSO, I deal with these possibilities daily. Doctors rattle off a patient name without spelling it and when they don't enter demographics, it is a guessing game. All we have to go on is to match the dictated age with the DOB and/or primary physician, if that is provided. This is a disaster waiting to happen but we have no power to do anything more than make a suggestion to the MTSO who will do absolutely nothing about it.

Unfortunately, until there is a malpractice suit and/or death, nothing will be done.

WOW - depressed

[ In Reply To ..]
I work for a large company and only get paid .03 a 64 character line. I just left a company that paid the same. And most of the doctors don't give names or account numbers. Would gladly trade jobs with you, lol!

Thanks! - Carrie

[ In Reply To ..]
Thank you for all of the replies and for sharing personal experiences. It is scary that a report could so easily go on the wrong account. I know our HIM manager has tried to get this doctor to give us the information, and I'm sure she is just as frustrated with it I am. She also has to deal with the fact that he has reports that are literally a couple of years late. I honestly don't think the doctor will change.

There is nothing in my contract about hunting down mystery accounts, but it sounds like I should be thankful for what I get paid. I think I may just start e-mailing the reports that I am not sure of back, and they can put them on the accounts. Maybe they will get the hint. Thanks again.

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