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

Has the fat lady sung? 95% accuracy. - SoOldSoTired

Posted: Sep 12, 2011

I had a conversation with my personal physician today. He was using a laptop throughout the course of my exam. I questioned him as to whether this was EMR. He stated that it was. His entire practice has converted to EMR in conjunction with front-end speech recognition.

This is the part that knocked me off of my feet--he stated that the physicians in the practice consistently get 95% accuracy in the drafts that present on the screen for them to edit. Note: They are editing the drafts themselves; no transcriptionists are involved.

We spoke for a long while. He's always been straight with me, and I have no reason to disbelieve what he said.

I saw absolutely NO PLACE for a transcriptionist in the work process for that practice. I believe that this is the future of medical transcription. Those employed with the MTSOs already, with few exceptions, know that the industry doesn't provide a sustainable living wage anymore, yet encourages grueling work hours.

Is there ANYBODY out there who can offer any hope or any reason to stay in this profession? Seriously, with the way things are today, i.e., quality of dictators, line pay, editing vs. straight transcription, offshoring, speech recognition, is there any way possible at all to make a living at this any more? The technology involved is a wonderful thing, but it doesn't seem to be conducive to our job security or to making a fair, honest living.

I've been down in the dumps every since we had that conversation. It was truly illuminating to hear things from the clinician's perspective. The irony of the matter is that he has great respect for medical transcription as a skilled profession and completely sympathizes with what we have to go through with challenging dictators. He even described scenarios that he knew of where physicians created more stress in the transcription process than they ought. He felt that if more physicians received more constructive feedback about their dictating practices that they would do better.

Sigh. I just don't know what else to say.

I have realized - sm

[ In Reply To ..]
that I no longer need the services of my personal physician. Heck, he's pretty much obsolete. I can diagnose most of my ailments with the assistance of the internet and web sites such as Web MD and only see this becoming the norm with all the other technological breakthroughs on the horizon;)

You are so wrong! Young people often feel that way beacuse...sm - oldtimer

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they are young and healthy. There is a reason that your physican went to school for such a long time. You cannot replace your personal physican with the internet.

Those MTs who are limited to doing clinic notes - sm

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are a dying breed indeed. EMR took over most all the clinics, large and small, in my area several years ago. However, acute care will never be able to go EMR, as there is too much variation for any template click and drag to work. Most acute care has gone VR, but MTs are very much needed to clean up this crap.

Audits need to score with 99% accuracy at the MTSO I am employed with and that will never happen without a great deal of MT editing skills.

Who writes your scripts? LOL! - mt2

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A long time ago, I partnered with my physician and let her know that. :) Course that was also in the days where I made as much as she did.

Regarding scripts - sm

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Seems pretty soon we should be able to go straight to the pharmaceutical companies. The way they advertise for us to "ask your doctor about...," they can write us the script and cut out the middleman. Save us all some $$$ :)

good luck ordering your yearly mammogram via internet - heemee beemee cheemee peemee NM

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x

I already do that - and read it, too NMnm

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xx

Yearly mammo is ridiculous - just a big moneymaker - for healthcare. Same with - sm

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all these colonoscopies they want to do on everybody. Anyone that tries doing a colonoscopy on me will never live to tell about it.

yearly mammogram saved my sister's life. small price to pay. - good luck to you and yours tho NM

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x

yearly mammogram - ej

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Yes, the mammograms are a big promotional thing. If everyone did self breast exams, there would be more found. Most people start going for mammograms because they find something. The radiation build up certainly helps one to have more cancers. I know this is very controversial, but also know it is true. I worked at a cancer clinic several years ago and the patients were all instructed on how to do the self breast exams. I do not plan on having another mammogram unless I find something. Personally, I think a blood test would be a better choice, if they would do them as a screening. Of course they are not always accurate either. I do not plan on having another colonoscopy either!

Actually.... - mt

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Last time I had a mammogram, I did not have a doctor's order. I called to make an appt and she just asked who my PCP was and then said "we'll just put him down, no need to call and ask him". So, once again, PCP not needed.

I hear ya there. Half the time the doctor gets it - wrong anyway. I find most of the -sm

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time I can figure out what it is on my own. I'm sure someday we'll be able to type all our symptoms into a website, or attach a picture of the rash, etc., and a robot will process the information and then send a prescription to our pharmacy.

I'm looking forward to the day when doctors only earn 3 to 7 cents per patient visit. See how THEY like it.

LOL! I only go to my PCP for a 2nd opinion - mthead

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and scripts!

Ditto that! - nm - Meerkat

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"I have realized" - Laughing my head off

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Suppose you need a 5-vessel bypass? Good luck with that.

I'd rather let nature take its course than go - through something like that. n/m

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*

Laughing Head - Personal phyician does not

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equate a more skilled SURGEON (reading comprehension comes in handy). I would buy the best one of those my insurance would afford

EMR - ej

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Yet, that about says it. One of my docs, a specialist, has hired a MT to go around with him to enter the information so he doesn't have to waste his valuable time. I am sure this will increase for those who can work out of the home. My family physician types his own notes while you wait!

Finally someone realizes it - XMT

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After 15 yrs as MT I have handed in towel and I now do Med Records. My experience as MT gave me the leg up with knowledge of labs, hospital notes, imaging and progress notes to file yes thats what I have been deminished too... filing these in charts. We will go to EMR in next yr and I hope you all see if that this will be a dying career take steps now to educate yourself while you can before its too late. good luck everyone

no one, but no one is coming in my exam room that is not - an RN, LPN or M.D. (sm)

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Period. Talk about an invasion of privacy...

Wrong, just wrong.

clackity clack - struckbyaturtle

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My PCP types his own notes in the office on this incredibly loud & clacky keyboard. It's completely unnerving. I have to shout to be heard over it. Last time I had to ask him to stop.

Well, the writing was on the wall a long time ago for - private practitioners making reports

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mostly for their own use. Few of them have reached the point where they routinely send their reports out to others. (BTW, who's saying 95%? The computer? Who programmed it? The vendor?)

I still suspect it will be somewhat different for acute care reports. Those need to be on the charts ASAP for the use of other hospital clinicians and staff. Also, those physicians work within the context of an entity that has to make sure many dozens of physicians keep records to an adequate standard--set by the hospital. It's not just the dictator's or private practice's own business. Somebody has to review at least a fair amount of the many thousands of reports generated to maintain standards, a very important part of due diligence. Then someone has to clean up the stuff that doesn't pass; the physicians instead of patient care?

Which leads into the fact that that editing reports is very poor use of a physician's time. Some will be fast enough to do it for themselves, yes, but many others will see a bunch fewer patients as a result. We know that because it's already happening, even among young, savvy physicians.

Again, no crystal ball here, but for the foreseeable future a mixture of front-end and back-end use seems to make good economic and quality care sense. Like one of my hospitalists who enters his own assessment and orders directly to the chart for immediate use but dictates the rest back-end when he has time for it.

state of the union - mt2

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EMR has been around for a good while, a decade or longer. What's new are the programs and applications now available to physician offices, although a decade ago I saw the beginnings of these at the AAMT conference.

There will be little need for MTs in many physician offices. Although as I write this, I realize I transcribe for 4 different oncology practices (large ones) and I straight type for every single one of them.

Transcription was doomed for eradication since its inception. It's always been a COST, not a income generator. So it's not only logical, it's good business sense for them to find a way to cut out the MT costs.

MTs will be editors. MTs will be data processing (in the true sense of the word, by inputting structured data). And the really top notch MTs will have good gigs. And I mean the really good MTs who can transcribe any specialty, any work type, any accent and do it nearly perfectly.

The reality is, the majority of MTs don't fit that bill. It's time to start looking at what those MTs will be doing in life after MT. There's no need to write letters, form unions, threaten, kick, or scream. It's the natural progression of this profession and where technology is taking it.

Not so fast... - radMT

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I saw my doctor the other day and as he was entering in all the info on the EMR he told me he and the others in his practice HATE using EMR and the reports they get back from it look like "crap." He said it takes forever and after he's finished seeing a patient he has to enter MORE stuff back in his office. He really, really hates it. So maybe there's hope for MTs yet :)

not likely - xmt

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EMR is a huge investment and if they want to comply with gov with medicare they cannot just get rid of it. Well said in that if you are good in your field you will find a place, working from hom as an MT most likely wont be it. I work for oncology group who still write progress notes its a joke to me as they should have converted long ago..last minute is just going to be plain ugly.

Non clinical staff in office - XMT

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Let me just remind you the front line people reception schedules, med records clerks all handle your information with the upmost privacy and are required to follow HIPAA to the highest degree. I see your results in medical records before the doc does and its all kept to ourselves as would be your in room discussion.

but he still uses it anyway - pumpernickel

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The doctor complains about how much he hates it, but the point to take away here is he uses it anyway.

The older doctors (generally speaking) are fighting EMR because they are too close to retirement to invest in it and learn it. The younger ones are a lot more open to it.

In the end it won't matter if you as a practitioner like it or not anyway because it will very soon be the new standard for reimbursement.

Yes, you can have EMR with transcribed notes, but that is double paying for the end product.

Are psychiatrists using point and click EMR software-sm - Susan

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Is a point and click EMR software useful to psychiatrists who usually dictate very lengthy reports, especially the initial admission note? I thought MT still had a future in psychiatry..

Now that the docs have all their fancy-schmancy - EMRs, and can edit their own work, -sm

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and don't need to pay for transcription, then maybe their fees should be lowered accordingly! Especially since they spend 95% of their time looking at the PC, and barely acknowledging the patient's presence anymore. Our wages went down because of all this technology, maybe theirs should, as well.

I agree. - mt

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I think the PCP is almost obsolete. How many times do they just send you to a specialist anyway? Total waste of time as far as I'm concerned.

She's singing as we type. - Redwriter

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Medical transcription is a sinking ship and for about 10 years has been doing what sinking ships do best. To use another analogy, when cars (horseless carriages) took over from horses, most blacksmiths lost their incomes. But there are, even today, some people who make full-time livings from shoeing horses. There will be pockets of MTs for a long time to come. But the profession of medical transcription is becoming obsolete. Some of us may have to hang on until the water closes over our heads, but it just can't be because we don't realize what is happening. Surely!

For every MD that feels that way, there are 10 that do not. sm - Old and Tired

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I have asked many, many doctors their opinion, and their responses differ as much as opinions of companies on this site!

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