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


How to handle a problem client... - Tara


Posted: Jan 23, 2013

Okay, so I have a client who is driving me nuts.  I wonder what the general consensus is about how to handle a really pesky issue I'm having with him.  This particular doctor is an older gentleman who wants to do things to look like he's keeping up with the times but doesn't want to change how he does things.  He's also cheap as sin and thinks that because he's a doctor and I'm an MT he's above me in life.  Not kidding.

Anyway, the issue I'm having is where to draw the line on the "customer is always right" sort of mindset.  This man is always griping about something, no matter how big or small.  I finally drew the line in the sand with him when he started using abbreviations that are considered dangerous in the field.  I type them out.  I told him when he first hired me and I set up his entire transcription end of his practice that I would not use the abbreviations on that list, gave him several copies of the list, and also explained the reasons why those abbrevaitions are dangerous in today's medical record mindset.  He wants to use them anyway now, and I know it's because he's trying to cut corners on his transcription fees. He uses a lot of strange abbreviations (for instance he wants MO instead of "mother" in general English and things like that) and I don't do much because they're not on "The List."  

How would you handle this?  Give in to yet another demand when you know it's wrong, or just let the customer have his way, or let him have his way but have him sign a waiver that if something is misinterpreted it is on his hands and that he understands that I am typing the abbreviations at his request only...  I'm just not sure what to do in this case.

Actually, most private practice docs don't have to abide by the dangerous abbreviation list. - anon

[ In Reply To ..]
Their office notes are not something the Joint Commission cares about or even checks. The dangerous abbreviation list is for hospitals.



Yes, I'm aware - Tara

[ In Reply To ..]
I'm aware of the fact that private practice docs don't have to abide, but this one's notes get put into the system that the local hospitals use frequently so it's sort of a grey area. Plus, we're in MA and many of the rules and regulations here are stricter when it comes to medical records so I want to cover all my bases.

It's also sort of an issue where I'm not sure where to draw the line with the client. He's always going to complain about something and is never happy. I'm not about to "fire" him, but I also don't want to have to continue to put up with this sort of thing where my reputation may come into question and it looks like I don't have basic understanding about how to transcribe. I just don't know what the proper thing to do is in this case.

You type what the MD wants - he pays you

[ In Reply To ..]
I dont care if he wants every cough put in quotes or a paragraph after every sentence. He gets what he pays for. He is the client. You do whatever he tells you or move on.
absolutely - nm
[ In Reply To ..]

Well, I think you answered your own question then. - anon

[ In Reply To ..]
dump him, let him try to find someone who cares about quality as much as you do.

His loss.

there is no gray area about it - ...

[ In Reply To ..]
this is the second post in which you have described having to "put up with" something or having to "give in to yet another demand." There is no need - and no usefulness - in "drawing the line." You either quit or you do the job as requested. I think you are taking yourself a little too seriously here. Your reputation is not on the line. There is nothing you have to "put up with."
So true, MT's are invisible, so either do it the doc's way or walk. - anon
[ In Reply To ..]
The doc signs the report, the final product is his responsibility alone.

Personally, I do whatever they want, collect my check and move along. We aren't doing brain surgery, there is wiggle room.

I sure wouldn't quibble over "banned" abbreviations since in this case it is totally irrelevant.

Do it the client's way - Cathy

[ In Reply To ..]
I would just do it the way the client wants it. He's paying you to type his notes the way he wants them. You say that "he's always going to complain about something and is never happy." I think maybe you should have a talk with him and write down his "rules" of how he wants you to do things. I don't think that he is necessarily a problem client because he complains about things. He likely just wants things done in a certain way since he has been doing them that way for a long time. He is probably wondering why you think you can come in and change the way that he does things. Just do whatever he wants. If he starts to contradict himself and say that he wants something one way and then the next day says something else, then I think you would have a problem client on your hands.

Do you have a contract? - anon

[ In Reply To ..]
If you do, are there any clauses in the contract you could hold him to? Or can you negotiate an agreement and sign some sort of abbreviations contract? I wouldn't worry about a waiver so much--he is the one who signs off on the reports, so he is the liable party.

I don't think this is a hard one... - sm

[ In Reply To ..]
You are being paid to perform a service. It's not a service if it is not performed the way the client wants it.

I don't think it's fair to assume that this guy isn't keeping up with the times just because he likes abbreviations in his notes. That's the way he wants it, that's the way it reads easy TO HIM. That's why it's also unfair to assume that he's trying to cut corners on transcription. I have had lots of physicians who prefer their notes typed in their own meaningful shorthand.

As for transcribing, there are styles and preferences beyond the BOS. Remember: just because you were trained a certain way does not mean that every other way is wrong. The joy of having a private client is the freedom to accommodate. For the private client the joy is being able to be accommodated.

If you don't like the job, don't do it. But you shouldn't step into someone's practice and tell them how to write their notes.

The customer is always right is a good expression. Here are two more:
Don't look a gift horse in the mouth.
Don't bite the hand that feeds you.


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