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

I am completely frustrated with these ladies I work with and I just don't know what to do. - SM HappyMT

Posted: Aug 01, 2014

Don't get me wrong, they are nice ladies, but they are just so very clueless. I just recently got a job here and I am in heaven. It is a small rural hospital (60 beds) with a staff of 6 transcriptionists in house. The dictators are fabulous. Sure there are some difficult ones, but nothing I can't handle especially when you consider that it is a short list and I transcribe the same dictators repeatedly on a daily basis. It is NICE! My background is such that I've been an MT for 20 years. I have worked for several large urban hospital, two teaching hospitals, and then did my time with the nationals. My last MT job before this one was working from home as an employee for 500+ bed facility. I was laid off from that job due to the fact that they decided to outsource the MT department to a national that offshores. I would not take the offered position with the service for that reason and for the reason that this has happened to me before at another urban hospital I worked for. I took the job with the service on the latter and found that I was assigned several "accounts" and NEVER typed for my hospital ever again. That work was offshored and I was given the crap. For nearly three years after I was laid off from my last MT job, I decided to leave transcription. I felt like the industry was dying, pay scales were getting lower rather than rising. Then this little hospital advertised in my local paper for an in-house MT. I've got a teenage daughter, so working at home isn't a priority for me anymore and the hospital is 20 minutes from my home and the drive is literally through the countryside. I am happy, happy, HAPPY!

The problem is these ladies I work with have no idea how great they have it. They act as though they are so completely stressed by the workload and they actually have a service that send work out to when they feel like the numbers are too high for them to handle. They measure productivity by minutes of dictation rather than lines and I was told that everyone is supposed to do at least 70 minutes of dictation a day which I feel is extremely low and quite frankly it is next to impossible for me to type that slow. From day one, I was transcribing 100+ minutes a day. Sometimes less, but most of the time more. I average somewhere around 120 minutes a day. I was told by the girl training me, half jokingly "you're making us all look bad." At first, I just laughed, but then she has said it repeatedly. I soon became aware that these ladies aren't evening average the minimum on a daily basis and sometimes they only get like 40 minutes in a day! The reason I know this is because at the end of shift, we have to write our minutes down on a spreadsheet and everyone can see everyone else's totals.

I've noticed that they send a lot of work out which could be done in house if everyone met the minimum. I crunched the numbers the other day because this industry has made me paranoid about keeping my job. On average, daily the doctors are putting about 500 minutes on the system - sometimes more, sometimes a little less. If each one of the six staff MTs did their required 70 minutes, we should be able to keep up with the daily workload no problem. No of course I realize people take vacation and are sick, but that should only require us to send out very minimal work. So in my opinion when they send all this work out because they only want to type 40 minutes a day, they are going to cost us all our jobs. One day the hospital administration are going to add up what they pay the outside services plus what they pay the six staff MTs including benefits, equipment costs, etc. and they are going to realize quite quickly where cost cuts might be beneficial.

I've thought about taking my concerns to the supervisor. Yes, we have a supervisor, but she lets us govern ourselves and really doesn't do much by sign off on our PDO and vacation requests. She is over MT and the coders, in addition to being one of the full-time coders, so she feels like she is really busy. The supervisor did make a fuss about the outside service invoice the other day because it was so high. I think she wanted to let us know it was outrageous, but she didn't take it any further. I just don't know what to do. I do not want to lose this job. I love it and I know how lucky I am to have this job. These ladies have been a bubble for too long. They have no idea how harsh it is in the real world of MT. The other day I literally begged the MT in charge of sending work out to not send out the 20 op notes that were on the system. I said "I can get those done by the end of the day." They were short, basic op notes, EGDs, lap choles, etc. I have normals because there are literally 2 general surgeons and 1 ortho surgeon. She seemed skeptical, but she let me do them and I cleared them. She just said I work too hard and went home early. What do I do to save my job?

Well - See Msg

[ In Reply To ..]
It's a moot issue. This field is going down the tubes anyway, so if it isn't the exact situation you're talking about, it will be another.

In other words, what difference does it make? Eventually, the hospital is going to outsource to one of the biggies or go EMR, whether or not the entire staff is fast and competent. You could have 15 of you keeping up, and it won't matter.

Sorry, but those are the facts.

Become compliant with the culture that is that - office.

[ In Reply To ..]
They have been working this way before you came there, this apparently works for them. Do what you are comfortable with as your best prductivity and let them worry about themselves. Your productivity will speak for itself. Frankly it sound A LOT, ALMOST IDENTICAL to our work environment and we average $20 to $26 per hour per transcriptionist, we have 8 transcriptionists.

It always starts with "sending a few reports" - to the outside service. Then, - sm

[ In Reply To ..]
one day one of the hospital suits will get the idea, "Hey! Let's just send ALL the work out, and turn the transcription department into a mammography center!" Then some MTSO will make them an offer they can't refuse, and the next thing you know, the MTSO will be "offering you a job." And we all know how the rest goes.

Obviously those women have only worked in house all their lives, right? I used to be the same way. Those of us working in house didn't know how cushy we had it. Low productivity quotas, paid vacations, healthcare, a living wage. The best thing all of them, not just you, can do to save your jobs is to ELIMINATE THE NEED for an outside service by reducing your overflow work to zero.

Beware, this happened to me once long time ago . . . - MacroDiva

[ In Reply To ..]
Circa 1985, I moved from the big city to a small town, and went to work for a small rural hospital, easy easy work. I was on the night shift by myself and had no one to pass the time with to help me meet the low standards of the department. Also I was not really aware of just how absymally slow the 5 or so MTs on the day shift really were (could this same hospital?) for quite some time until it became painfully obvious to me how hated I was, they kept up a barrage of complaints to the supervisor about everything they could think of, I didn't put a dictionary back in the right place, really petty stuff, but it piled up.

Then the doctors started complimenting us about how much better the TAT was, and the hospital was able to stop sending work out. All of this, simply because I was working in the same way I had always been expected to work, with the advantages of being alone on the night shift with no distractions, and being such an easy hospital to do after having worked for years for a huge teaching hospital.

The long and short of its, the director decided that they did not need the new hire (me) if the day shift produced what they should produce, and since I was able to do it, it was obvious they could too. So she decided to fire me just before the end of my 6-month probationary period. This created such a firestorm among the day shift, they got plenty scared and knuckled down and started producing because they felt if the director did not have a problem firing me, they were certainly next on the chopping block.

I don't know what to tell you except to warn you, this will probably not have a good outcome for you. The other MTs have it in for you, they will not make life pleasant for you. Indeed, it is possible your supervisor will let you go just because of the discord in the department, created by your professional presence. Oil and water do not mix.

Your work ethic and production demonstrates to management what should be expected from the rest of the staff, and you as the most junior are the most vulnerable, not to mention that firing you would have a most efficacious effect on the rest of the staff from the management standpoint. So be prepared for the worst.

I know I am pretty cynical but I have been around for quite awhile now. Good luck to you, you are going to need it.

Suggestion - Been there

[ In Reply To ..]
Those ladies are not going to speed up. Their dense little brains are pre-set at that leisurely speed. Instead, they will use all that free time to bully you. Lies, lies, and insidious little setups to get you. You will have little defense.

My advice is to not say anything about them. Fly under the radar. Be a great employee, but don't complain about or aggravate your coworkers. Be pleasantly professional.

You are in a great spot, whether you know it or not. If your supervisor is a coder, ask her if you can train after you finish your MT work. If no, ask if she will let you practice on real cases if you do a coding program. Then, sign up for Andrews coding course and get the heck out of Dodge!!

Seriously, you need to find a new career. The universe just gave you a chance.

To Don't Know What to Do - Anonymous one

[ In Reply To ..]
To me it does not sound like your job is in jeopardy, I'm not sure where that is coming from. My last MT job was pay by minute and there were 3 experience tiers. I also work in a rural health care system. The minimums ranged from 110 to 120 minutes a day. The rule of thumb is usually transcribing 3 times the number of minutes, i.e., 5 minutes of dictation should take 15, 20 minutes max to transcribe. 70 minutes of dictation in 8 hours is considered extremely slow. My advice is not to go to your supervisor, it makes you look like a tattle tale and it is her problem, not yours. You need to keep doing what you are doing and hopefully management will see the discrepancy. I would think they would want to keep the most productive person on board. If management thinks the outsource bill is too high, then maybe they need to stop sending work to outsourcing and allowing you and your coworkers to swim or sink. I also think they need to look at the daily minimum minutes, perhaps comparing your facility to others in your area. How do you know how much your supervisor does? I work in HIM now and I can tell you that if your supervisor is managing coding and coding full time as well as managing MT, she is a busy person. She is managing 6 MTs plus a coding staff, and that is not as easy as it sounds. Reading between the lines, it sounds as if you are saying that you are the only one in that department who does any work. I had a co-worker like that, who knew everyone's numbers, thought she was perfect and was stabbing people in the back right and left. Having gone through partial outsourcing in my MT department, I hate to say it but once that trend starts it usually continues until all the work is done outside.

Same thing happened to me twice - sm

[ In Reply To ..]
The first place my fellow MTs all disliked me because I got off full QA in 2 days and I was working nights with 3 ladies who had been on full QA for over a year! Ended up working there only 3 months because the supervisor started trying to document all my mistakes and I had a ready rebuttal (and I was right) but it was obvious it was going to keep happening so I just found another job. Then the next job I was in an office with a lady who couldn't keep the work done by herself and she'd had temp workers for several years but convinced them she needed a full-time helper. A year later I was doing all the work while she was chatting up all the front office workers, they decided she didn't need anybody if she had time to spend out in the front office and so since I had less time they laid me off. In both cases, they outsourced the department shortly thereafter and none of them still have jobs. Oh well.

Opinion - Anonymous one

[ In Reply To ..]
All I can say is that there are 2 sides to every story. This seems to be an issue with quite a few people - worrying about what our coworkers are doing. Those who call others clueless or incompetent need to remember that they have probably formed an opinion of you as well. There was no need for any of you to share your QA scores. And of course, it's always the supervisor's fault. I had a coworker who consistently scored 100% on her QA because she sucked up to the QA person and tattled on the rest of us, enough said. Poor you, doing all the work by yourself; you found out that no one is indispensable including you. Something that a manager said to me once that has stuck with me: "Unless your neighbor's wastebasket is on fire, what they do is not your business." I could write a book on office politics, maybe I will someday!

Fire in the wastebasket..sm - Old Woman

[ In Reply To ..]
There is some truth in that adage. However, I have been in the same situation as the original poster, and I can say that it would serve her well to know what her coworkers are doing, not so much as to the amount of work they are producing but more so to what they are saying to the supervisor.

Let me tell my story. I had worked as an MT for over 20 years at home and was ecstatic when I found a position in a small hospital's transcription department. There were 3 full-time and 1 part-time MTs there. The part-time lady worked nights and weekends, so I seldom saw her except at the end of my shift when I was leaving and she was coming in. The other 2 ladies had both been there for a long time, and one of them was due to retire about 2 months after I came on. These 2 ladies literally fought for my friendship and each told me things about the other in an effort gain my friendship. I quickly saw through that, but because the soon to retire lady sat next to me, we naturally exchanged more conversation and became friends eventually. The other lady didn't like it one bit and did everything in her power to cause problems for us, up to and including the removal of the credenza the 2 of us had because she didn't have one. She went to the supervisor, who was young and new at her job and had no MT experience whatsoever, and complained about everything we did, up to and including completing the 120 minutes of dictation we were required to do each day. Eventually, she gained the ear of the supervisor and called the other lady and me on the carpet for rather trumped up charges. The supervisor was making changes in the way the transcription was done, including "typing exactly what they say" even if it was a wrong patient name or drug dose. After all, the doctors and other dictators were "licensed professionals" and we should not question their knowledge or flag anything for clarification. Suddenly, my 22 years' experience that had made me "such an asset to the department" meant nothing and I was terminated. Had the other lady not been retiring, I feel certain she would have been let go as well.

Office politics are usually a vile and vicious thing, and my best advice to the original poster is to just do your work and keep your head down. However, don't stick your head in the sand and ignore what the other ladies are doing or saying about you to the supervisor. Be courteous and be prepared to defend yourself and hope that your supervisor is mature and experienced enough to see what is actually going on.

Wow. I can feel your pain. - What I dont understand is...

[ In Reply To ..]
How are they managing to only produce 40 minutes of dictation a day? What in the world are they doing the whole 8 hours? I worked at the same hospital 11 yrs and it was much larger than that, but knew the dictators like the back of my hand and had normals for every thing. I could pull 200 minutes a shift without a problem. Being paid hourly plus $500 incentive just for meeting production was my motivation to sit still and type.

Sounds like you're between a rock and a hard place; being the newcomer you don't want to step on anyone's toes or rock the boat, but yet you don't want to lose your job either. Sounds like they're extremely laxed and set in their ways.

Maybe tell them to come read MT Stars so they can get an idea of what this industry has become, what they stand to lose and how easily replaceable they are.

Feel your pain- - why should she have

[ In Reply To ..]
any pain? She isn't hired to improve the department. She is a worker-bee. If I was one of those ladies and she told me to read MTStars I'd tell her to mind her own business. She needs to adapt to the situation not be a bull in a china shop. They live in a different world, no one has asked her to change it.

Excuse me but "feel your pain" is a figure of speech. - Nobody said anything about

[ In Reply To ..]
Her being there to fix the department. As a matter of fact I clearly stated she doesn't want to step on any toes or rock the boat and saying I feel her pain only means I understand where she's coming from; did I really need to break it down for you?

You read far too much into my post. I happen to agree with OP that 40 minutes of dictation for an 8hr shift is extremely low and sending out 20 OP notes sounds ridiculous. As far as me saying maybe she should tell them to read MT stars - Again, you blew it out of proportion. But so what if she does tell them to read here, BIG DEAL; what of it?

Everyone has a right to their opinion and thats mine. If you don't like it so be it. But don't try to scold me for voicing mine.

frustrated with these ladies- - you stated this is

[ In Reply To ..]
a rural hospital. Maybe they are not aware of the shortcuts and ways to increase their line counts. I would just do my work but let it be known there are ways to increase line counts if they are interested. How old are they? I would be very careful not to be the odd-man out in this situation and stir up trouble. Just because you have experienced other situations and have been geared to push-push-push, does not mean it is what works for them. You weren't hired to "fix" anything, be glad they are as nonproductive as they are or perhaps you wouldn't have a job. Be a team player even if you are best. Enjoy that you are out of the dog-eat-dog situation and enjoy your job. There may come a time your experience and knowledge is needed, wanted or asked for. I personally would get off my high-horse and not be the 1 to change the department at least not when you are still the new kid on the block. It is a job, only a job, relax and enjoy that aspect of it.

I'm not on my "high horse" about anything. I simply would like to - HappyMT

[ In Reply To ..]
keep this job for as long as I possibly can. I have no intention of tattling to the supervisor nor do I want to alienate my coworkers. I want to help them understand that they have very VERY good with this hospital and it is a cold, cold world beyond those doors.

And yes most of these ladies have been at this hospital for 20+ years, so they don't have a true picture of what the MT industry is like now. I have for them to have a reality check by losing their jobs and not being able to find another decent one.

But hey I guess I could just stick my head in the sand, keep my fingers crossed, and just work, work, work....

I think I'll take the poster's advice who said I should hit my supervisor up for some coding training. Look out for number one...

For goodness sake - while I agree OP should keep

[ In Reply To ..]
Quiet and do her job, I have to disagree with how nonchalant some are regarding the production of her coworkers. If this is a small rural hospital I would expect they are typing for the same docs on a regular basis. Even if they don't know how to create macros, they should be able to create a template.

The downside of being speedy - Fast MT

[ In Reply To ..]
I hear you! I had a job once in a cardiac clinic that was to be full-time and I was hired full-time. After a few weeks the office manager told the boss that I got through all the work in half the time of anyone that had been there before me, so guess what happened? They CUT MY HOURS to part-time!

Tread carefully. - Ayn

[ In Reply To ..]
I completely understand where you are coming from. I find myself wondering what ever happened to work ethic in this country (not just MT).

However, I think as the new person you need to tread lightly and not rock any boats too hard or too fast. Keep in mind you are the newbie here regardless of your years of experience. You were, I presume, told of the daily production requirement before taking the job, so you had your chance to comment on whether you thought that was too high or too low at that time. You have accepted the job and are meeting the requirements. It really is none of your business whether others are meeting that requirement or not and it is too late to fuss about whether you think it is too low or too easy to reach. I suggest you just keep doing your job the best you know how and work by example to show the others what can be done. Obviously, no one has expected these folks to work up to their potential in the past - but that should not really be your concern. The only thing you have control over is yourself and your own performance. Do not worry about anyone else. If they want tips on increasing their performance, they will ask you. If the supervisor wants ideas/suggestions, she/he will ask you. However, if you go in pointing fingers and saying, "gee, gals, you all could do as much as me if only you ..." it will backfire, guaranteed.

Also, as an aside, as a newbie you are not privy to all of the history and what has transpired with the staff or with the outsourcing firm up to now. For example, it may be that they have a contract with the outsourcing company that the hospital is required to send X amount to them every day or every week or whatever in order to satisfy the contract. You do not now what they are locked into to or what their arrangement is. I would suggest you sit back quietly and learn more before jumping in to reinvent the wheel here.

I could not tell from your post whose idea this spreadsheet showing production was or who enforces it. You said that each day you must write down your production for the day, but you also said that the supervisor lets the MTs manage themselves. So, who is posting this spreadsheet and just exactly what happens if you do not fill in your daily counts? Do you fill it in or does someone else? I would ask why it is there in the first place -- sounds like a source of ill feelings for no real purpose to me. I would suggest it be done away with if there is no legitimate reason for it or I would simply not fill it in and see if anyone says anything about it. It really is no one's business who does how many minutes each day. However, that is the only suggestion I would make if I were in your shoes. Otherwise, I would just quietly go about doing my job. If your co-workers are bothered by how hard you work - so what? I would not shove it in their face that I was producing considerably more, but I would not slow down just to save their feelings either. When the supervisor/admin notices, they may have a positive reaction or a negative reaction, but, again, you cannot control their reactions. All you can do is your best. If that is not good enough for the supervisor/admin and for some reason they react negatively to it (which, I agree with other posters, could happen in this backwards world we live in), it may not be a good place to work anyway.

You ask how you can save your job -- Well, it's an MT job, so there is no guarantee. Yes, it could be outsourced or changed to speech wreck at any time. Do not fool yourself that your actions will be the deciding factor in that decision! You are there to do a job. The sad truth is that you could do it superbly, transform the entire department and get them to follow your lead and double their production, eliminate the need for the overflow outsourcing, and it could all still go away tomorrow.

I agree... Also.... - Mary Roach

[ In Reply To ..]
I agree with your points. I am also wondering if the OP is feeling anxious because this is a new job to her. The jittery feelings of being in a new environment, with a new group of co-workers, and feeling like she has to be on her toes may be adding to her worries. For the OP, just relax, keep doing a good job, give your new co-workers a pat on the back for being a good group of people to join, and before long, you will fit in and feel like a part of the team. It is not a competition, so just enjoy having a job that makes you so happy. It is indeed a blessing these days.

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