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

Is it just my imagination or is the quality of dictators out there getting progressively worse? - sm

Posted: Jul 23, 2011

I know that a lot of my perception is being influenced by the mass influx of ESL dictators over the last few years, but the problem just doesn't seem to be about accents; it seems that the dictators are much more sloppy and careless than they used to be in time past. Also, some of the younger ones seem to consider dictating to be some sort of a game. It's as if they do things on purpose to make the dictation more difficult (such as racing through certain portions of the narrative as fast as they can in a manner that they clearly believe to be funny). It just doesn't seem that we're partnering with the clinician to produce a quality medical document. It's as if the entire weight of the quality is placed solely on our backs while they have little to no responsibility in the matter. I know that we're here to serve, but there's a fine line between giving quality service and just plain being abused. Don't send me out to run a race but then break my legs before I even get out of the gate and expect me to win.

I'm really feeling like I have some sort of 'abused wife syndrome' today. I'm doing the very best that I can to put out quality work, but I'm not getting much cooperation, and nothing I do seems to be good enough, but the problem in this equation is not me!

As you can tell, I'm very frustrated today. Thank you for allowing me to vent about it. No flames or negative responses please. I'm just not up to taking even more of a beating while I'm down.

I totally understand where you are coming from..... - Old-n-tired

[ In Reply To ..]
I have run into one dictator lately who dictates every medication in grams...i.e., morphine 5 GRAMS IV, Xanax 1 GRAM t.i.d.....and another one today dictated iron 5 GRAMS b.i.d. (this after already dictating it at 325 mg which would be 5 GRAINS, not grams). These were changed by me to the proper dosage, but it scares me to think that a new MT could get these dictators and transcribe verbatim, not knowing any better or taking the time to research the proper dosing of these medications. As far as an influx of ESLs.....hoo boy, I don't even want to go there....sigh.

I think you're right. They just don't seem to care - if their dictation is even understood at all. nm

[ In Reply To ..]

Dictators getting worse - tl

[ In Reply To ..]
You said it so well. It's like being raked over the coals and nobody cares. I also wonder about the quality of patient care. So often, I've thought I'd sure hate to be that doctor's patient.

I don't know if they're really getting worse - sm

[ In Reply To ..]
I think it's the perception because that's all we get. I think they've always been pretty bad, but they were balanced by better dictators. Now anybody that is good goes to VR or offshore, leaving us these horrible people.

Adding insult to injury, they have steadily increased the QA requirements, too. It has gone from 97%, which is still pretty dang good, to a current 99%, even while they're breathing down our neck to type more faster, and the doctors are dictating with their cell phones on the sink while they're "busy" in a bathroom stall. Yeah, that's conductive to 99% accuracy.

Yeah, I feel really respected when they can't stop their conversation with another doctor - to do their dictation. sm

[ In Reply To ..]
It's really, really frustrating to have them laughing and joking with someone else in the room in random places in the middle of sentences. It not only makes our job much more difficult to separate what is actually dictation and what is random conversation, but it shows just how little they actually respect us.

Here's something my team leader sent about dictators. - mtm

[ In Reply To ..]
DICTATION GUIDELINES FOR DOCTORS Adherence to these guidelines will assure the highest quality transcribed reports in the shortest amount of time. 1. At the beginning of the dictation, take as deep a breath as you can. Now, try to dictate the entire report before you have to inhale again.
2. When dictating a difficult word or phrase, turn your head and speak directly into your armpit.
3. We charge per character, including periods. An effective way to cut your costs is to dictate your entire report as one sentence.
4. It is not necessary to repeat the same sentence multiple times in the same dictation.
5. If you have to sneeze or cough suddenly, please remove your head from your armpit and sneeze or cough directly into the microphone.
6. If you must eat while you dictate, please stay away from foods such as marshmallows, bananas, and pudding. Apples, pretzels, and celery are much better choices.
7. Please don't stop dictating when you yawn. It throws off our rhythm.
8. If the patient's name is Alan Ratzlaffenhasenphepherzinsky, please have the courtesy to spell "Alan" - there are several possible spellings. For the last name, simply state "the usual spelling".
9. It is not necessary to repeat the same sentence multiple times in the same dictation.
10. Please note: The phrase "well-developed, well-nourished white female" is only three syllables.
11. Cardiologists: It is not necessary to dictate at the rate of your patient's atrial fibrillation.
12. Do not stop dictating in the event of minor background noise such as an office party, the janitor's vacuum cleaner, a screaming infant, etc. Again, it throws off our rhythm.
13. Be sure to place the emPHAsis on the CORrect syLLABLE, especially if EnGLISH is your SECond lanGUAGE.
14. It is not necessary to repeat the same sentence multiple times in the same dictation.
15. Talk as fast as you possibly can. Fair's fair. After all, we type as fast as we possibly can.
16. Please speak as quietly as you can...We want to be able to hear what's going on around you.
17. If you need to pause for 5 or 10 minutes between words or phrases, pounding the receiver on the desk, or repeatedly saying "still dictating...still dictating..." or "check...check...check...check..." reminds us that indeed, you are still dictating.
18. Just because you need to use the restroom is no reason to stop dictating. Time is money!
19. Don't dictate so loudly that you disrupt your fellow physicians' football game in the doctors' lounge. In fact, you really should whisper all of your dictation, especially those lab values, since the information is confidential.
20. Similarly, if you are going to watch TV while dictating at home, please watch a war movie with lots of bombing and be sure to have the volume high enough so everybody in your living room can hear above your talking.
21. If you need to correct yourself-sorry, correct an error, please do not rewind the tape-sorry, do not back up and record over the error-sorry, wait, the mistake-just continue with the sentence-wait-go back-with the paragraph and fix the error-err, the mistake.
22. Please go back and delete the last guideline.
23. When dictating on your cell phone from your car, be sure to go through as many tunnels as possible. This will ensure confidentiality of the information.
24. You (y-o-u) do not need (n-e-e-d) to spell (s-p-e-l-l) obvious words (w-o-r-d-s) for us (u-s). It is our job (j-o-b) to know (k-n-o-w) how to (t-o) spell words that (t-h-a-t) we learned (l-e-a-r-n-e-d) in third (t-h-i-r-d) grade (g-r-a-d-e).
25. One last thing: It is not necessary to repeat the same sentence multiple times in the same dictation.

I am cracking up!! - Thank you!!

[ In Reply To ..]
That is the best thing I've read in a long time - and so very true! Thank you thank you thank you - just what I needed LMAO!!!

Quality of dictation - Alice

[ In Reply To ..]
In the old days, a dictating clinician was expected to provide a decent dictation. If he/she did not, he/she was required to redo it. These days, it seems, the MTSOs and office managers do not DARE even inform the dictating clinician that they might CONSIDER improving their bad habits. For instance, they might not even realize that coughing into the microphone causes us pain. However, I tend to think that they don't know any better, and maybe I am in denial to think that they would really care about the quality of the dictations.

Priceless! How about the dictators - Susan

[ In Reply To ..]
who dictate at home with barking dogs, squawking parrots, and screaming children. Argghh

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