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

Learning to Dictate the RIGHT WAY? - Dr. Dr. John

Posted: Jun 04, 2013

I am an experienced nurse practitioner with seven years of experience. Now that I am working in an acute care environment, I am required to dictact all of my consultations. I have a template from which I am dictating. But from the results of my transcriptions, I could use some help from medical transcriptionists on how to dictate the RIGHT WAY.

Of course, I was never taught how to dictate. I was taught how to use the telephone to dictate, but I was never taught the right way to dictate clearly so the transcriptionist has no question about what I intend to have transcribed.

Any sources you recommend or can point me to?

Thank you!

John

? - LT

[ In Reply To ..]
I don't really understand what you mean. If you are getting a chopped up job of transcription, if it is VR, then you deserve it, saving money means less accuracy. If it is an actual live MT that is botching your reports, then get a more experienced one. A good MT could figure out what you mean while you are smacking on a bag of chips, radio blaring in the background and your cell phone going off every 5 seconds.

I wish this reply had not been the first one. - It is just kind of...rude.

[ In Reply To ..]
I think actually giving some advice on great dictating would have been more helpful.

i totally agree with you...very rude...nm - LoveMT

[ In Reply To ..]
nm

To Dr. Dr. John - care about my work

[ In Reply To ..]
We're not all like the above poster. I'm curious, is it wording, or formatting that gives you a problem? Some formatting is not allowed by the hospital (and/or platform we work on), to have consistency. If it is the actual dictation, are you very specialized? Maybe inexperience on the MT's part may account for some errors, although if there is anything ambiguous about what we hear, we flag it for "another pair of ears" to listen to.
I hope it gets better as you go forth! I also hope the MTs show as much dedication to their task as you do!

I agree - rude answer - oldtimer

[ In Reply To ..]
I would give anything to have a dictator ask me this question. This dictator is a priceless person who is reaching out. I get SO MANY mispronounced, misspelled medications and medical terminology, English that just be wrong (hehehe), and poorly thought out formats.... (Does anyone out there know the difference between 'brought' and 'taken' to an ER?)

Anyway, the very fact that Dr. John is reaching out is fabulous. Yes, he needs to establish a communication with his MT - if she/he cannot meet his needs, then he needs to move on to a person who will help him become a superstar.

Good Luck, Dr. John - most of us would love to help you!!

a few tips - anon mt38yrs

[ In Reply To ..]
~~Get your thoughts together before you call in to avoid going back and restating constantly. I have one that rewords very other sentence in mid sentence to say exactly hte same thing with different words, or the same words but adding an adjective. Collect yourself.

~~When you do mishap and need to change something you just said, let us know that is what you are doing. Four little words - 'let me restate that'.

~~Make the time to take your time and use that time to enunciate. Be aware that phrases/sentences you use over and over again, you will start to pronounce as one big long word in haste out of habit.

~~Do not turn away from the receiver or mic, and too close mars the voice as well.

~~Paper/chart flipping and someone talking/laughing 10 feet behind you override your voice right at the receiver for some reason, and we strain. BEEPERS PIERCE EARDRUMS AND WE'RE WEARING EARPHONES INSIDE THE EARS!

~~Puh-lease do not chew gum, eat, and for pitty sake if you have the snivels, blow your nose. These 'wet' functions pick up loud and clear and make most people nautious. (sorry)

~~No cell phones, period. Gets us nowhere.

~~If clicking on and off while pausing, get thumb/mouth coordination in line so you don't cut yourself off.

~~Know that the transcriptionist is sitting anywhere in the US and may not know your city, county, or 'Dr. Jones, the pathologist.' Any other information for us to successfully google would be appreciated.

~~Don't attempt to spell unless it is something you cannot pronounce yourself, then take a stab at it and let us verify.

GIVE US FEEDBACK ON YOUR LIKES/DISLIKES WITH YOUR REPORTS.

Good luck, you'll get a boatload of answers to this post - hope you are who you say you are and not another MT playing bored/board games.

Dictation Best Practices - sm

[ In Reply To ..]

As much as I despise AHDI for selling MTs down the river, this is actually something beneficial from them that you might find helpful, particularly the Dictation 101 and powerpoint and tip sheet, etc.

http://www.ahdionline.org/ProfessionalPractices/ToolKits/DictationBestPractices/tabid/270/Default.aspx

To reiterate what was mentioned in the great list given by anon mt38yrs, "background noise" to you becomes foreground noise to us through our headphones, so please find as quiet a place to dictate as possible. I had to leave some unavoidable blanks in a report last night because of the beeping alarm going on in the background while the dictator continued non-stop, and nearly ended up with a migraine after struggling through 20 minutes of that too. And NO SPEAKERPHONES! (augh)

Also, please spell as best you can any info such as obscure physician names, streets, place where patient works, etc., or any other non-standard spellings for non-medical info. "Send a cc to Dr. Czechoslovakina Smith, that's s-m-i-t-h," is less than useless to us. I find that searching for practitioners for copies is one of the biggest wastes of my time, actually.

Bravo to you for seeking feedback on this! Any more info you can give us about the *kinds* of errors you're getting back in your reports might help us help you more.

Just the fact that you care tells me - you are probably already good. :)

[ In Reply To ..]
Speak clearly at a normal speaking rate and say the same things over and over again. ;)

I have another thing, maybe knowing how to - pronouce the terms used

[ In Reply To ..]
There are many RNs, NPs, and others who absolutely cannot say the words they want to. I have one in particular who tries and tries several times and then winds up spelling because does not know the pronucination. With voice recognition wrong words thrown in when a dicator coughs, sneezes, eats, people talking in the background and OMG please do not sit the phone next to where you dictate. Our ears get blown out like that. We are graded on how we do our work (I am graded every day I work) and we are expected to have almost perfect work turned out. It is extremely hard to do this when a person dictating thinks time for me to eat this sandwich while I am dictating, killing those 2 birds with the 1 stone. Gosh, just a thank you goes so, so far because it is something we rarely hear. Things you might find funny and sit there laughing with someone else around is rather annoying to us. We want you to have your thoughts together as much as possible. You should know before starting a dictation amputation of the right, oh excuse me the left and please, please don't ask us every few seconds to go back and change something higher up in the report. We are on production and trying our best to make a living out of what is paid now which is not much, 4 cents a line for voice and maybe 8 for straight typing and you have to really go at it to make a decent salary. Oh, now backing off my soap box.

just one more thing.... - oldtimer

[ In Reply To ..]
The replies you are receiving a priceless. Kudos to those who took the time to list so many valuable suggestions. I would add that if you are dictating to a human (not VR) and if you run into an "issue" - just say, "Note to transcriptionist," or similar words and talk to them human being to human being. We are not machines - we will respond - and our basic nature is to give you the product you want. Just let us know...we are listening. Good luck - Sure wish I had you (or your clones) in my headset.

Hi. 1. Many of our search engines cannot search without the - first letter or two. Breathe out the first

[ In Reply To ..]
part of a name or unusual drug or other term, and we may not be able to identify it at all. So, if you develop a habit of enunciating the beginnings of names and terms especially you'll see a lot fewer blanks.

2. Remember that our brains interpret what the sounds mean. Sounds that aren't surrounded by words that put them in context, drastically narrowing possible meanings, often just can't be made out, or worse, may be misinterpreted as something that seems to make sense. So any stand-alones -- diagnoses, drug names, person names (wide open, totally impossible) and so on -- are much more likely to turn into blanks than sounds that are words being used to express complete thoughts.

3. Probably doesn't apply to you, but some clinicians do routinely mispronounce drug names, skipping and transposing syllables. Kind of a fun challenge for me sometimes, but dangerous!

4. Developing standard dictation for those parts of your reports that allow is very helpful to us. We typically get at least familiar with your patterns and often put your usual in storage for reference. If you hopelessly slur the heart PE for a 17-year-old with a strained ankle, we can run the usual "regular rate and rhythm" through for interpretation, compare length of the slur, spikes and waves (clicks and sibilants), and decide, yup, no changes from baseline.

Thanks for asking, BTW. Such a simple, good sense approach is nice to see. :) If you eventually come back with specific examples of any problems you keep seeing in your transcribed copy, I'm sure you'll get lots of good, specific feedback on what you can do to mostly put an end to them.

I'd like to add one thing - about reading

[ In Reply To ..]
You may not realize how poor dictation can become when the clinician starts reading from a previous x-ray or other report. If you find it necessary to do this, make a special effort to be clear in doing so. Thanks! Appreciate it!

Thank You Dr. John! (See mssg for some tips) - Angie

[ In Reply To ..]
In the 80's we made .10 cents per line. In the 90's we made .12 cents per line. Today we get .04 cents per line, no matter how much you pay the transcription company (middleman), so MT life is financially devastating right now. We are only paid by the line, not all the research we have to do to find out which Dr. Jones in the US you want to cc, or the spelling of that business dictated. That is all uncompensated labor so we try to keep research and having to correct demographic errors to a minimum.

With that said, a few tips:

Pause command: If you need to pause to review the chart for labs, meds, etc. please use the pause command. Remember that you need to use this like you would in keying a mic, allowing half a second before speaking again so it doesn't cut off a word.

Sound alikes: Letters B, P & V. Also M and N. When dictating acronyms for labs, etc. it's helpful to speak clearly or use phonetic "N as in Nancy".

Word sound alikes: Abduction and adduction can sound identical when spoken very fast.

"Uh regular rate" sounds like "irregular rate"

If you have dictation that is repetitive, you can create templates to cut down on your dictation time. These are often used for Review of Systems, PE, and normal diagnostics. You can then simply dictate "Normal PE but change the Extremities to..." or "add ___ to the neurologic..."

I commend you for coming here and asking for suggestions! What a nice change considering all the work we have to do with no compensation to correct demographic and dictation errors. You are a breath of fresh air and whoever gets to transcribe your dictation is going to be very happy!

Wondering why you are asking this - Questions

[ In Reply To ..]
In your post, you said this . . . "I was never taught the right way to dictate clearly so the transcriptionist has no question about what I intend to have transcribed."

That tells me that you are trying to over-dictate formatting, style, spellings, punctuation, and goodness knows what else.

You say you have a template. Are you trying to figure out how to communicate the line spacing and such so that you get an exact match to that template? If so, that isn't going to happen because it isn't the way most MTs work.

There really is no "dictation training" required. All you have to do is tell us what you want to say. We do the writing. I am obviously writing this without a little man standing over me saying "capital letter, now space, now type the letter a, now the letter b, now put a period and 2 spaces after it, now drop down a line and tab in." If I wanted to dictate what I'm writing now, it would sound like "if i wanted to dictate what im writing now it would sound like . . . "

All you should have to do is speak normally, just like you do in regular conversation. That's what we work with . . . regular speech.

We already know how to format your report. This may be facility-specific or we may use one we feel is appropriate. There are lots of them and they are generally industry standards.

If you are not getting the formatting you expect, there may be something wrong with your formatting. I don't know where you got the template, but it might be a bad template, or the facility might not allow it, or something. Or, the MT is just unaware of what you need to use.

In the last case, you should just provide the MT with a sample of your template. That prevents you from having to waste your time and spares the MT from the torment of trying to figure out formatting instructions. There is really no way to dictate something like that.

If you would like, tell us what the problem is. Post a sample of what you want and a sample of what you get back. I'm sure we can explain what is wrong and how to fix it.

Here are a few - from

[ In Reply To ..]
an MT who has worked in acute care for along time.

Always at the beginning of your dictation: Identify yourself by full name. Identify the patient by name, DOB and any identifying number that the patient is assigned. Always give the date of service. If it's a discharge, given date of admission and date of discharge. If you require a cosignature, give that at the beginning of your dictation, which is where most database systems require it to be entered.

Body of report: Always follow your institution's preferred guidelines for setup. that will speed your TAT.

At the end: Make sure you ask for copies. Always state the full name of the copy recipient. If it's a provider who is not local, make sure you give some info that will allow that person to be identified (send copies to the wrong recipient is a HIPAA violation). Always say when you are finished: "end of dictation." That way we know you're done and not cut off.

I hope this helps.

Yea right! - Wasting your breath

[ In Reply To ..]
Really??? This is a bored MT and you all are wasting your breath (or your fingers) responding to this. Seriously, an NP decides to come to an MT board to get advice on the problems he is having with the MT typing his reports? Why not ask her?

AND, if you will notice, the post from "Dr. John" is so eloquently punctuated that you can clearly see that an NP first of all probably wouldn't have known so much correct punctuation and grammar and secondly, probably wouldn't have taken the time to use it. Most doctors I transcribe for will say comma, comma, comma and they have no clue that a comma doesn't possibly go there. Most NPs can't even pronounce most medications or anything else for that matter!! I was complaining about it to a NP that I know and she said "I know, I'm so guilty, I can't pronounce the meds either".

Well, at least it gave some MTs something to respond to for the day:)

so now we have given him all our ideas - and opinions

[ In Reply To ..]
and nothing?

Yeah... where is "he" ? - Paging Dr. Dr. John

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Curious that "he" has not responded to all the Heloises nosing at "his" ... feet.

I think he didn't want tips - I think

[ In Reply To ..]
I think we misunderstood Dr. Dr. John. I think what he was trying to say was, these stupid MTs can't format my reports the way I like them. How can I get that across to them?

Dictation and use of templates - anon

[ In Reply To ..]
Some MTs are more familiar with working with templates than others and know what is required of them. Others, you might have to give instructions or unfortunately are limited if they work for MTSOs. Just be clear on their editing abilities and your expectations. I work with templates and am expected to fix things not dictated. It is a "use your head" situation.

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