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

What is the deal with VR? - Angie

Posted: Jun 27, 2012

Okay, guess I will show how dumb I am. I am an MT in a in-house office for a urologist. he dictates, I listen and transcribe. i get on here and read everyone fussing about VR. I get that VR is voice recognition...but what is your job? If you are an MT, you have VR, I realize it gets it wrong sometimes but what do you do? Read it to make sure VR gets it right and then make the changes? Just wondering. Any reply appreciated. Thanks!

No, VR does not get it wrong sometimes... - it gets it wrong all the time

[ In Reply To ..]
I have to make 4 or 5 changes per line, and at 50% of my transcription rate, it reduces my actual pay to minimum wage. That is what is wrong with it.

So do you still listen to dictation and read along to see if its right?nm - Angie

[ In Reply To ..]
xx

um, yea, but it takes double the time as straight typing - try it sometime

[ In Reply To ..]
For HALF THE PAY!

Double the time - Dickens

[ In Reply To ..]
It takes double the time for me, too.

It's faster to type something from scratch than to delete errors, re-type and insert punctuation, etc.

So when you consider that it takes twice the time and we are paid half as much, that's a 75% loss for us.

you didn't answer the question - Snow Bunny

[ In Reply To ..]
You said what the end result was.

I worked for a company until recently that used VR, and it was very well trained. I had no problem producing 300-350 lph. If the MTSO and/or hospital are not willing to put the time and effort into training it (this is where QA comes in), then it will continue to be riddled with dictation errors.

But VR at 300 lph is still a paycut - MT

[ In Reply To ..]
That's the problem. I average 300 lph straight, so if one considers VR well-trained at 300-350 lph, it's a huge 50% paycut. The only one who would benefit from that production is an MT who averages 150 straight. That's another facet of VR - the faster MTs for straight are penalized the most.

agree about VR - anon

[ In Reply To ..]
Same here, but my straight type averages around 250, my VR around 325, a HUGE pay cut, even though I am considered near the top producers for VR. Hmpphh!!

it wasn't much of a pay cut for me - Snow Bunny

[ In Reply To ..]
1. The speech engine was very well trained, so there wasn't much that I had to correct.

2. Most of the dictators were very good.

3. About 85% of what I do is full typing, 'cause I don't have a good memory in terms of the abbreviations.

So, it would be 325 (average) lph at 0.5 cpl versus 225 lph at 0.07 or $16.25 for VR and $15.75 for straight typing.

Pay cut for VR - MT

[ In Reply To ..]
Bigger here: If 300 cpl straight at 8.25 cpl = $24.75. If cut to 4 cpl for VR and averaging 325 = $13.00.

I think a well-trained speech recognition program should allow MTs to do at least 400, and that MTSOs should put the responsibilities on the maker of these programs, not the MTs. It's crazy - the worse the VR program, the more WE are penalized monetarily. MTSOs should be INSISTING that these programs they are paying for work the way they are supposed to.

Real VR problem IMHO - anon

[ In Reply To ..]
If I am on fire, have minimal distractions and had a REALLY good nights sleep the night before, I can do over 400 lph on VR.

I honestly believe, in my case at least, it is the mind numbing boredom of doing VR hour after hour that decreases my line count, not necessarily the quality of VR itself (which I agree can be atrocious). Sometimes I hurl my headphones across the room, jump up and sprint around the house to prevent the onset of complete insanity.

Exactly - Alice

[ In Reply To ..]
Yes, with VR, we listen to the report and make sure that VR got it right, making changes as we go. Oftentimes, VR isn't too good, so we may have to practically type the report from scratch. Our main complaint with VR, IMHO, is that we do not receive the same pay as with straight transcription even though it may take just as long to complete the report, depending on the quality of the VR.

IMHO, you are very lucky to have an in-house job and not be transcribing/editing VR for a ton of difficult dictators such as many of us do who work for an MTSO on many different accounts at a time.

Thanks, makes it easier to understand the complaints. nm - angie

[ In Reply To ..]
x

With today's technology and VR - I am wondering

[ In Reply To ..]
If the MTSOs insist on putting absolutely everything on VR, whether it should be on there or not, and with today's technology, I do not understand why a platform has not been invented to calculate our actual keystrokes in the VR program, allowing us to be paid the typing rate for the typing we are doing in VR.

I can see getting half the pay for editing text that does not need to be changed, or deleting text that should not be there, but what about when a whole sentence or two constantly needs to be added and/or changed. We are actually typing, are we not? If this sort of advanced technology is not possible, IMO the pay should be increased. We are not actually doing double the work, so why half the pay?

double the work for half the pay - Snow Bunny

[ In Reply To ..]
Let's go back to the late 1970s, when I entered the field. Two MTs are working for a service on typewriters, averaging 200 lph (everything is typed out). Now, MT #1 buys a computer and an expansion program, so now s/he has double their production to 400 lph. The service learns of this and cuts their rate in half.

It's the same situation, only in reverse.

Same situation only in reverse - - do you mean

[ In Reply To ..]
That with VR instead of doubling productivity at half the rate, it actually cripples productivity (at least in a lot of cases) at half the rate?

I did not realize that computers and expanders contributed to a lower pay scale for MTs. I guess I thought that off-shoring and MTSOs taking over as middlemen had more to do with that, along with MTs going home to work and being willing to take just about any pay just to be at home. Interesting...

I didn't say computers and expanders - Snow Bunny

[ In Reply To ..]
contributed to a lower pay scale for MTs. What I said (or was trying to say) was ... one of the issues happening today is that services are doing what MTs have done for years, and that is to take advantage of technology to increase profits without increasing line rates.

Take 2 MTs ... Betty and Wilma. They both type 75 wpm, transcribe 200 lph using a typewriter (no expander), and bill 7 cpl = $14.00/hour. Equal playing field.

After a year, Wilma buys a computer and uses an abbreviation expander, and instead of typing "The patient is a 65-year-old white male" she can now type "tp65wm" and get the same result. After a few months of adding more and more abbreviations she's no longer making $14.00 per hour. She's now so proficient with the expander she's doubled her line production to 400 lph and is making $28.00 per hour. Betty learns of this and feels it is not fair for Wilma to make twice as much just because of the technology Wilma is using. --- Is Betty right?

The MTSOs are simply doing what was done, and continues to be done, by MTs for years ... take advantage of technology. The shoe is now on the other foot. --- The AAMT screamed for years about MTs being "medical language specialists," and taking on more knowledge than they were legally responsible for, thereby justifying their billing rates, under the guise of "quality." This bunch of MTs yelling UNION, and that bunch of MTs emphasizing certification ... well, it hasn't worked. Hospitals had to cut costs somewhere ... and if you think they're going to choose the MTs pocket over a new MRI scan. Ditto for doctors.

You all know the definition of insanity ... doing the same thing over and over and expecting the same result. It's time to stop. You are NOT responsible for the contents of the medical record BEYOND what is dictated. You never have been, and you never will be. It is the DOCTOR's responsibility. If you want to be nice and flag the report, that's fine. But you're not legally obligated to do so.

And if you want to talk legalities ... it is ILLEGAL (in violation of federal law) to make less than minimum wage. How is it happening?

MT_not_much_longer has caught on ... pick up the hint.

Oh! I see what you are saying now - Leaving MT

[ In Reply To ..]
Thanks for the clarification.

Regarding picking up the hint, I don't edit VR and will not do it. I am training for a new profession. I still have a straight typing job, but I know it will not last forever. Every time our contract is up for renewal, we all hold our breaths. It is only a matter of time before we lose our accounts (very small MTSO with only 2 accounts, albeit big accounts, and not able to compete with the biggies to procure more).

Of course the MTSOs are taking advantage of the technology. But without expecting a little more from the facilities, that is, from the dictators, to keep their MTs happy and able to make a living wage editing VR and without letting go of the over editing, I think they may be shooting themselves in the foot as well. Time will tell. Maybe a revolving door of newbies will work out just fine for these big MTSOs.

I took a speech editing course just to see what it was like, and I was appalled. That's when I decided it was time to leave the profession. I thought editing was a lot harder than straight transcription. A lot harder in that and required a lot more focus and knowledge to catch those errors VR puts out.

Alice, you stated the truth with these words - Snow Bunny

[ In Reply To ..]
"depending on the quality of the VR"

To offer a dopey analogy: You can't get ripped abs if with the remote in your left hand and a bag of Cheetos in the right.

I just have one question ... for those who say they can produce more lines with "straight typing," do they mean typing an entire document WITHOUT the use of an abbreviation expander, or with the use of one (perhaps containing thousands of abbreviations).

If you say it's behind door #1, that's also why MTs are experiencing such a huge loss of earnings.

oops ... my boo-boo - Snow Bunny

[ In Reply To ..]
I meant to say WITH the use of an abbreviation expander (behind door #1)

I'm only guessing, but I think the line rate was calculated based upon production if things were typed out as opposed to expanded. IOW, if one document took 20 minutes to transcribe without the expander, it might take 10 minutes to transcribe with one. Hence, you pay 2x as much for straight typing.

Expander - Dickens

[ In Reply To ..]
Always, always, always use an expander. Always. Otherwise you're selling yourself short.

here's a sample - Snow Bunny

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This is what I dictated using the untrained
Dragon:

The patient was given a Bier block anesthetic.
His left upper extremity was prepped and draped. A curved incision was made paralleling the
thenar crease. The palmar fascia was
identified and divided under direct vision.
The volar carpal ligament was divided and the longus ulnar aspect was divided
under direct vision, also decompressing the canal. The recurrent branch was identified and was completely
intact into thenar muscles. Irrigation was
performed. The skin was closed with nylon. Sterile dressings were applied. The patient did well and was sent to recovery
in good condition.

This is what appeared on the screen:

the patient was given a Bier
block unaesthetic. His left
upper extremity was prepped and draped. A curved incision was made paralleling
the thenar crease. The palmar fashion
was identified and divided under direct vision. The volar carpal ligament was
divided in the longus omer
aspect was divided under direct vision, also decompressing the canal. The
recurrent branch was identified and was completely intact into the thenar
muscles. Irrigation was performed. The skin was close with nylon. Sterile dressings were applied.

My understanding is that hospital-based VR systems would have a LOT more errors than this.

yes, like 35 more errors than that - at least

[ In Reply To ..]
.

That would be nice... - MT

[ In Reply To ..]
I'd be thrilled if the VR on my current accounts had only 5 errors in a paragraph (and that the dictator spoke in clear complete sentences).

A sample from today:

Patient is her for here 3 months follow. She is said to be in very well and.

This had nine corrections in the first two sentences to be corrected as:

Patient is here for her 3-month followup. She is doing very well.

This is more realistic of what MTs are complaining of. And that doesn't even factor in doctors who correct, backtrack, slur words, or speed through their dictation.

my perspective of the issue - Snow Bunny

[ In Reply To ..]
First, I'm using Dragon (which is a Nuance product), which is set up for one dictator (me). I also know how to articulate correctly and the proper speed to dictate. I have an excellent sound card and microphone. Plus, I never stop training it. --- Your likely not going to have this with a high-end product, such as what is used in a hospital. And for the record, if the product is trained properly you can dictate quite rapidly. I've done it myself.

This subject can be bantered 4-ever, but I think there's only one solution and that is for MTs to be paid an hourly wage. If that happens, it won't matter how much time is spent researching or correcting things. The MT will have a guaranteed income.

So, with all factors in place, what do you (and everyone else) feel would be a reasonable hourly rate, commensurate with your experience?

the thing about VR - they would have fired us

[ In Reply To ..]
If I was training an MT and he or she kept making the same mistake, 50, 100, 1000 times after being told repeatedly,"look, it's this, not that", how long do you think I'd keep that MT around?

Technology to decrease pay - see message

[ In Reply To ..]
I was trying to explain it to my husband the other day. He was dumbfounded that a technology that was put into place to help a worker be more productive has actually hurt them. Neither one of us could think of an example where automation or technology resulted in a lower pay scale for the worker utilizing it. The word processor did not lower pay scales for typists or secretaries, correct? Automation on an assembly line did not lower pay scales for manufacturing workers, right? I understand that these technologies might have eliminated the need for as many workers, but they certainly did not lower the pay rate for the workers utilizing the technology. I WILL NOT edit VR. I am leaving MT. I still have a straight typing job, but I know it may not last forever, and I absolutely will not edit VR for half the pay rate of straight typing. Ridiculous.

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