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Wondering how much do the docs really know??? - ej
Posted: May 04, 2015
About VR? Yesterday, I went with my fiance to his post-op followup appointment. As the nurse was taking us to the exam room, she told us the doctor would be right with us, he was dictating his clinic notes from the morning. We had to walk by his office, and his door was wide open. He was sitting at his desk dictating into his phone, which was lying on his desk, had the speaker phone on, going a mile a minute, slurring, skipping words/entire phrases, all while eating something out of a takeout container.
When he came into the room, he apologized for making us wait, but if he didn't dictate after the morning's appointments, he would "never remember" what to say. As we know this doctor quite well, I felt comfortable enough to tell him I overheard some of what he was dictating as we walked by, and asked if he realized the person on the other end who would have to listen to that report would have a terrible time trying to decipher his garbled speech, speaker phone noise, and the fact that he skipped entire phrases? His reponse?
"Person? No, we don't have human transcriptionists. I just speak into the phone and it appears in the EMR in a day or 2 for me to sign. I can skip phrases and skip words because the software knows what I mean and will type it right. The technology is so great the way you can get through so many more reports since you don't have to spell or enunciate or say every word you want in the final draft."
I was floored. I informed him that regardless of how wonderful their software was, some human, somewhere, was having to listen and edit the speech draft to ensure it was correct and appropriate for the patient's record. He truly had absolutely no idea. When this hospital system began using this software, he watched a tutorial video and that was it. No idea about what goes on behind the scenes at all. He was genuinely shocked that humans still have to listen to what is being said.
I don't think my conversation with him will change the way he dictates; however, it would be nice if they were at least aware (and many, most are,) that the quality of that voice file does have an impact on how quickly and correctly that record is completed.
Eye opener. - Please sm
[ In Reply To ..]Wow. So that's one of the reasons why the quality of dictation has gone down. And the software knows what he means and will type is right? smh. I recall one of our VR reports was sent to the client and the doc was appalled at what he received. I wish I was devious enough to hack the system so every doc received a pre-edited report. Hey, I can dream.
I don't think the MDs ever had much of an - idea what MTs did....
[ In Reply To ..]even back when we were doing straight typing, thus allowing the hospitals to dispose of us like so much bed pan waste, and it's even worse now that we are 99.9% outsourced. Why else would we end up with so much of the dismal mess that's dished out to those of us left still trying to do this job?
When I was in house once a year they put the doc - MT
[ In Reply To ..]on the spot. They would have a drawing for the worst dictator of that year (by the MTs). The fellow who won would have to sit down and try to transcribe himself. The docs were willing to take part in it. It was part of some kind of a fair where they had booths and tables. Anyway, the docs would sit and listen to themselves and they could not type what they said. They were shocked. We had one doc who refused to change his habits and every year he would have to sit and listen to himself. He would every year apologize to us in person. As the years went by he got better. Not much, but eventually he gave up the worst dictator spot. Of course the whole department was eventually switched to VR and a year ago was sent to Nuance. I no longer worked there but I ran across a doc who I used to transcribe for when I accompanied a family member to his urology procedure. The doc begged me to come back to type his reports. He said the software did not understand him nor did the MTs correcting it. I said sorry, I was replaced. He just shook his head. Regret, regret, regret. If they only truly knew...
East Indian docs seem to know we exist... - Linda
[ In Reply To ..]Through every long pause they apologize through every pause "so soddy, so soddy." Imagine the increase in productivity if we only had contact with the MDs like we used to. I had one doc who used a portable recorder and her dictation was so soft I could barely hear it. When I went to see how she held the recorder, she held the speaker up to her mouth, not the mic. At least back then I could laugh and correct her. Today that problem would never be corrected.
Are the MTSOs ignorant to the fact that educating dictators could increase production, in some cases double it?
VR - Longtimemt
[ In Reply To ..]I went to the doctor yesterday and he was ready to throw his computer thru the wall, he has to literally type the report while in the office with the patient for office notes. Said it cut his office visits down 25% because of having to do that. I asked him if the hospital used voice and said it was a real joke, full of errors. Said at least when a person did it they would leave a blank, no such thing in his reports now, just mistakes. When they taught them to dictate he said they told them to speak fast and get it done until the assessment or impression and plan then they needed to slow down so it would be understood.
It is funny that software would take a couple of days to show up in EMR - sm
[ In Reply To ..]If it was so great it would show up on the spot. Did he ever think of why it took a couple of days to convert into a report?
Did you also remind him of HIPAA? I was waiting outside a room at a hospital - cheated
[ In Reply To ..]near the nurse's station and overhead patient name and the whole 9 yards. Im too backward to speak up about such things. Good for you for doing it.
Baboon - Macaca
[ In Reply To ..]Yes, I concur! A nurse working in the hospital setting should check all doors, windows, escape routes before proceeding on to speak in a hush-hush voice about PHI so that HIPAA is not violated.
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