A community of 30,000 US Transcriptionist serving Medical Transcription Industry
Hang on! - MQ oldtimer
Posted: Mar 06, 2010
I've worked for MQ for over 15 years. I've seen lots of ups and downs... bad days, despairing days, and good days too...
My advice to everyone upset by recent changes, first time right, etc.: Calm down and hang on! Wait and see how this actually works out.
If you are having problems filling blanks, then start guessing to get you through this period. We all know that the vast majority of problems with medical reports are caused by the dictators themselves, many of whom don't seem to care about their own reports.
THAT'S THE WAY IT ALWAYS HAS BEEN! NOTHING NEW HERE!
Perhaps MQ is trying to get rid of MTs whose skills are not sufficiently advanced. I don't know. But if you can't fake your way through this, guessing when you have to in order to avoid leaving blanks, then that really is a signal to you that you are not going to do well in this profession. Most of us oldtimers have heard so many reports, that guessing is 2nd nature. I can often look at blanks and guess what it might be without even listening to the report. So can most of the other oldtimers.
For younger, newer MTs, I am sorry to say that there is no substitute for experience. But assuming that you are getting work appropriate to your tier level, then even the lowest tier MTs should be able to start guessing based on hearing the same dictators all the time.
Don't just listen to something and become discouraged when you can't get it. Don't waste time listening and relistening. Do the whole report, then go back and fill in as many blanks as you can and make educated guesses about the rest of those spots.
If you are a youngster just starting: FOR GOD'S SAKE, READ THE WRITING ON THE WALLS AND GET OUT NOW. This industry is changing so much, so rapidly! I personally am shocked by how much ASR is capable of doing now. Huge numbers of MTs needed to type reports from scratch are no longer needed in this profession. What is needed are editors who can look at a medical report and see what is wrong with it just by looking at it, but that takes a lot of experience. So, I think it is likely MQ is setting up roadblocks that some people can't jump over. In the long run, it is better for you to leave if you can't jump over these roadblocks, as that means you haven't got enough experience to make it in the long run.
I hate to say it, but ASR is not a good place to start learning. It takes an experienced MT to do ASR reports quickly.
IT IS ONLY POSSIBLE TO MAKE DECENT MONEY AS AN MT IF YOUR SKILLS ARE REALLY ADVANCED. Otherwise, you are facing such a daunting uphill, stressful climb... AND YOU REALLY CANNOT DEVELOP THOSE SKILLS DOING ASR.
For those of you who can't quit or start over for one reason or another, then listen, THE MOST IMPORTANT SKILL (AND THIS HAS ALWAYS BEEN TRUE) is the ability to guess. The more you do it, the better you get at it.
My feeling is if a dictator is unclear, and if I am going to risk a cut in pay for leaving blanks, I am going to make an educated guess if I can, and the physician who signs the report has the responsibility to proof-read the report before signing. If s/he created the problem, then that doctor can fix it before signing.
I am going to guess. I guess by asking myself 1st, what is the dictator likely saying? Most dictators are at their worst when they say things they say all the time.
Type the whole report as fast as you can. Then go back and guess at blanks. Often, I get the 2nd pair of ears I need from myself when I do this.
You must learn to QA your own work. You actually can get quite good at this.
Get smart about using Google. type in as much of the phrase you hear, then see what google comes up with for the rest.
Old timers, hang on. MedQuist is not likely to maintain a policy of docking pay... Maybe for a while, but I predict it won't last. Just hang on!
Ignore the ****, don't read this board frequently (way too depressing -- and it really is only the disgruntled/discouraged who spend a lot of time here -- not very productive).
You have to maintain a good attitude and just do your work as best you can, otherwise I guarantee you will have lots and lots of misery at this job.
Good advice--Guess on reports and harm a - patient in teh process. Good advice. NM
[ In Reply To ..]x
Get real - old and burned out
[ In Reply To ..]Transcription can only harm a patient if the doctor doesn't read and confirm its accuracy. It's the doctor's responsibility. He's getting paid for it, not the MT who could be getting 1 cent per line with the new changes.
Guessing - Wendi970
[ In Reply To ..]So you must be the MT whose reports I run across and write notes to my CCM about. I mean seriously..do you actually believe the only way poor transcription habits can harm the patient is if the doctor does not review his/her note? None of this matters anyway; already I've seen "guessing" in action. It's bad enough without the FTR program. If MQ implements this little program, the company will surely fold. The clients will be furious in no time. I think it's a disgrace that anyone would give advice to guess at words. Better to leave this business holding your head high, knowing you cared about the patient's medical information as opposed to no conscience.
Guessing - OldMT
[ In Reply To ..]Nope, I agree with the old timer. She made some excellent points! She said "educated" guess not popping in anything to avoid a blank. When we get all the tools we need they will be very helpful. Everyone needs to chill. This is going to separate the women from the girls and if you think there are not MT's right now who are Guessing just to rack up the lines, well, there are. MQ is trying to weed out the abusers and I'm glad. If you are experienced and good at this which comes from experience, you have nothing to worry about. Just my two cents.
Then the company needs to get rid of - FIRST TIME RIGHT! NM
[ In Reply To ..]MQ is the one who wants this and they shall get it.
I know, lets give all the blank reports to the board of directors and they can fill in the blanks.
got me tickled on that one! - mushroom
[ In Reply To ..]I got this mental cartoon picture of suits sitting around a table and looking at each other with a piece of paper in their hands (a report), scratching their heads, and saying." What the ________ is this?" no pun intended on the blank -- my brain is really suffering - pay no attention!
Raiders of the Lost Medical Report - L&L
[ In Reply To ..]Have you ever worked in a hospital and seen what a medical records department is like. Remember the last scene of Raiders of the Lost Ark where the crate with the ark is parked away in this enormous warehouse?
Most of the stuff we do is done simply because documentation is required, not to really provide anyone with important information.
More dangerous was an incident report I saw where a patient was going to get a potassium bolus for a potassium value of 1. It was really 3.1. The person in the lab had not changed not the ribbon in the printer so the report showed only the 1.
Yes, days of paper charts are going going gone, but I doubt any MT ever caused serious harm to a patient. Medical personnel have managed that well enough without any of our mistakes.
Oh, I beg to differ on "I doubt any MT - Just passing through
[ In Reply To ..]ever caused serious harm to a patient." Especially now with medical records accessible on the computer as soon as they are transcribed. This patient record is what doctors use to determine course of treatment. Example: A patient comes into the ER after an MVA and cannot communicate any history. The ER staff pulls up their medical record on the computer and an MT had mistyped or guessed at a drug allergy dictated and the patient is given something they are allergic to. Or the MT has mistyped or guessed at some medication dosage and the patient is given a dose that could kill them. This has been documented many times with pharmacies giving the wrong dose and/or medication out due to errors on records. Or some MT has mistyped or guessed at a lab value and the patient is treated or not treated due to that wrong lab value. What about the MT who does not catch when the dictator dictates on the wrong patient so this report goes into someone elses record, which could cause all kinds of harm...I could go on and on about how an MT can seriously harm a patient by guessing/mind reading. Wake up.
specious arguments - L&L
[ In Reply To ..]If they refer to old records, they will not assume the patient is currently on drugs. They don't use our reports for laboratory data...they use the lab reports.
Our reports are to document treatment for insurance companies, not as an indication of treatment to be given.
This is why DOCTORS WRITE ORDERS and why they don't do anything w/o the laboratory reports or x-rays reports themselves or verbally from their colleagues.
Doctors have always assumed we are idiots and have not trusted us to do this work accurately.
Get off your high horse. We are just not that important.
OMG, I did not realize how ignorant some can be - You are scary
[ In Reply To ..]So, who do you think transcribes these orders, lab reports, radiology reports so other doctors can see what has been ordered and what treatment has been or needs to be done? Do you think they all call each other on the phone to get the scoop on every patient, like they remember everything on every patient off the top of their heads and do not need any records to refer to? It is the medical records we transcribe that communicates this information between doctors/facilities. "If they refer to old records they will not assume the patient is currently on drugs..." Of course not, they will look at the current information you have transcribed. If you are correct in what you are saying, then these hospitals are really stupid paying for a service they do not use.
Absolutely no point in arguing this further with you.
Have you ever seen a patient chart. - L&L
[ In Reply To ..]Lab values are printed in the labs. I watch docs flip through looking at them to compare with previous ones as they are stored in the same area.
If there is anything significant on radiology, the radiologist calls the physician. Ditto with pathology.
Unless you are working in a tertiary hospital, and not necessarily even then, most info turns out to be unimportant and redundant.
I stand by this, we are just here to documnent events for insurance companies.
They don't wait for some 24-hour turnaround report for a life-threatening event.
I don't shirk my work; my line count could definitely be better if I didn't spend so much time searching for correct equipment, new drugs, research protocols, etc.
I just don't elude myself that what I do really affects patient care and that I cannot be replaced by EPIC.
No, they are LEGAL DOCUMENTS, submissible in any court of law. - Where do you get this stuff?
[ In Reply To ..]LAB REPORTS ARE TRANSCRIBED.
RADIOLOGY REPORTS ARE TRANSCRIBED.
BASIC MEDICAL REPORTS ARE TRANSCRIBED.
JCAHO CHECKS ALL THE ABOVE FOR ACCURACY IN THE PATIENT'S RECORDS. IF THERE ARE DISCREPANCIES, THE HOSPITAL CAN LOSE ACCREDITATION.
ALL MEDICAL RECORDS INCLUDING EVERYTHING THAT IS TRANSCRIBED WITHIN CAN BE HELD AGAINST A HOSPITAL IN A COURT CASE.
GET EDUCATED AND QUIT ACTING LIKE YOU JUST CLIMBED UP FROM UNDER A ROCK.
Don't comment on things you know NOTHING about.
I know, she is scaring me, too. - She should not have this job.
[ In Reply To ..]Maybe she will be one of the ones to be fired first.
Hopefully.
Like I said, - You are scary
[ In Reply To ..]no use arguing with people like this, pointless. MOST MTs already know how the system works and pointing that out here will only fall on deaf ears for this one particular MT. Don't waste any more space.
Yep. You are right. - Like talking to a rock.
[ In Reply To ..]Hopefully, people who don't understand the system will be weeded out.
Very very scary.
Weeded out? - What?
[ In Reply To ..]Just passing through. I have a lot of family members who are doctors and they just feel sorry for us MT's.
If you are so concerned about the system and people leaving in blanks and guessing, THEN WHY ARE YOU ALLOWING THIS FIRST TIME RIGHT TO TAKE PLACE?
UNBELIEVABLE!
Comical. - You should go into comedy.
[ In Reply To ..]Really. Oh! Your serious?!!!
Wow. Again, don't miss the half-off sale at the WIZ brain blow out.
You obviously know nothing about medical records. You should not have this job if you consider it not important.
Go visit a MR department. As the director to explain to you the role of the medical report in the patient's health documentation.
HINT HINT: THESE ARE LEGAL DOCUMENTS WE TYPING.
Oh sheesh . . . . . I can't believe you.
DONT GET SIDETRACKED! Just an observation here: - see msg
[ In Reply To ..]The same thing is happening on this thread that seems to always happen when a contentious or stressful subject comes up - the discussion degenerates into an argument, we all end up fighting amongst ourselves over things that aren't the main point.
And the main point is, don't forget that you should all be sticking together and fighting MEDQUIST, not each other.
Point... - Appalled
[ In Reply To ..]I routinely go to a local clinic for medical care when needed. I've been there 5-6 times. Total chaos, see a different PA or RN every time I go in and have to retell my life story every visit. It gets tiresome and irksome.
At my last visit, the PA I was seeing asked about my diabetes and hepatitis C. I have neither of those, yet someone, either the dictator or the MT, had put inaccurate information in my history indicating I had type 2 diabetes AND hepatitis C. I've never had either condition.
Guessing - Maybe not always dangerous but probably not a very good idea in actuality. If I were ever hospitalized and unable to communicate, I'd hate to think treatment for either of those conditions was undertaken when I had neither. There's nothing in my medical history that even remotely SOUNDS either of those 2 conditions, so I cannot imagine where the dictator or the MT pulled them from.
Oh, you NEVER worked in a hospital MR Department. - Well I HAVE.
[ In Reply To ..]And yes, a patient can get HURT from mistakes on the record.
I worked many years in a MR Department. Tell JCAHO that you think the medical record is not important.
Don't know what JCAHO is? Look it up oh intelligent one.
Haaaa. It is people like YOU who have brought this profession down to dirt.
I heard the wizard is having a half off sale on brains -- don't miss the sale!
Been through JCAHO 3 times at 2 different hospitals - L&L
[ In Reply To ..]I'm the first to acknowledge they are legal documents; how many of yours have ever shown up in court? I know some of mine have.
I'm not advocating bad/slackoff work.
I just think you all tend to overinflate your self worth.
We will be replaced by EPIC and the world will go along just fine and dandy without us.
Then how can you make statesments like you do? - Heads would roll in my hospital.
[ In Reply To ..]They are not redundant.
Do you work at veterinary hospital by chance?
I am currently working in MRD, so I KNOW. Like I said, your postings are coming to work with me. We need a laugh.
They will provide many.
Um, by the way, it has nothing to do with self-worth. It has to do with patient safety and the hospital getting sued.
No matter if it is entered into EPIC or transcribed by a human.
It all matters.
If your ears are ringing on Monday, it is because we are laughing our butts off in MR. Huge teaching hospital.
Get off of a subject you know LITTLE about.
I started out in a teaching hospital in 1972 - L&L
[ In Reply To ..]Look, you're not on the front lines making critical decisions.
You're just blankety blank typing, for goodness sake.
All my labs come printed out by the laboratory...not transcribed by some dumas MT.
Docs like to read x-rays for themselves, NOT rely on the transcribed report.
I've filed in charts probably for more years than you've been an adult.
What we do is simply not as critical as you would like to believe. Get off these highfaluting horses, already.
Oh, excuse me, I have to get back to burying all the people I've killed with my work.
So true! Michael Jackson's doc did him a LOT of harm - all by himself. Nurses & PAs do the same.
[ In Reply To ..]nm
I personally believe that... - JTBB
[ In Reply To ..]when you get to the point where a buck is more important than patient safety, you probably don't need to be in this profession, and this attitude puts you in the same category as the Q itself.
As far as employment, guessing at blanks and getting caught at guessing at blanks will lead to termination with no recourse. I do believe this would be the ultimate goal for MQ.
Leaving blanks and not guessing may also lead to termination; however, you can at least say that you did your best and did not violate standard practices.
Too late. Gone back to school. Been with MQ 1998. - They got me
[ In Reply To ..]Had enough with their crap and being treated like crap.
New MT's? Run as fast as you can! Enroll now at school for another career. There was a post written a few days ago about all these new wonderful jobs to do at home and make 10-25 an hour.
True. But you don't really have to guess - Old part-timer
[ In Reply To ..]We will have the option of sending reports directly to the hospital with the blanks in them. I guess they can always come back to us and say QA could have filled them in, but that's always a judgment call. Most of what I send to QA doesn't get filled in.
(As an aside, I did have one funny one I sent to QA today - something that sounded like Graubert's position that came back filled in as McRobert's. I guess the first part of the word was cut off and my brain didn't catch it! I'll miss QA for that kind of stuff.)
As far as those screaming about jeopardizing patient care, there are things I will never guess at, such as allergies. If they don't sound clear to me, I will leave a blank. A lot of what we fill in as an educated guess has little or no impact on patient care.
I am not one of those who guess at every - Another longtime MT
[ In Reply To ..]blank I have to leave, not a good practice for patient safety...I am not a mind reader or a doctor. Even an educated guess is still a guess. MQ is giving the option to send blanks to the client without penalty (for now anyway) and so that is the course I am taking. Safer for the patient to let the report go back to the doctor for clarification and safer for me. If I am fired for sending ligitimate blanks to the client I will have a much easier time getting UI and another job than if fired for guessing wrong. I don't care how long one has been an MT, not all guesses are going to be correct and eventually it will come back to haunt you.
I believe what MQ is doing with this policy is eliminating QUALITY ASSURANCE altogether and it will ultimately end in thier downfall. I cannot believe clients will put up with it very long. After all, the service they are paying for is to receive complete accurate reports the FIRST TIME, not have to do the QA work themselves, which costs them money. I think you are going to see some changes to this policy as this moves along, if not doing away with it altogether in the longrun. The more experienced MTs out the door, the faster clients are going to feel the brunt of this policy because the only MTs MQ will be able to attract are the new and inexperienced ones and that will be a revolving door with high turnover, thus poorer quality and clients leaving because of it.
I will wait around to see how this pans out as I have nothing to lose by sending these blanks on to the client for the reasons mentioned above. Right now I am making a livable wage with retirement in a few years.
Wow. If my loved one's record had an error because - YOU guessed, I would sue YOU. nm
[ In Reply To ..]nm
Hang On! Do you have M.D. behind your name? - mrs.krabs
[ In Reply To ..]You could be jeopardizing someone's life by even "educational" guessing. Do you want that on your conscience? Then you are no better than MQ. This is totally unethical and illegal. You are posing as a doctor by second guessing his dictation. MQ is going to implode over this issue.
unethical educated guessing? - old timer
[ In Reply To ..]every single word you edit or transcribe is educated guessing -- more or less.
I don't think it unethical to advise people how to succeed, as I personally am a very successful MT.
If you think it unethical to make an educated guess, you either think you have the physician's responsibility or you actually are not very cognizant of what you do when you transcribe.
Yes, you're playing doctor! - mrs.krabs
[ In Reply To ..]You cannot "educationally guess" at what the doctor is going to say if it is not dictated or is unclear. You are so wrong in doing that, and I wonder how many charts you have screwed up in your lifetime of being the best MT ever.
hangin - planetspinz
[ In Reply To ..]I've worked for this company since 1988 - yep 1988- and here's what I've seen since Transcription Ltd (that's what it used to be called) became Medquist - lots and lots of CEOs, CFOs, and a whole alphabet soups worth of other initials.
So wait at least six months to one year, and the newest group of execs will have added Medquist to their resumes and moved on.
See the problem we oldtimers have is we have been here too long. Some of us may even think that we have some kind of loyalty to the company - which is a really good way to hold ourselves back from moving forward.
But these CEOs are only loyal to their own self interest - a good lesson to learn from people who do not get paid diminishing pennies per line.
When a new CEO arrives he brings his whole entourage from his last gig with him, and their technology too. The last one gave us ASR - and he moved on. The one before that (or the one before that) put us on the internet. One of them gave us ETime. One of them closed all the offices. One gave us the Impact Room (remember those phone calls). One upgraded the computers to XPs. None of them are here anymore.
The CEO today will not be here for too long either. That's just the way American corporations work now.
So either learn from these CEOs or just hang in there.
Guessing? - typingirl
[ In Reply To ..]Guessing, huh?? I'm not saying either of you are wrong or right But when i was wet behind the ears new-timer (15+ years ago), the old timers always told me the rule was ...
"When in doubt, leave it OUT"
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