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

Just gotta gripe - newvhmt

Posted: Oct 30, 2009

I am just so exasperated right now! I'm a new MT, been at it a little over 3 months. I think the company I work for is pretty good. We have mostly good dictators, good platform, plenty of work, and nice QA and staff. I type 70 wpm, and I add to my word expander and autocorrect daily. Our minimal required line count per week is 6,000, and I'm only averaging about 3,500 to 3,800. I'm putting in 50 hours or a little more and still can't get it. The other thing I'm wondering about is that I'm only making 6 cpl for an 80 character line. They say it's because it's clinic work, but I have 30+ dictators and go between about 7 different specialties a day. I'm working my butt off, but I am not having to do as much research as I did when I first began, yet I'm still not increasing my line count much and definitely not making much money. Everyone says hang in there, but I'm bringing home between $175 to $200 a week for a 50-hour week. I'm averaging what..$4 an hour. I didn't just spend $20,000 on an educatioin to make $4 an hour. I really love this work and love being able to work from home, but I'm already almost to the point to throw in the towel. Luckily, I got an Associate's degree in Administrative Medical Office Management. The only thing about that is that I live in a small small town with no work. The closest places to go to get a job like that would be at least an hour away each direction. I have 4 kids in school and one at home that makes it more difficult for me to travel that far to work everyday. Does anyone have any advice on getting my line count up? My husband hollers everyday because he thinks it isn't worth it for me to sit down here and bust my backside for $4 an hour.

Are you being serious, spending - Questions

[ In Reply To ..]
$20,000 for some kind of so called degree to work in transcription? I read and sent email to 1 company I saw their ad for this week and asked them how in the world were they stating someone typing 75 wpm should be typing 300 lines per hour. Talk about fast advertising. I plan on putting this school's listing on (which I told her I planned to do) and then let real transcriptions who have worked in this profession a long time tell it like it is really. Most lines are 65 characters, donâ��t know why they say yours is 80- that is very long line in transcription. I think you need lots of speed in this type of work to really make a go at it. Most will say to get expanders, etc. but really goes back to how much you are able to produce. Did you go to a school for your training and if so could I ask which one?

Serious as a heart attack - newvhmt

[ In Reply To ..]
I went to an online school in Virginia Beach. It was the Tidewater Technical Institute but was changed over to Centura College about halfway through my schooling. They are fully accredited. I didn't go specifically for transcription. I went for Medical Office Management. I got an Associates in Science degree for Administrative Medical Assisting with a focus in management. They just taught us everything though..transcription, billing and coding, health information management, accounting. Once I got into it, I found that I really LOVED MT work and decided I wanted to pursue that, which I was told I could with that degree. I do type a minimum of 70 wpm and use my expanders and autocorrect religously. We use the Crescendo platform, but I noticed just a while ago, I finished a report and had a total of 411 lines for 6-1/2 hours of work. Then I typed one more report that was two pages, checked again, and my line count was 419. I'm still new at this, but that doesn't seem right. Heck, I typed 2500 lines the first week of work. I research a lot less, I am getting faster both by regular typing and by setting up templates, expanders and autocorrecting a lot of stuff that should save time. Also, when I first started, I listened to the report after I finished it to make sure it was 100%. They told me to stop that, which I have, and still...no faster. My QA is 99.4%. It's not because I don't know what I'm doing.

Getting ripped off - Tara

[ In Reply To ..]
I have been doing MT work for the last 9 years and I have worked for many different companies. Nowhere have I ever heard that a line is 80 characters. The minimum should be 65 characters. Also, if you are using a platform that automatically counts your lines, I would copy and paste it into Microsoft word and find out how accurate the platform is counting your words/lines/characters. I think the place you are working for is taking advantage of a new MT and I would start looking elsewhere. I type pretty fast now, but when I started I was probably around 80 to 90 wpm and between all the companies I was working for, which was probably about 50 to 60 hours a week, I was easily making about $4000 a month. You need to start looking for a new job. If you want to send me your e-mail, I can give you a recommendation of some other companies that I know pay more than that and I have previously worked for. Some of them aren't medical, but they still pay decent and hours are pretty flexible.

8 lines for a 2-page report?! You need to get out - sm

[ In Reply To ..]
of that place & find a more reputable company. You're being ripped off!

It takes time. - Varmint_hunting

[ In Reply To ..]
Yeah, I know that's not a very helpful answer. But it's true.

You've probably found that your various dictators use a lot of the same phrases over and over. Some will even dictate entire paragraphs practically verbatim from one job to the next. My suggestion would be to start saving samples, if you're not already doing so. (If you're not working in Word, you can copy and paste into Word from other programs. Just be sure there is no patient-identifying information in your samples, so the HIPAA police can't get you.) You can try highlighting some of the most-used phrases so you can spot them quickly. Then just copy and paste them back into the new report.

You can also use your expander to create shortcuts for not just words, but combinations of words, phrases, even entire paragraphs. One of my dictators gives the exact same list of possible risks of surgery that were outlined to the patient, every time. That's in my expander. But, for the most part, there are too many dictators to customize expansions that way and remember all their shortcuts, which is why I resort to the copy-and-paste-from-samples method. (And learn to use your ALT-tab key combination to switch back and forth between the sample and the "real" dictation; it's a whole lot faster than using the mouse for the switch.)

You need to figure out an expansion keyword system that works for YOU, but if you are looking for suggestions for how to beef up your system, just Google medical transcription productivity, and you'll find everything from companies that sell expander software to blogs where people talk about increasing productivity. There are plenty of people with plenty of advice and suggestions.

Speaking for myself... I use the transcription platform's own autocorrect function to fix misspelled words, and I use my expander (mine is Shorthand) for words and phrases. That can help fix any possible conflicts. Somebody posted a question here not too long ago and the answer was that she had some of the same shortcuts/corrections in both her autocorrect and her expander, and they were both trying to expand at the same time, so she got interesting results. So that is why I keep them separate.

I also take the time to add just about EVERY word I misspell or make a typo on, because it saves time in the long run. (I have a lot of repeat typos because my fingers tend to go haywire in the same directions when they go.) You can also use this to make sure you always have the correct capitalization; there are some drugs that even after all these years, I have mental blocks on whether they're generic or brand names. Those I put into my autocorrect (if I haven't made an expander shortcut for them already) with the proper capitalization.

And bigger is not always better. I have expansions for even short words (drug names, mostly), because every single keystroke you save adds up over the course of a workday. Here are just a few of my own, to give you some ideas:

las = Lasix
zo = Zofran
zoc = Zocor
lis = Lisinopril
lipi = Lipitor
prx = Protonix
pril = Prilosec
isuf = iron sulfate
peni = penicillin
prd = prednisone
zyp = Zyprexa
tpx = Toprol XL
dn1 = Darvocet N 100
insu = insulin
slsc = sliding scale
slsi = sliding scale insulin

I also try to think up a system for related words. For instance:

chole = cholecystectomy
choll = cholelithiasis
cholt = cholecystitis
chold = choledocholithiasis

divi = diverticulitis
divo = diverticulosis
divu = diverticulum

Also, be sure you're using expansions for things like:

prn = p.r.n.
bid = b.i.d.
q4 = q.4 hours
q46 = q.4 to 6 hours
24h = 24 hours
1d = 1 day
1w = 1 week
1m = 1 month
1y = 1 year
And so forth for numbers of days, weeks, months, even years.

Or whatever keywords work for YOU.

I also use a number of one-letter keywords:

n = night
l = left
r = right
y = year
m = month
w = week

Since we're supposed to use "L" for liters, but I use the word "left" a lot more than I use liters, I just use ll and that expands to L. Same thing if I need a capital R by itself - rr expands to that. Same with nn expanding to N.

You can also use left and right with various body parts. I've done a lot of orthopedics, so I have lh and rh for left and right hip, lk and rk for the knees, lsh and rsh, lwr and rwr, lel and rel, lak and rak (you can probably figure out what all those are for).

You can also use your expander for any section headings with special formatting that you might need to use. It might help to use an H at the front of the keyword. For instance... when I type 'hros' I get the formatted heading for REVIEW OF SYSTEMS. However, if I simply type 'ros' I get 'review of systems' with no special formatting.

There's no law against expanding plain English words (as opposed to medical words). For me, 'appn' is 'apparent' and 'appnl' becomes 'apparently'. There are plenty of others as well.

I make up new ones as I work. Usually it will penetrate my thick skull that I'm typing a word or phrase that I type a LOT, so then I'll try to think up an expander keyword for it that will work for me. Sometimes I discover that I've already done it and forgot.

Finally... again, it does take time. I wasn't typing warp speed right away either. I really couldn't tell you how many WPM I type. But if it's an easy dictator and I have plenty of expansions available, and I don't make any mistakes (yeah, right) I can keep up with most dictators, even some of the faster talkers. I even find myself speeding up some of the slower talkers so they don't slow me down. But it has taken YEARS to get to this point. And I'm still looking for ways to increase my speed--or cut down on my number of keystrokes, at least, to save my hands and wrists....

Just keep plugging away, keep adding in new expansions and shortcuts when you can, remember to use them, and try not to stress over it too much. It's a very steep learning curve--even for old pharts like me who've been at it waaaay too long. When I get a new dictator it isn't QUITE like starting completely over, but each one takes some getting used to, the cadence of their voice, and how they word things. But then it all falls into place and you "get it."

Best of luck, don't sweat it when you have a day when nothing seems to work (we all have those), and above all, go hunt down some of those resources for ideas!

Thanks - newvhmt

[ In Reply To ..]
Thanks for all that info! I was almost afraid to post on here because some of the most innocent of posts get the snottiest comments. I really do all of that stuff. That's why I'm having a hard time understanding what's going on. I mean I typed 2500 lines my first week without using any type of expander or anything. After I got comfortable with the platform and such, I started working on my expander. The company provided their own, and I also use the autocorrect, but I only started that this week. I finally figured out that I could type in tsh and autocorrect it TSH and prn to p.r.n., etc. I have 30 dictators and, so far, have whole templates with their "usual" phrases already inserted. We have a tab marker that we can use on our expander, so for __-year-olds, I type yo-, and it expands out to a tab marker-year-old. I can then hit F8 to jump to that marker and insert the correct age. I have noticed that I forget to use alot of my abbreviations though. I do a lot of ortho, too, and have bex for bilateral lower extremities, mpj-, which expands to metatarsal phalangeal joint (that is account specific), and then when I need to type MPJ, I have it in the autocorrect without the hyphen and it capitalizes it for me. I still have a lot of building to do, I know. Thank you, again, for your kind words and helpful tips!!!

You're welcome. :) - Varmint_hunting

[ In Reply To ..]
Know what you mean about the snark around here... I've been subjected to it many times myself.

Here's another one of my tricks that I've invented fairly recently. (I use a slash mark in a lot of my keywords because I started out back in the dark ages with an expander that accepted that, and the person who taught me how to use it used that. Hopefully yours will accept that as a character, if you see something you like below. Or you may be able to use some other character for the purpose.)

cad = CAD
cad/ = coronary artery disease
cadx = coronary artery disease (CAD)

That last one is for the times when we're supposed to do it that way, such as in a list of diagnoses, if they dictate CAD, we're not supposed to use an abbreviation in a diagnosis list, and we're supposed to use it the way I show it above, with both the spelled-out version and the abbreviation in parentheses. (Good grief, that was an awkward sentence. I must be getting tired.)

I chose the x just arbitrarily because it is not a common letter. Of course I promptly got into trouble with MI because 'mix' is a real word, not used often, but a real word nonetheless. So that one is an exception; 'mii' is the keyword for the fully expanded version.

Other candidates for this system: CHF, ASCVD, CKD, CVA, CABG, GERD--the list goes on and on. For these, you just make your play on the standard acronym/abbreviation, so they'll be easy to remember.

I also started using the letter j in some of my keywords, just because it's close to home. For instance:

aj = afebrile
cj = complaints
ij = injection
tj = temperature
wj = who complains of

Don't ask me what my brain was doing when I came up with those--but you know what? They work. For me, anyway.

I actually keep very detailed statistics of my production. These were very helpful for me not to get discouraged by my abysmal slowness when I first started my current job. I keep track of my lines per hour every day, and it's very gratifying to see it creep up, little by little. (Another use for my detailed stats is for the extremely rare occasion when they screw up my paycheck. Fortunately, that has only happened maybe once.)

Again... best of luck, and if anybody gets snarky with you, refer them to me. I bite. Hard. But only when provoked. :)

Another tip - gourdpainter

[ In Reply To ..]
Don't waste time going back to correct typos. When you run spell check it will pick them up and you can correct them at that time. This will save a lot of time.

You sound like a hard worker and a conscientious MT, so you will - Fuller

[ In Reply To ..]
get better at it as time goes by. I was trained on the job back in 2001, only having a typing and transcription class, and for the first 6 months I would just go to the lady's room and hang my head, tair my hair and debate whether to just walk out and quit and go back to waiting tables, but I kept at it. Now 8 years later I love what I do. I was very, very lucky, as not many hospitals here have in-house MTs, much less give on the job training. You are using expanders, that's great. You have been at your first MT job for 3 months and already you are typing clinic with 7 specialties. That alone deserves a pat on the back. At first when I started training my lines gradually went from 150 lines per day to 1,500 or so lines per day. I asked my 1st supervisor about lines and she said "Honey, just concentrate on quality, your production will go up as you get better at it." And it did.

I know that's not much comfort when you have bills, but things will get better.

Here's another expander trick that might help.v - Varmint_hunting

[ In Reply To ..]
Saves you having to hit the shift key, anyway....

OR is, of course, a frequently-dictated abbreviation.

Or is a frequently-used word.

My expander shortcut 'oor' expands to OR with the capitalization in place.

I use the add-an-extra-letter trick in other places. For instance, 'ms' normally expands to 'months,' but what if I need to refer to somebody as Ms. So-and-so? My keyword for that is 'mss.'

And 'dr' expands to Dr. complete with the capitalization and period. 2 keystrokes saved right there--the shift key and the period.

It does add up, even in the smallest increments.

And another lifesaving trick... - Varmint_hunting

[ In Reply To ..]
I have a keystroke combination that reverses the positions of 2 characters. I happened to assign it to CTRL-G because that combination was not being used by anything else. Your mileage may vary.

I was able to make it happen using the keystroke recording feature of my expander. If you're using Word, you can use the macro recording feature to do the same thing.

I put the cursor on the first of the 2 characters I want to reverse. The recorded keystroke order is then select (shift-right-arrow), copy (CTRL-C), delete (DELETE key), right arrow (to move past the second character), paste (CTRL-V).

So then, when I want to make it happen, I just put the cursor in front of the first of the 2 characters I want to reverse, then hit CTRL-G. Voila!

I tacked an additional command to the end of mine which is simply the END key, meaning the cursor then jumps to the end of the current line. That usually takes me back to the place I was typing before my brain kicked in to notice the error.

Clear as mud?

If you can get this one working, it is definitely a real time-saver, because how many times do you reverse 2 characters, and then have to back up and fix them? This little trick speeds up the process. A lot.

6 cpl for an 80 character line is way too low for one thing. - sm

[ In Reply To ..]
Please tell me this isn't as an IC too! And are they counting spaces?

My advice to you is send some resumes out & look for the companies who let you test directly from their site because now you have your foot in the door & you need to find a better company who will pay you more & on a 65-char line.

Similar Messages:

Jul 19, 2012

I've got a gripe. I hope this is not too long but would really like suggestions if any of my fellow MTs have been in this predicament. If you are QA turned MT, don't bother to reply. I don't need sarcasm to start my day. The company I worked for went into partnership with another company. The new company even changed the name of the company and the new partner is the president of the company. We're supposed to make all complaints to her; however ...

Oct 18, 2012

Sometimes you just cant be happy. MTs have always had it made. Now that real work is involved, and you finally need to put in a full 8-hour day for your paycheck, like many Administrators do, the whining begins. I can work in jammies, not fix my hair, save gas, I can eat/drink/watch TV, not leave home unless I want to run to the local department store or walk the mall for hours. You could come home and put in a couple hours of work it was great - not so easy anymo ...

Aug 27, 2012

Was recently told by two new physicians to "use my standard." The standards that were provided were virtually unrecognizable as medical reports. Even though they were eventually fixed by the QC person, they nevertheless had been produced by someone, somewhere in the first place. Is this what the ILPs are producing? And they want us to be 99% accurate? You would have had to see these "standards" to believe what they looked like. My unedited work looks better th ...

Dec 01, 2012

How many times, I mean how many, really, must we stack the subheading to the left, capitalize it, put a colon after it, and remove the word "is" before this stupid speech engine figures out that's how it's supposed to do it, not all in one paragraph? I mean, it's a client specific, and I am pretty everyone is doing it this way, every time, so don't tell me this is the MTs fault. ...

Dec 23, 2010

with 1 other girl, and then the QA girl types on this clinic also. I still have not figured this out. We keep the work caught up and this QA girl gets on there and types with us when there is nothing to type. I mean there can be 10 jobs there and she will get on to help us type 10 jobs. My company makes me type any other clinic that is behind and this being the holiday, we have been given an extra 45-50 jobs to type from other clinics and the QA girl is nowhere to be seen ...

Jul 24, 2012

I just had to turn a job down, (after giving it very careful consideration) due to their LPH requirements on VR. I am in my late 50s, have been doing this for years, mainly straight typing and I also have a slight physical distability, where I am not a "speed typist," but I am accurate. I get so frustrated with these companies and the fact that they require "125-150 lph" for straight typing and "200-250 lph " for VR and if you for some unforeseen reason, you can' ...

Mar 23, 2010

Gotta wonder if all these patients with "poor hearing acuity" are really deaf or just can't understand the doctor (which I can totally identify with, but feel my hearing acuity is fine). So patients are at fault also if they can't understand the doctor? ...

Jun 17, 2010

ASR: tachy fell axis I am wiping the tears from my eyes on this one. What a stupid program. I swear it is written by the Indians. I had a wonderful English-speaking clear-as-day doctor yesterday, first name of Daniel, and the ASR did not get 75% of his dictation. It was just words and gibberish. It was a crying shame. That could have been a helpful tool in that instance. It should have been able to transcribe him perfectly and editing should have ...

Jan 30, 2011

x ...

Feb 14, 2011

what do you do if you find out you need to take a day or day and a half to attend symposium (need the CECs for my CMT) and it's during the first 90 days? should you forget it and skip the symposium, or would you ask to be off and make up your time? ...

Dec 11, 2011

Okay guys, I just have to vent because I know many of you share the same frustrations and will understand where I'm coming from. I've got over 10 years of transcription experience and I'm making $10 an hour. This is a $5 per hour cut from what I made in a larger city before I had to move to a smaller one in a different state. I got divorced earlier this year and this is no longer enough to survive on for me with just one income in the household now. I pride myself on being a good, ...

Jan 20, 2012

On my semi-yearly quality analysis, I achieved 98.8%, the best I've done in three years. I am a happy camper! ...

Feb 16, 2012

After not being audited since last August, I just received an audit. Do you suppose it was because I went over my CCM's head and complained to her supervisor about not hearing from her regarding the loss of a 10 minute report when DQS went down? I thought they were going to slam me but, lo and behold, a near-perfect audit. They gotta be getting desperate for MTs who can transcribe this crap and make it even moderately coherent. Next time I think I'll leave profu ...

Mar 20, 2012

transcribed: feet 1/2 pill a Rubin. instead of bilirubin,,so close so close... ...

Aug 07, 2012

Gee whiz, Nuance's revenue was up approximately 34% in the 3rd quarter ending June 2012 especially in their healthcare market. This sickens me IMO. http://www.marketwatch.com/story/nuance-announces-third-quarter-fiscal-2012-results-2012-08-07 ...

Oct 24, 2014

I am doing a dictation from a doctor who sounds like he's got a mouth full of mush. His speech is slurred and I can't understand half of what he's saying. As a result, this report is going to QA with so many blanks in it that it looks like Swiss cheese. At this point I really don't care any more. I've had it up to my eyeballs with this guy and everyone like him. If I could afford to quit, I would right now. ...

Nov 17, 2014

Feeling so frustrated that MDs can't be bothered to articulate... The company I work for "dings" me for blanks...but their QA is merciless about mistakes. (Non-critical, stupid grammatical issues, i.e., "The son agreed with the plan" versus "HIS son agreed with the plan.") I am feeling like I can't do this anymore. I am GOOD at what I do, but when audio sucks, what do they expect? I am screwed no matter what I do. If I made more than $13 an hour, (which took me ye ...

May 18, 2015

Dr. dictates: Postsurgical drains over the abdomen ... VR types: Postsurgical brains over the abdomen ... Bwahahahahahahahaha!!! ...

Feb 22, 2010

Why is it that when a doctor cannot pronounce a medication they will spend FIVE minutes TRYING to sound it out and STILL leave me with no clue what they are trying to say, when it would be MUCH quicker if they could just SPELL it? I mean if you can't pronounce it, just SPELL it, even if you spell it wrong, I can find it quicker from it being spelled to me incorrectly than having to decipher out how you MIGHT be pronouncing it! Just my rant for today, lol. ...

Jul 14, 2012

I was actually gonna go for it with the increased days and lower line count ...

Aug 07, 2012

CRITICAL ERRORS - Okay, a patient comes into the hospital, gravely ill. They take some xrays (I am radiology so I use that example). Maybe a CT or an MRI. The radiologist is allerted this is a rush because the patient is so ill, he calls the report to the MD taking care of the patient to let him know what he sees. Then, after he calls the report, he dictates it, and I type it...I make a mistake and put, lets say, no congestive heart failure noted, because he mumbles and talks ...

May 31, 2014

VR transcribed. "The patient came in and from the bikini was not feeling good." ...

May 23, 2015

Dictated: vegetations SR: bitch dictations I sat and laughed for a good 2 minutes...smh and the thing I wonder the most is HOW does SR even know that word?? LOL ...

Jun 02, 2015

Either get email or phone call asking when they can contact me, I reply, and they never do! Why not just tell me the job is filled?? GRR... ...

Sep 16, 2010

Dictator said: Sturge-Weber syndrome System typed: stirred should we burst syndrome ...

Jan 03, 2011

It states, "Most important plenty of work. We do all we can to assure you will stay busy your entire shift. NO waiting or praying for work to come." I guess today and the last 2 months have been my imagination. ...

Feb 24, 2011

d ...