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I feel just horrible, got 2 critical errors in the SAME report....sm - LoveMT

Posted: Aug 11, 2013

I got a rather lengthy dictation by the most horrifying ESL physician who happened to be dictating next to the emergency room radio for traumas or something similar (bad dictator + lots of radio noise + already noisy emergency room). I was so flustered and frustrated by the time I finally managed to finish editing it that I could've cried. I spent an enormous amount of time in the report, and yet I was still not careful enough not to make 2 very stupid mistakes. Yes, they were mistakes on my part because I didn't correct 2 lab values that were apparently dictated incorrectly in one section of the report as compared to another section of the report. I'm positive I made these mistakes because I remember the horrible dictation so well. I sent it in for QC review because he changed his mind a million times about whether the patient had a wound on the left leg and/or the right leg. By the time he was finished, I couldn't figure out whether he meant right or left or both, so I blanked all of them, and the report was 100% reviewed, bringing to light the 2 critical errors.

In my quest to try and perfect the report and not have any mistakes, I managed to STILL miss the lab values that were dictated with different values in 2 different sections of the report. God, I feel like a idiot!! I am always so very careful! Since I know these were my mistakes, I am now second-guessing every little thing I hear, edit and/or transcribe! I am thankful that a QC person reviewed it and was nice enough to give me constructive feedback.

I'm also thankful that the report wasn't post-audited because it was such a nightmare, there's no telling what offshore QA would have done to it. I'm just upset with myself for not being more attentive and for allowing the horrible dictation to frustrate me to the point of tears and critical mistakes.

I normally do not have any problem at all with ESL physicians. I just have an "ear" for them, something I could never explain. I'm an experienced MT with 17 years under my belt, but at this point I'd welcome any suggestions from other experienced/seasoned MTs on what you do when you get these awful ESL physicians and/or physicians who insist on dictating in a place with the most background noise they can find. Any tips or tricks that you do to get you through a really bad dictator and make sure that you don't have these kinds of errors? Please don't flame me. I feel bad enough as it is. Thanks for any input, encouragement, etc.

I'm to the point that I want to quit and never look back. I don't ever want to have to do MT again, for ANY company (good or bad), which is just sad because I have always loved MT, even after VR came along, but now... I don't know... I just don't know how much longer I can do this and not lose my mind.... I said 6 months and then I was getting out for good, but 6 months is a LONG time from now!

you are NOT an idiot, you CARE. - beulah

[ In Reply To ..]
and having said that, I can't think of any particular tips except to thank the Lord that these "special" dictators are the exception and not the rule! (otherwise, would any of us still be MTs? LOL) And despite the horrible ordeal, it did end up working out for the best -- because of his L/R errors you routed the job to QA, they happened to find the other error and it got properly flagged for him, and the QA person sounds like she was pleasant about it; after all, they had to deal with listening to him too, so certainly they had to appreciate what you went through. Really, objectively, I'd say all's well that ends well as far as the report goes. The system worked and it got fixed. But then there's you, and it sounds like you're beating yourself bloody for missing the lab thing. We all have winced (or in my case practically had my heart stop) to find the mistakes we've made from time to time, I guarantee it, but you'll drive yourself crazy by dwelling on it. Like my dad always said, when things went wrong: "What are you going to do? Just go sit in a dark corner?" He was right, you can't go there, you have to pick yourself up, dust yourself off, and make a decision to continue on ahead. It's all any of us can do. And guess what--I am betting that from now on you will be just PHENOMENAL in catching lab discrepancies. See? You just became even MORE skilled at what you do.

As an aside, I too have a "special" ESL MD on one of my accounts and I just LOVE to see his name fall into my queue with a 20-minute dictation near the end of my shift when I'm already tired, and aside from his accent, he is one to change his mind all the time, so needless to say, most of his reports end up on QA's desk, even after I've literally inched my way through his report, agonizing all the way.

I guess one thing I have learned to do (and you probably do it too) is to go back and review the entire report for sense and for discrepancies, when I'm finished typing. I'd say that 80% of the time I will find at LEAST one very significant mistake that I blew past -- if not more -- so that makes it very worthwhile to me, even tho it takes an extra minute or two that I'd rather not spend.

Hope this has helped just a little, and sure hope it doesn't come off sounding patronizing. I'm sure things will look better in the morning, too!

Thank you to EVERYONE here for your thoughts and advice!...sm - LoveMT

[ In Reply To ..]
You all have made me feel a whole lot better about this. I have been off of work for at least 24 hours or so, and I feel much more refreshed and able to "face" whatever is thrown at me today, tomorrow, or the next day.

As someone said below, a good night's sleep does wonders for my whole perspective with regard to work. I already have horrid insomnia, but add in the anxiety on top of that and well...you can only guess what my mindset will be on any given day, LOL!

I have always had excellent feedback from QC1, with the exception of 1 instance where the QC person had "magic headphones" that heard audio that was nonexistent to my headphones... I honestly felt sorry for the person who had to QC review this particular dictation. It was beyond awful, and I'm sure it took that person as long or longer than I did to get through it. I have done this particular account for more than 5 years, so one reason for my "kicking myself" was because it is SO familiar to me and the dictator is not a new dictator by any means... I would be willing to bet the person who had to QC review it hasn't done this particular physician or hospital account nearly as often as I have, and I'm extrenely grateful to the person who did QC review it simply because he/she took the time to give me hints or suggestions for the errors that he/she caught that were not flagged.

I do realize that I'm doing my best and just as much as I can humanly do to make sure that I don't have these types of errors. Someone else below mentioned something to the effect that we shouldn't be responsible for "catching errors" that were incorrectly dictated. I'm almost certain that one of the two errors I made was one that was dictated incorrectly. I'm also certain that I didn't catch it because I was so aggravated and frustrated with everything else that was WRONG with this dictation that I wasn't paying close enough attention. I agree that we aren't paid enough by any means for everything that we are expected to do, BUT I still believe that it is my responsibility to make sure the document is correct, whether I'm straight transcribing it or editing it. I have ALWAYS done my best to make sure that I have transcribed a document correctly, and I treat the EDITED document in the same manner, regardless of what I'm paid (which is next to nothing for some reports!). I try to think of it as though the patient is one of my loved ones and how horrified I'd be to find something glaringly incorrect and dangerous in a loved one's medical record.

Again, thank you all for your encouragement AND for your advice. Have a great day!!

Critical error - blah, blah, blah

[ In Reply To ..]
One word: Xanax. This profession is on its deathbed. Stage IV.

first of all dont get frazzled - mtr

[ In Reply To ..]
and if you become so during a report
like that again stop and take a deep
breath and then go back and relisten
to everything again and even if you have to go back a third time and relisten to it all again. Send the job only when
you are feeling comfortable again.

Today's environment just requires more "blanking." - Where we used to take pride in none,

[ In Reply To ..]
the new pride has to be in refusing to guess. 0 tolerance for adding mistakes to reports.

If some of them end up looking like rotted lace that just went through the long cycle, oh well. That's what a good job on those looks like today. At least that's what I'm telling myself; eventually I'll stop wincing as I send.

Remember, though, the rates of harm to patients through medical mistakes are unbelievably and inexcusably high at most hospitals today. You don't want to be part of that. Use your pride to REFUSE to be part of the problem.

BTW, hope a good night's sleep took care of 98% of your anxiety. Serious errors raise my stress level tremendously too, but somehow maintaining balance and perspective is a good thing. :)

Critical errors - fedupMT

[ In Reply To ..]
Sorry, I may be in the minority but this is a big bone of contention with me. Back in the day when I started doing this job, it was the dictator who was responsible for what he/she said. Why should you, or I or anyone be punished for not catching THEIR mistake? We are not paid nearly enough to expect almost perfection and then make sure Doctor almighty hasn't made a mistake. Throwing the BS flag.

Critical errors - burnedoutco

[ In Reply To ..]
I agree that we should not be responsible for dictator errors. If we catch an error, well and good, but if they dictate, for example, a wrong dosage and the transcriptionist does not catch it as such (which has happened to me, the doctor gave the dosage clearly, he is the doctor I thought he should know, but it was my mistake). Should it always be the fault of the minimum wage transcriptionist, should we always be responsible for their carelessness? Is that part of our jobs now to know every drug's correct dosage, I guess so. Also some American doctors think they can mumble anything and it magically becomes a perfect document, especially in VR. Also, I think foreign doctors should be able to speak English properly before they can work here and not get special 100% review on their reports. They are doctors for heavens' sake, I have talked to customer service people in India who speak better English than some of these doctors. Have come across many Russians who work in department stores who speak better English. These ESL dictators should be ashamed for making our lives miserable. As for the person who was beating themselves up over "critical errors" just don't, better to just leave blanks and move on. Sounds like you did your best and more. I do get frazzled sometimes in that situation but more and more I am able to get in a mindset where I just do the best I can and leave blanks if in any doubt. Lastly, also anyone who has a number of years to work, get out of this profession. We have become the lowest of the low in anyone's regard.

Critical Errors - Texas MT

[ In Reply To ..]
The dictator should be held accountable for their dictated reports. "Back in the day"... (I hate that term) a report did not make it to the chart until it was signed by the dictating physician, indicating that he/she can attest to what was in the dictation. Way too much responsibility is being placed on MTs and QAs !!!!!

We are paid far too little for what they're asking, - BUT we are not asked for

[ In Reply To ..]
more than we can and should do. We're involved with every word of every report we work on and should of course serve as yet another layer of protection for the patients. (Also the providers and companies involved, but I don't worry about the latter--just the patients and secondarily the hard-working clinicians).

Bottom line, though, any mistakes we CAN catch are mistakes we SHOULD catch.

If it makes you any happier, this is yet another, very obvious proof that our skills are worth a lot more than current rates, and it may just pay off for us in the future.

Degrading our work to appropriate for minimum wage (not sure HOW we'd manage that, we are literate, skilled workers after all) would gain us nothing, lose us the right to demand more, and cost us our own self respect. At least it would me. My work is worth far more, and I don't even intend that it not be.

Paid far too little... - Seriously?

[ In Reply To ..]
Lose us the right to demand more? Where have you been? That ship sailed long ago. If it makes you happy on your high horse to waste unpaid time, when our wages have been cut to a ridiculous level, to go back and peruse every report word for word and make sure the dictator made no mistakes, including knowing or looking up the dosages of all medications, knock yourself out. It will get you nothing more than broke. Obviously if we happen to come across an error that is blatantly obvious, you flag it. However, to hold me responsible for somebody else's mistakes who makes 10 times what I do is bullshit, plain and simple.

If you cannot let feedback for these understandable lapses - roll off you back, then you can

[ In Reply To ..]
always get up and walk away from the computer after finishing one of these truly exhausting and frustrating reports before you upload it. Then when you come back from your break, give it a quick once over to see if there are any glaring errors remaining and perhaps re-listening to lab values. Then you know you have given the report your best under the circumstances that we work, and if a mistake is still there and caught by a fresh set of ears and eyes, so be it. We are only human. Please remember that it is a lot easier to spot mistakes when 99.9 percent of the report is correct than when we slog through a report that requires multiple edits to every LINE.

hard dictation - new but old

[ In Reply To ..]
I had one the other day which was very very long and the audio was horrible. Every few words were cut out. I don't think I have ever left that many blanks ever. I of course pended it and put in my remarks how bad the audio was and I tried slowing down the audio to see if that would help. In FIESA of course it came back with some percentage that was horrible (at least it was review and not post audit) but with very smart and sarcastic remarks for the corrections that they made. Out of probably 30 and yes I said 30 blanks, they were only able to fill in 3 and of those I got a sarcastic statement of what I should have done. Well obviously it helped tremendously since they were able to fill in only 3 of the blanks that I left and I was penalized for all of them as failure to flag!!! What is that????

That is just WRONG - and INSANE

[ In Reply To ..]
This is why I do not even open these emails any more. It is so outrageeously unjust that I don't want to subject myself to it! When I first started here I did learn some things by reviewing these. Now, however, all I learn is that I am sorry I opened the message! If they start requiring me to read these or else be fired, so be it.

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