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

CJ, regarding the speech and editing errors... - sm

Posted: Dec 29, 2010

Maybe what you are seeing is already the result of many people like yourself who have already left the field for the same reason you did. When you get the responsible, diligent workers leaving because the pay has been cut so drastically they can't afford to work anymore, the field becomes saturated with new or substandard workers. If you're already seeing these errors a lot, imagine how much more there will be when more MTs leave. Who will be left to do the editing then?

Secondly, you pointed the finger directly at the editors for the problems with errors in patient documentation. It isn't JUST the editors that bear a responsibility. What about the doctors themselves? You stated that once a doctor e-signs that chart, the error is documented permanently. Doesn't the final responsibility also rest with the doctor and his obligation to READ the entire report, just like we have to proofread the entire report? You may say that's why they hire us, but they also have a legal obligation to READ before signing. That's why there is a system of checks and balances because no human is perfect and each has his/her part.

There have been so many cuts in every division of healthcare that the blame for mistakes lies with everyone. How many doctors do you know that now double or triple book appointments because of cuts in Medicare/Medicaid, etc.? When a doctor is seeing a patient in the same 15-minute (or in some cases 10-minute) time slot, how efficient can he REALLY be in thoroughly examing and reviewing history, medications, and complaints? Is that really quality care or is he rushing through the day based on how much money he's making? Is he putting the patient first?

I had a PCP one time that we fired because we had a car accident and I ended up with 2 broken ribs and my husband 2 black eyes. The ER physician told us that it was imperative we have next-day followup with our PCP. I called the next day to make an appointment and the secretary actually told me that the doctor doesn't take automobile accident cases. I explained that we weren't new patients and that he was our PCP, and she matter of factly came right out and said, "He will NOT do automobile cases because a good share of the time he doesn't get reimbursed by the insurance companies or lawyers expect him to settle for next to nothing." We were left to return to the ED for followup because our PCP was afraid he wouldn't get paid. Is that putting the patient first or compromising quality based on income?

Maybe it's time to start saying something to the people at the top instead of blaming the ones on the bottom of the food chain. The blame for this mess goes ALL THE WAY AROUND. I sincerely doubt you will find positive change in this regard if the MTSOs keep going in the direction they are with editing pay. The only change you'll see is that it will get worse.

When we read messages on these boards we assume the posters are skilled MTs - but we really have no idea

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Just throwing in another thing to consider as we read message boards in general and this one specifically. Anyone and everyone who posts presents themselves as one of the skilled MTs as opposed to those we are writing to complain about. The truth is, we don't know. A person who comes on here and writes complaining about others may or may not be as good as they claim to be. They may or may not be a part of the problem rather than being the person with the answers to the problem.

I never said anything about my skills or what field I work in. - OP

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I'm not sure what you mean about "this one specifically" or presenting themselves as skilled MTs. What people present themselves as on a board really has nothing to do with the sad condition in healthcare documentation or healthcare in general.

My post was mainly about the fact that everyone involved plays a role in the quality of patient documentation and healthcare, but CJ was addressing only the editors. I had wondered if she also felt the need to admonish the physicians themselves or even the hospital administrators and MTSOs as well since they're part of the reason for the sad state of VR documentation too.

No, you didn't, but I think CJ did - See message

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While I agree with CJ completely that MTs should continue doing quality work as long as they accept work to do, my point is we don't know anything about the quality of work CJ, you, or anyone else on here does. We just take each other's word for it that we are being abused by MTSOs even though we do really great work or we lost a job or quit a job because even though we were great at our work, we weren't being compensated for it, etc. We don't know. The person who claims to do really great work may do sloppy work. They may have lost their job because they have poor MT skills. They may have made very little money because they were not able to produce an acceptable amount of work in a reasonable amount of time. We don't know. There are good and bad MTSOs just as there are good and bad MTs. When we read a thread on here we get one person's opinion from their own experience. That doesn't make it true for everyone else.

I certainly agree with CJ that anyone doing MT should do their best while they are doing it and get out of it the moment you realize you can't or don't want to do it well.

I agree with you 100% about the quality of the work. - OP

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However, we don't really need to know the status of any poster's QA anyway to know what certain companies pay for VR editing. Most of the larger companies pay 50% to 60% of the transcription rate, and some have raised the quota by 40% to 50% in order to qualify for benefits. That is completely unacceptable and is the perfect equation for poor quality.

Let me ask you a question, please. What is your opinion on doctors double or triple booking appointments? Do you honestly believe that a physician can provide QUALITY healthcare if he or she has to divide that 15-minute slot between 3 people? Would you want to go to a surgeon that has allotted you 5 minutes to completely discuss the risks and benefits, the procedure, the recovery time, etc., AND do an exam?

My point is that quality suffers in any segment of the healthcare profession when the providers of that service (be it physician or MT) are forced to work faster and harder for less pay. Mistakes are guaranteed to happen when this occurs no matter how much the provider tries to be conscientious about quality. We're only human...we're not the computers.

My opinion - see message

[ In Reply To ..]
I think it's terrible that doctors are double- or triple-booking appointments. If I were a doctor, I would refuse to do it. As a medical transcriptionist, I would do something else for a living the moment I realized that I could no longer do quality work, for whatever reason.

Kudos - nm

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.

you are correct - cj

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I totally agree that the final responsiblity lies with the person signing the report. It makes me nuts to see the stuff these guys sign. Just this morning I attempted to code a case that went back an forth between hypo- and hyperparathyroidism. In the end, it will go back to the MD for clarification. He/she should have seen this before signing it and made the necessary correction then. But he/she didn't. And before everybody jumps all over me, let me say no one knows where the breakdown occurred here, if it was VR error, dictator error, or whatever. But someone should have caught it and made sure it was correct before it hit the patient's record. I also totally agree with the fact that the blame goes all the way around. I wasn't actually blaming the editors. My original post simply asked people to read with a critical eye and came from the fact that what appeared to be a VR error made me laugh. I had no idea it would start such a riot, but after all of that is said and done, I still believe every individual should do their best work and not think it is okay to do less than that simply because someone else does.

..."simply because someone else does." Really? - anonMT

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We're doing "less than that simply because" we don't want to lose our home or end up bankrupt before we find supplemental income or another career altogether.

Our own circumstances are our responsibilities and not the patient's fault - This is not a new concept

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I suspect people have used that line of reasoning for years when they wanted an excuse for poor work. As a patient, I expect quality work. It is not my concern or responsibility how the quality work happens. People need to start taking responsibility for themselves. If you can't do quality work, do something else. If you can't make enough money in your current job, do something else. Let someone do it who can do it well.

With that attitude, Suit, you wonder why all the good MTs are quitting the field - Simv Statin

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You know what I expect in return for quality work? A quality PAYCHECK. TINFL, as someone famously said (Robert Heinlein, to be exact)--There Is No Free Lunch. In other words, for the dense out there, You Get What You Pay For. It's called REALITY, Suits. This is your reality check. Let's see, you cut MTs pay to the bone and then you expect us to give 2 sheets about the quality of our work??? You know, I have this nice bridge near me you might be interested in investing in...

SIMV, Robert Heinlein had a VERY poor opinion of - of sloppy workers. As I recall,

[ In Reply To ..]
he described being tossed in the soup pot by aliens as "their finest hour" for 2 hypocritical shirkers who believed the excuses they offered for abandoning principles they almost certainly never had in the first place.

Talk about scary, Simv Statin - Scared patient

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What I'm hearing you say is that you don't care about the quality of your work...you simply type as fast as you can to make more money. Amazing!

I can only hope that your accounts are FAR AWAY from me and my loved ones and feel sorry for those patients' whose records you transcribe!

No problem. - sm

[ In Reply To ..]
Your work ethics are obvious. You wouldn't be working for me. If I had hired you and then discovered your attitude, I would just stop giving you any work. Your attitude is unacceptable. That's not to say that there are employers and work situations that are equally inappropriate, but the answer is clear there as well. Don't work for them.

speech and editing errors - willie

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DITTO. When Social Security Disability pays 3x more than the wages for editing, what's wrong with this picture. I was with Medquist for 4 years. They cut our wages by 40% when the editing was being crammed in with the intent of going 100% VR. A seasoned MT (20-30 years experience) suddenly making even less than minimum wage - what's wrong with this picture? When MQ brags about how great they are and how things will change for the better, they're talking about themselves, not the MT/ME. Every change made is another dig into our wages. Just when you think MQ couldn't possible cut the fat any more, they find a way. The entire MT industry has tanked. What once was a highly respectable job is now considered glorified typist, if that.

You're talking about 1 MTSO, but not all MTSOs are equal - nm

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nm

Every MTSO mentioned on this board seems to be equally GREEDY. nm - Simv Statin

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nm

Willie, what's wrong with the picture is a 20-year vet - who makes minimum wage.

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wage. Obviously, there are 20-years vets and...people with a lot of years that didn't create the skills and/or work ethic needed today.

NO company has cut rates so low that genuinely a skilled MT could make only a minimum hourly wage--without sitting on at least one hand, anyway. As soon as anyone talks this way, I KNOW there's a really significant problem, or problems, at their end.

With all due respect, you are not correct or looking at the full. - Backwards Typist

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picture. VR combined with lower rates plus NJA equals minimum or less, wages. Most of the "significant problem" as you put it, has to do with VR being pushed so hard and NJA because of it. That's the real problem.

It's happening at all MTSO's and it's not the MT's fault that there is no work. Companies expect higher line production because of VR. Thus, grabbing as much work as possible while it's there causes errors....it's a vicious circle.

Unless you work for a company with an over abundance of work with overtime and not a lot of over hiring, then you have it good. Most MT's do not have that pleasure. When a new account comes in, the company hires MORE MT's and, therefore, the game's the same. No chance to have a decent workflow and decent wages.

I must respectfully disagree with you - Seasoned and struggling

[ In Reply To ..]
I am a seasoned MT with 22 years experience. I have a very good skill set and a very good work ethic. I have worked extremely hard over the years and have taken great pride in my work. I work for two companies, one straight transcription, the other all VR. On the transcription side, I type 1000-1200 lines per four hours at 12 cents per line. It's good money. I know the account well and have lots of shortcuts built in, so it's relatively easy work for me to do. On the VR side, I am making 4 cents per line and virtually making minimum wage. Four hours of VR editing the other day earned me $29. I finished working for that company and then went to my transcription work and made $140 for five hours work. So that was a nine-hour day for me, and that it pretty typical of my workload. You can see the drastic difference between the two pay scales. Companies are cutting transcription/editing pay to the point where it is very difficult to make a living and it is unfair to generalize and say that the problem is usually on the MT side. You have no possible way of knowing all the variables in a company or in an MT's work ability. There are many, many of us out here who are working as hard as we ever have and making a heck of a lot less money. The reason for this is that a good percentage of us will eventually be replaced by VR software and EMR, so it makes sense that the companies are paying seasoned people a lot less who need to work and need to make money. Some feel that "A" job is better than "NO" job, so we do what we have to do in order to support our families. I feel that your are making a statement about companies not cutting pay to minimum hourly wage without any evidence to back it up. I know what has happened to me in terms of my salary and my job, and one company is indeed paying me minimum wage to edit. I am not complaining about it; I am just stating the facts. I am ashamed that I have been reduced to working for minimum wage with all my years of experience, but I have a family to take care of, and it is frustrating to hear someone indicate that the problem is on my end when, in fact, companies are indeed doing what you say they are not.

and you, my friend, are dead on! - dbcj

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I couldn't have said it better myself! I agree wholly with your paragraph. I'm in your boat, BTW, and I'm not liking it either. Me, too, 20+ years of experience. The problem is on my end?? I don't think so!!!

bravo, 18+ years in transcription, very well said!!! nm - jmn

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