Talk about words the spell-checker doesn’t like.
This has been happening for a long time and I never blogged about it because I told myself even rachellucas.com should have certain standards, but today I decided standards are for wimps. Just go with me on this.
I transcribe for a certain female oncologist of South American descent and accent. I’m not sure exactly where she’s from but it’s not Mexico – the accent is different than that. It sounds a lot like a Colombian I knew in college so let’s just pick that and call it a day. The accent really isn’t the point anyway.
The point is what she does when she is describing certain surgical wounds.
You know how infected wounds will have redness, inflammation, swelling, and…wait for it…that white yucky stuff we call “pus”?
Okay then. Yeah. So this doctor, I don’t think she understands that the word “pus” SHOULD NEVER HAVE AN “-SY” ON THE END OF IT.
At least once every few weeks, it happens. There she goes, describing an infected wound, talking about its red and inflammatory appearance, but most unfortunately, also its pus condition. As in, she will actually dictate, “The surgical wound is red and pus-sy.”
I’m just saying. It creates issues with my transcription. Am I seriously supposed to submit an official report with the word “pussy” in it? I just can’t do it.
So I always change it to something like, “The surgical wound is red and has pus.” God, even that freaks me out. What an awful word. Pus.
While we’re on the subject of medical transcription, I get a few emails a month from people asking me how I got into the job and how they can, too. I usually don’t even respond because I have no idea and also I’m a jerk. I fell into this because I was friends with a doctor. There are tons of scam companies out there on the internet and I don’t know how you parse them out because I’ve worked with the same people for 12 years. I never went to any training because I didn’t need to as I have a savant-like knack for medical language (seriously, it’s the only thing I ever brag about), and if you don’t have that same skill you will need training and I have no clue where you can get it. Also, yes, it is great money IF you get the right dictators; otherwise, frankly, it’s a pain in the ass and I honestly can’t recommend it in good conscience. Working at home alone typing about other people’s misfortunes and diseases all day will make you INSANE. This is why I have gone back to college for another degree.
Anyway. Pus-sy. I just wanted to share that with everyone because it amuses me so that a medical professional who has lived in the U.S. for 20 years can be unaware of the fact that that’s a dirty word.
Which reminds me. I have watched enough BBC America and read enough of my Brit-to-American book to learn that in England, pussy means actual feline animal. They say it freely on How Clean is Your House? and I laugh and laugh. “Oh! Look at the pretty pussy!” That sounds so horribly dirty here on my blog but hey, it ain’t dirty in the UK so deal with it.
Meanwhile I will deal with the context-based ads and spam I’ll get as soon as I publish this post. God bless it.
I once worked in the communications department of a chemical company, and I constantly ran across the word “testes” instead of “tested” when proofing the scientists’ work. At least the letters “d” and “s” are right beside of each other on the keyboard, so it’s clearly a mistake, and an understandable one at that.
The worst however is when I was at a PR writing seminar and the instructor had written “pubic” instead of “public” on her oh-so-professional flip chart.
January 2nd, 2009 at 5:42 pmESTHmmmm — “pustulous”? Nah, not really — more like “suppurative”, or with a “purulent discharge”, or a “purulent exudate”
(sry — with all the critters in the clearcut, I spend way too much time reading vet manuals!)
To save yourself the embarrassment of using the “p-word” ‘over there’, you could get by with “moggy”, I think.
First?
January 2nd, 2009 at 5:43 pmESTProlly notAkshully, yes!I’m pretty sure it also means the same thing over there. One of the characters on “Are you being served” uses that word to talk about her cat all the time, and they *love* to overuse that joke.
January 2nd, 2009 at 5:46 pmESTSo far, so good, Rachel: all that’s showing up are “Ask a Veterinarian” and “The Honest Kitchen”.
And Mrs. Hill: I regret to inform you that most Brits pronounce actually as “Hack-shully”. It boggles the mind!
January 2nd, 2009 at 5:55 pmESTMy mother-in-law is from central America and when my daughter was a baby I overheard her, when giving her a bath, telling her to wash her pussy cat! I nearly died from trying not to laugh as I informed her that nice girls don’t use that term.
What I really wanted to know was where she heard in, seeing as how she moved here as an adult married woman. I guess that just leaves her husband. Heh. More than I wanted to know about my in-laws.
January 2nd, 2009 at 6:00 pmESTOh dear. For the first time ever I have a comment in moderation. I blame Rachel for leading me down this path of iniquity.
January 2nd, 2009 at 6:01 pmESTThe second most embarrassing parental thing to happen to me was, when I was maybe 14 or so, playing Trivial Pursuit with my parents. The question on the card that my Dad read to my Mom was basically “What color is Blofeld’s cat in the James Bond movies?” but for some evil reason the card ACTUALLY said “What color was Blofeld’s pus-sy in the James Bond movies?” My dad was embarrassed, my Mom was mortified and I felt awkward.
The most embarrassing parental moment? Walking in on my parents and grandparents watching 9 1/2 weeks.
Eww.
January 2nd, 2009 at 6:07 pmEST“p***y” in America = “fanny” in Britain.
That’s why you’ll never hear a Brit refer to a fanny-pack as such.
January 2nd, 2009 at 6:10 pmESTMy daughter and I had a conversation today on the way to the soccer store..(yea, we go there alot)..we were behind a car at a stop light that had a bumper sticker on the back that said “Bitch on Board”…so we agreed that they must have a dog in the car..especially since it was a guy driving! I guess they didn’t realize that it’s a bad word either….must be from “over there” somewhere as well!
January 2nd, 2009 at 6:10 pmESTlangtry,
You haspirate your hayches even when they haren’t there? And I thought all that sticking in of “r”s between vowels was bad!
Oh, and:
Heh — right the first time!
January 2nd, 2009 at 6:12 pmESTI have so much going through my brain right now, I can not really form a coherent sentence.
January 2nd, 2009 at 6:18 pmESTI wonder if she uses that word with her patients too??
Eggshualli — I have a friend who is taking an on-line medical transcriptionist course at this very time. From what she’s told me, it’s a very good outfit; and they are very concerned that she learn the proper way to do things. She has regular tests – and she really sweats over them. And, they are available all of the time for her to ask questions and talk out any problems she may be having with the material. If anyone wants, I’ll get the name of the place and publish it for you.
January 2nd, 2009 at 6:21 pmESTWell, I suspect it’s her accent that’s messing it up. I’ve always pronounced it like [p uh s] but if she says it with a Spanish oo instead uh , that would explain Rachel’s difficulty when she hears the term.
January 2nd, 2009 at 6:28 pmESTFor transcription, I think the trouble is not so much the pronunciation of the word as its being one of a pair of heterographs (eg. “bass”/”bass”, “tear”/”tear”) — i.e., Rachel hears it perfectly well, knows how to spell it, but just can’t stand to see it spelt out
!
January 2nd, 2009 at 6:40 pmESTDefinitions of pussy on the Web:
c**t: obscene terms for female genitals
kitty: informal terms referring to a domestic cat
purulent: containing pus; “a purulent wound”
Slow news day. I looked it up. It does exist. LOL
January 2nd, 2009 at 6:42 pmESTWait until you get over there and somebody asks “if they can borrow your rubber”. (ewwwww)
Think red rubber, as in “eraser”.
January 2nd, 2009 at 6:57 pmESTOh dear – Rachel types pu**y and the ad that comes up now is for bride wars – coincidence? I think not…
January 2nd, 2009 at 6:58 pmESTPussy has always meant a kitty cat to people whose minds aren’t stuck in the gutter. It’s the context.
This reminds me of the time on SNL many years ago when the guest host started ad libbing and said “shot his wad” in a non sexual context and then turned completely red as though she had said something dirty on TV. That term has nothing to do with sex unless you intend it to have that meaning, but there are so many ignorant people out there that I suppose her reaction should be expected.
It’s also like the Californian politician who got in trouble for using the word “niggardly.”
Pussy is a perfectly legitimate word here in the US. Just like cock, dick, prick, and ass are perfectly legitimate words. Any impolite meaning only comes from context.
January 2nd, 2009 at 7:11 pmESTI might have mentioned this before, but over here in the UK, the word ‘fag’ means ‘cigarette’.
I know enough about American English now though, to know never to say something like “I’m just going outside to smoke a fag” while in the US.
January 2nd, 2009 at 7:32 pmESTI think I’ve heard people say “p-uh-ssy” to describe a yucky wound. But I agree, what else are you supposed to think when you see it spelled out? It’s just one of those things that I wouldn’t have thought about until actually reading the written word.
January 2nd, 2009 at 7:33 pmESTSpeaking of SNL skits, and on topic if you have a bawdy sense of humor, one of the funniest in recent memory (and this was several years ago) was the “Colonel Angus returns from the war” skit. Several Southern women sitting on the veranda excited that the Col. was coming back. More Benny Hill than Oscar Wilde, but funny is funny and I lol’d.
January 2nd, 2009 at 8:01 pmESTAnother transcriptionist here, and like Rachel, I can’t in good conscience recommend this career to others (and I’m paid fairly well). It will make you INSANE. I work in a cancer center, people are dying all around me, and I have to hear the stories.
Anyway, I also know of a very good online school for those who want training. Be wary of anything that sounds too good (or short) to be true, or anything that is advertised on the inside of a matchbook.
January 2nd, 2009 at 8:02 pmESTI’ll go Girl Thursday one better. Back in college, I had a class in Scientific Writing. We all were given previously-written papers to proofread and revise. I got a beaut. 117 times in the paper I got, the student misspelled the word ‘organism’. I’ll let you guess what word got used. Needless to say, I had to return the paper and ask for another, because every time I tried to revise it, I busted into hysterical laughter.
January 2nd, 2009 at 8:13 pmESTRob Farrington,
Also, despite the correctness of the term —
– it’s probably best not to discuss the burning of faggots in one’s wood stove!
(Mmmmmm . . . wood stove — so toasty warm . . . sry Schrodinger’s Other Cat!)
January 2nd, 2009 at 8:15 pmESTThe sad fact is that everyone’s mind is the gutter.
In the 1950s pussy meant cat and gay meant happy.
January 2nd, 2009 at 9:24 pmESTFuck the 1960s.
Mrs. Hill has it correct. We never want to see the word ‘pussy’ in a medical record. I was taught by some outstanding professors that the correct terminology is ‘purulent exudate.’ But it is fun to train the new staff in regarding this issue.
January 2nd, 2009 at 9:50 pmEST-Dr. Helen “the veterinarian”
Speaking of fags and confusing UK terms . . .
I used to work for a company that had a factory in Ireland. The Irish engineers would come to the states and the first time I heard one ask me “how’s the crack?” I nearly lost it. I had never heard that term before (I think the spelling is different) but it was at a bar and I thought he was trying to score some drugs! Apparently it simply means, “how’s things?”
January 2nd, 2009 at 10:11 pmESTheh. Maybe you should write it as, pussie. or pussey. You should be reading ScaryDuck for the more fun phrases.
January 2nd, 2009 at 10:15 pmESTEASY, EASY, EASY!!!!
Wounds are NOT p–sy, they are pustulent!
“The surgical wound is red and pustulent.”
Easy, Easy, Easy!!!
Any more questions?
January 2nd, 2009 at 10:32 pmEST“Fanny” is vulgar in British English?
January 2nd, 2009 at 11:39 pmESTISTR Grimm on The Thin Blue Line accusing Fowler of “fannying about” at least once per episode, and I think Patsy on Absolutely Fabulous said that at least once.
Didn’t realize it was more than low-brow, at worst.
From Steadman’s Electronic Dictionary:
pus
A fluid product of inflammation, consisting of a liquid containing leukocytes and the debris of dead cells and tissue elements liquefied by the proteolytic and histolytic enzymes (e.g., leukoprotease) that are elaborated by polymorphonuclear leukocytes.
Origin
[L.]
blue pus
cheesey pus
curdy pus
green pus
ichorous pus
laudable pus
sanious pus
Sorry Rachel, I tried to find some sort of way to expand pus to read pus-ee, no luck. I’ve also heard latin American doctors use this same pronounciation, cracks me up every time.
You know what I tell people who ask me about getting into medical transcription? RUN FOR YOUR LIFE.
I don’t care how much of an introverted, antisocial, geekball someone is, medical transcription is THE most isolating job in the world, second only to whichever schmuck offers to be the guinea pig shot into space for a decade to test how crazy a person gets without human contact.
There was a time that this profession paid well enough, but now we are competing with India where they pay “transcriptionists” 3 cents a line and doctors who think we are simply machines who don’t care if we make a decent wage, as long as they get their work done in a 6 hour turn around. I especially enjoy how many physicians (whose first language is English) cannot pronounce nor spell many of the medications, body parts, and various strains of disease, yet I am expected to decipher when they say “doxysosasil” they actually mean Doxazosin (or do they really mean Doxil?)
Does that make me sound bitter? Yeah. I’m bitter.
But this profession allowed me to stay at home with my daughter when I was first divorced, so I’m thankful for that.
Hey Rachel, I do radiology oncology transcription too. Could there be a more depressing kind of work?
I have decided 2009 is my year to find something else to do to make a living. Hopefully, I will find myself working in a dusty filthy backstage, painting scenery and building props.
Sorry to go on so long. I just really hate my job.
January 2nd, 2009 at 11:40 pmESTRob -
When you hear the term “Pussy Galore”, do you break into a cold sweat?
If I ever caught my parents or (egads) grandparents watching 9-1/2 Weeks I would seriously seek therapy.
January 2nd, 2009 at 11:58 pmESTHey Rachel –
What about the ESL doctors who spell every other word, especially the looonnngggg words in the hopes that we can better understand them?
What about the docs who spell out “hemorrhoid”, but won’t take the time to spell out a referring physician’s name like Dr. “Frickenfrackenhoffendoofer”? Even though they have the doc’s name right there in the chart in front of them??? (Hey, I can just Google that, right? Easy peasy.)
And what about the doctors who puctuate and punctuate and punctuate…INCORRECTLY?
And…and…
Oh I’ll stop. I’ve already admitted how bitter I really am.
January 3rd, 2009 at 12:05 amESTSo if your cat has a genital infection, would that be a pussy pussy pussy?
January 3rd, 2009 at 12:09 amESTYou know, I think I’ve said puh-ssy a number of times in my life, and the spelling never even entered my mind. Pretty funny.
January 3rd, 2009 at 12:43 amESTI’m an MT too, and I also have a couple of doctors who say that a wound is “pus-y” rather than that the wound has pus. Rachel, you handled it the correct way.
One of the ob-gyn doctors who is some sort of Asian practically sings his dictation. He also spells out stuff that doesn’t need to be spelled out; I suspect it’s because he gets into a certain rhythm.
I got trained on the job in medical transcription, which is still possible but getting more rare as time goes on.
I’ll write more on this subject later. I have to take a nap. Food and household shopping is hard work, and I’m tired.
January 3rd, 2009 at 1:07 amESTHere are some places you can check out which might have some information regarding medical transcription and how to get into the field:
http://www.mtdaily.com (Paid subscription, but with some good forums)
http://www.mtjobs.com (Free site; mostly job listings and forums)
http://www.mtstars.com (Free forums, take their comments with a grain of salt)
My significant other took his online course through Career Step. It’s not the only one, maybe not the top-ranked one, but he’s been working in the field for a couple of years. Career Step also has links to two of the biggest national companies out there, so that some of their graduates are able to work at home after they complete the course. It used to be that an MT had to get a number of years of experience before being able to work at home, so this is a good thing.
You will need to buy a fair number of reference books in order to work at home, and it might still be a good idea to work in someone else’s office for a while before working at home.
Warning: There are good things about this occupation, particularly the part about working at home in my own office. However, wages have gone down… I got an approximately 30% pay cut within the last few years (they changed the way lines were counted).
That said, however, my boss was paying well above the average going rate before the pay cut, and he still pays better than most of the big national companies out there. Believe me, I checked it out, because I needed to know what my options are. I have chosen to stay with my boss.
Getting your first job or two is hard. Once you actually have two or three years of experience under your belt, it will become much easier to get another job.
There is a lot of competition from overseas, which is one reason the wages are stagnating or going down; however, there is still plenty of work out there in this country for transcriptionists.
In general, there are a few different kinds of MT work… The two main types are hospital reports (acute care) and clinic/doctors’ office reports (and doctors’ office correspondence). With hospital reports, you will have exposure to many different specialties. The clinic/doctors’ office reports may be just as complex and challenging, but if you work for a clinic, you may be exposed to only one specialty, and if you move on to another specialty, it will be brand-new to you.
I advise people not to get “stuck in a rut” doing only emergency room reports… because, if your employer loses an emergency room account, you may be laid off. If you start off with hospital reports and get exposed to a broad variety, that is more job security for the MT.
There are also other specialty niches such as radiology, pathology, medical examiners’/coroners’ reports, police reports, etc. There are also some folks who do medical-legal reports.
Anyway, I’m more than willing to answer questions, if you have any, if you either post them here or send them to me at pbmaltzman@yahoo.com
January 3rd, 2009 at 1:12 amESTThere is a trade organization (formerly American Association for Medical Transcription, now the Association for Healthcare Documentation Integrity) which is attempting to take control of this occupation… they want to make credentialing and licensing mandatory; they want to make it mandatory to take certain courses which have been approved by them. They are engaging in lobbying at the state and federal levels. Yeah, right–at a time when many MTs’ wages are going down, they want to make it so that we have to pay them several hundred dollars for the privilege of doing this job.
There has been a “certified MT” or “CMT” credential around for years, but it had always been voluntary. They claim it’s not all about the money, but if they succeed in forcing their scheme down our throats, they will have a windfall of millions of dollars (about 101,000 MTs in this country x several hundred dollars to take some damned test, whether or not you want to join the organization). Well, it may not be ALL about the money, but I’d bet that’s #1.
I don’t see how anyone except AHDI and their cronies will benefit… they’re not the ones sitting down and having to struggle with the crappy dictators, and wearing out body parts such as hands.
Oh, yeah, and the CEO of AHDI has also recently become the CEO of the MTIA (Medical Transcription Industry Association), a trade organization for MT business owners.
Count me as cynical.
I learned on the job. My guy took an online course. He asks me to help him, not the other way around; of course, I have nearly 10 times the experience he does. He helps me out on things like computer and household stuff. He also eats just about anything I cook for him.
January 3rd, 2009 at 1:31 amESTFellow MT here (27 years, formal trained, acute care) and have heard numerous doctors of all types say pus-sy. I usually change it to “purulent” or “has pus,” even though I was told that it is a correct word. Verbatim accounts suck…
January 3rd, 2009 at 1:33 amESTWow, cardeblu, I think you’re the senior MT here. I have about 20 years of experience, but you’ve got me beat!
January 3rd, 2009 at 1:43 amESTremoved
January 3rd, 2009 at 2:10 amESTIt is interesting how words acquire new meanings and connotations. In GB, “Fanny” used to be an affectionate form of the feminine name “Frances”!
There’s a tune (not a song this time!), the name of which inevitably brought giggles from the young (and even not-so-young) members of the Irish music group that Homeschool Girl used to play with — so I guess “fanny” isn’t exactly neutral on this side of the pond either!
Skyler,
January 3rd, 2009 at 2:14 amESTHow’s the “craic”?
My favorite pussy story:
Eva Gabor was a guest on The Tonight Show when Johnny Carson was still the host. She brought a pet. She settled into the guest’s chair, petting her cat gently and when the applause quieted, she turned to Johnny and, seemingly without guile, asked him “Would you like to pet my pussy?”
Johnny replied without missing a beat, “Move your cat out of the way and I will.”
We kids rolled around with our faces pressed into our pillows. Good times.
January 3rd, 2009 at 3:32 amESTGee, I wish the official reports I have to muddle through contained the word “pussy” once in a while…
January 3rd, 2009 at 8:42 amESTSomehow I don’t think “Fanny” is vulgar in British English.
The woman who caddied for British golfer Nick Faldo for ten years was named Fanny Sunesson.
January 3rd, 2009 at 9:14 amESTHmmm — the Beeb’s web site has a whole page devoted to British swear words, including poor “fanny”!
It carries the following proviso:
Faggots, on the other hand, apparently remain not only innocent, but edible! (Well, sort of — H/T S. Weasel)
January 3rd, 2009 at 10:11 amESTHow about just replacing the word ‘pus-sy’ with ‘the wound was oozing a vile, yellow-green slime that smelled like week-old chicken-livers’?
January 3rd, 2009 at 10:20 amEST(Not that I’ve ever smelled week-old chicken livers, mind you…)
A Nursing Professor once told me the term to describe a pus laden wound is purulent.
January 3rd, 2009 at 10:37 amESTAlso talk about words the moderation and spam filters don’t like!! BWAHAHA
I log on this morning and there are 15 comments in moderation and 4 in spam. All because you perverts kept writing the word pussy. Heh
It’s good to hear from some other MT’s! We should start our own little support group. I’m serious. I wonder if there’s a niche to fill that is isn’t filled yet, like a humor-focused MT blog. Anyone know? Because I’ll totally do it. I know there are forums and chat rooms but they bore me. We are much more fun here.
January 3rd, 2009 at 10:57 amESTI had this very experience at work a couple of weeks ago. I work in an adult foster care/group home. We keep a daily log to keep all shifts informed. One ditz that works there had written something to the effect of “Gladys has stuff leaking out of her right ear, it is green pussy and gross!” Yes, we laughed and laughed about the green pussy in Gladys’ right ear. Did I mention she’s a ditz? And American through and through. And she’s going to school to be a nurse. heh.
And as long as I’m on the subject, another thing we log is the occurance of bowel movements. I, personally logged the following, “Irene had the most spectacular, extrodinary, supercalafraciglistic, toilet buster today!” Seriously, it was about 10″ long and 5″ diameter (not circumference). Took 20 minutes of plunging to get it to go down. Irene is about 5′ tall and weighs about 90 lbs. Amazing. She does it on a regular basis.
Uh, what? TMI you say? Hey. It was the highlight of our night! Good times. Good times. ;o)
January 3rd, 2009 at 10:59 amESTOoooooooh!! My first moderation!!!!! I’m truly LOVED here in Rachelland!!!!!!!!
January 3rd, 2009 at 11:03 amESTWhat a load of hooey. Johnny Carson never said that.
You can look it up.
George Steinbrenner called a player pus-sy. That was misunderstood, imagine that.
Found this in a dictionary:
Main Entry: pus·sy
Function: adjective
Inflected Form(s): pus·si·er; pus·si·est
Date: circa 1890
: full of or resembling pus
So there you have it. One can be pussier than someone who is less pussy.
January 3rd, 2009 at 11:44 amESTPurulent is also appropriate, but may refer to wounds that appear infected but are not necessarily full of pus, but other drainage as well.
There is NO doubt when you use the word pustulent.
January 3rd, 2009 at 11:46 amESTROFL! As a stenographer, I can relate, Rachel! I do use legal terminology most of the time, but if the deposition is related to a personal injury or workers’ comp matter, I use the medical terminology as well. Here we have more Middle Eastern and Indian doctors and they are very difficult to understand, but I’ve never transcribed “pus-sy” yet. I won’t hold my breath though. It could happen any day now.
January 3rd, 2009 at 12:03 pmESTBritish lingo:
faggots = cigarettes
boot = car trunk
bonnet = car hood
bollocks = male “berries” of the twig and berries
wanker = male “twig” of the twig and berries
twat = um, I believe we use that term here too
whatsits = the nether regions on either male or female
bum fodder = pubic hair (Thank you, Kim Woodburn.)
I realize this post will probably get booted, but I’m trying to help you, Rachel, brush up on your British potty mouth. LOL
January 3rd, 2009 at 12:08 pmESTIt’s kind of funny that this post comes up shortly after this cartoon (go back a few panels if you want context).
Also, did any of you Heinlein fans think of the conversation in the doctor’s office in “To Sail Beyond the Sunset,” where Maureen is standing there naked, talking to the doctor, who tells her she has a most beautiful pu**y (talking about her cat, Pixel, of course).
January 3rd, 2009 at 1:02 pmESTI shouldn’t reply until I have my coffee. Fanny Sunesson is Swedish.
Jeebus.
January 3rd, 2009 at 1:04 pmESTTrue story:
January 3rd, 2009 at 1:46 pmESTMy most Ancient and Venerable Mater kept a wild cottontail as a pet for some years. On one occasion, a visitor to the house admired the beast and announced that she herself had “two beautiful buns at home!” It was all my mother could do to keep a straight face and refrain from asking what the woman sat on when out and about!
Fanny?
Like… Fanny Mae?
January 3rd, 2009 at 1:47 pmESTThanks for the correct spelling, Mrs. Hill.
I have to say, I’ve never seen so many sensitive people on line before. There is absolutely nothing wrong with pussy. I’m not a doctor but I would imagine that some might no like their words changed so lightly.
January 3rd, 2009 at 2:52 pmESTMay I suggest the substitution “liquor puris”?
January 3rd, 2009 at 4:33 pmESTBill Waites: “There is NO doubt when you use the word pustulent.”
Good word choice, and I’ll have to remember that, but there might be some doubt. While pustulent does mean full of pus, it usually connotes its root form–pustule–which would be different. Fire ant bites or acne are pustulent. The material inside something like a peritoneal abscess or an infected, open wound would be pus but not necessarily be a pustule.
Skyler: Some doctors do not like to have their words changed, which is why I said verbatim accounts suck (and why I don’t stay on them very long). Even if what they said was wrong, we would have to leave it as is. We could edit grammar but only to a very minor degree. I got kicked off an account because I refused to transcribe the dosage as the always incorrectly dictated “mg” instead of the correct “mcg.” I was told that he was the doctor, after all, and what did I (or all those reference materials) know.
Most doctors DO like to be correct(ed) and have their reports look better than the way they dictate. It makes them look better, and those are my initials (or traceable #) at the bottom of that report, as well. I had one who always spoke in incomplete phrases but fully expected us to make them complete, correct and coherent sentences. One may change the words around, but one should not change the implied meaning.
January 3rd, 2009 at 5:45 pmESTOn the 2 occasions I’ve heard doctors say “pussy” I changed it to “pus-like” at the advice of an MT board.
I didn’t even know “pussy” could be a dirty word until the Bill O’Reilly sex scandal. Everything I know I learned from TV.
January 3rd, 2009 at 6:33 pmESTMrs. Hill? It’s 80° today. I shall survive your slings and arrows! Til Monday. When it’s in the 40s.
My only contribution to the MT discussion is I’ve a friend who’s been doing online training for what seems like three years now. I don’t know if that’s common or not. It just doesn’t seem like much progress.
January 3rd, 2009 at 7:24 pmESTWell, it’s anecdotal but clear proof that bilingualism isn’t all that it has been talked up to be.
So, we have doctors discussing wounds that are pussy, and chemical companies that have testes.
Looks like the gammarians lost.
January 3rd, 2009 at 8:07 pmESTOnly time I ever heard a Brit make that request, what he actually asked was to “pinch your rubber.”
Brits also ask you to “knock me up” when they mean “drop by.”
And when canceling a social engagement, they refer to it as “blowing someone out.” Never as “blowing someone off,” if you know what I mean.
And yes, if you tell someone to sit right there on their fanny and wait for you, you’ll get some strange looks.
Was it David Allen Coe that wrote the song about a kitty cat going through various predicaments — a parking lot on a hot summer day, a rainstorm, inebriation, and depilation by a rocking chair — to the final chorus ending in “Hot, wet, tight, bald pussy”?
January 3rd, 2009 at 8:29 pmESTY’all are scaring me. I’m currently training to become a medical transcriber because I type very quickly, I know a lot about medicine already because of many family members with serious medical issues, and because I need a job where I can work from home due to things that are personal and boring to anyone not living it.
January 3rd, 2009 at 8:35 pmESTThough the discussion of pus is amusing me. I would’ve said “pus-filled,” personally.
“I got kicked off an account because I refused to transcribe the dosage as the always incorrectly dictated “mg” instead of the correct “mcg.” I was told that he was the doctor, after all, and what did I (or all those reference materials) know.”
Sorry, but mg and mcg are not the same thing. mg = milligrams while mcg = micrograms. 1mg = 1000mcg
January 3rd, 2009 at 9:37 pmESTTO THE ORIGINAL KIT: There is still plenty of work out there for MTs. The main problem is that it doesn’t pay as well as it used to.
I am still averaging over $20 per hour (usually 200 lines per hour at 10-1/2 cents per line), but I used to average more like 300 lines per hour at a lower rate, about $27 to $30 per hour.
My boss changed the way lines were counted. Used to be counted “line-for-line” or “gross” lines. Now it’s total bytes divided by the line length. About a 30% pay cut, although he upped my line rate a bit.
I can’t fault him for doing that, because one of the accounts threatened to take their work elsewhere if he didn’t cut his rates. Like I said before, he still pays more than the big national companies do.
It takes a while to build up your speed doing this kind of work, no matter how fast you can type regular text. The big words slow you down, especially when you have to look up stuff; but it’s the doctors’ crappy dictation that slows me down most of all.
It also takes a while to build up your earning power. My guy is kind of appalled that it can be such a challenging job that pays as little as it does to start out.
Expect to be offered maybe 6 or 7 cents per line to start out with, although some companies will pay by the hour for training. Yes, you will still be considered a trainee after your course work is over. You will also learn something new every night you work in this field.
Beware… a lot of the national companies are offering only maybe 7 or 8 cents per line even for experienced MTs.
Sometimes the smaller companies will pay better… they have less overhead, in terms of fewer non-MT employees who must be also paid out of the same money they charge for what you do.
There are relatively few companies which take on brand-new MTs, so you may have to start out with one of them.
The websites I mentioned above have either lots of job listings and/or recommendations for which companies they like or ones to avoid.
Yeah, it’s true… the folks over in India and the Philippines think 3 cents per line is a big deal. They also don’t have to deal with all of our taxes and business and other regulations.
My strategy is to get my bills paid off (most of which I ran up after my pay cut!) and then move to a town where the cost of living is much less than in California.
I’ve been checking it out… if I move to a small town in northern Arizona, or any other similarly inexpensive place, I can pay little more than half the rent and probably also half the utilities and car insurance. It’s a no-brainer to me! We could even save up for a down payment on some kind of property by doing that.
January 3rd, 2009 at 10:01 pmESTSam, exactly! He would dictate Synthroid 100 milligrams (mg), when the dose should be in micrograms (mcg); same thing with fentanyl at 75 mcg, which he would dictate as 75 mg. I was told to transcribe him verbatim, and QA would count it wrong if it didn’t match or even left blank. Thankfully that company is no longer in business, but I do worry about where their QA person went.
As far as any future in MT, I, too, am hesitant in recommending this for a new career. Offshore outsourcing is a problem, but the bigger one, imo, is ASR/VR, as well as the EMR to some extent. I love to transcribe, especially OPs because they can be so interesting, and the more long and complicated the better. However, I hate editing or QA’ing other people’s work, and with the voice recognition programs out there (like eScription), that’s about all an MT does–QA the computer’s work at 3-4 cpl (cents per line) instead of transcribing the same report for 8-10 cpl (in about the same amount of time). As an added bonus, you’re teaching the computer your job.
Just a couple of years ago, my pay was cut back to what I was making over 15 years ago, which at that time had also been a cut to 5+ years or so prior to then. In 27 years, the most I’ve made in 1 year was just a little over $40K (and that was at $2/pg about 15 years ago). I usually average $25-35K for 6-8 hours per day/5 days per week. Although I’m an employee and not an IC (though have been that, too), I have no paid time off. I currently make a little over 9 cpl; the most has been 10.5+ cpl (as an IC), and the least was 7 cpl–which is what happened a couple years ago and 15 years ago, as above. I also blame AAMT (or whatever they call themselves now) in stating that there should be some kind of standardized pay rate and that only visible characters should be counted (no spaces).
It also tends to be a feast or famine kind of proposition as far as the availability of work goes, particularly for MTSO’s.
Again, I love transcribing and getting into that “zone” where the doctor’s words flow into your ears and through your fingertips into the keyboard and up onto the screen almost effortlessly and in perfect rhythm (the Zen of MT–heh!). At one time I thought I would be able to retire from doing this. However, I still have 20-25 years left before then, and I don’t see it staying around that long–at least not in a viable way for me.
Rachel is wise; however, I have no idea what else I would do.
January 3rd, 2009 at 11:31 pmESTI just got done with a report which encapsulates all that I most hate about this occupation: I had a nasty accent, mumbling, and gum chewing/smacking all in one fewkingly disgusting dictator/report.
Mumble mumble, smack smack, mumble mumble, smack smack… from the first phrase to the last. Luckily for me, it was under 4 minutes long.
Yeah, there are days when I’d rather be doing damned near anything else for a living (although I don’t know what else I’d do, at this point).
But it’s even more disgusting (for me) to work in an office surrounded by gum-chewing cows in the flesh than it is to have them over the earphones at home.
I’ve quit jobs where co-workers were too bovine to chew with their mouths closed. I can hear that crap over and above what’s coming in through the headphones.
January 4th, 2009 at 12:06 amESTHow about QA people who drop little turd-bombs on your work by leaving behind errors that weren’t there before?
I’m not saying I’m perfect, but when I leave a blank it’s because I can’t understand what the asshole dictator is saying. When I do make a mistake (fairly rare), I appreciate it being changed.
However, seems to me that some QA people will “mark their territory” by nitpicking to death everything and rewriting it… then leave a few more errors behind. Turd-bombs indeed! Then the dictator gets the report back and probably thinks I’m the one who screwed up.
January 4th, 2009 at 12:12 amESTInteresting!
Having been the “dictator” for most of the last 13 years, and NOT being an ESL, I haven’t heard many of these complaints.
I dictate the words I want in the dictation, and would absolutely REAM a transcriptionist for changing anything, although I also always let them know that I am available to answer any questions they might have or clarify something if it seems unclear. (Correcting inadvertant mistakes like mg vs mcg would be the exception to the above.)
I have switched to VR software because the error rate is lower, (I actually see what is being typed as it happens), and because the notes are available immediately for referrals if I send someone out for specialty consultation.
Transcription was my largest cost, after staff salaries, so VR has had a big impact on my bottom line, as well. My transcription cost was running close to $2000/month, and I was paying an independant contractor 14.5 cents per line when I switched to VR software. I had a very good transcriptionist, and paid more than I could have using a national service or offshore. (Offshore is a crap shoot, from what friends tell me. Some have had great luck, others terrible!)
BTW, no provider I know would think of the root word, pustule, if faced with the phrase using pustulent.
January 4th, 2009 at 1:55 amESTMr. Waites: If you are as well-spoken as your comments indicate, then you are a pretty rare dictator, even among the non-ESLs.
We MTs are supposed to edit with a light hand. But frankly, most nights, I am surprised and appalled that many such allegedly well-educated people are dictating so poorly. A lot of them are just not very well spoken.
BTW, it’s “independent” and “inadvertent.” I’d have changed those had you dictated it to me that way. We also help out with punctuation (the comma should come after the closing parenthesis).
In my experience, most of the time when doctors spell something out, we always verify… because, in my experience, most doctors are not good spellers, whether it’s a medical word, a brand name of something, or a patient’s name.
With offshoring of transcription, there is also the little problem of confidentiality and/or loyalty. There has been at least one such scandal already.
You might “ream” a transcriptionist for not transcribing exactly what you say; but unless a dictator happens to be one of those rare good spellers and also a good proofreader, frankly, a good MT makes most dictators look better than they sound.
We do earn our keep–although you are certainly within your rights to use VR and edit the document yourself, as well as save money by eliminating those costs. I know that some people think that you can drag in anyone off the street and have them work as a medical transcriptionist, but that is simply not true.
Also, BTW, most of us MTs who work for a service or a hospital are prohibited from contacting the dictators directly and complaining about their lousy dictation. It’s usually grounds for firing.
The usual chain of command is for the MT to complain to a supervisor, and *maybe* that request will get passed along to the liaison from the hospital, who may or may not pass along the request to the actual dictator. In the software we use, we do have a “Post-It Note” function, but we are restricted as to the content of those notes.
January 4th, 2009 at 3:19 amESTMr. Waites –
You, not being ESL, are a rarity, at least in my field (nuclear medicine radiology/oncology – PET/CT etc).
The ESL docs I work with have tried and failed with VR. It just doesn’t work for them because they do not speak recognizable English. I’m not exaggerating. Even when they “train” the VR, it just doesn’t work for them. When what the software hears is, “Mih Smih hah hirry uh simmo coh caah ay zenz f’reesting”, Dr. Wong is not going to get “Mrs. Smith has a history of sigmoid colon cancer and presents for restaging.” He has to sit there and correct it longer than it takes to dictate it and have me type it (we’re on 1-3 hour turnaround).
Just staying. I’m glad VR works for you but it doesn’t work for many. And I don’t know what your subject matter is but when we’re talking about nuclear radiology, it gets pretty hairy with the terminology.
And also in my specialty, what gets a transcriptionist REAMED is to NOT correct blatant, stupid-sounding mistakes because they say “that’s what the doctor dictated! I can’t change his dictation!” Bullshit. I’ve been doing this for 12 years and I’ve seen at least five MT’s get fired for refusing to correct mistakes. The doctors hate-hate-hate it when they accidentally dictate something like, “The patient presents for followup comma she is 65 years old and has a history of lung cancer.” That just looks stupid on paper and they rely on us to make it NOT look stupid.
You say you dictate what you want the report to say, and you may be the exception and good for you, but trust me, these docs I work for are so busy (one of them does 50 PET/CT readings a day) that they make a lot of mistakes. Like saying the left lung has the tumor throughout the report but saying right lung in the impression. Do you really think they want me to type what they said because they said it and that’s that? Not so much. How about if they say the patient has prostate cancer and then use the word “she” and “her” later in the report? I should type it verbatim? I’d lose my job if I did that.
This is fun. Pam, Mrs. Hill, MAMT6 and others – we really should start a support group blog. The Agony of Being an MT. LOL
January 4th, 2009 at 10:46 amESTI can’t be in the same room with people who are chewing gum, eating loudly, or, God forbid, talking while eating. It makes my skin crawl. I literally have to get up and leave.
And yet listening to cats or dogs eating doesn’t bother me in the slightest. In fact, I like listening to my kitties munching away and slurping their water. My late cat, Leo, even had a habit of slapping his tongue against the side of the glass while drinking. It sounded like a bell ringing.
January 4th, 2009 at 11:22 amESTAww, shucks — that would be a promotion for me! You MTs are super-humans, compared to whom, I am a retarded monkey!
The nearest I’ve come is doing data entry (or screen build, then entry) from reports by docs participating in clinical drug trials — so all written. Hand written, though, so there are deciphering issues, as well as unit of measure conversions. But most annoying is having to distill a paragraph of commentary* into the two-word phrase (or check mark!) called for in the form. The form (painstakingly designed to generate usable data) on which they were trained. At the training session they attended. At that resort. With the golf course. Yeah, that form. The one the Clinical Research Associate went back over for them in their offices. (And people wonder why drugs are so expensive!)
So, yeah — I stand in your giant shadows! (But I’d totally read that blog!)
*I think I’ve mentioned before that there are several dermatologists in NZ who need to die. Slowly. By being stabbed repeatedly with leaky fountain pens.
January 4th, 2009 at 1:57 pmESTBelieve me, I read the type of dictations you are talking about.
I’ve spent 13 years in Internal Med, so most of the dictations and terms you discuss are part of my everyday dictations.
VR software has improved, but I would agree 100% that ESL speakers would have a difficult time with it. My error rate hovers around 95-97% which is consistent with the rates that I have gotten from MT’s, even those who are supposedly “certified”.
I have seen patients and dictated up to 35 visit notes in one day, which are typically much more involved than a PET/CT reading, often extending to 3 full pages.
As for the spelling errors above, my typing skills are nowhere near my actual spelling skills. I don’t proof my posts here, nor do I use VR software at home, I hate listening to myself speak more than I have to!!!
The major problem I have with a transcriptionist changing my dictation are the legal ramifications of doing so. I have just finished testifying in a case where the there are multiple errors in the dictation, many of which are obviously the transcriptionist trying to correct poor grammar or phrasing by the doctor. Knowing the doctor, I know that he does not speak that way, nor would he say something similar to what ended up in his dictation. However, it is his responsibility to make sure that they do say what he intended, in this case, he didn’t do a good job, but he certainly wasn’t helped by his MT.
One thing to remember is that Medical Providers are taught to document in phrasing, not in complete sentences. When the MT tries to make complete, flowing prose from the phrasing, it often creates something that neither looks like the doctors actual intent, nor what he would say.
I dictate as if I was talking with the patient present, (when I used a service, I often dicated while WITH the patient) and try to make my notes understandable to them, not just another medical professional. I avoid medical jargon as much as possible, (maybe that’s why VR works as well as it does for me) and stick with normal conversational language as much is possible.
In 13 years, the only complaint I have had about my dictations, either from an MT or another provider, was that they wish I would tell them BEFORE the dictation if I wanted it in an H&P format. Can’t blame them there, and I try to do so when using a service now.
January 4th, 2009 at 3:30 pmESTThis may be perceived as perseverating and probably getting away from the purulent/pustulent/pus-filled problem put forth in the primary post, and perhaps be more in keeping with the professional prognistications pondered post scriptum, but I present for your possible pleasure:
Dictation Guidelines for Physicians
January 4th, 2009 at 3:34 pmESTI learned from the greatest sitcom ever – Arrested Development – that the word “pussy” mean sweet, kind person to the English.
I suspect it might not be common usage.
January 4th, 2009 at 3:37 pmESTNow y’all know why I laugh my a** off watching British comedies.
January 4th, 2009 at 5:55 pmESTRight now, a good MT with a good word processing program and a good abbreviation expander program is just as fast, or possibly faster, than someone who is editing VR.
Yeah, VR probably does work for those dictators who are relatively clear and who are willing to correct their own work (though, as I’ve stated, most doctors don’t seem to be very good spellers); this will probably leave us with only the crappiest dictators to actually transcribe from scratch.
And if things get to that point, then you will probably see a mass exodus of MTs from this occupation.
I originally got into MT to have a better way to put myself through school, working nights and going to school days, but I have stuck with it, and it with me. Had I become a veterinarian, my starting pay would have actually been lower than what I was making in MT before my pay cut.
I used to do many other kinds of word processing before MT, including legal work. The best attorney I worked for, in terms of his being a boss, was a fellow whose undergraduate degree was in English. He appreciated my low rate of errors and my speed, and I appreciated his literacy and his ability to correct my few errors.
There was another attorney in that office, however, who could barely string sentences together. He was a piss-poor speller. He had a freelance typist working for him. She was definitely fast, all right, but she couldn’t spell any better than he could… so his work got done fast but sloppily. And he didn’t seem to realize how sloppy she was, because he wasn’t knowledgeable enough to know how many mistakes she made.
It wasn’t my place to be the bearer of bad news, so I refrained from saying anything. But I will say that while I was freelancing in their office, my services were much in demand, as I could take up the overflow; and while I didn’t know all the court procedures, I made a good team with a paralegal who did.
January 4th, 2009 at 6:49 pmESTRachel: What I do when I see a mistake regarding right-left confusion is leave a message in the Post-It note function on our software to that effect, and to please verify.
“Please verify left versus right leg. Transcribed as dictated. Thank you.”
Sometimes I’ll leave blanks. Hopefully the doctor will actually read the report and correct the mistake. As it is, working at home, I have no access to any medical records.
There may be differences here between doing hospital reports and clinic/doctors’ office/outpatient centers’ reports, in terms of what you are expected to correct.
Were I doing your kind of work, Rachel, I’d probably leave blanks and ask them to verify right versus left.
January 4th, 2009 at 6:58 pmESTHave also heard that some dictators belch and fart while dictating. Also that some dictators dictate while they’re going to the bathroom, and the flushing sound is rather obvious.
January 4th, 2009 at 7:09 pmESTWell, I attempted a reply, rather lengthy, but it didn’t post for some reason.
I am Bill, to my patients as well as staff, not Mr. Waites (he’s my dad). Occasionally people call me Dr. Bill, which I also discourage.
First, I don’t use VR or reread for posts on blogs, so I am sure that several times per post I make typing errors and misspell words, as well as punctuation errors. I get annoyed having to scroll up in the little tiny space they use for replies.
Second, I’ll certainly agree that VR software doesn’t work for everyone. You must be willing to speak clearly and read your own dictation to catch errors. ESL doctors would have an extremely difficult time. I do know of some MT’s who are using VR for their better speakers, then proofing it while listening at faster than normal speeds. They say it’s about 20% faster that way. It allows them to make 20% more money.
Third, error rates for good VR software and MT are roughly the same, although being able to see the transcription as it happens lets me catch the vast majority.
Fourth, MT’s who change the doctors wording can inadvertently change the meaning. I just finished testifying in a case where the transcriptionist, in a good faith effort to improve the doctors lazy dictation habits, completely changed the intent of his dictation. In one of those tragicomedies, what he meant to say, and what she interpreted it as, were so different as to be almost completely opposed. Unfortunately, he didn’t catch it when he signed the dictation, (his error, and one of the reasons I like VR, it keeps us from being lazy). Since I knew his manner of dictation, and was also involved in the patients care, I was able to clarify his intent. It was ugly, but at least resolvable.
One issue not discussed is how doctors, PA’s, and NP’s are taught to chart. It is in phrases, not prose. Changing those phrases to readable prose is an art that many MT’s are good at, while others struggle. Those phrases work perfectly for other medical personnel, not so well for lawyers and patients.
With costs rising, the $25-30000 yearly that I save has allowed me to keep one additional staff person in the office, helping improve patient care. The paperwork from an office doesn’t improve care directly, and in fact often impedes it, as staff has to fill all the boxes for the insurance companies while spending less time with patients.
January 4th, 2009 at 7:52 pmESTI try to dictate as if the patient was sitting there, (in fact while using MT’s I often dictated with the patient present, and then asked if there was anything I should add or subtract.)
I avoid medical jargon if at all possible, and only use it when clarifying a particular diagnosis, (staging of tumors, for instance).
I try to make my notes as readable by the patient as by the medical staff.
Finally, I appreciate the efforts of good transcriptionists. I also have to read those notes from ESL specialists, and even talk to them on the phone frequently, trying to decipher their intent when their notes aren’t clear. It is a nightmare at times!
Thanks for your help when it is needed!!
January 4th, 2009 at 7:59 pmESTBILL WAITES SAID: I do know of some MT’s who are using VR for their better speakers, then proofing it while listening at faster than normal speeds. They say it’s about 20% faster that way. It allows them to make 20% more money.
That is only true if the MT is being paid the same rate for editing VR as for original transcribing from scratch.
In fact, with VR, most companies that I know of are paying considerably less per line… something like 3 cents per line is what I have seen.
Not the same at all. There is reputed to be an increase in the number of lines per hour, but that is only after the learning curve has been gotten through.
I agree that an MT should not be changing the meaning of what the doctor intends to say… but let me say that in many cases it is very damned hard to discern just what that is. Did he or did he not break his leg? Was it right or left?
I will say that most MTs do the very best they can.
In hospitals, if you ask me, maybe they ought to save money by getting rid of some administrators, who are often the ones who think that you can take any damned person off the street and use them for an MT.
I am not disputing your right to run your office any way you see fit and thereby save money. I also don’t dispute that dictating reports is an activity that doesn’t generate revenue, in and of itself.
But it doesn’t mean that I have to *like* the prospect of finding another field of work in a few years (I’m now 55 and not near retirement at all).
Yeah, it might seem to be a great deal to pay 3 cents per line to some outsourced person in India or the Philippines. However, my understanding is that quite a bit of their work has to be edited by U.S. MT editors.
And while there are undoubtedly some doctors who can either transcribe or who write well to begin with, I haven’t seen very many of them, and the other MTs I’ve talked with haven’t seen very many either.
January 4th, 2009 at 8:43 pmESTTO BILL WAITES: One more thing I wonder about: If you are doing your own transcription in your office, it’s probably not saving you any time.
True, you’re not having to pay someone else to transcribe it, and it’s available right away… but those 30 minutes you spent doing the transcription yourself might be time taken away from your ability to see another patient, might it not? So, if time is money, you’re paying either way.
Again, the error rate with VR is only low if you’re a clear speaker. At the current state of VR, I’ve seen indications of a lot of bloopers which must be corrected.
Now, with another generation of VR, who knows? I don’t think VR is going to totally get rid of MTs yet for some time.
January 4th, 2009 at 8:47 pmESTOther obnoxious things that some dictators do while attempting to dictate:
-Sucking and slurping on cough drops or hard candies.
-Eating food and crunching raw vegetables/fruits.
-Sniffing their noses constantly… can literally hear the snot being sucked up in the nose and throat. One guy sounded like he was going to hock a loogie into the microphone… repeatedly!… all of which went directly through the headphones into my ears. I just about puked while doing his report.
-Clearing their throats constantly… sounds very affected if done all throughout a report.
-Some doctors dictate while driving. Much background noise, among other things.
-Some doctors dictate in the bathroom, complete with the sounds of tinkling, plopping, and toilet flushing.
-Farting and belching.
A lot of gum chewers think that they’re not making any noise unless they’re actually popping their gum. This is not true. Their chewing, shlomping, sucking, slurping, Darth-Vader-like breathing, and squishing sounds come through loud and clear. Anyone who doubts this ought to record themselves chewing… you’d be just fricking amazed at what you can hear.
January 4th, 2009 at 8:50 pmESTSomething of the same process happened with legal transcription. When I first got into doing word processing, about 30 years ago, there were ads everywhere, in the L.A. Times and in the legal newspaper, for word processors, legal and otherwise. You could work steadily on a temporary basis for a very long time.
Then, some attorneys started doing their own word processing, which cut down the need for so many word processors, but did not totally eliminate the need for them. A lot of legal secretaries found themselves working for two, three, or more attorneys, when they had formerly worked for only one.
The bigger law firms still have pools of word processors who handle the heavy-duty typing; some of them run 24 hours per day, or at least have night shifts (which was good for me when I was going to school).
January 4th, 2009 at 9:06 pmESTRachel, there have been several entries which I wrote which did not show up on your blog. Is something wrong, or is there a limit to how many entries I can write?
January 4th, 2009 at 9:07 pmESTHey Pam, welcome to the moderation fairy. lol
I got hit the first time I posted from work instead of home. Sometimes the system just grabs you for no reason, though.
January 4th, 2009 at 9:48 pmESTPam, re: those MT’s using VR are doing so on their own, they have their docs use digital recorders, then plug them into Dragon and let the machine do its work, then go back and proofread. They get paid per line at standard rates, as if they were actually doing all the transcribing.
And no, I couldn’t see more patients, I have seen up to 30 in an 8 hour shift, 35 in a 12 hour shift, 40 in a 15, and still had to do the dictation. It doesn’t save time, but it does save money. I see everyone who wants to be seen that day, regardless, and I don’t got home until they are all seen.
PS, I have lost 2 posts here as well.
January 4th, 2009 at 10:04 pmESTBILL WAITES: Then those MTs of whom you speak are self-employed, independent contractors who charge their own rates.
They obviously are not working for the big MT service companies, which are paying only about 3 cents per line. I’ve been checking ads to see what the going rates are, and that’s a big pay cut. Even if I could proofread 500 lines per hour, that’s still less than I can make now doing original transcription.
My boss told me once that he was going to implement speech recognition but pay the same line rate as for original transcription. That hasn’t happened yet, so I can’t say for sure what’s going to happen. I’m an independent contractor, but I get my work from an MT company which does hospital accounts.
January 4th, 2009 at 10:16 pmESTPam,
I don’t think all MT is EVER going away.
Yes, most of the MT’s in my area, (that I know), Eastern Washington, are either independent, or work and have full benefits from a large clinic, or maybe a hospital. Some of the clinics are using VR, and having their MT’s proofread. Those MT’s are hourly employees, so they really don’t care which they do.
I suspect that they hope to use VR long term, letting the MT’s go, but they have too many ESL docs to allow that to happen. (Management in large clinics or hospitals isn’t always in touch with the real world!)
I would say the larger impact will be EMR, with Medicare pushing to “fill the box” type forms instead of SOAP or H&P type notes that they actually have to read! Heaven forbid that they actually be forced to understand something about what they are paying for. One clinic that I know of has gone EMR, and only uses dictated notes for hospital admissions and outside referrals.
However, I just read today that 85% of the VR market is now medical, which is a pretty significant chunk of change. Just as an aside, Dragon 10 Medical is a big step forward from Dragon 9, which was a huge step up from 7, which was the first version that was practical at all, at least from my experience.
January 5th, 2009 at 12:06 amESTNothere Says:
While I may not have quoted him verbatim, I can assure you, Johnny Carson did make THAT joke. It was hilarious.
Perhaps you are hinting that Rachl should donate her VHS copy of the episode in question to you? I doubt she’ll do that, I mean, I suppose it was worth a try though.
~Dave’s Not Here, Man
January 5th, 2009 at 4:01 amESTPhysicians: The Anointed Ones who are Blessed with Divine Right of Kings. Question Not Their Word.
January 5th, 2009 at 7:27 amESTBILL WAITES: I myself have not tried VR yet, but I have heard from some MTs that they do not like doing it, and would rather transcribe “from scratch.” I don’t know any MTs yet who don’t care which they do who are also paid by the hour.
Those MTs who are pretty fast transcriptionists would often rather get paid by production (I am one of those).
January 5th, 2009 at 7:54 amESTMy daughter used to call a belt a “belk”. Someone taught her a “better” name for, ahem, her privates. She wound up calling it her “China”. That made for an interesting conversation when I asked her mother if she wanted to eat at New China or The China Garden one night when deciding on dinner. Something like, “why would anyone need new “china”?” And something else about it being just gross. Being the damn genius I am (after wifey-poo made it crystal clear as to what she was laughing so hard about), I decided not to mention eating at China Dragon.
January 5th, 2009 at 1:09 pmESTI work with a guy from Brazil. His spoken English is very good and I’ve worked thru the accent issues pretty well, although I still have to get him to repeat himself every now and again. His written English is still somewhat shaky, and has placed me into a similar situation as your ‘pus’ doctor has placed you.
Last spring, he flew to our NY office and trained me on some processes. One of these processes is to analyze rates for our system. We get several different input files from various sources for these rates, then have to analyze them to make sure all of the input files are correct and consolidate them into one file. With me so far? Good.
Anyhoo, during the rate analysis session, he lost his internet connection, so he switched over to my PC to finish up He did the intial analysis, made some updates and had a completed post-analysis record for submission consolidated into one consolidated file.
Which he titled AFTER ANAL.
Apparently, he figured he was saving me a few bytes of storage by shortening the word ‘ANALYSIS’ to ‘ANAL’, but what he did was cause me months of grief.
I had to refer to this file regularly during the 2nd and 3rd quarters of the year. So in my Recent Documents folder, AFTER ANAL was the first file listed for months. I regularly have web meetings where people working remotely can see my screen, so most of the people in my department have seen the AFTER ANAL file listed on my PC; some have asked if its a picture or video file or if it is appropriate for work.
Sure, I could change the file name, but I kind of like the weird attention I get.
January 5th, 2009 at 4:20 pmEST