Yes, I have better things to do with my time besides complain...but the board seems a little slow and I feel like "venting". I'm sure a lot of you can identify with some of these!! Read on...

1. Doctors who don't know where the "pause" button is on the touchpad: Sometimes I do dictation where I spend more time listening to a doctor rustle through a chart or discuss his/her weekend plans with the nursing staff than transcribing...whilst I contemplate what I will be doing this weekend...working.

2. The "spellers": You know, the ones who spell everything I already know how to spell and then slur over something I have never heard of, like a surgical instrument, a disease, bacteria, etc. Oh and don't forget the ones who spell something that you thought was spelled a different way, go through the trouble of looking it up... only to find the doctor has misspelled it!

3. Doctors with beepers: Why do they always hold it up to the microphone/receiver before shutting it off? Do they want me to know they have a page? Do I care? No!! But then maybe they are trying to drum up business for their ENT buddies when I have to get my perforated ear drum fixed!

4. Residents, P.A.s, R.N.s who dictate for the "real" doctor, a.k.a. "the readers": Why do they have to give me a day-by-day of EVERYTHING??? I would say including whenever the patient goes to the bathroom, but I guess that is a pertinent thing to dictate... hmmm

Well, that's it for now... I know there are more and maybe you have some too?

Jeany:

You may have opened a can of worms here.

On spelling: Ditto on everything you said. Happens to us frequently. One client still spells some very basic terms and medications. We've only been doing his work for - 10 YEARS. His work has been going out 100% error free for almost the same amount of time. I cannot even remember the last time we had a report returned for an error. Go figure.

We have one client who likes to dictate after midnight. The only problem is, she's almost falling asleep the whole time she is dictating. She talks while yawning - her voice is barely audible - she makes all kinds of mistakes - good luck figuring out what she's saying. She never edits. She dictates then tells you to correct it right after you've transcribed it. - Arghhh!

How about this one. One specialist we've had as a client for two years always waits about four weeks to pay us. His last bill had a late charge of $5.46 on it. He calls me today saying he thought it was unfair and would I reverse the charge. We had a short discussion about payment terms - again - and I reluctantly agreed. By the way, he is currently enjoying a huge discount over other clients. The bill he was disputing had a $200.00 discount on it. Also, two days before he called, we gave him 10 new Philips' dictation tapes, which would be worth about $80.00 - for no charge, since he would not buy new ones himself and the ones he was using were just cr*p. I thought he was phoning to thank us for the free tapes - no luck - just wanted his $5.46 credit. He bills about $500,000.00 a year.

I think this is going to be a good thread.

SOMara

SOMara,

Loved your stories! However, I think I would have lost my patience with "Dr. Moneybags Squeaky Wheel" a long time ago!!

After posting last night, I went back to work and remembered my REAL #1 PET PEEVE: Doctors that want their dictation typed "ver batim". Don't they realize that the one joy I get from transcribing is turning their fragmented, often grammatically incorrect ramblings into full sentences that actually make sense? My skin actually crawls when I have to type something like this, knowing someone is going to read it and wonder, "where did she go to school?" I feel like attaching a disclaimer to every one I type like that.

Can you take one more? ...well here it is anyhow... No fault of the doctor, I don't think, but when there is a constant beeping sound in the background (heart monitor, patient call button, etc.). It's torture!! The doc might as well be standing over me dripping oil on my head!!!

Hope you're right about being a good thread. I love stories [img]http://www.medword.com/ubb/smile.gif[/img]

Hi Jeany and SOMara,

I just loved reading your stories. (I'm not an MT yet - still in school).

However, your topic does bring up a concern of mine that I haven't seen discussed yet.
I've heard a lot about mumbling, slurring, bad tapes, etc., and it makes me wonder - what is an MT's liability when honest mistakes are made? I understand the finished document is a medical/LEGAL document, and with all the problems with dictation, mistakes I'm sure do get made - sometimes with possibly grave results. My question is: if the MT does make a mistake caused by the dictator, what is the liability here? Have there been any cases?

Thanks for all your help - past, present and future.

Kathy

Kathy,

SOMara may be better able to answer this question, but the one thing that is always stressed is not to guess. The agency I work for has what they call "deficiency notes" where all blanks are documented and while they only require the line number of the blank (for time sake), I usually try to put a S/L or the reason (word cut off, background noise, bad technical quality). Sometimes it's hard to tell if they say the patient "does" or "does not" have a specific condition and in this case I always leave it blank because that could have a legal impact as well as an impact on future medical treatment for the patient.

I personally have never known of a transcriptionist or a doctor being held liable for something incorrectly dictated or transcribed, but I suppose it's possible and maybe someone else would know. I do know, however, when I worked in a hospital, if there was a case that was potentially going to court or was going to court for sure, the Medical Records Department, doctor, etc. would go over the chart with a fine tooth comb, especially type-written/transcribed reports. On a few occasions, I have had to ammend reports but all of this is documented on either the ammended report or the original is also made part of the record...to the best of my knowledge.

Also, the doctor is supposed to read and sign his transcribed reports and has the option of correcting any errors. So I assume he would be responsible for the final document.

Hope that helps you out. You are right, there are a lot of horror stories associated with conditions beyond our control and it can be quite frustrating. Just keep in mind that they are just that...out of our control, so don't be discouraged when you encounter them.

Jeany

Kathy:

Everything Jeany stated is accurate as far as I know in most countries based on British Common Law and in the United States. Also, Jeany is correct in stating the physician is ultimately responsible. They are supposed to catch our errors whether they sign the report or send it out marked "Dictated but not read."

That said of course, MTs do have a very serious professional, moral, and ethical responsibility to transcribe the dictation as accurately as possible. Experienced MTs also often point out errors physicians make in drugs, drug doses, dates, etc.

Since even a report on a regular patient visit comprises part of the patient's medical record and therefore possibly one day part of a court record, (patient may be in an MVA, or sue someone for medical reasons, etc.) we are unwavering in our company policy of 100 percent accuracy in all reports - with no guessing of words. "If you can't hear it - you can't transcribe it" is what we believe.

SOMara

Another story:

One of our clients "does not believe in hyphens." Believe it or not, this physician told us directly not to hyphenate any words. No amount of explaining the rules of grammar and basic word/sentence construction convinced him that his request was ludicrous. He decided he could ignore the rules. We still do his work but don't put our name anywhere on the reports.

SOMara

A light went off in my head when I read your post about the non-hyphen doctor. I cannot remove my "MT number" from reports because they are automatically electronically entered, but from now on, when I do a "ver batim" doctor, I will leave a deficiency note stating that the report was "typed ver batim". If the office wants to rip it up, that's up to them, but as you stated, we have a responsibility to be professional. It's too bad some doctors don't have confidence in MTs to let us do our job.

Your statement about being professional, ethical, etc., also made me think about something I had not thought about in ages... I used to work with a girl who was a "skipper". She would pick and choose tapes and at times, even hide tapes that had difficult doctors on them. One time, she listened to the beginning of a report that was from about 2 years previously. She erased it stating, "She has no business dictating something that old"!!! Can you believe it? Anyhow, not five minutes later the Medical Records Dept. called and requested the very report she had just erased!!! You should have seen her face. I would like to say she learned her lesson, but she didn't. After she left, we found a stockpile of tapes that she had hidden so she wouldn't have to do them. How's that for ethics??

I am really enjoying this thread on "pet peaves"! I am so glad I found this mb...I
have just set up my office to begin doing
medical transcription in the next few days.
I am excited and nervous but you folks have
given me comfort in the thought that there will be a place where "I" can VENT, too!
Thanks for being here!
Teresa

To Jeany and SoMara - thank you both so much for your very informative replies. I first realized that medical documents can become legal documents when I read a book on becoming a medical transcriptionist by George Morton. It had never occurred to me before and this litigious (sp) society we live in can be scarey. This concerned me because of the huge responsibility we bear, but your answers relieved my concerns a lot. I used to do office dictation as a secretary and I would get the impression that the dictator could care less about getting the information across correctly. Nevertheless, I LOVE transcribing and can't wait to get started in this field! Thank you again for your replies.

A question for SoMara - when I first started posting questions on this BB a few months ago, I would get an e-mail notifying me that a reply to my question had been posted. Has the e-mail notification been discontinued?

Thanks for all your hard work and correspondence. I love this site.

Kathy

Kathy:

Thank you for your comments about the site. I really do wish I could spend more time on our own BB but between the tons of transcription, maintaining the web site and the MT Gab - and sleeping and eating - there's not much time left for anything else.



As far as I am aware this should be working Kathy. If you are not getting an e-mail informing you that someone has responded to your message, please check your "Profile" settings. Let me know if this does not work. Thanks.

SOMara

SOMara - you simply amaze me with your fast replies! I checked my profile and my e-mail address is there, so we'll see what happens with future postings. Tomorrow night I have my final exam in Medical Terminology. So far I have an A in my class, so I hope I don't blow it on the final!! Gotta go study. Thanks again for your site and your attention. It is so appreciated!

Kathy

Kathy:

You're welcome! I am sure you will do well on your medical terminology exam. I bet you get an A+

(This is also a test to see if your automatic e-mail notification is working.)

SOMara

Hi everyone!

I have to stop in here more frequently, you guys have me in stitches! I agree with all of you but especially the doctors who are oh-so-helpful and spell things for you, except that they are WRRRRRONNNGGGGGG!!!!! My personal rule is, if the doc spells it, I better look it up! Also, along the same lines of the yawning doc, how about the EATING doc?? This drives me nutty! How about the ones who start talking a split second before they turn their machine on, and then turn it off about half a word shy of being finished talking? I currently have an ortho surgeon who is a nightmare, but is a good sport about it, and thankfully, the ofc manager is "on my side." He has been known to dictate in the kitchen, with people chatting, the water running, dishes clanking, and once or twice he has even taken the dictaphone in the BATHROOM with him!! And his dictation is a slurred, fuzzy disaster anyway! Dictating in the car is another wonderful thing. Once I had a psychologist who liked to dictate outside, even when it was WINDY and I could not hear ONE WORD!! Uh-oh, I'm on a roll now. Okay, just one more. The doctor sits on a dictation for days and days and suddenly, guess what! It is MY emergency! This was worse when I worked in the office. At 3 minutes to 5:00, someone would rush in and sheepishly ask, "Um, I forgot to do this earlier, do you think you could do just a quick letter?" Of course, once you agree, you usually would hear, "Oh, as long as you're at it..." Aaahhhhh, thanks for letting me vent, that felt good! -Ada

Pet peeves. This is great. I love it. I once worked for a transcription company that told me never to leave a blank and to always "wing" it. I never heard of such a thing. Also, the agency called me screaming because the doctor got on her case insisting the past medical history was transcribed wrong and that the patient didn't have a particular disease that was typed. Not only was this what the doctor said, but it was dictated and transcribed six months before the doctor telephoned. (Shouldn't it have been proofed earlier?) Could it be the doctor was wrong??? NEVER... I should have known. Or, how about the most recent-dictated reports that are typed but need to be dated years before (I went as far back to dating a report 1995, before I even was a MT). This same physician used to dictate his reports with his "talking parrot" in the background and THOUGHT IT WAS CUTE. If it was so cute, then why not teach the parrot to TYPE. This physician would also go to the park with his children (and dictate) and better yet, go to hockey games, and even parties and dictate. Whenever, I would send a polite letter explaining this, I would get no reponse. Sometimes, it would take one hour (or more) just to get two pages typed in between the "goals", "pretty baby", and partying going on. The worst is one party was for his son's birthday. I guess if a doctor is rude or inconsiderate enough to go to his own children's parties and dictate during them, why would he listen to me??? Believe it or not, I could go on, and on, and on ......

Ada and Renee,
You both had me in stitches!! I've experienced ALL of those too.

Renee, forget about leaving notes - you are right - if they are not considerate enough to dictate in the proper place, then a note means nothing to them. I don't even waste time with notes or complaints any more. I do the best I can, but when push comes to shove, a report full of holes usually gets their attention. And about the doc who didn't get back to you after such a long time about the correction - probably was a court case or something and he was trying to cover his arse!

Ada - read your other posts and congradulations on you son. Things certainly do get hectic this time of year. It's funny how in June I'm so happy school is out and then by August I can't wait for it to start again! Also, I just "discovered" the message board you mentioned in another post. It is full of info and can be quite amusing at times. I work for MedQuist and someone told me there were postings from the "higher ups" there regarding new benefits (my company was just bought out by them) so I visited the site and got more than I expected! Lots of MedQuist bashing! Oh well, everybody has to make the decision that is right for them.

You guys forgot about the doc that dictates from a speaker phone!! A quote from Angelica on Rug Rats: "What are we - chopped sliver?" [img]http://www.medword.com/ubb/smile.gif[/img]

Have a great weekend!! [img]http://www.medword.com/ubb/smile.gif[/img]
Jeany

Hi Y'all!

And another thing!! Sometimes a doc will say something muffled that I can't understand, right at the same time that a baby screams, or some other horrifying noise happens. The trouble is, then you have to listen to that spot over and over again to get the word! Oh, the headaches and torture we go through! :-) I used to type for a P.A. who was a very nice person other than this one horrible habit. She was so used to babies screaming, that she would stand right in the hall and dictate, right by the check-out desk. Unfortunately, half the babies had just gotten their shots, and the other half were sick! In other words, all her tapes were infused with the crazy-making music of SCREAMING BABIES!! We nearly went mad, and finally got up the guts to ask her to come in and listen to what the tapes sounded like. You'll never believe it, she was horrified, apologized profusely, and didn't do it any more! We started rewarding her with candy and goodies just so she didn't backslide! -Ada

How about doctor's who stockpile all of their dictation and then hand you three days worth of dictation on one tape (from three months earlier, no less) and expect it back the next morning? We've tried to explain to her if she wants to give us all of her work at once, could she at least put each day on a separate tape so we can split it up since we all have our "regular" transcription to do, as well. Of course, she also likes to go on and on and on ... It's not unusual for her to dictate a two-page report on a patient who is being seen for "allergic rhinitis" I guess you could say she's thorough when she finally gets around to the dictation. Everybody cringes when they get her tapes, but we can't complain too loudly because the other doctors in the group are too good to lose! I also had a lawn mower in the background of one tape and the doc apologized for the noise. I'm still not sure if she was mowing and dictating ot the same time or sitting in the middle of a field while it was being mowed! Oh well, keeps things interesting and you learn to appreciate the "good docs"!

What about the doctor who finds it extremely necessary to dictate over the office PA system, except when he dictates his voice goes lower and lower and lower instead of louder. He dictates as if he's telling a secret. Or, here's another ... when you're not given a patient sheet (for office notes) and the doctor spells the patient's last name two or three times ... each time differently! I have a doctor that corrects a correct spelling of a word. This might be a whole new topic ... but what do you do?

Well, Renee, personally I choose to SCREAM AND CRY. But seriously, usually with my office I just use my best judgment and then put a sticky note on it saying something like "doc spelled several ways - pls double check spelling - I'll gladly fix and reprint." My office is real nice about that, though. Another idea would be to collect your questions and call before printing your dictations, asking for the right info. On the other hand, sometimes the doc only learns to behave if they get blanks they have to fill in. I love these new icon thingies up top. Here goes. Have a great day!

How about this situation. A couple weeks ago, an office called and hired me. They were desperate and needed someone right away. I agreed and they gave me 2 days' worth of work to start off with. The problem? This was a new specialty for me which they knew, and I got no time for training. Oh, and their printer didn't work. I got a full week behind even with working nights, early mornings, weekends, and until my fingers were having muscle spasms, I was in tears and my back was screaming for mercy. I apologized but explained that realistically I would need some time to get used to the docs, procedures, terms, etc. They just didn't seem to understand this and became annoyed with me. By the end of the second week I was totally caught up, but my dad fell ill at the same time. I called and explained, and we agreed that they would just find someone else. I just didn't need that level of stress in my life. I wish I could get these kind of folks to understand that we work so much harder when we want to, rather than because we're afraid not to. Anyway, I know I'm having a pity party here but you guys all seem so nice and understanding. I really tried my best to please these people but they don't seem to get that even an experienced MT needs SOME time to adjust and train, especially when they know you're on your own and doing a new specialty. BTW, one of their docs was the worst I've ever typed for! He holds his recorder up so close to his mouth that it sounds like a two-year-old giving a speech through a New York subway loudspeaker, only sped up! Okay, I'm better now. :-) Back to my other 2 jobs which are nice and fun and a vacation in comparison!
-Ada

[This message has been edited by Ada (edited 25 June 1999).]

Hello to all of you here on this site. This is an awesome site. I am studying to be a MT through ICS learning systems. I'm finding it a bit mind boggling though. We have five children and I'm holding a part time job at Taco Bell. I'm having a hard time finding the time I would want to study my books. I am about halfway through my course, but I feel like I don't know very much. It's a little discouraging when I think maybe I won't make a good MT. Is there anyone that I could correspond with about these matters? Please e-mail me, for I'm not real familiar with how this site works. I get lost sometimes. My e-mail is chasg@top.monad.net thanks, Linda

Hehehehe. Oh, I love this place! Pet Peeves! Gotta love em!

1. The doctor who eats candy, chips, or whatever while they are dictating, crunching and munching all the while, swallowing loudly, but speaking softly because his mouth is so FULL!

2. The doctor who is tired/sleepy and yawns through the whole thing, but continues to speak while yawning and expects you to interpret the yawned words too.

3. The doctor who belches, hiccups, and worse while dictating and never once bothers to say "excuse me".

4. The doctors who tap their pencil on the machine while they ruffle through the chart or repeat a phrase over and over because they mistakenly believe that, if there is no noise, the dictation machine will shut down or you will think the report is at an end.

5. Doctors who "make up" their own medical terms.

6. Doctors who speak very fast or very softly, or both, apparently worrying that someone else will hear them??

7. Doctors who dictate from mobile phones or car phones. There is nothing like the noise of traffic jams in the background, or the noise of the golf course, the grocery store, the newborn nursery, even, yes, parties... Yes, Virginia, there are doctors who do this.

8. Doctors who expect you to pay THEIR bill when it is due, but who do not want to pay YOUR bill when it is due (without countless reminders or threats to call a lawyer or a collection agency).

9. Doctors who make mistakes in their dictation blame you for their mistakes.

10. Yes, there really are doctors also who never, never read their dictation once it is typed before they sign it. I knew a doctor who actually signed an op note which stated that the patient was "prepped and raped on the operating table". hehehehe

11. Doctors who never let you know you are making a mistake. We had a doctor once who sent us a letter regarding the term "Scarpa's fascia" (which was not in our books at the time). He made fun of the many different ways that the transcriptionists had spelled it and how stupid we all were. Our supervisor sent him back a very polite letter stating that, had he bothered to correct us the first time he had seen it misspelled, we would have written it in all our reference books and spelled it correctly from then on; therefore, which was more stupid? She was very offended at this letter. You know, that guy never complained again?

------------------
SgrmtnHoneybee

Oooo, ooooo, ask me! I could write a novel. I love those doctors who are the first to get their panties in a wad when something isn't right, but like to make up words when they aren't sure what to say. For instance, I had an ENT doc dictate that the patient was seizurating in his office. What the heck is that?

And it makes nuts to transcribe for the ones who are SOOOOO busy, they have to eat their lunch and take a poo while dictating (I have even heard a neurologist straining on the toilet before!).

I am also totally on board with the resident/PA complaint. I think they are so new, they don't want to leave anything out and they hardly ever do! Whenever I pull up an extremely long dictation, I can almost always bet it's a resident before I even look at the dictator name. They go on and on and on and on......

I love these pet peeves. I have the same peeves. Once one of my teachers at trans. school jokingly said if a doctor spelled a word while dictating it was our signal to stop and look it up. You all know the doctor's spellings are usually wrong.

I've had docs dictate on airplanes with that roaring in the background, at tennis matches, in traffic with the convertible top down and radio on, in the hospital cafeteria, the bathroom...I love it though when they leave the recorder on unintentionally in their pocket and I hear the whole office visits and conversations with other doctors.

On name spellings, it seems all my docs have been taught just to spell last names - as is, the patient's name is "Zonquavia Jones, that's J-O-N-E-S."

The lady I had my externship with said to me over a decade ago that all doctors should have to go through transcription school to learn how to dictate. So true!

my neighbor thinks i am a doctor. she is a hypochondriac and she bounces every ailment off me. i tell her, i type words, i don't diagnose. one day she showed me blue veins on her arms. asked to see mine, see you have them too. yah, we all have them. yah but yours aren't as dark as mine. she was worried she had a blood disorder. i said check with your doctor. every day she asked me. i googled it. something about a lot of oxygen in your blood. told her that. she seemed satisfied. she came back two days later. i know you told me blue veins mean a lot of oxygen in the blood, but what about blue-green veins. omg

she had a rash. what do u think it is. i said, it looks like leprosy. you better call doc right away. lol

oh how bout people, when they find out u work at home. they say, i could do that. i worked at dunkin donuts and i was really quick on the keypad...really? yah this job is that easy.