Passage : Education

Truth in Advertising

Jeanne Johnston — Sun, 12 Jul 2009 22:53:00 GMT

Apology in advance as I am about to repeat myself. I have often launched into tirades about unscrupulous MT schools marketing their product in sneaky ways and the need for potential students to exercise due diligence when shopping around. Indeed, some...(read more)

If Wishes Were Horses

Jeanne Johnston — Fri, 17 Apr 2009 15:01:00 GMT

Ahhh , it must be springtime because the scams are bursting out all over. On one MT message board alone, I have counted no fewer than six threads this last week or so from starry-eyed MT wannabes hoping for advice on school choice, or thinly-veiled propaganda...(read more)

Is Coding Any More Secure Than MT?

Jeanne Johnston — Mon, 30 Mar 2009 12:08:00 GMT

I notice that Advance has no one here blogging about coding, yet the discussion forum is predominantly skewed that way. Does the topic just not lend itself to conversation because it is so black and white, like accounting? When I realized my art major...(read more)

No Man Is an Island

Jeanne Johnston — Tue, 30 Dec 2008 19:03:00 GMT

It seems most issues of Advance contain at least one letter from a new graduate, bemoaning the fact that regardless of the field, there's a Catch-22 wherein you need experience to get that first job, but you can't get that first job because no one's willing to give you experience. Just perusing the message boards here, it's also a common topic of discussion.

So how do you beat that conundrum? Obviously, the first advice people give is to be persistent. Put in your application and follow it up often--not enough to be a pest, but often enough so that they might start to think of you the next time there's an opening for a newbie. If your education is good enough, all you really need is the opportunity to test and show them your potential, right?

Another tactic that seems crucial to me--and yet rarely discussed--is networking. But. . . how do you network when you're a "nobody" in the field? Well, you figure out where the veterans are and you plop down in the middle of them and soak up everything they care to impart. Professional organizations usually offer student rates, but these days you don't have to invest a thing if you simply google your way around the internet and find a well-run message board. For MTs (and some coders), the best site out there is MT Chat, which is frequented by some of the grande dames of the biz, n00bs, students, and frequently, people who just stumble in looking for information on the field. If you sidle in and observe a good while, you can pick up a lot of information about everything from techniques for improving your skills to heads-up on job openings. You can't necessarily tell which posters are the vets because they don't make an issue of it, but most are pretty compulsive about answering questions. The board has a reputation for not tolerating fools gladly, but don't let the occasional directness scare you; most of the crusty ones have a chewy marshmallow center and feel very strongly they have a responsibility to share their knowledge with the next generation. Many employers read the forum--both to get a feel for which posters to avoid as well as which ones are good prospects (yes, you can post with a silly user name, but it's often very easy to match them up to actual applications. . .) Not only is there a forum there with job openings, there are often offers made behind the scenes. There are a couple school forums and instructors are very free with their advice. Coding is not as established there, but enough to be a valuable addition to your arsenal.

Your specific field should also have resources like this. For registrars, the NCRA has a jobs board that not only allows you to peruse openings (including internships), but also allows you to post your own résumé, to help match you with prospective employers. Now that the new certification requirements are changing, I suspect they will be working harder to fill those openings.

Advance itself has recently added a facebook page to help network. I have to admit I've not ventured to stick myself on facebook or any similar networking sites (yet) and I'd wager a guess that the majority who have joined this one are probably fairly young. Still, it seems a brilliant way to network, especially as so many of us are telecommuting and never actually get a chance to mingle on the job or at professional gatherings.

I'm sure there are other avenues to network I've not even thought of yet (I tend to be kind of stuck on the internet as my main venue, and I find it's a great equalizer), so I'd love to hear other suggestions. Yes, it's frustrating and sometimes it's very therapeutic to write that letter to the editor or post on a message board and just whine out of frustration--but in the end, the only way to ensure you get that big break is to become proactive and actually DO something. Don't feel helpless and isolated--think how you can build a bridge to connect with others who might give you a hand up to make that big leap.

Happy Solstice!

Jeanne Johnston — Mon, 22 Dec 2008 18:14:00 GMT

I don't expect any sympathy from people who are probably sitting under two feet of snow whilst I'm fluctuating between 50s and 80s, but this is a time of year I find crucial for recentering myself and regrouping for the coming year. Forget New Year's resolutions, which are more often forgotten once the holiday fog lifts. Solstice is my counterpoint to spring cleaning, a watershed wherein I am often starting to drag psychically and need to set my sights on new goals, toss the flotsam and jetsam that I've accumulated (literally and emotionally), and start fresh. With the rebirth of the Sun and that extra minute or two of daylight every day, surely I will find that old drive and ambition, right?

My plan is to start with the physical. Since I work at night, I recently realized (one of those rare occasions I was up and about in the afternoon) that my house is starting to look like your stereotypically gothic movie set. In fact, I bemoaned the cobwebs dancing around the circumference of my beautiful stained glass lampshade to my son as I noticed them, and he shrugged it off with a "Vampire" (think Johnny Depp declaring "Pirate") like it's nothing out of the ordinary. Well, he's on his own now and it probably isn't. . . Further inspection showed crud under neglected toe kicks, grimy switchplates, and various collections of treasures the cat likes to stash away for future use (Q-tips, socks, jewelry, old Kleenex, and an assortment of bug and lizard carcasses from the lanai). A book junkie, I've got libraries in four rooms now--all dust magnets. Clearly, I'm overdue for a spring cleaning. I also like to periodically weed out superfluous junk, so whatever I'm sure the kids won't glom onto at some point will find its way to Goodwill or freecycle--not worth the misery of holding a yard sale, and karmically better to gift them anyway.

After the cleaning, I'll turn to myself and pamper and ponder. I could probably stand to indulge myself to a spa day, but my "frugal" gene means it will suffice to buy a nice conditioner, maybe a new scent, and spend an evening exfoliating, moisturizing, deforesting, and filing. Follow that with a day in the hammock with some introspective tunes, and I should be ready to dive back into the old routine again without feeling like it's sucking the soul out of me.

Fortunately, the kids are old enough that even they see no need to succumb to the crass commercialism of the holidays, so my problems haven't been compounded by those extraneous pressures for the past few years. I just need to stop my world, blow the stink off, and get back on the road with a full tank of gas.

And now, having just braved the dreaded WM (where I already see plastic champagne glasses and chocolate hearts) for an emergency cat litter run, I feel it's proper to close with an all-inclusive Happy Hallochristmakwanukaheastergiving! May you all likewise find a little zing as you head into the new year.

Runnin' on Empty

Jeanne Johnston — Tue, 09 Dec 2008 12:51:00 GMT

I don't know what it is. Could be the fact that it's winter--though that's kind of theoretical in FL, despite the fact I've had to close the house up, and as I work graveyard, I don't see the sun year-round, so this is not a change for me. Could be that my baby has moved across the country and I'm suffering empty nest syndrome--though I've been so relieved to be able to start cleaning up her room and making use of it that I haven't had time to be sad about it. (Besides, we email and phone all the time.) Really, I never had a problem with my own company. Could be the holidays, which traditionally bum as many people out as they thrill--though we've pretty much done without tradition for years, so Christmas doesn't really have much power over me. Could be the Vacation That Wasn't or that I'm still recovering from my son's recent hospitalization (he already lost one leg, and though this was obviously not an infection in the same league, it did deliver quite an emotional whammy just the same), or maybe that I'm so disgusted with the way my job is headed (dwindling pay and bennies, never a raise, and an employer who obviously cares nothing for loyalty or quality). My kids are thriving--daughter happily ensconced in a new life with a nice guy, and they're already threatening to move closer (i.e. away from the snow--duh. . . MA is COLD!) Son just landed The Job he should have had years ago and will not only quit mooching "loans" from me, but might actually start to whittle down his debt. I even got an early men-in-kilts fix a couple weeks ago (I live for the Highland Games in the spring, but the Renaissance Faire was a good stopgap). In many ways, this should shape up to be a really great new year.

Still, I dunno. I'm just. . . not coping. I work. I sleep. The space between the two seems to shrink daily. I look forward to weekends, and as soon as they come I turn around and it's time to slap the headphones on and get back to work. It's like the less responsibilities I have, the less time I seem to have to deal with them (this runs contrary to the laws of income, in which the more you have, the more your necessities expand to accommodate it). How did I manage to squeeze so much into my life the first time I did college, and still have energy to add more? Surely, this is not simply a sign of decrepitude, it is? (Sadly, I have no way of adequately conveying the horror at that concept using mere html.) Between family crises, computer problems, and now motivation, I have a sinking feeling I will never finish my pharmacology course in time. Knowing I would have to pay the tuition a second time is oddly not enough to kick me into gear. I even have trouble feeling outrage at injustice--which I now see is totally different from pessimism, because that apparently engenders apathy.

Maybe it's because I know the holidays bring tourist traffic and I'm back in my "I hate people" mode. Maybe this is because I quit drinking coffee (which I never loved anyway) and went back to tea; in retrospect, that did involve a two-week withdrawal before the fog cleared. Maybe I really do need some vitamin D. Studies show that only 15 minutes of sunshine a day is crucial to good health, physical and emotional. It can prevent breast cancer, and some studies suggest that areas with less sunlight have higher concentrations of diseases like MS. After so many years on the graveyard shift, I don't even handle sunlight well (going for that "whiter shade of pale," donchaknow), but I suppose I should get serious and give it a try. All I need is a boost over the hump so I can survive the rest of this coursework. If I can at least get far enough to see the finish line, I should be able to power through after all.

Career 2.0

Jeanne Johnston — Mon, 20 Oct 2008 11:52:00 GMT

How did you fall into your career in healthcare? In my case, I thought I found the perfect fit for my interests and abilities--and were it not for the current state of affairs, with the drive to wring greater production from us for less pay and shrinking benefits, I would have been content to stay put until I'm old and grey. That obviously being the case, however, I've started down this path--hopefully, toward a better-paying, more secure, more respected, and perhaps even more meaningful career. Much as I enjoy my job in general, I find the fact that cancer registrars actually can help define which treatments work and which factors predispose people to disease somehow more noble than merely helping to document a patient's bowel habits and pill count for the billing department.

Still, as I was already at an age where my kids were fairly self sufficient when I started MT, I've had even more misgivings about starting from scratch again. Do I have the strength? the brain power? the intestinal fortitude to start back at the bottom of the pile? This time around, I also have to work around a full-time job as I struggle to complete my studies, often a source of frustration and discouragement--and I'm not even counting the entropy that's overtaken my household anymore. Not like I have time or energy to entertain anyway, right?

Apparently, though, mid-life career change is all the rage. I got an invitation to enter a contest at site called Encore, which is apparently skewed toward baby boomers turning their lives inside out as middle age (ugh) threatens. Now, my first inclination was akin to when I get those AARP ads (OMG--those people start trolling when they see you turn 40!); as soon as I saw grey, I winced and closed the tab. In my head, I'm cruising along in my early 20s. I have more in common with my kids (who were born already older than I), and will probably never feel a connection with those people in the AARP flyers. It irks me to see Sean Connery looking paunchy and tired and songs I grew up with appearing as Muzak at the supermarket. After wasting half my life on a lousy marriage, I'm looking for the do-over of that misspent youth, not looking ahead to empathize with incontinence, laxative, and Viagra ads. . . Criminy.

After thinking about it, though, I decided it might be helpful to at least see what they claim to offer. It's not easy to decide to change careers, especially when you're talking about women who've played the thankless role of Mommy for 20+ years (we know that mommies in general make up the vast majority in the pink collar ghetto of medical transcription) and have no clue how to base a résumé on something employers don't respect. According to the site, "Encore.org provides news, resources and connections for individuals and organizations establishing "encore careers" that combine social contribution, personal meaning and financial security. People in their encore careers are helping to improve health care, educate the next generation, protect the environment and much more."

I haven't had time to investigate the site thoroughly, but I do note that they appear to offer educational grants, including one category specifically to provide "grants for innovative community colleges preparing people 50+ for careers in education, health care and social services." "Find your Encore" helps you figure out where to begin thinking about a new career, which might be helpful for those of us without much of a clue beyond, "I really need to make a change. . ." but floundering helplessly beyond that. If the site offers nothing beyond this, it might be worthwhile.

What I find most interesting is that baby boomers (we're talking the generation that helped end segregation and stop a war, remember) seem to be challenging and redefining everything as we go. Granted, our parents didn't have to cope with the same problems we do, but it would have been inconceivable 20 years ago to jettison a career you'd trained for and start fresh. Of course, "back in the day," respect between employer and employee was more of a two-way street than it is now. Perhaps in declaring ourselves unwilling to settle for something that doesn't satisfy our needs for financial security, acknowledgement of our worth, and some sense of purpose beyond the workplace, the paradigm will begin to change for the better.

Send in the Cannibals!

Jeanne Johnston — Thu, 11 Sep 2008 12:43:00 GMT

It's become pretty obvious to me that MT has started eating her young. This is not exactly a new phenomenon, and I've railed for ages against the practices of entities like AAMT and the Crappy Schools that have made a career of marketing themselves for profit's sake, rather than for the betterment of the field of transcription. I think the disease is spreading, though. Everyone seems to want to ensure they get their share of the profits before the whole thing goes belly up.

The school approval process is a dud because AAMT chose to dumb down the criteria to allow more schools to earn it. Better money for them because more are willing to risk the hefty application fee for the process, knowing they stand a good chance of ending up promoted on an equal footing with the giants M-TEC and Andrews, but bad for the hapless newbie who thinks seeing a school in that list means they're all equal and invests all that time, money, and most of all, hope that this will result in a lucrative career. No, those are not the only two schools who can turn out good MTs--but the list is a mishmash, with no way to discern the level at which each school listed managed to qualify for the dubious honor. Like those top two, did they knock it out of the park and set the standard, or did they squeak by with the minimum criteria or even get special dispensation and fail to truly even meet them?

In my humble opinion, a good clue when picking a school is whether it even requires you to take a preadmission test before they accept your money. Those who are truly in it for the right reasons DO, not just for their benefit, but for yours. Do you have the skills necessary for MT? Do you perhaps need to spend some time getting remedial help in keyboard skills or basic English language/grammar first? As there is generally a finite time to complete a course, it's obviously best not to fritter that away trying to get up to speed on spelling, grammar, or learning to type. A legitimate school will test you and let you know that you will want to brush up on specific skills and invite you to return and try again afterwards, if it's obvious you're going to struggle with the material. They're not going to push all your trigger points for a quick sale, but are truly interested in seeing you succeed. If you want to factor greed in there, it reflects poorly on them to have graduates fail because they don't cultivate deals to funnel their grads into further on-the-job training; their grads are simply ready for the workforce and that word of mouth is their bloodline.

On the other hand, a red flag goes up when you see a course willing to accept your money NOW. All that is required is NOT a big enough desire to succeed, no matter how much you want to believe them. Ask yourself if that friendly come-on really indicates a desire to help you support yourself or if it's merely the ka-ching of the cash register they're interested in. You only have to get out your calculator and do some simple math to see why they would be so eager to accept everyone. . . It doesn't matter to them if anyone finishes their course at all or even if those who do manage to get jobs at the end. What matters is that they take in the most money possible with the least given out in return. Say a course costs $1500. Multiply by only 100 starry-eyed hopefuls a month (and man, you know they're snagging far, far more than that) by $1500 and again by 12 months, and you're talking almost a cool $2,000,000 (that's TWO MILLION) a year. Subtract a few homemade workbooks, maybe a dictionary (purchased with a nice bulk discount), a handful of people to answer the phone, run a basic website, and the profits are staggering. Bonus if you slap up a message board and can let the students "teach" themselves. Bigger bonus if you can sucker them further by helping to promote the school for you by letting them call themselves "partners." What's a $50 referral fee when you're doing all the work to bring them another $1500? It's multilevel marketing at its worst.

So you've got AAMT promoting everyone who wants in on their approval process AND anyone else who wants to buy ad space on their website--including schools that could never pass the approval. I'm sure that confuses enough prospective students to make it worthwhile. You've got bogus schools not only promoting themselves, but getting their students to do it for them. We also have more independent-minded folks who have opted to create message boards and website directories--ostensibly to simplify matters for those of us who might be looking for a clue, but in actuality simply following the crowd and looking for their piece of the pie. Just because a school or business is listed in such a place does NOT mean it is legitimate. It simply means that entity was willing to cough up the money to be included. Good or bad? It's apparently every woman for herself to figure that out. Caveat emptor is the law of the land now. By some miracle of osmosis, newbies should apparently "know" who's legitimate. If you're too ignorant and pick a course because it's affordable, you deserve what you get, I guess.

There are plenty of other ways to scam newcomers, starting with those self-described humanitarians who claim to offer undereducated graduates a way around the Catch-22 of experience. Without a proper education, you often aren't even allowed to test for jobs--or if you are, you're not likely to pass. Yet, no one will hire without at least a year or two of experience. What's a new grad to do? Enter the guy who tells you he'll give you that on-the-job experience. Of course, as you'll require massive mentoring and editing help, you're only going to be paid 2 cents per line, but hey--you'll have something to slap on your résumé! Are they filling a necessary function or just capitalizing on slave labor? If the school approval process works, why are there even graduates who NEED this kind of stopgap? Surely, completing an approved course means MTSOs will hire you, right? But wait, you say--there are nationals who hire grads of courses not considered great by the MT community at large, so how bad can those courses be? Again, consider the possible mutual behind-the-scenes back scratching, lower wages, and a need to find warm bodies, none of which reflect a measure of excellence. Beware, also, the MTSOs who have simply created a school as an offshoot. Occasionally, these might be legitimate, though limiting, because other companies might not see that kind of specific grooming as useful on a résumé. Worst-case scenario, it can be a way to simply get their work done for free, again benefiting you nothing but street smarts.

As a tangent, I think this all relates very well to the concept of how working in jammies is viewed as an integral part of MT, for good or bad. Of course, telecommuting and being able to work in ones jammies (heck, even NO jammies) is not necessarily a bad thing. It's not even noteworthy or relevant at all, but what IS bad is that it is specifically a concept being used to market the job to those stay-at-home-mommies who are having such a negative impact on our wages in general. Have jammies and baby? MT is for you! The very schools I gripe about above are the ones marketing specifically to this demographic. They don't care if these women are looking for a real career or just a hobby, they don't care if they even finish their courses or get a job--but in marketing this way, they are bringing in the MT hobbyists in droves and have impacted the legitimacy of MT as a true profession in the worst possible way. I think this has had a far greater impact than even offshoring, though cheap offshore labor and speech recognition are the nails in the coffin.

What is apparently very good for some individuals and companies has just been deadly to the field of transcription in general. I guess what really gripes me is that it's not just US versus THEM anymore. Many of the most egregious abuses, especially of potential and new MTs, are being propagated by people who come from within the field and were once newbies themselves. Forget honor amongst thieves, honor in general apparently means very little in the world today.

Dang. I really didn't expect to go off on another rampage this week. Having passed my terminology course with near-perfection, I should have been crowing! Onward now to pharmacology and pathophysiology, the last hurdle to my cancer registry management course proper. I look forward to the time I can "get off my high horse" (as I was recently described) and turn my back on MT with the rest of the cynics. Somehow, though, between my overdeveloped sense of fairness and vegetarian leanings, I doubt my old MT peers will be on my menu, even when I've managed to leave the field behind.

Be Here Now

Jeanne Johnston — Fri, 05 Sep 2008 07:46:00 GMT

My mom and I, separated by about 1500 miles, have settled into a little email routine wherein we are as content to touch base with such oh-so-non-newsworthy events as trash day, the arrival of the lawn guy, turning on the A/C, opening the house, and occasionally, even the results episode of some lame reality teevee show as we are with actual News. After surviving everything from illnesses, deaths, squirrel attacks, crack whore neighbors, loss of limb, and snarky teenage daughters, we've come to appreciate the mundane as "okay." As in, "Yeah, I really could stand to get a life, but at least nothing happened today." I like to think of it as cultivating those lessons Baba Ram Dass espoused many years ago, appreciating each moment for what it is. The main point is that we've made our obligatory contact and the other person can relax for the day, knowing that nothing untoward has befallen the other. No new IS good news.

This last week has been kind of a string of those not-so-special days. I think the high point was finally hanging up all my orchids and wind chimes that I'd taken down when Hurricane Fay threatened (no sense giving her projectiles to work with), and then the relief of knowing that Gustav--whilst he provided a lot more excitement in a shorter time than she did--wasn't going to make me take them all down again. I'm crossing my fingers that Ike isn't going to totally ruin my September, but for now I'm "being here now," happy to have survived almost another work week and ready for the weekend. Last weekend was a bit on the hectic side and I failed to meet my goal of finishing my course so I could study all week and take my final, but I'm just one chapter shy and may just make it anyway, if I pull a few all-nighters.

Even with my brain either halfway disengaged or at least focused on a ridiculously close horizon and my rationale that Ram Dass would agree with my savoring the moment instead of fretting about what I'm not getting done, I'm fighting a bit of guilt over my Lazy Libra-ness. . . My frenzy to get out of MT is stymied by the fact I do work full time (and on the worst possible shift), and I'm probably fighting old age, as well (that could just be the lingering back problem talking). When I studied to become an MT, being a student was all I had to do, and I was a fiend about it. Knowing what a disservice the femininists of the '70s did when they convinced us we could "have it all," it's still discouraging to experience first hand that you really can't. The only time we will really be able to compete on equal footing with men is the time someone figures out how to give us ALL wives. Until then, we (i.e. mostly women) get to figure out what part of our lives will suffer from neglect to make room to accomplish something more pressing.

I think part of my problem is that I have quite a few friends who are also scrambling to leave MT, and they've either chosen areas that require much less work to slip into or they're just infinitely better-organized than I am. I have one on the verge of being hired to become a police dispatcher (wow--what a great way to utilize those MT's ears!), another becoming a virtual real estate mogul (money aside, at least this one doesn't appeal to me), and another big MTSO who seems to do more world traveling now than ever before (some people just live right, I guess). The one who makes me feel most inadequate, however, is the Energizer Bunny of the group--not just a mother of two kids under five, but also running an online cross stitch business AND writing a novel (or six) in her "spare" time. But it gets worse. Failing to find a publisher who knew what to do with a genre like Mormon bodice-rippers, she's started her own publishing company. (I suspect the spectacle of Good Girls Behaving Badly will have a much larger audience than the mainstream publishing world grasps, so let me crow right now that "I knew her back in the day," before she starts making the talk show circuit and becomes famous without me.) The woman just started tearing into about 10,000 pages of editor's notes--we're talking a hands-on thinker with scissors and scotch tape here, folks, no crazy modern conveniences like computers--and I suspect she will meet her self-imposed timeframe and get it on the shelves this fall as planned. And her kids will still have clean clothes, her house will be neat, she'll still be churning out as many transcription lines as I do, and even her yard will be ready for winter. At least she has a husband who doesn't have to be hit over the head to pick up a dish towel.

So yeah, I've tripped over a little something this week in that woodsy path through my head and am feeling, if not discouraged, a little inadequate. At least I can take solace in the fact that at least nothing happened this week. Here's hoping when it does, it will involve a bright, shiny A on my terminology course and heading into my final prerequisite class.

Live and Learn

Jeanne Johnston — Thu, 28 Aug 2008 14:41:00 GMT

I think I blame Hurricane Fay--the dumb storm that, instead of plowing into Florida and falling apart once it hit land like a normal storm, pooped along in its own leisurely way and simply dropped a couple feet of water on us over the course of last week--for souring my mood much in the same way she soured my laundry. . . which I was forced to hang in the garage because I couldn't string together even an hour of sunshine to attempt the clothesline.

Whether in my head or out loud, I think I had may have vowed to simply ignore the deluded folks at AAMT, but for some reason I tripped across another ridiculous episode from Modesto last week, and a rant was inevitable. This week, they've actually countered with Part II, in which they outline their plan to up the ante for people wanting to become MTs, requiring at least an Associate's degree by the year 2016. . . totally oblivious to the reality that no one is going to want to spring for additional college tuition for a job where you can't even bring home minimum wage because everyone's now paying us in rupees to become editors for speech recognition engines. Additional obstacles to attract new people to a field that's falling apart? Clearly, the disconnect from reality is growing. . .

But now I don't feel so much like chortling.

It's therapeutic for MTs to commiserate over everything from mush-mouthed dictators to lousy wages to the state of the field in general. It's also really important to educate potential students so that they can at least go into the field with their eyes wide open and able to make the best choices to maximize their success. . . but I overlooked the third part of the equation--students who are already committed, especially to sub par "schools."

I don't intend to be a downer, honest. I'm simply compulsive at times about speaking honestly--especially on topics where information is scarce or there's a lot of MISinformation out there *coughschoolapprovalprogramcough* to trip you up. My compulsions stem from the fact that there was even less information when I started and I feel like I might be saving someone--anyone--from making the same mistakes if I blather on about what I've learned in the school of hard knocks.

So. . . having knocked the blinders or rose-colored glasses off some now-discouraged students, how can I make it better? Honestly, I don't know if there's a good answer. If you failed to do your research before plunking down your tuition and now think you've been suckered, do you hike up the blinders, cover your ears, and repeat that mantra from Stepford promising that if you only want it enough and work hard enough, you WILL be one of the ones who make it? Alas, you can't learn what they don't teach--or if they teach you wrong--and once that doubt takes hold, it sets you up to feel inadequate no matter how many superlatives that school slaps on your certificate at the end. Do you attempt to get your tuition back and start over? Sadly again, poor schools generally give you a very short time to bail out before keeping your money. For me, the question would be whether to finish anyway and move immediately to a better course or just walk away from my initial investment and get on with it--and I honestly couldn't justify learning bad information just to get my "money's worth." I would cut and run to the best course out there.

Well, except that I'm essentially running to a whole 'nuther healthcare field altogether.

I suppose I shouldn't feel too guilty for raining on someone's parade because I'm not doing it from a lofty spot, but from a position of empathy. I am pretty much turning my back on my own initial investment and starting over from scratch, too. In my case, though, I consider that investment has at least taught me some lessons to build on and make more educated choices from this point forward. The further I get into my current studies, the more lacking I realize my original education was. The courses I've had so far have not only been an eye-opener, but have enhanced my current skill set immensely--and have also shown me dozens of related jobs I might have considered if I'd only had a clue way back when. If I had it to do over again, I surely would not have chosen the same school. Rather than curl up into a fetal position and nurture an ulcer over wasting that money, though, I guess I just consider it an introductory course to healthcare. It got my feet wet and set me on a path to something much better.

It's like anything else in life--you have lows to help you appreciate the good parts. Besides, it's not like you can change past events, so why dwell on them? Sometimes Fay comes along and sours your wash and you just have to get a little creative, start over, and maybe invest in a trip to the laundromat to tide you over until the next sunny day.

What, me perky?

Jeanne Johnston — Thu, 10 Jul 2008 16:15:00 GMT

What a difference a week makes. Yes, the fates have flung me from negativity to contentment in just a handful of days. I don’t know whether to blame (or thank) the stars or the fact I’ve left the dreaded Computers in Healthcare course behind me, but I’m having a hard time getting my knickers in a twist over anything this week. This is about as close as I ever care to come to channeling that perky cheerleader type I always hated in school (minus the raspy voice), or perhaps even Carol Smillie, the BBC’s human equivalent to Prozac.

What’s my problem? I’m a blissful three chapters and one test into something I enjoy--word games. Latin, Greek, plain old English--doesn’t matter. It’s on to Medical Terminology and it could just as easily be Tetris for all the time I can spend on it. I think besides having a more interesting subject matter than Office 2003, the textbook is just excellent. It’s organized nicely, breaks things up with frequent exercises, and kudos to Elsevier for thinking clearly enough to counteract the sheer weight of the thing by putting it in a spiral-bound format. I was going to keep the thing pristine for resale and write all my answers in a separate notebook, but quickly heeded that voice in my head (which sounded an awful lot like Cybill Shepherd, telling me, "I’m worth it!") and decided to simplify my life, indulge myself, and just use the thing up. The book is even printed on good enough stock that you can erase cleanly and highlighter doesn’t bleed through to the other side. Add in the fact that it comes with a CD ridiculously full of silly little Flash games to help reinforce the material and it’s even better.

As I’ve admitted before, I’ve been through a Crappy School for medical transcription and have spent the ensuing years supplementing my studies to make up for it. I had pretty much aced the terminology module at that time and I live with this stuff in my job for what seems like a majority of my waking hours, so it should be easy. Though it is almost entirely review for me at this point, it’s still an ego boost to do well. Despite my supposed expertise at this point, by golly, I am learning some new things and it’s presented in a way that clearly shows how the words relate to the actual job. Many exercises are presented as medical records which you scour for answers and there are quite a few sidebars elaborating on various healthcare careers that make use of what’s being taught--definitely a lot more options than had ever occurred to me. Whether you’re looking for remedial work to supplement your own Crappy School experience or starting fresh, this is an excellent text. I can’t recall the last time I was even impressed with a textbook, and I’ve already reaped some benefits on the job just because the terminology is that much more concrete in my head.

Of course, give me a couple weeks and my neat handwriting and crisp corners may be a thing of the past, but I suspect my enjoyment will last through the final exam. With any luck, I’ll be so high on life at that point that I’ll be able to catapult a good way into my final prerequisite (pharmacology and pathophysiology) without getting bogged down. For now, "perky" is not such a bad place to be!

Tunnelvision

Jeanne Johnston — Thu, 03 Jul 2008 16:37:00 GMT

As the transcriptionist is the little guy who seems to be the first target in a hospital’s budget crunch or in an MTSO’s grasp for even greater profits, it’s hard not to get rather myopic and feel like THE target these days. Every once in a while, though, I get a reminder that it’s not just MTs who are facing big, bad changes these days. Case in point is my monthly fix from Placebo Journal, which is pretty much where good doctors go to get snarky about the state of medicine from their perspective, vent some frustrations, get silly, and I assume manage to stay sane another month. Now, transcribing four dozen reports or so a night, you get a good feeling for what they have to put up with. Yes, there's always a handful of docs who give you the feeling they’re a few years overdue for retirement, but the vast majority sound like they care.

At least, they must or they wouldn’t be able to muster such a dispassionate tone when so many of their patients seem to be noncompliant frequent flyers, and the vast majority are in the hospital almost assuredly because they refuse to do as they’re told. I'm not sure I'd have the patience to calmly repeat 20 times a day, “Quit drinking. Quit smoking. Lose weight. Take your medicines as prescribed. Use a condom. Don’t put things in there.” You just know that drunk is going to be back in two weeks needing a belly tap, the diabetic is going to lose a foot, the woman with asthma is going to be back on the ventilator because she won’t give up her cigs, and 20 people are going to trail in for pregnancy tests or penicillin in any given night because they’re just idjuts. That doctors can even have a sense of humor is amazing. I suppose that’s where the last guy comes in--the one who seems to have a knack for sleepwalking, slipping, and landing just so, so that assorted household items miraculously lodge themselves in his colon. . . every couple months.

Yeah, it’s a little hard to sympathize, knowing they make 1000 times more than we do, but consider how they earn it. Being a doctor is not about Medicine anymore. It’s about business. It’s about squeezing in 20 patients a day to keep your practice afloat. It’s about battling insurance companies to get services paid for in this lifetime (if at all). It’s about cookbook medicine--following strict protocols for every condition so that your hospital will be less likely to be sued when someone dies. It’s about Big Pharma controlling the drug supply (did you know they’re now trying to get OTC nutritional supplements outlawed so they can market them as brand items?) and their pushy pharmaceutical sales reps--which, thanks to the miracle of television, now includes thousands of gullible patients, eager to do the job for them for free.

You just know that most patients don’t get it. The proof of this lies in the response to a recent Reader’s Digest article, 41 Secrets Your Doctor Would Never Share, wherein two dozen doctors honestly shared their frustrations, regrets, disenchantment, and advice on how to be a better patient--and far from being grateful for the eye opener, many readers responded in a huff. It’s a shame, because there’s a lot of wisdom behind the statements shared.

In the old days, I resented the pedestal most doctors seemed to place themselves on, as though they were the wise, fatherly figures and we were children who should simply do as we were told, without question. Whilst I think it’s great that we now have a world of information at our fingertips and can now have a more educated say in our medical treatment, I think we’ve lost something important in the process. The masses are deciding that those years of study and hard work don’t count for much. Insurance companies are trying to dictate treatment. New technology means you have to churn more patients through, even though you don’t have time enough for meaningful interactions as it is. Malpractice involves more greed than legitimate complaints. I think there’s a good reason doctors commit suicide, nurture addictions, and probably divorce in far greater numbers than the general public. MTs certainly have earned the lifetime Rodney Dangerfield “I don’t get no respect” Award (acknowledging that there's a passel of clerks, coders, billers, and even nurses as close runners-up), but I don’t see the practice of medicine maintaining its appeal as a career choice, either, given that do-gooders are beaten down by the system and the guys in it just for the money would have an easier time becoming lawyers.

Of course, my sympathy will fly out the window next time Dr. Jones forces me to sit idly (I don’t make money if I’m not typing!) whilst he’s on another line for 20 minutes trying to cajole a salesman into giving a discount on his new Cessna, or Dr. Brown zips another young mother off for his routine, time-saving C-section. It is a good exercise to remove my blinders once in a while and think beyond myself, though--and in looking even further out there, I get the feeling that our problems aren’t even unique to the world of medicine. The business climate these days has generated a lot of negativity across social strata, and I think things are going to get worse before something revolutionary happens to change it.

So I don’t end on such a dismal note, I will veer off to my happy spot, wherein I finally meshed with my proctor and completed my Computers in Healthcare final last weekend. I’m in no way happy with the substance of the course (filler, fluff, and material cancer registry students couldn’t even access--yet were tested on), but it’s one more prerequisite behind me. I am once more gleefully cracking open a new text with fresh highlighters and enthusiasm, in the hopes that Medical Terminology gets me back on track. I work with these words every day--surely, this will be an easier credit, right?

Next time: Famous Last Words.

Is that all there is?

Jeanne Johnston — Thu, 19 Jun 2008 15:51:00 GMT

Yes, I’m still studying for my Computers in Healthcare final, so nothing exciting (or dire) to report there--but I have been cogitating about the course in general and I’m curious to know if others have had the same, better, or worse experiences with this standard prerequisite for most healthcare courses. There are a couple alternate "schools" I had considered and I guess I'm just curious to know if anyone had a better experience in theirs. I do recall my son grousing about having to take a basic computer course to begin his degree (in digital media, at a school dedicated to computer brainiacs!), so perhaps this is just a cross we all must bear.

In a long preamble to the actual course, AHIMA informs us that since the class is taken by students in more than one course, “some” of the online coursework will be inaccessible to students in the cancer registry course and “some” of the test questions will pertain to these areas. Never fear, however--it won’t be many and it should still be quite easy to pass anyway. Mkay, that sounds a little odd, but I’m a sucker for a good reassurance, so plowed ahead.

In actuality, however, MANY of the sections had nothing whatsoever to do with the cancer registry side of the coin and HUGE numbers of questions pertained to this hidden wealth of knowledge. The coding students are apparently required to become members of AHIMA and thus, have access to the message boards and library that many of the lessons came from. Granted, in the final portion of the course pertaining to HIPAA and information security, many of these articles were reprinted so the rest of us had access, but in assessing the entire course I would say that almost three-fourths actually was irrelevant to cancer registry. Yes, it’s interesting to see how coding software works and no, I had no idea there were virtual shelves of dusty literature stockpiled in the AHIMA vaults, but really, what does all that have to do with the rest of us? And what the heck? The first module (one-fourth of the class) was spent getting us familiar with the message boards and online course format and how to navigate and post. That’s something that should be given as a free FAQ for anyone considering enrolling, not fleshing out a skimpy course! The way the online courses are presented, I know darned well most people probably have already taken the anatomy course and are also surprised that this information was not available beforehand.

I would humbly suggest that this course would better serve us--remembering that we’ve paid a hefty sum and want our money’s worth--by offering separate versions of the class to mesh with the specific courses of study it’s being required for. Utilize the modules with the word processing and database introductions and (yawn) security for everyone, but substitute more appropriate modules for the rest. It would be a lot more useful to know what software looks like for tumor registrars (yes, I know it’s probably similar--but not specific) and something else for the behind-the-scenes mumbo jumbo. Why not require us to become members of NCRA and walk us by the hand behind the scenes there to give us a leg up on mentors and resources? And fer cryin’ out loud. . . test us on things we really need to know. Half that stuff was from lessons I was instructed to skip over because they weren’t pertinent to my course of study and I simply had to guess at the answers. That just grates against my overdeveloped sense of what’s fair.

I dunno. It was just. . . lightweight. I suspect the course is also a prerequisite for other HIM courses and those students are even more bummed at what they need to learn. It would be far more valuable to have lessons more in depth about working with data in ways that we may actually encounter on the job. Biggest shock of all, perhaps, was that the actual hands-on part of the class involved Office 2003! That's amazingly outdated, as software goes. . .

Maybe I wouldn’t be such a whiner if the course was priced half as much as the others or if I hadn’t gone nuts last week researching software to better do my exercises (which actually proved totally unnecessary as they never went back to them!) *sigh* Well, I’ll just do my best to blow through the final and get back into the fun stuff.

As for my exercise in geekhood last week (LOL--as I know probably two people care), I did indeed install Leopard and with the new OS, Bento. I don’t see the latter as being quite powerful enough for serious database use in the big business world of brown-shoed squares (their FileMaker Pro is made for that), but WOW--it’s a blast! It takes those boring old tables of information and slaps a ton of Mac-style eye candy over it. My address book and calendar never looked so appealing and I’m going to be in danger of ruining my reputation as the black sheep of the family who can never manage a birthday card on time. I must have Virgo looming around my sign because I’m suddenly fantasizing about what I can catalogue next--recipes? books? movies? music? maybe a household inventory, complete with photos, or perhaps I'll finally organize and unload my stack of unused text and reference books I keep threatening to eBay!

Happily, though this computer course was not centered around the platform or applications I prefer, I can say that I am taking away some new knowledge that I’ll be able to apply everywhere. I just wish there was more of it.

Channeling Walter Mossberg

Jeanne Johnston — Thu, 12 Jun 2008 16:32:00 GMT

Still struggling to find a way to make my coursework doable on my Mac with the least contortions possible, I’ve spent the last week indulging my inner geek and trying on different software for size, and I have to say I’m enjoying it immensely.

My Computers In Healthcare course has presented more than a few challenges, not the least of which is that the text is written around things like Word 2003--absolutely ancient, in software terms. Granted, they mention frequently that students are not required to own M$ products and we can do the exercises using open source apps like OpenOffice (or any of its permutations--available for every platform out there). Now, last week I had slogged through all the chapters from Word to Access to Excel to Powerpoint, using my favorite of these, NeoOffice. This is basically a clone of OOo, except that it runs as its own application (OOo actually utilizes X11 and runs through UNIX, which can get a little tricky if you get confused by seeing that command line business.) It looks like the M$ Office applications. . . but as I discovered, there are occasional bugs in that a crucial button or function is missing here and there (hello, no one at OOo thought we might like to delete a record from a database?) I got through the exercises okay, but I knew it had been harder than it should have been.

I’m not sure why it took me until afterward to hit upon the idea of using the Mac counterparts I already had and simply saving them as Office-friendly formats. Rummaged around my hard drive and tried out my old iWork applications--which are so completely wonderful in comparison, it isn’t funny. Keynote versus Powerpoint is like comparing satellite HDTV to that 13” B&W set with rabbit ears that barely got four channels. It’s slick, it’s easy, it packs so much stuff in there that my mother (who didn’t do Ziploc bags until they came out with the ones with a zipper) could grope around it and look like a professional in the end. Likewise, Pages is Word to the nth degree--not just a WP app, but complete enough to do desktop publishing. Except. . . dang--Numbers is simply a spreadsheet app and I needed to be able to work with a relational database. It compares to Excel, but there was no way I could substitute that for Access. . .

So I flitted around the internet a bit and found the solution is Bento (lovers of Japanese cuisine will appreciate how cute and clever that name is), which is not just a database app from the makers of the old fave Filemaker Pro, but may be The Ultimate Database app. It syncs everything you’ve got into one place so your calendar, address book, iTunes library, iPhone/iPod, projects, event planning, and anything else you want to throw at it is in one cool spot. No fumbling around with formulas, queries, and awkward menus like I just learned in Excel--this is gorgeous, effortless, and powerful. Of course, I’m only able to vouch for that because I have no life and spent a morning watching all the tutorials. . . As I never got around to upgrading my OS from Tiger, I can’t even run the trial version yet. I had to throw some money at Apple and am awaiting my new Leopard installer this week so I can try it, but I have no doubt I’ll be paying to keep Bento around, even if I never use it for work.

In the meantime, however, how do I deal with this coursework? Well, much as I am loathe to install anything M$ on my computer, I decided just to bite the bullet and get the trial of Office 2008 and see if that didn’t make me see my homework in a little different light. Harumf--what a difference 5 years makes! It’s still a fairly ugly bunch of applications, but it’s nowhere near as basic as 2003. You can call up windows for tools, rather than just the mishmash of icons on the toolbar at the top of your window. You still have to run queries as a separate function, rather than filtering within the spreadsheet as you can do in the Mac apps (where you simply hold down a cell to bring up a menu), but it seems a little less clunky than what I’ve been working with. The jury is still out until I have time to go back and re-do all my exercises for comparison. In the end, however, I don’t see this as worth the price tag of over $300 because they chose not to include the most important part of the suite: Access! What the heck? In the end, it’s going to be cheaper to stick with my Mac apps and cough up another $70 for Bento, which I’ll use for everything IRL anyway, or continue plugging away with OpenOffice (FREE). Office 2008 without the database application is insane. I'm just glad I didn't buy the suite outright and then find it isn't complete!

I don’t know who decided that business applications needed to be ugly, boring, and soulless because keeping things cutting edge certainly makes the job easier to focus on, easier to impress people, and just more fun. If you're going to go utilitarian, it does make sense to use open source applications; I've encountered some pretty slick ones currently in use as ER and other hospital platforms, like Synapse EMR, which I believe was originally written by a doctor. The beauty of open source apps is that no one profits from their sale, only from providing support (ask Linux!), which means actual users can have a hand at developing products to maximize their usefulness, rather than software vendors who simply throw things together and make a fortune by endlessly correcting their problems. As a former accounting major, I do have a strange joy at plunking numbers into neat little boxes, but in the end, I really thrive on a 3D, Technicolor world. I don’t think I’m unique in that. Of course, in the end I’m going to wind up in a job that most likely will use the ugly, utilitarian, 2-dimensional applications because that’s what they do. I really have had a blast geeking out this week and playing with all the possibilities, though.

Life is just a B movie

Jeanne Johnston — Thu, 05 Jun 2008 13:51:00 GMT

Memory can be a fickle thing--or perhaps it's just the way my particular brain works. I apparently have a knack for picking out minutiae from any situation and applying it to myself. In fact, it often seems to be deliberately set in my path because it's something I need to learn. Case in point: An old song from the early '80s done by poet Gil Scott Heron, called B Movie. Now, I remembered this was political, from the Reagan era, but I didn't remember that it was seriously political the whole way (actually, a very relevant rap even today). What I took from it was one of those life-changing ideas that I actually have a hard time even finding in the spiel now--that life is like a movie script and we're just extras. (Hey, maybe I'm mixing Shakespeare in there!) You don't like the way your story is written? As the author, you have no one to blame but yourself. You cast costars you don't care for, a role or lines you don't like? Then change them!

This has occasionally been a touchstone for me. It took some years to work up my gumption, but I eventually rewrote my script to train for a new career (maybe I should make that "career," now I've found it's really just a job. . .), jettison a lousy marriage, and now to begin to recreate myself and perhaps recapture those lost years and get a do-over. When I became dissatisfied with the direction MT has taken and the feeling that the job security and my ability to support myself with it are crumbling away, I once again hearkened back to that concept and researched where I might take my skills again, to continue my story to the happy ending I desire--that I deserve, even!

I know I've been very vocal about the state of affairs in transcription, the fact that MTs have been badly served by the organization that was supposed to represent us, and you can't go anywhere online in MTville without running smack-dab into people even more angry and frustrated than I am. It is often jokingly said that the reason MTs never succeeded in unionizing is that they're too independent. You get more than a handful in one place and it's like herding cats--i.e. you just can't do it. It's an exercise in futility. At this stage of the game, it's not even worth attempting.

What remains when MTs as a group cannot change our future? We need to do what we've always done--look out for our own interests. Whining, complaining, and threatening to revolt do no good. At a time when veteran MTs are valued at the same substandard wages as rank beginners, employers can just laugh and invite us to be quick about our exit, if that's our wish, because there are misguided people eager to start at any wage to take our place, and clients are quickly learning to accept any quality as long as someone promises a quick turnaround time, so experience isn't even much of a bargaining chip anymore. Hardly a week goes by that I don't see some nitwit declaring they'd be glad to work for FREE, if it would help them get a foot in the door. (Thanks for helping to tamp those wages down, people. . .) So what to do? I know quite a few MTs--many of them veteran and highly respected small service owners themselves--who have stopped to look around, have seen the futility, and are making plans for another chapter in their own lives.

Rather than stand around with fists clenched, a lump in our throats, and a rising panic in our guts, maybe it's time for everyone to take stock of where they stand and where they want to be, whether next year or ten years down the line. Perhaps you're an MT who doesn't mind the spiraling wages or crush to move the work to speech recognition editing. Many of the SAHMs who were lured into MT aren't looking to support their families and just want to make enough for extras, so maybe the crap wages aren't an issue. Otherwise, perhaps there's something healthcare-related that would utilize your MT skills, or perhaps you have a yearning to get into something else altogether or build a hobby that you love into your next career. Surely, there's something that would cast you into a happier role, a starring role, rather than a bit player with the crappy lines.

Change is scary, but it can be revitalizing--and it beats the heck out of sitting there frozen like a deer in the headlights as the future bears down on you.

They always say time changes things, but you actually have to change them yourself. - Andy Warhol