Passage : Medical Transcription

You Know You've Worked the Night Shift Too Long When. . .

Jeanne Johnston — Wed, 29 Jul 2009 14:05:00 GMT

Years ago, when my grandma was getting on in years and her housekeeping wasn't what it used to be, my mom drug me over there to spend the day really cleaning house for her. Actually, this may have been triggered by the infamous strawberries with baked...(read more)

A Matter of Perspective

Jeanne Johnston — Thu, 16 Jul 2009 23:18:00 GMT

I love to toss off the headset and get a change of scenery, and find myself occasionally rummaging around other Advance boards to see what's up (did you even notice they've got like 243 magazines skewed toward different areas in health care?) Lately,...(read more)

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)

Call Me WAHMmy

Jeanne Johnston — Thu, 02 Jul 2009 13:23:00 GMT

I remember back when my daughter was born, getting a card that gave me permission to let my regular work go to seed because there was a new baby in the house--not that I really care what anyone thinks of that dust bunny collection behind the toilet anyway,...(read more)

MT as the Economic Canary

Jeanne Johnston — Fri, 19 Jun 2009 16:42:00 GMT

I suppose there is no real mystery in why I almost killed my computer. After a painful $300 for a new power supply, I vowed to mend my ways and not leave the poor dear up and running endlessly--yet here it hums since I got it back home. The fact that...(read more)

May I Mambo Dogface to the Banana Patch?

Jeanne Johnston — Tue, 09 Jun 2009 18:53:00 GMT

That line from Steve Martin's book, Cruel Shoes --where he thought it would be clever, if he ever had a child, to teach him the wrong words to everything so that when he went to school, no one would understand what he was talking about--used to be hysterical...(read more)

Fan Mail From Some Flounder

Jeanne Johnston — Tue, 19 May 2009 12:31:00 GMT

I am beat. Spent the last week being thrown into the deep end of the pool without swimming lessons (well, I had them, but that was almost 10 months ago and I forgot most of it) and am just now feeling like I'm starting to learn how to float again. I used...(read more)

Why Plan Ahead When You Can Panic Now?

Jeanne Johnston — Tue, 05 May 2009 12:34:00 GMT

Some of us in the medical field (especially transcriptionists, I think) are in a unique position to observe certain trends in society. If you work a clinic account, your work has definite seasons, even if you don't: Fall brings school physicals and general...(read more)

A Question of Style

Jeanne Johnston — Thu, 23 Apr 2009 15:53:00 GMT

When it comes to language, there are accepted formulae for how things work--not just the actual words used, but specifics as to punctuation, grammar, etc. They used to teach that in school, right? In the workplace, the rules are supposed to be more formal....(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)

Tempus Does Fairly Fugit

Jeanne Johnston — Thu, 09 Apr 2009 17:38:00 GMT

It's apparently time to go shopping for walkers because the unthinkable has happened. I have apparently jumped a generation gap. Amazingly, it's already been a year since Doctor Appreciation Day (never fear--they're as neglected on their day as MTs are...(read more)

Can You Afford to Trade Your House Payment for a Political Statement?

Jeanne Johnston — Thu, 12 Mar 2009 16:37:00 GMT

I love the internet, but it does bring out the worst in some people. . . Whilst it is wildly liberating to people with limited ability to make connections in real life, the polar opposite is that it enables some real narcissists to run amok, as well....(read more)

Speech Wreck

Jeanne Johnston — Wed, 04 Mar 2009 14:04:00 GMT

I hate the term, and I find it intensely annoying that not only MTs are using this as a pet name for that silly, old speech recognition now making our lives miserable, but even employers are sending out "humorous" emails with today's funny from the engine that will not learn. Except for recent grads who went straight into SR editing and don't have a clue how big a step down it is from straight transcription or the full ramifications of it on our perceived value in the workplace, I don't know any MTs who are happy with it. After years of typing on a normal QWERTY or Dvorak keyboard, SR utilizes an awkward set of key commands, resulting in a whole new generation of occupational injuries. All those normals you've spent years creating in Shorthand, Instant Text, or other expander? Sorry, you're not supposed to just plug them in when SR makes mincemeat of what's actually dictated because unless you fix each mistake it makes individually, the poor thing can't learn from its mistakes and you will make it take longer to replace you.

Honestly, the only ones I've heard rave about SR are the crap sales people who foist it off on unsuspecting clients and the management of those greedy and gullible companies who are desperate to whip up some enthusiasm amongst their employees, who are now faced with the choice of working twice as hard for half the pay or not working at all. They seem unwilling to accept that this isn't equitable and is lousy for morale. There are incredible numbers of veteran MTs who are now crying because they are seeing their paychecks fall precipitously because there's no way to double production to make up for half the wages. MTs are finding there are fewer and fewer straight transcription jobs to go to, the ones out there are not paying any more for experience than for new grads, and many who have supported themselves adequately for years are now facing bankruptcy and foreclosure as a result. Hardly a joking matter.

Thanks to a friend who suffers as bad an internet addiction as I do, I was linked to a brilliant illustration of this on a message board I don't normally frequent. I've tried in vain to contact the author, who apparently (and justifiably) feels the need to remain anonymous, but perhaps when she leaves her position (retiring to clean toilets or something more lucrative, I wager), she'll put in an appearance and accept the kudos she so richly deserves. I predict this could be one of those things that appears for years to come in email forwards and MT message boards. It is just that good. If MTSOs are smart, they will take this as more than a harmless joke because, though it is funny on the surface, the message is anything but.

As an empty with plenty years experience comma eye was vary this dress to learn that I will shortly be demoted from an empty to a VR quote editor unquote making far less money than my training and years of experience deserve period you are comma node out comma counting on technology to eventually fix the bugs in yore VR soft wear period mean while comma you are ????? a viable resource period sum of us wood much rather retire than see our tail ends miss used by working as VR editors period to whom will you turn when this VR idea fails to pan out question mark period paragraph person alley what I have all ways enjoyed a bout transcription work is the actual typing comma the rhythm and flow comma inserting a punk situation mark here comma subtly colorectal sin tax there comma and turning a complete mismatch of a dictation in to a real double report period lets face it comma many doctors are complete idiots period the dictate the rung medications comma or the rite medications at potentially fetal doe sages period they mambo comma wrestle peppers comma talk to colleges comma eat comma bleach into the phone and make other bodily noises while they dictate period even naive English beakers often do not have the first idea of proper sentence structure or grammar period yet comma you expect olive us to clean up a VR mess for half the money we are making now question mark we think not explanation point paragraph so cut costs as you wish comma in one or 2 years when VR comes to our accounts parenthesis or before parenthesis we will have found something else to do comma and the profess shun will be pourer for the lost of all of us period have a nice stay explanation point

For those of you who aren't skilled transcriptionists (or are merely overwrought from dealing with this garbage on the job and are getting woozy at the prospect of having to waste your personal time on it, as well), here's the translation:

As an MT with 20 years’ experience, I was very distressed to learn that I will shortly be demoted from an MT to a VR “editor” making far less money than my training and years of experience deserve. You are, no doubt, counting on technology to eventually fix the bugs in your VR software. Meanwhile, you are jeopardizing a valuable resource. Some of us would much rather retire than see our talents misused by working as VR editors. To whom will you turn when this VR idea fails to pan out? Many of us believe it is time to retire or find another line of work.

Personally, what I have always enjoyed about transcription work is the actual typing, the rhythm and flow, inserting a punctuation mark here, subtly correcting syntax there, and turning a complete mishmash of a dictation into a readable report. Let’s face it, many doctors are complete idiots. They dictate the wrong medications, or the right ones at potentially fatal doses. They mumble, rustle papers, talk to colleagues, eat, belch into the phone and make other bodily noises while they dictate. Even native English speakers often do not have the first idea of proper sentence structure or grammar. Yet, you expect all of us to clean up a VR mess for half the money we are making now? We think not!

So, cut costs as you wish, in 1 or 2 years when VR comes to our accounts (or before) we will have found something else to do, and the profession will be poorer for the loss of all of us. Have a nice day!

To "so disappointed," the author of this masterpiece, I doff my hat to you. To the rest of the MTs out there who aren't at all happy at the prospect of being assimilated by this Borg, I'm afraid I don't see a solution because no one's ever bothered to ask for our input on the front end of this abomination. When clients start tearing their hair out and screaming about the sorry de-evolution of the medical record, we'll at least be able to say, "I told you so."

Where Have All the Nurses Gone?

Jeanne Johnston — Thu, 19 Feb 2009 13:31:00 GMT

I know I whine a lot about MTs being the first and hardest-hit casualties in a budget crunch (and I wasn't even around with you vets who were relegated to the supply room downstairs next to the morgue because MTs have always been so highly respected), but obviously, that's my reality and it's hard to see beyond your world when you're struggling to simply survive. With all the talk of the economic stimulus package and how much of an impact it will really have on real people, you pretty much have to poke your head up and see how everyone else is doing. End result is that I've had a little wake-up call this week to give me even more to feel pessimistic about.

Those of you who decry the bastardization of what was supposed to be our representative (AAMT is long dead--it's every MT for herself) and advocate channeling our indignation into organizing a union are, in my humble opinion, dreamers. Cats lend themselves to herding better than MTs, and with most of us working harder than ever for less money than ever, there's not a lot of incentive to volunteer our precious time to any extracurricular activities. We are long past the point of no return. The ship has sailed. MT is fading fast and it's all about automation, baby. Yadayadayada and so forth.

What has reinforced my rosy outlook, you ask? If I have to pick one thing, it might be this message board thread. I can't even distill it into a pithy Reader's Digest version, so I hope you do go and read at least the first post. The gist is that MTs may have simply served as the canary, dying in the mines to warn the rest of the healthcare system that something Bad is swooping in. Obviously, executive bonuses are as big a problem in our world as they are on Wall Street, but I was naïve enough to believe that nurses--people with a strong union, fer cryin' out loud--were probably safe from all this. Apparently, nothing could be further from the truth. Nurses are hurting. Budgets are shrinking, nursing staff is dwindling, nurse-to-patient ratios are growing, and they are leaving the field in droves--if not bailing out of the acute care scene for an easier life in private practice, simply leaving nursing altogether. One poster here claims 50% of nurses have left already (sorry, I'm too pressed for time to research that figure, but it's not hard to believe). These are people who are crucial to the system--the backbone, if you will. Anyone who's ever been in the hospital knows you're lucky to see a doctor for three minutes a day; it's the nurses who do the work, which means everything from monitoring vital signs to scrubbing Granddad's butt when he's been incontinent to simply connecting with an anxious patient as a human being. I thank a nurse for my son's life, because she recognized he was septic when no one else did. The fact that nurses even need a union to fight for their due is obscene.

Heck, when someone asks my opinion for a field to get into, I've always recommended nursing. I've nudged my own daughter that way. It's a field that should always be secure, right? It pays well, especially in comparison to other jobs these days. It comes with great benefits and perks. It's got to be a soul-satisfying job--you're not selling someone junk they don't need, you're providing something society really needs and values, right? It's something that can't be outsourced (oops--not so fast there. . . imported nurses are gaining a huge foothold in hospitals in some markets) and it's a job that you can do anywhere in the country, yes? In our area, nurses are so desperately needed that the local public hospital is helping to pay your way through vo-tech, getting you into a job after only three months' training so you can earn as you learn, and even buying up property around the hospital to provide affordable housing to its employees. Great deal, huh?

It seems I have to rethink that now. I've seen how hospitals are breaking under the weight of uninsured patients using the ERs as their only source of primary care. Indigent care has been the demise of many hospitals already, leaving large communities with no public hospital at all. Well-insured patients get the lowest negotiated rates, indigents get totally free care, and the rest of us who either have to pay cash or find our so-called health insurance covers next to nothing are charged the highest rates of all, to take up the slack. (Honestly, what use is insurance that has a $6000 deductible and cap of $80K when a single catastrophic injury can add up to twice that amount?) Doctors, like nurses, are sick of the rigamarole and cookbook medicine they're forced to practice in hospitals (honestly, if there's a strict protocol for every condition, why don't they just use that tech support in India since they love those savings?) and are retreating to private practice. And now, I see that nurses are just as abused as everyone else.

When the foundation of our healthcare system is breaking down, it's time for someone to just scrap the whole system and start over. When you do the research, you see that every other developed country in the world values its people enough to treat health care as a right, not a privilege. Even not-so-swift countries (Cuba anyone?) provide better, cheaper care to every citizen. What is wrong with this system is that we are sheep. Too many people believe the nonsense that universal healthcare = socialism and the end of society as we know it. I bet dollars to doughnuts that sentiment has been fostered by the people who stand to lose the most if we get it: Big Pharma and the insurance industry.

Other countries are run by governments that are afraid of their citizens. When those people are not happy, they protest. Where all of France stages a walkout, government listens. In the US, however, we've lost our rebellious nature. Maybe we've just allowed ourselves to be distracted with celebrity gossip and reality teevee. We have become complacent and afraid of our government. Sure, we can rally a bit of support to "Throw the bums out!" at election time, but I don't see the level of outrage necessary to demand the kind of representation we pay for. We need to become outraged, proactive, and ready to make some demands of our own. There are bankers who have burned through millions of dollars in bailout money, haven't changed the way they do business, and are demanding more. In the meantime, 95% of the country is suffering, including the people we rely on for our most basic needs.

I am just astounded that nursing in particular--and all of health care in general--are not even safe from what's happening. It's not just about MTs anymore, and woe to us all if someone doesn't fix this.

Epic Fail

Jeanne Johnston — Tue, 03 Feb 2009 13:56:00 GMT

Yes, I've been wallowing in grief all week, hardly sleeping, hardly eating, hardly leaving the house, even over the weekend. Though we're convinced the house is haunted (not in a bad way), Wee Ailís has not managed to join the activity and put in an appearance, and I'm feeling the void in a bad way. The dynamics in the house are changing in weird ways as the cats jockey for position (my nonfurry kids were never like this!) and the one-upmanship is riding a fine line between hysterical and downright obnoxious.

Worst of all, between the never-ending family crises, I have managed to neglect my insanely boring pharmacology course to the point of no return and now get to haul myself up by the bootstraps and just start over. I figure I will allow myself a very finite period of time to get my head on straight and rediscover my gusto.

For now, I've only made a feeble attempt and found one suitable self-help site that promises to help me learn the 10 Sure-Fire Ways to Be a Complete Failure At Everything. THIS, I can do:

1. Chase other people's dreams.
2. Start 17 Projects, Finish None.
3. Give Up When It Gets Tough.
4. Persist at all costs.
5. Never ask for help.
6. Trample On Other People.
7. Never say no.
8. Be Disorganized.
9. Stay In Your Comfort Zone.
10. Procrastinate.

Yes, some of them seem contradictory at first, but it is possible to exceed at several simultaneously. Clearly, I have a lock on numbers 2, 3, 4, 5, 7, 8, and 10, with the emphasis on the disorganization and procrastination. I don't see that they offer a prize for this, sadly enough. Of course, I lose points because I have not carried this loserishness into my workplace and in fact, have been so intent on ignoring my painful reality that I've managed record production numbers of late.

Obviously, this is all tongue in cheek and really offers a perspective on behaviors to avoid in chasing your dream. Perhaps I'll follow some links in the article and find further sage advice. Maybe I'll begin by making an entry on Dreaminder to kick myself in the whatsis every couple weeks because it usually takes me about six months into a new year before I finally remember to buy a new calendar and this will defeat #10, if only temporarily.