Do you recommend starting with clinic notes or acute care when just starting in the MT field?

• Do you recommend starting with clinic notes or acute care when just starting in the MT field? - curious
  • I think acute care is a great way to go - ortho girl
  • If an MTSO is willing to start you on acute care with - good QA and feedback, grab it! sm
  • my experience.. - aa
    • i would definitely start out with clinic notes first to get a good base. - ty

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I have been an MT for 20 years.  I have hired and trained MTs for a service.  There is a HUGE difference between clinic notes and acute care.  The poster who says she made the switch and didn't have problems is lucky and is probably a very good MT, who had a good base of knowledge to start with.  It can be done, but not in every case. 

Some MTs who work on clinic notes work for the same set of dictators every day typing about colds and aches and pains.  Dictators tend to say the same things over and over.  Most clinic notes are only a 2 or 3 paragraphs.  They work for the same set of dictators for years and even have their stuff canned, just pull it in and make the changes.

You put that same MT on an acute care account for a large teaching hospital and they may have a nervous breakdown, I've seen the meltdown, it's not pretty.  On an acute care account like that you may have all the specialities and subspecialties, probably 30-40 or maybe more, adults and peds, with all the dictators, anywhere from 5 to ??  And residents, let's not forget them.  And all the work types.  They are dictating DS, H&Ps, consults, ORs, clinic visits, progress notes, etc.  They are dictating about new procedures and medications that may not even be in reference books yet or that are experimental.  Some of those reports are 20-30 minutes long, 7 or 8 pages.

I'm not knocking the clinic MTs, but don't just assume because one does clinic notes, they can jump into acute care.  That would be very misleading and a total injustice to a newbie who read that and got into an acute care position, possibly setting themselves up for failure. 

My company has been out of work quite a lot lately and their only explanation is you know how it is during the off-season but the off-season now has been pretty much all of this year. My question is are MTs now all paid the same way for notes as opposed to reports. I distinctly remember that MTs who did progress notes and ER notes were generally paid differently because the notes were so short it was next to impossible to get an adequate line count. I feel like I am getting shafted because I am reduced to doing progress notes on a daily basis and I am generally spending 10 hours a day just to make my 1100 lines. Keep in mind that these are still ESL doctors who either don't know or don't care about putting in demographics so that too still has to be looked up and in the end I may get 5 lines per report. I understand that things do change but if its gotten to this point then maybe I need to be the one to make the change.

There are a few posts already about Axolotl if you want to do a search.  A lot of negative lately.  Clinic work is not bad but the pay is average.  Acute Care is terrible.  90% ESL on some accounts and every account has conflicting Account Specifics so you really have to pay attention to which account you are on. (for example, if the dictator says 50 cc - you type on one account 50 cc, but on another 50 mL), and QA will nail you on that if you do it wrong.   Work comes in by TAT, so you may switch every other job between 2 or 3 accounts all day or get a string of the same horrible ESL dictator in a row.  No flexibility.  They are a small company with only enough MTs to cover incoming jobs.  You tell them what hours you are going to work and you have to be there at that specific time.  Really depends on what you are looking for in a new job.  Ask lots of questions.  Let us know how it goes. 

Which do you feel you can get a better line count on and would you take a slight pay cut to do just clinic work?  Most acute care accounts have such difficult dictators and such I was wondering if it would just be better to go to a good clinic account even if it meant less per line.  Opinions? 

I was wondering if it is possible to make a good line count with a multi-speciality clinic.  I was offered a PT position; one with acute care and one with a multi-clinic.  Just wondering what you all thought.

I've got about the same amount of experience as you have.  I know what you mean about working at home and trying to take care of yourself, too, sometimes hard to balance everything, but for right now, even though I miss the social aspects at times, think this is what I still need for right now.  Just need to a 'little'  more exercise time somewhere, or in other words make it a priority!! to fit it in.  Thanks for the encouragement!  Good luck to you