I do 100+ acute care (op notes, ER) per day, apx 5-6 hrs of dictation. nm

• Question for Editors - NeedInfo
  • I do 100+ acute care (op notes, ER) per day, apx 5-6 hrs of dictation. nm - QAGoddess
  • I do 25-30, but I also transcribe 25-30. nm - NCMT
  • 100+ clinic and 50+ acute - really depends on - length of reports though - nm
  • 45-50 reports acute care - sam
    • curious about editing - Florida gal
      • It does not matter who you work for, a true QA person - QA specialist who does not work there

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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.

I started out right out of school working for a national doing acute care for a large hospital.  Let me tell you, it was very scary for me.  But, I look back on it now, and I am glad that I had that experience because I learned a lot right from the very beginning.  I have transcribed every type of report in every specialty.  Acute care can be very difficult, but what I like about it is the variety.  For me, it never gets boring.  I am still working for the same company I started out with (along with another) and I am still very happy.

Since you already have quite a bit of experience, you will have a somewhat easier time than I did, but it will still be difficult.  In the beginning you will have to spend a lot of time looking things up and doing research and your production will probably not be that great.  In the long run though, I think you will enjoy it, I know I do.  But, you may also find it is not for you.  You just won't know until you try. 

Probably the hardest thing about working for a large hospital is getting used to the large variety of dictators.  At this point in time, I have approximately 30 doctors that I transcribe for that I would consider my regular docs.  Then, there is a very large pool of approximately 200 doctors, any of whom I may get on any given day.  Rarely a day goes by that I don't get a doctor that is new to me.  But, that is also something about the job that I enjoy because that keeps it from getting old and boring for me.

I have created tons of normals and expansions and that has helped me beyond belief.  I know that is no big secret for someone who has experience such as you.  My advice would be to give it a shot and see how it goes.  It could be the best decision you ever made.  And if you find out you don't like it, at least you will know that for the future.

Best of luck to you!

they told me to call them.  I called and Heather was busy at the time and told me she'd call me RIGHT back.  She never called and I never checked back; I accepted a job with another company that DID call me back.  I was very interested in DSG but since they weren't excited enough about ME to call me back, I figured I'd go with one who was.

With all the acute care experience I have (as a hospital employee, as an MTSO myself, and as an IC for other companies), I am used to companies falling all over themselves trying to hire me, trying to convince me to work for them, etc.  I guess they didn't recognize how VALUABLE I am! 

not sure about clinic work.

Does anyone work at Transtech in acute care?  I would like to email some questions if they have a minute or two to spare.  You can reply by emailing me. Thanks! 

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.