Pay for acute care versus ER/progress notes

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.

• Pay for acute care versus ER/progress notes - dtmt

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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. 

I did pathology transcription for 13 years and have been doing acute care for 8 years now.  Pathology can be very detailed, especially in the hospital surgical setting where you have a lot of surgeons performing every type of surgery imaginable.  The specimens run the entire anatomical gamut.  If you are going to be doing pathology in a laboratory setting, such as LabCorp, your work will be repetitious and you should be able to use many macros. Also remember, in pathology you will have no meds and no equipment to research.  In the hospital surgical setting, you would have more detailed anatomy dictation than a typical hospital OP note, but you will not have this in the typical laboratory setting.  Pathology reports are also completed in stages that are dictated days apart, and that is the biggest difference between them and medical records type work, in my opinion.  If you have been successful in doing acute care for any length of time, you will be able to do pathology and do it very well.  My concern would be that you would become bored with the work.  In a lab setting you will probably be doing lots and lots of prostate and skin biopsies, and biopsies taken from EGDs and colonoscopies.  Best of luck in whatever you decide to do.  :)

acute care medical transcriptionist, and working from home the past 7 years, I have decided to go back out in the workforce.   I have an interview on Monday with LabCorp as pathology transcriptionist.   After almost 30 years in the medical transcription profession, and at age 50, I am facing no retirement benefits, no health insurance, no sick time or holiday or vacation time.   I know it's a little late to wake up and smell the coffee, but I figure in the next 15 years, I may have a little retirement to look forward to.      Anyone working for LabCorp know anything about the benefits?

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'm getting ready to start applying and these are the companies that I'm looking at.  So give me the low-down.  Good, bad, India?

Here are my criteria:

9 cpl or better

Does NOT send work to India

Good accounts with at least 50/50 of ESL versus American dictators

Consistent work flow - no downtime or time spent waiting for work

Upper management should be professional, positive, and encouraging.

Pay for lines WITH spaces.

Is there such a job out there or am I just dreaming?  If there are other companies other than the ones I listed that would fit the bill, please feel free to let me know. I tested with TransHealth and I felt like I tanked.  It was a hard test and I had to use the mouse to stop and start the dictation as it was online test and you couldn't download the voice files.  So that made it a lot more difficult.  One of the dictators was cutting himself off through the report and I had to leave some blanks.  I'm very frustrated with this whole process of looking and testing.  Are all the tests like that?  Or are there companies that allow you download the test files and transcribe them using your pedal and software?  Ugh!  I am just so frustrated and discouraged.

Thanks for any helpf.

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.