progress notes
Posted By: dtmt on 2006-03-28
In Reply to: No work at all - pj
My company, XXX, 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.
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My account has all progress notes.
everything was straightforward. I thought I was doing everything right but then I was notified I'm doing certain things incorrectly. One day last week I asked someone in the office how to do something and got an answer but then I got more corrections telling me this way was wrong. It's a little confusing and I hope it's just the new account adjustment. Like I said I'll wait a full 90 days before making any definite decision. What account are you on?
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.
it has all to do with the evolution and progress
of technology:
Manual typwewriter
Electric typewriter
Computer
Straight transcription
Voice recognition (VR)
EMR
etc......
That's how movements get started, and progress
nm
Progress and change cannot be stopped, nowhere, anywhere...nm
nm
Why does progress mean accepting a lower wage?
I want to point out the contrast between the OP and this response.
The OP says MDI moving to VR is to cut costs. Had to Respond says it is keeping up with the times and says nothing about reducing costs. Is moving to VR keeping up with (sic) technological times or is it being used to reduce costs?
I believe it is the latter, not the former. And if that is the case, Had to respond has no straws to grasp to justify the transition. It is NOT about moving with technology and everything to do with paying less to the ICs.
I am so not impressed with Had to Respond and her big girl panties to accept less money.
Why do you think there are so many notes SM
on this board pertaining to how long it takes to get a decent line count?
They will tell you it is a 65 character line. It is not. As stated, more like 75-80. There are ways to work with it, make tons of macros, etc. But it is tough.
I only wish I had ER or OP notes, mostly
consults, discharge summaries, H&Ps and the occasional progress notes. I've been at this for almost 20 years though.
op notes
I do acute care which includes a pretty good many op notes but there are other work types too. I dont know if you are looking strictly for only op notes. I work for Alphamed solutions who is currently hiring. I have DSL. I believe it is required. There is usually plenty of work on my account. I hardly ever get on and no work. Rare. I work on the Dictaphone Extext with Transnet. But they also have other platforms. I hope I was of help.
ERS/OP NOTES
Does anyone remember seeing the job posting for someone to do ERs and op notes? What company was it? I cannot find it.
Can't you do everything but op notes?
H&P reports and consultations are similar whether acute care or clinic work. Discharge summaries aren't that difficult either for someone coming from clinic work. I agree that the op notes will take lots of time to learn. So why not ask if you could just do H&P reports for a while and then consultations, and then discharge summaries and maybe later on the op notes? I just received the opportunity to do discharge summaries after having only clinic work experience, and what I like the most is that this offers the opportunity to expand my knowledge because I get to transcribe reports in so many specialties. I understand that you are mad at the recruiter and somewhat unhappy because of computer issues, which means there are several things going on here. First you might want to figure out whether you want to stay with them or move on. If you like working for Precyse, then I would try to find a solution as mentioned above. If you do not like working for them, then it would be best to move on.
PO/OT notes
I agree. Not only are they boring, good grammar is lacking on many of them; they slur through the reports and don't seem to have any continuity of thought or format. I had one very good dictator the other day; I could have kissed her! Otherwise, I don't consider those medical reports, just a mess of words on a page. This is from my experience. You can also nix about 50% of the psych dictators. Just my take on this.
Vet notes
The trend has always been that vets handwrite their own reports in order to save on costs, but that may be changing now that they are hearing other vet groups are using transcription services? The company I work for only types veterinary ophthalmology reports, along with a few simple op reports. The ophthalmology terms and medications are pretty much the same as those for humans, but the reports can be a lot more interesting at times, since the animals don't always cooperate! Once you are comfortable with the terminology the doctors use on a regular basis and the company guidelines as to how the reports should be formatted, the work is a breeze!
soap notes
Does anyone know of a company that does strictly SOAP notes?
If you like doing chart notes at 7 cpl! (nm)
xx
After reading the below notes sm
After the below notes, along with things posted here in the past, I'm truly beginning to believe it has something to do with who is your supervisor/QA. I have been there for a number of years, have been very happy and still am; however, I have heard a few things about other supervisors that makes me believe I am one of the lucky ones. Sad, but I believe it is true. I believe Amphion's management reads these posts once in a while. Maybe they'll give this some thought.
Surgical Notes
This is a company based in Dallas, Texas. They do surgery centers. QA staff are just ordinary clerks--not transcriptionists. There is a lot of orthopedic, plastic surgery, ENT, and GI surgery. Any work up to 5 p.m. is due by the next day--usually by 9 or 10 a.m. This is for weekdays M-T. Friday's work up to 5 p.m. is due back Monday. After 5 and Sat and Sun due back Tue. Pay is always on time and is very good, 0.09 to 0.12 cents a line.
Why do you prefer OP notes? nm
+++
No ESL docs, no op notes (as far as I know) SM
They are mainly consults, soap notes, some radiology. You use their templates and get paid for headers/footers.
I don't know if everyone makes the same, but I make 8 cpl (55 characters per line) without spaces. I compared it to the normal 65 characters per line with spaces, and it is equivalent to 8 cents per line with spaces. So, not too bad...just average I guess.
But the dictators are really clear and there are a lot of samples. I think the work is pretty easy. I think it makes a really good p.r.n. position.
Good luck with whatever you decide to do. :)
Chickadee
Op notes exclusively
Try Deventure.
Surgical Notes
Yes-- I worked for them indirectly. I subcontracted to a contracting MTSO. Their virtual private network is just horrible. It is slow and you get kicked off frequently. I know of MTs who worked an entire week and only made $10.00 because of the system. They have an FTP site system that I loved. You could just download the voice file and type in Word then return it; however, when they changed over to this new program everything went down hill very quickly. My doctors were not happy with it either. SN raised the rates, went to this system -- by the way you need to buy a 15-pin pedal and forget any tech help. When I was there it was also lacking. Anyway my doctors took their accounts and walked away. I ended up leaving for that and other reasons. I haven't worked indirectly for them since July of 2006.
Surgical Notes
I should also add when I was working for them indirectly, for several English was second language.
My notes from the meeting - s/m
Apparently Acusis started in India, not the US. It's not very old - only 6 years. The CEO seems to know alot about business & making money, but not much about MT-ing. Says he's learning. They apparently have aspirations to be THE largest MT company not only in the US, but globally. He thought he could do it from India, but found he couldn't, partly because of the fact that some US medical institutions don't want offshored work. Others will allow PART of their work offshore (like radiology, etc.), but not other work. So instead this would be what he called a Hybrid US+India company. Hmmm.
So, according to what he said, he feels the best way to grow the company FAST is to also have a US MT force, so clients have a choice. They will have to pay more for US transcription, though he assures us the Indians are also good. (Yeah, RIGHT!) Initially the two-tiered business platform made sense to me. But other comments made later in the meeting made me wonder about what the REAL truth might be. Among other things, they plan to buy many other US MT companies, as well. DRC is just the first. He seems to think bigger is better. Having worked at PAMC since it was smaller, and seeing how nasty it got when it was bigger, I certainly don't agree.
Someone asked the question about the less-skilled, or even the accurate, but slower transcribers' role there. For now he seems to want only top-notch people, but later says how having a plan for bringing less-skilled MTs up to speed would be a good thing. Some questions sounded slightly hedged or evaded, and sometimes had the words for now thrown in, like maybe we weren't going to notice them or something. This had to do mainly with questions about change as it affected us. Red flag.
When asked about all the extra management people after the merge, he said that for now there was a seat for everyone on the bus. But he also allowed as how his company has always tended to have more execs than they really needed. Well, that certainly is one of the problems at PAMC, and it seems to cause them to continually find fault with the MTs, if for no other reason than to make themselves look good. So that was another rather loud warning-bell I heard.....it's a management-heavy company.
Re: Pay/Benefits - He says so far it'll remain the same. He wants it well above average, but doesn't specifically say whether or not MTs are part of that plan. He does say that by improving the software, etc., they can make the MTs more productive, and thus enable them to make more money. I didn't particularly like that part, either.
One thing that DID sound good was that although we would have to change over to Acusis' 401K (and who knows how good it is.....), he says they'll match it with 3%. Well, to me that isn't exactly MATCHING.... but I guess if you put in $100, they put in another $3.
Their company goals were:
- Global world-class customer satisfaction (sounds kinda' generic, but whatever...)
- Service flexibility & choice of options (the Hybrid-thing).
- Create the strongest organization (so they can gobble up & digest the competition?)
- Have the best technology (boys do like their toys.....)
I guess we'll lose the nice DRC software we're using now. He says he wants to have a new, blended software platform that will be called AcuSuite 3.0. It is supposed to have enhanced user-friendliness (hard to believe, if it's not written by someone who knows a LOT about MT!). He also mentions back-end speech-recognition.
He also mentioned that he was a leader in his church. (Oh, pul-eeeze! Not more holy-rollers trying to take over the healthcare industry!?!?) Definitely a red flag in my book.
The Future Plans are:
- To acquire more MT companies.
- To develop a repetitive model to acquire and integrate future acquisitions.
Again, all this talk about growing, merging, acquiring -- has nothing to do with the nuts & bolts of MEDICAL TRANSCRIPTION. He talked about MONEY, a LOT. But not MTs making money - but instead about his goal of having this be the world's BIGGEST and WEALTHIEST MT company. I don't think anyone can have those kind of aspirations and stay honest or have their employee's best interests at heart for very long.
One person brought up the fact that the Chief Officer of Acusis-India desires India to dominate the medical information field worldwide, and wanted to know if he intended to convert the clients from US-transcribed to Indian-transcribed. His answer was very ODD, and most certainly got me wondering: It was that it was his belief until 55 minutes ago. (Whaaaat?) He tried to clarify that by saying he used to think domination of the MT industry could be done solely through India, and that now he believes it cannot. But, either way, all this domination talk makes me uneasy.
Another question was How do US clients view the above statement by the C.O.O.? He admits it was viewed with skepticism. He also says hes been trying to take our clients for a long time, now. (What???) (I guess he tried from India, couldn't do it, and so now has come onshore.)
When asked about accrued vacation time, and would the MTs be able to keep it, the answer was YES. (Though said he doesn't yet understand DRCs system of accrual of vacation time according to Keystrokes typed, or how much can be carried.
In the first 100 days they plan to:
- Integrate talent, IT, Processes, Benefits.
- Establish performance goals, alignment.
- Retain only high customer satisfaction performers who get results. (Does this pertain to management? MTs? Everyone? What exactly does this mean? This wasn't clear).
- Continue to have quarterly conference calls. (Jeez .... even semi-annually would be more than I could stand.)
Later he says the MTs are where the rubber meets the road. (Good analogy, but will Acusis follow through on their statement that they consider the US-based MTs to be a valuable part of the company?) I wonder if he is aware of how many people are ready to walk out RIGHT NOW, just based on their strong ties with India?
Well, anyway, that was my take on everything, from all the notes I took. I don't plan to do anything rash.... and will instead just keep on typin' and see what develops. If I like it I'll stay, if I don't, then I guess I'll leave. But I won't cross that bridge 'til I come to it, as it's still too early to tell how the takeover will ultimately go. What we were told could be the truth, or it could all just be smoke and mirrors.
Lotus Notes
Notes is basically a computer program. We type in Word, through Lotus Notes. Notes has several functions. It is where you sign on and receive your work, check your line counts, edited reports, etc.
You also have your account specs there, account address books with doc names, PA names, etc. Your E-mail is also on Notes.
It is a great program. Everything is right there for you. Very user friendly!!!
Yes, it is Lotus Notes and
They supply the computer.
I only know that they use Lotus Notes. Don't
s
What are SOAP notes??
SOAP notes
SOAP stands for subjective, objective, assessment, plan. Those are the headings that usually comprise a clinic note.
I did not agree to OP notes at 7.5 cpl
Thanks for not reading correctly.
I was getting 9 cpl with them and they let me go stating I could not do op notes sm
Op notes are all I do for MQ and my other job. They just didn't want to pay me 9 cpl and they dropped me to 7 cpl on er reports. It is an awful company to work for. I would not go there in any way, shape or form.
I truly despise doing PT/OT notes...
.
surgical notes
Surgical notes outsource to India....90% of the jobs
Surgical Notes
Any info on this company from IC's currently or recently?
9 cpl as an IC doing clinic notes vs. 8 cpl is
still quite a bit of difference, especially 8 cpl as an IC at Softscript...
that count on none of us comparing notes...
what else can they say when confronted? I doubt much of middle management even realizes how easily their line counting system can be manipulated...
Love doing psych notes
nm
Any good companies for op notes? nm
nm
These places keep notes on us. I know this from experience. nm
s
Expanders and Lotus Notes
Axolotl uses a great Expander called SpeedType. It is a great program. It will hold reports as long as 8 pages. The platform is one of the best I have used. Very little, if any, demographics to input.
Do you know Lotus Notes? I think that's the software they use. nm
s
Yes, at least some accounts have operative notes..sm
I have been hired to do a mix of OPs and ERs and will be starting next week. I looked on my offer letter but didn't see a tier status mentioned. I already have my account specs, platform instructions, etc., and amvery much looking forward to it!
Did a doc's office notes for 15 years and never once got sm
anything, no bonus, no gift, no card.
Also, one day found out he was going to start using a speech rec program. They never even told me until last minute and said they would call me if they needed me. Well, they still have not called a year later!!!
How's that for 15 years worth of service?
Anyone doing OP notes and want to share info
nm
I make $18.50 typing in EMR notes -- too low
Sometimes even if they put you on an hourly rate if you are considered management they can not pay overtime and just pay you for the 40 hours worked, look at the contract carefully and see if it is an Exempt (exempt from overtime) or Non exempt (paid for overtime and actual hours worked). See if they pay time and half for over time also. Like I said, I type for just one doc into EMR's and make $18.50 hour, about 8 to 10 hours per week. Seems very low to me,.
Lotus Notes Platform
Lotus Notes is a Word-based program. Everything you need is on the desktop within Lotus notes. It is where you sign on to receive your work, check your line counts, find account specifics and samples, etc. It is very easy to use.
You do receive 6 reports in your queue. The system replicates every 5 minutes and you will receive jobs to keep you with 6 at all times.
The system is not set up to spy on anyone. However, managers/QA can tell who is signed on and what reports that are in all queues. This is very important in case there are any problems such as the MTs internet goes down or if there are any issues with signing off any particular report.
Axolotl management does ask that if we are going to be away from our desk for more than 15 minutes to please sign out of the system. They do not want the work sitting in the queues when other MTs can be typing them.
One reason why Axolotl is such a great place to work is we always have plenty of work and they do not over hire. They base the number of MTs needed for any specific account by each MT producing 1200 lines per day. They do not treat us like little kids and watch every move we make.
I have been here over 2 years and it is the best place I have worked. They just ask you stick to your schedule and produce your minimum line counts.
Axolotl uses Lotus Notes, but you
type in Word, use SpeedTyple (the same as ShortHand) for an expander, and Stedman's Spellchecker. They provide all equipment/software. FT only, employee. Great benefits, better than average pay. I had never seen a pay range, they just asked me what I wanted.
Pretty strict QA, but not nitpicky about punctuation and are helpful. You don't deal with 1 QA person and for the most part all are on the same page. Daily feedback, monthly QA report. Very reasonable insurance and cheaper than anything I've seen yet. Tons of work, paid downtime (which is rare), good tech support.
They just hired a bunch of MTs and don't know if they are still hiring, but you can apply through their website and they will contact you within a couple of days if they are hiring. Testing down through a third party. Written part was challenging but the transcription part very easy.
A couple of challenging accounts, but overall not excessive ESLs. Not able to view past reports, though lots of samples available.
You are allowed to set your schedule, but has to include a weekend day, and you are expected to adhere to your schedule, very little flexibility, though no issues with getting off for doctor's appointments, etc.
Best company I've worked for in a long time.
9 cents for clinic notes
nm
you could start saving these IM notes -
use them or not - protect yourself.
Clinic notes 6.65 then 7 when off proofing within 90 days
It was supposed to be 7.5 cents if off proofing within 30 days, but they never did a QA assessment, so got 7 cents after calling and asking for an assessment.
I need sample dictations with their final notes.
Hi,
Can someone suggest me a place to find a few sample dictations with their final notes, so that I could evaluate myself?
thanks
philips
I do 100+ acute care (op notes, ER) per day, apx 5-6 hrs of dictation. nm
:)
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