Do hospitals and MTSOs not care that
Posted By: wannie on 2009-06-23
In Reply to:
we are dealing with people's medical records. Obviously not since they allow ESLs who can't possibly put together a whole sentence dictate patient records. If they can actually put together a sentence, they speak so quietly or with such a thick accent that they can't be understood. I am coming to dislike transcription so very much because of a few doctors who should probably go back to their country of origin to practice medicine. I don't think I will ever go to a physician who is an ESL simply for that reason. If I can't understand what they're saying, I certainly don't want them rendering medical care for me. Sorry about this, but just had to vent before I blow a gasket. I really wish Wal-Mart or McDonald's or scrubbing toilets paid more.
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Hospitals vs. MTSOs
I am applying at both a hospital for a prn position and with an MT company for part time work. I have the option to work in-house with the hospital, which I may do because I have to drive 25 miles to the city to bring my kids to their preschool anyway. My question is, what are some of the differences between working for a hospital and working for a company? (Pros and cons for each) I have less than 2 years experience, and some of that time was spent doing chiropractic transcription, so I am concerned that I might need more experience or training for the hospital work. Is it more difficult to work for a hospital? Thanks in advance for any comments.
Business plans don't work either...been there done that with SBC & ATT...MTSOs/hospitals need to.
 either offer 1-800 numbers or internet transcription if they want to keep hiring us all over the US....that's it!! Maybe we could all share the cost of a 1-800 number or something, and for goodness sake, with all the technology out there, everything needs to go to digital dictation anyway. Bottom line is MT is NOT allowed for ULD. I even asked about some sort of special ULD transcription package through SBC & ATT and they wouldn't even consider it. So, MTSOs, please listen up...the ULD is going to be a thing of the past real soon. It's a wonderful option to you and it broadens the MT's working capabilities, but without ULD, nobody can rake out that kind of money! We should all put our heads together (MTSOs and MTs) and try to get something going here. We can no longer overlook this situation.
Good luck everyone...I will be holding my breath for us all!
Acute care for 5 hospitals. Don't run out, but
z
Since WHEN do MTSOs or CLIENTS care
if MTing, in any form, is profitable for us, the MTs.
You cannaot say..'this can't happen', because your line rate goes down.
Don't you think that the doctors are also fed up always hearing how badly they are dictating? And we constantly complaining and nagging? And wht about the high costs of standard transcription?
Maybe a 'perfected' AVR and EMR are the solution.
Machines do not complain and to not ask for line raises.
Always more - in less than 8 hours, acute care, ops only, own hospitals. nm
x
Hospitals do not care about quality, just productivity, and oust their old MTs for others to pay the
this happened to me. I was making 23/hr inhouse plus a shift differential. That was taken from me when they kept nailing me on productivity. I was right there at the line rate, but they wanted more for their buck. My QAs were 99.8, but productivity was average 132/hour over a 6 month period, they wanted 135. Some weeks I was higher, some lower, never the same work reports, etc. Always different doctors and formatting issues. I finally quit, just walked out. Now, they cannot replace 3rd shift. So hospitals inhouse are not all the answer. I have been making more on my own as an IC for several companies. Less aggravation, and when I take the time to research something, not getting "nonproductivity" as being a problem. HEY hospitals, we are only as good as you allow us to be. If your in this profession, your a perfectionist. I hate leaving blanks. Have seen girls turn in reports with 6 or more at this facility and they are praised for their high productivity. WAKE UP HOSPITALS!! This is not how us old MTs were trained.
Yeah, but hospitals are already largely using VR in hospitals. (nm)
(nm)
Yup ... smaller MTSOs, local MTSOs (sm)
local doctor's offices or clinics! Don't get discouraged!! :)
Kinship care versus foster care/adoption
Having been placed in a position where I now have custody of my 3 YO granddaughter and going through the legal system, I sought an online network of relative caregivers for children. I would encourage you, especially since you are in Georgia, that if you take any children into foster care with the idea of adopting them, there is federal law that requires the state to take certain actions in a specific time frame. When a child is removed from it's bio parent(s), the state is required to investigate any possible relatives who can take the child before foster care is considered, but even before that, reunification with the parents is the priority. Once a child enters the system and is in the system for 15 out of any 22 months, the state is required to find permanent placement for the child.
The problem with this is that there are case workers who may favor a foster family and do not seek out relative care. I have a good friend in Georgia who had to fight all the way to the state level to get custody of her grandson after the child was placed from the hospital into a foster care home with the promise that the foster parents would be allowed to adopt. She has now adopted her grandson, but it was a long, hard battle to get the state to admit their own interests were placed above those of the child and/or family.
If you get a child placed through the state, please make certain there is not a relative who wants that child before you get your hopes up. The courts are now favoring return of children to relatives even after a child has spent years with a foster family who hoped to adopt them.
States get bonus federal funds by complying with the time lines and being able to close the case, so some states place children in foster care because it is easier than trying to locate relatives.
Didn't mean to go off on a tangent, but I can't imagine my sweet bella going to someone outside her family.
If it was a clinic, it might have been urgent care, but it was NOT acute care. sm
Acute care refers to work in an acute care setting, a hospital, doing at least History and Physicals, Discharge Summaries, Consultations, Surgery notes, Emergency Department notes, and much more, including GI procedures, Cardiology procedures, Neurological procedures, Pulmonary Function Studies. It goes on and on and it means and acute care hospital setting, not a clinic.
I always figure if they don't care about their dictation, they probably don't care about their
nm
Dont care how many languages you took. Care
x
MTSOs
You are not wrong but in my opinion, you are giving them too much credit. The reason why they don't do what you ask is because most of them are not concerned with making your life easier; rather, they are more concerned with figuring out more ways to cheat you and to make your life more difficult. Then when you get disgusted and quit, they will just get somebody else in a very short time to replace you because you are very expendable. And it goes on and on in the same vicious cycle.
MTSOs
You know, there has to be a market between the dastardly corporate MTSOs and small transcription companies. It seems to me that if a talented, aggressive MT with a good business sense could find a way to create a "team" approach to the transcription business, perhaps one could find that niche and sell "team transcription" to good accounts that the MTSOs screw up and have cheated. After all, you have to believe that with the scandals in the transcription corporations - over billing, sending work over seas without informing the client, a lot of trust is lost by some of these unsatisfied accounts. I say, find a way to market to those clients in a "team group" and find the right price, somewhere a little lower than the MTSO charges and go after those accounts aggressively in a group. There is a market there you know.
Most hospitals have ......
contracted their work out to the national service, a practice I hope comes full circle eventually and hospitals reopen their own departments in the name of confidentiality and quality control. I only know of 2 hospitals out of about 8 in my area that have their own department (I work for one of them). It is by far the best MT job there is, or that I have ever had. I am at home, but a regular employee. The hospital is only 20 min from my house (we have to live local). I have worked for the big nationals and saw nothing but a decline in pay. Now I get regular raises, good hourly pay, production incentive pay, benefits, and vacation time. I wish more MTs could find my situation. I have hopes for the future once the industry figures out that they are cutting off their nose in spite of their face.
Do All Hospitals
In Tennessee pay that well? I have been considering moving to Tennessee to try to get away from the hurricanes.
VA Hospitals
I did the VA Hospital dictation here in Portland and it was all contracted out to companies, no employees. But you might contact your local VA Hospital but if it is as an employee 95% chance you will have to go into work and not do it at home, if it is at home it will be as an IC and no benefits. Just what I know about it. If you think your ESL's are bad at a regular hospital, this is worse as there is a lot of ESL's there on their rotation and they could care less how they dictate as they are only there for 6 to 8 weeks. Changes that often.
The hospitals are not going to get
dial into. They'd be better off hiring MTs and paying benefits than doing that. And if you dial directly into the hospital, instead of into the MTSO's dictation system, then the MTSO has no say in 800 lines. The truth is, hospitals usually do not want to just turn all of their dictation over to a service and they certainly aren't going to pay for long distance incoming calls in addition to what they pay the service.
just sometimes it is the hospitals...
they are actually told to hold back dictation at times, due to costs. sometimes the hospitals sneak around and try other services, or voice recognition.
in the future, there will not even be any voice dictation...just templates where information is added, like data entry...
Not that many hospitals.......
still have their own dept. That's how Medquist and Spheris and all those huge nationals exist... They have whole hospital accounts. Out of the 3 large hospitals in my vicinity, only 1 still has their own department. I trolled their website for months before I found an opening, but I eventually got in. Some hospitals don't have their MTs at home, mine does. It all depends. Most hospitals have a website, so fine the one you're interested in and check out their job opportunities, and then check it almost every day and if they do have a dept, they'll eventually have an opening.
Well - believe it. Hospitals pay that. I can tell you
at least hospitals in the Philadelphia area pay up to 24 cpl. MQ charges 23 cpl. I have one small department of a hospital at 17 cpl. It is out there - pull your head out of the sand and go looking.
I wonder if hospitals know
There are American transcription companies opening up here in the US that actually work for companies in India? I had a job offer from an American company and they let it slip that they were actually getting paid by Focus Infomatics. I thought about this and what an idea! You open up a company in the states, the facilities think they are getting American work, then you actually have the work done overseas.....hmmmmm
hospitals
do hospitals now go by minutes instead of lines in regards to productivity? if so, what is the usual they are asking for an 8 hour day?
thanx!
more than most other MTSOs pay.
it is not kosher to share on public forums what a company pays.
I would not think many MTSOs would want to
x
No, it's not just the MTSOs (sm)
The actual doctors don't want to pay more than minimum wage for transcription either. As an independent, I've had doctors balk at 12 cpl (which is BELOW what the MTSOs are getting, believe me) and I've lost business because I wouldn't take $6 an hour or what equated to 7 cents a line.
So where am I at? Making peanuts working for MTSOs who are getting 15+ cents per line as a middleman for these same kinds of physician while I'm making a paltry 7-8 cpl. It's a no-win situation.
All hospitals are different. Concerning
your "past," if it has been exspunged from your record, then basically it never happened. This happened to my BFs son and his attorney told him that since his record was exspunged, nothing ever took place, so he does not have to mention it on any job application. You might want to call your local court house or your attorney on that particular question.
I would say go ahead and apply. Good luck.
All hospitals are different. when I sm
first started, ERs did their own stuff too. But as the years went on, ER combined with the MR departments and was considered part of acute care. It is not as detailed but you get some of the same language in an abbreviated from by doing ERs, even some OP reports. I don't like ERs either though simply because the docs are usually in a hurry and they are motor mouths. I do think though that MTs now should consider ERs as part of acute care especially if they don't like ERs.
Some MT companies do split them up though and hire folks for just ERs.
Help for new MTSOs? sm
I have questions about proposals, equipment, and what to charge in order to get started. Are there any web sites out there to help me in this? I have books that I have read, but they go over the basics of start-up MT services.
SM hospitals
It's been years since I have heard of any hospital that has ANYbody working in-house.
You should run this by the MTSOs and
see what they think.
This is why the MTSOs have gone so low
single mom, does not want to work away from home. I bet they love reading postings like yours. They have women where they want them, just lower the rates because these people are saying they cannot leave the house.
When MTSOs overhire, this is what happens:
There are actually MTs who work to support their family or supplement their income to meet the customary lifestyle. When MTSOs overhire, leaving the MT with very little work, I have observed this - Jobs are done hurriedly. When extra foot work is required (due to discrepancy in report, incomplete info provided, etc.), the MT who is desperately trying to meet their bills will skip the job or disregard the need to research and go on to the next job. This is extremely dangerous for everyone concerned. At times, it is weeks before the incomplete report is realized.
I do not fault the MT entirely. When the MTSO overhires, they are setting themselves up for this. I do believe 98% of us want to do a really good job, especially those who have been at this for years. But, I have noticed this more and more, and it will, MTSOs, come back and bite YOU.
When you have a dependable employee who can be counted on for production of a certain amount of work, provide that to them.
MTSO - When you get a new account and hire top shelf MTs initially to get the ball rolling and make a splashing impression, do not replace them with lower rate MTs afterwards - it is obvious when the company is hiring nonstop and they already have MTs sitting at home idle for hours at a time. And this creates, MTSO, the "disgruntled employee" who may make every attempt to ruin your reputation each time they can.
I have just come home after being in house for a few years and after three months, I see this happening with my company and, according to the board, it is widespread. It is an issue that needs addressed before someone, namely the patient, is hurt by it.
Unfortunately MTSOs now do good if....sm
they collect 15 cpl. With the pressures from overseas vendors the pricing has dropped to 12-14 cpl. In the "old" days (prior to say 5 years ago) the going rate was 20-25 cpl and of course companies could afford to pay 10-12 cpl easily.
Wellll, I don't know about MTSOs, but JLG -- Please SM
was helping with our hospital transcription.
We got paid $1.50 a minute if we did 2500 minutes a month ($1.75 a minute for all minutes over 2500).
JLG got $3.25 a minute. I saw the bill. I saw it with my own eyes. I nearly fell over. And to boot, it was horrible transcription, FULL of ridiculous errors, blanks. And we had to convert the text files. It was such a bunged up mess.
I lost all my trust at all in the hospital since they were paying us HALF of what they paid a service. I even contacted JLG to see if I could hired to work on MY hospital's account. They were going to pay me 7 cpl. What a joke.
Any Medikin using MTSOs out there?
I am in the process of opening my own mid-sized transcription company. I am still in the process of deciding what TASP to go with as I do not want the hassle of maintaining my own equipment. I have been looking at Medikin's website and am very impressed with what they have to offer for the price. If anyone is currently using or has used them in the past, could you please post your experience here.
Good MTSOs are even
more difficult to find than good MTs. Many of them have negative attitudes and expect indentured servitude in exchange for peanut wages. Many of them have limited, at best, technical or MT knowledge. We get tired of the ranting emails that don't even apply to us from a PMSing or menopausal females. Disorganized, poor communication skills, cheap, selfish, zero management skills, lack of a formal education, lousy platform, personal life issues conflicting with job performance. You'd be able to find good MTs if you were a good MTSO.
From an MTSOs standpoint
no, I'm not one ... just throwing a coin into the playing field ...
Wouldn't having only ICs working "for" a company mean less liability. IOW, if MQ phased out the SE status, could that take a potential monkey off their back?
OTOH, they can hire all the ICs they want, but if those ICs only work for MQ, they're still considered SEs ... correct?
What hospitals?? I'm soooo there
No, even the hospitals don't want to hire new MTs.
Doctors don't want to hire newbies. In office, at home, it doesn't matter. It's not about being a stay at home mommy, as you are so assuming and generalizing yourself. Everyone wants to hire experienced workers, but nobody is willing to train them. As I said, every other industry in the country trains their workers. MT seems to be the only one where people are expected to walk into it knowing everything. It's not an assumption; it's an observation. Just because my experience and observations are different than yours does not make me wrong. You're not the know all, end all to the MT world. I do have business management experience and education, so don't dismiss my observation as lacking just because it doesn't match yours.
Hospitals being sued
Seems to me the hospitals must not be very worried about being sued or they would require fluency in the English language as a pre-requisite for staff privileges. Secondly, any doctor who doesn't read what he signs pretty much deserves what he gets. Transcriptionists make mistakes....so do doctors. Thirdly, maybe hospitals should re-think how their work is contracted out. Far fewer problems when transcription was done in house.
i am sure you are aware that there are still hospitals out there
that have not yet adopted these rules. I type for one major hospital that still wants the patient's name typed in the report. Another still wants cc instead of mL. Had this person tested and changed it to the "correct" form, who is to say that she wouldn't have gotten marked off for changed verbatim. Nervous MT2, hang in there, and if you test again make sure you ask up front whether they want you to follow BOS or type it verbatim that way you know ahead of time.
but what percentage of hospitals allow that?
From what I've been reading ... the home-based service MT is averaging 8 cpl, for those dictators which make you run screaming from the room. And, I don't forsee things improving. Then again, some are lucky enough to make a line rate worthy of their skills, without worry about the dictators from Hades.
This is a bit out of date: http://www.bls.gov/oco/pdf/ocos271.pdf
My nearby hospitals pay around $10 as well (sm)
I make 22-25$/hr at home. I live in an area where average pay is low, but likewise cost of living is reasonable.
I miss the hospitals too.
But things are so different there now that the online companies exist. It changed the way transcription is handled in most places. When I went back to working for a hospital last year, the supervisor wanted a certain amount of lines per day versus minutes per day like the old days. It was an outrageous number and with no Expander or medical speller or anything.
Hospitals oursourcing
HIPPA is all about smoke and mirrors, designed to keep the masses feeling "secure." If the powers that be were concerned about privacy and the state of the world, they would have built that provision right in there from the beginning, but powerful special interest groups designed HIPPA and left out this all important factor. I personally know hospitals that directly outsource overseas, and maybe, just maybe it may have to do with the fact that the owners (doctors) are foreigners living in this country and have colleagues in India. Wheh I questioned an administration about HIPPA and what they were doing, I was told, "Not to worry, they take the same precautions and follow protocols we do here for HIPPA." I say, yeah, but who can see from here what potential dangers lurk overseas, especially with so much concern of volatility in those areas of the world. Terrorists live in India, Pakistan, the Phillipines, etc. and all it would take is a nasty vendetta against our nation and POFF!!! There goes our medical records! Now we have to be concerned that the United Nations may take over the supervision of the internet!!
small MTSOs
There's a great online resource for MTSOs of all sizes, varying benefits and pay, and variety of work. It's called www.MTJobs.com. Sign up to be on their mailing list. There are usually at least 50 companies listed on each newsletter, which comes out twice a month. Good luck in your search, and prayers for God's healing of your medical problems. :)
Nationals: Sometimes the hospitals have their own MTs sm
and pull the MTSO off the account when work is low to keep the hospital employees busy. This probably happens more often than one might think these days. IMHO
To MTSOs or QA Managers
I recently took over QA for a small company just purchased. Previously there had been essentially no QA rules. If any of you could send me examples of how your QA is set up, the percentages you deduct for errors - common, critical, etc., it would be most appreciated. Any rewards given for high QA or deductions would be appreciated as well.
Patti or other MTSOs...
Hi,
Need to get my own account/s instead of relying solely on the national (guess who). Getting a client in my area is probably the easy part. The hard part is the logistics of software, paper, etc. Not having dealt with this stuff working with a national, it is the *simple* things that are a mystery to me (and others, I suppose). I hate to even inquire about transcribing for someone, not knowing what equipment I will need, what software, kinds of paper. I am sure I would come across as an idiot (like right now, maybe?)
OKay, well, I looked online at Dictaphone and it looks like there are mini, micro, and standard cassette units (not to mention digital online programs), so I guess you WOULD have to find out which the client prefers before investing in one, and I know you can get them on EBay, but what else? Does the software come with the transcriber? I don't suppose you can type them out in Word? I suppose one can buy a medical spellchecker. Then you need paper if you are going to print them out...what kind? Anything else? There are so many variables. I suppose I should first contact the two MTSOs that I know locally and ask for overflow work. That way, they could help me learn about this stuff.
No slamming, please. Very sensitive tonight as I just received a call from my Supervisor, very nicely hinting that I need to bring my line count up but, as we talked and now, hours later, I have *no jobs* on my screen. Pretty hard to get that line count up with no jobs!
Thanks for any tutoring and/or advice. 
You have 911. There are local hospitals
with free nurse referral lines. That's just for starters.
You just take the cake for stupidity with your original question and now your silly offended replies.
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