Exams Dictated But Not Done
Posted By: Ellen S. on 2007-09-19
In Reply to: doctors lie - what do you think?
I transcribe for a local multispecialty clinic and have seen many of my own reports. It just gripes my butt when the doctor dictates a standard physical exam and I know for a fact that he/she hasn't even touched me. Did not check my heart, lungs, abdomen, neuro, extremities, etc. The only things that are legit are the vital signs. It's like if I come in for a sore throat he looks at my throat but nothing else. My fibromyalgia clinic NP only talks to me - no exam at all - yet she dictates an exam, review of systems (that we didn't even talk about). She will say conjunctivae and lids are clear; PERLA, etc., and she hasn't even gotten within 6 feet of my eyes. This just doesn't seem right. And when you have labs or other tests, they NEVER call you back with the results. My PCP never suggests any preventive testing - I have to ask for it myself. I know they're not all like that but my eyes are opened much wider than they used to be. It's all about getting it done in under 15 minutes and on to the patient in the next room.
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Rad exams
I have heard of these 100+ reports in an 8-hr day. I work on 2 different a/c's with 2 different methods of calculating lines. I do many MRI/CTs that are 40-50 lines or more. Interventionals are 100+ lines. 70-80 reports constitutes about 1700-1800 gross lines. No one on the a/c's I work on types more than 100 reports in a day - and these are top-notch MTs. I am waiting to work on an a/c where people type 150 reports a day - simply because I want to see what these reports are like.
Here's the scoop on the RMT and CMT exams...
From what I understand, the RMT is an entry level test which means nothing basically. My employer doesn't pay anything for it. However, we get a dollar an hour raise for passing the CMT, which is worth roughly 2000 dollars a year for me, so as useless as people like to say it is, would you take 2000 dollars or say "no thanks." I know many employers pay nothing for it, in which case I wouldn't pursue it, but since mine does, I will probably try to pass it in the next year or so. I hear the pass rate is abysmally low, which makes me wonder what is up with that.
Does the state pay for exams, or is
this out of your pocket???
I read that about the college exams! sm
I don't think my son will have a problem. He wants to be a pharmacist. I've tried to talk him out of it and have tried to have him concentrate on his writing.
He has written several stories that have won awards.
Pharmacists are being held up at gunpoint for OxyContin. Scares the jeez out of me!
Oh well, you gotta let them choose what they want to do for a career unless they decide to deal drugs instead of dispense them legally. 
5-10 of each a day with 2 others on acct doing 350-400 exams daily
Works out good if you are paid by exam which I hope you are.
We have three tiers, after 700 exams a week. 1.46/exam
We are happy with this, at least I am.
Don't have a favorite but HATE opthalmology. Everything about it, exams, ops, just everything! nm
nm
The first thing I think of is independent medical exams. NM
x
Physical fitness exams DO NOT require
breast exams. We are required to have them for school before certain grades in our state, and never do they do breast or GYN exams on kids.
Well, was thinking people were not going to doctor's appt or scheduling exams.
dd
foreign med school gradutes take separate board exams..nm
which are different than American med school grads. There was an article in The NY Times indicating that new regulations are being pushed that would require foreign med school graduates to take a two-part board exam to practice medicine here, with one part of the exam being English proficiency. Hmmm..that should be interesting. I don't think you have all of your facts straight.
and think, the Dr. may have dictated that
At least you ARE concerned about it. Many wouldn't be. Hang in there!
Has she ever actually dictated a sm
report in the format that she is required to do. I do forms for a cardiologist in this manner, but when I first started working for him, he actually dictated the letters. I think all physicians need to include certain things for a new patient, and then can do follow-up letters without including past medical history, allergies, etc. I wonder if she has any colleagues that would be willing to share samples of their reports, but that specialize in the same field.
ROFL at what this MD just dictated...sm
NEUROLOGIC: He does have diminished memory. I did start him on Aricept for this last year, but he has forgotten to take it.
They pay per minute dictated. Sux.
Especially when they assign the work. It's not fun when all your work is less than 1 minute, two line reports, ESL docs, etc.
dictated, not read
I'd take it as a compliment.
If the docs dictated like that, they would never get anything done, lol
nn
H&Ps dictated by a very thorough dictator. nm
Doesn't have to be dictated...but he does
xx
I always leave these as dictated.
Let's say you're Asian and have a doc who seems to possibily have a bit of an ''attitude'' about your ethnicity. In perusing your own medical records, you see that this doc uses the term Oriental instead of Asian. There's some confirmation that your suspicions were correct, allowing you to make a more informed decision about your medical care and who you want providing it. Especially true with the word Negro, IMO, which I haven't heard in quite some time but have actually had dictated and left as is, even if I had the leeway to change it.
IOW, I think it's a patient's right to know if a doc is using words like that, so I don't change them.
Doctor who dictated during the PE sm
I had a doc I used to do who treated a lot of brain injuries and strokes. He always dictated during the interview and PE. He would say, in front of the patient...the pt is completely obtunded...the pt is befuddled...the pt is extremely obese, just enormous...the pt's mom is once again out of touch with the pt's needs...and so it went.
The noise was sometimes out of hand, he was a grumbling gravely dictator and that IS all part of the job. It is the thought of being his patient and having him be so brutally honest, well it smacked of unprofessional behavior.
I had a podiatrist who was "too busy" to dictate the day of service, so he would dictate on Sundays. One weekend, he dictated 8 reports...from the bathroom...in the span of about 20 minutes. I got to hear the toilet flush no fewer than 6 times in 5 dictated reports. He kept pausing to concentrate and it wasn't on the report he was dictating!
If the noise is too bad, it gets a blank. I don't care what they say and I don't care where they are when the dictate, but please don't make me know that you have the crap$ while you are on the phone with me. Plainly, I don't want to know.
I would type it as dictated. nm
nm
type as dictated
The word lesbian, unless used in a derrogatory manner, is simply stating the patient's sexual orientation, which could be quite relevant in a psych report. It's the same as describing a patient as a heterosexual female. Not intended to "label" someone, simply stating a fact. I see no problem with typing it as dictated.
I transcribe just what is dictated.
x
I do think, if the doctor dictated this
you should put it in the report.
transcribe as dictated...(sm)
Transcribe as dictated: "Patent shotty veins." This is perfectly acceptable as is and does not require rewording.
dictated / typed
Doctor says "jiddo, jiddo, jiddo" - what does this mean" Why.... 0-0-0 - OMG. The things we put up with for no money.
Dictated Minute
There is/was a transcription service called Alert and Oriented that pays by the dictated/recorded minute. You might try doing a search on that company to see if any MTs posted their experiences being paid by time using this method.
$2 per dictated minute would be around
$40 per hour. Very nice....
But they are not dictated when the IC has to work.
They are alerting the potential contractor to when the work is available. If the contractor does not wish to work when the contractee requires the work done, the the contractor should not seek that position.
Now if the contractor accepted the position and signed a contract committing to working those hours, and the company attempted to force a change in the agreed upon hours to make the contractor work a different schedule, that would be a violation.
My dictated funny for the day
Dictated: He lives with his third wife. First wife was a widow, second wife divorced.
He just dictated she has lots of poop in the
GI tract. Would you type that or change to feces????
Yes, that's why it's funny. If we only typed exactly what they dictated....
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One more question - why then are they dictated as MS4 and not MD? Enlighten me please sm
Maybe I have been misinformed all of these years by physicians themselves.
Need help asap - Doctor dictated the following:
a sixteen one-thousandth split-thickness skin graft. How do you type it? Is it 0.0016-inch or 16/1000-inch or something else? HELP
Can I play files dictated in DVI on my PC?
I was recently approached by a local doctor and asked if I would like to type for them. The doctor's office uses a DVI system but they did not know anything else including what equipment I would need to play the files. I was wondering if I could purchase software that would alow me to dial into their DVI system with my computer instead of using a separate DVI machine.
Thanks,
Mariah
Paid by the dictated minute? sm
Is anyone paid by the dictated minute and if so what is a fair rate? I was offered what I think is a great rate, however, this is my first experience and I would like to compare. Thanks!
You can't transcribe what hasn't been dictated. I don't see
p
And so you would spell it incorrectly as dictated?
Just wondering.
Usually dictated in the same fashion, but sometimes the SOAP
s
As stated below, transcribe what is dictated - sm
no matter how much you don't like it. The doctor/dictator told you what to do, and you chose to ignore him which was wrong. I have dictated a few reports of this nature to, and I just kept on going, type what they tell, put in quotes if they want it that way, etc. Don't dwell on it and just do your job.
I had several counselors dictated at a psychiatric
xx
Pretty sure it's $2 per dictated minute
Humongous bucks if you ask me. That would make me extremely happy.
verbatim means exactly as dictated (sm)
and you said yourself that you were told the account is verbatim and that includes not spelling out abbreviations if dictated.
If you ignored those instructions and spelled them out anyway, then you weren't following the account instructions.
The name issue is definitely something that should be straightened out with QA if your instructions specifically tell you to never type the patient's name in the text regardless of the account's verbatim status.
True IC status - not dictated like that. sm
If you are a true IC, that basically means the company says "here's the work, have it back by x". They cannot tell you (by federal law) what hours to work or when to work. They can set a minimum line count that they would like to see met, and can use that as a reason to terminate a contract, but they cannot tell you when to do your job. How to do your job, yes, as in account specifics and ways they want files put together. Any company that tells you what hours to work and yet still refers to you as IC is doing so illegally, and basically is treating you like an employee to get out of paying taxes, or maybe, just maybe, they don't know the difference.
I have only ever been IC, and would not do Employee Status simply because I have to be able to set my own hours due to some outside work situations. Now, if something happened and I needed Employee Status, say for health insurance or other benefits, I would have to switch, but I much prefer IC.
Sounds to me like the company you are with is either ignorant of federal law or is undeterred by it. That alone would send up a red flag with me, but the decision has to be up to you.
Good luck with whatever you decide.
HC
So then they dictated with all those snacks in their mouths! LOL. nm
x
Thanks to both of you...verbatim account. Has to be as dictated unless in diagnosis.
pay per dictated minute versus per line
which is better being paid per dictated minute or paid per line?
True but if they dictated in mother language, might not be AS bad. nm
:?
Would you give a dictator "neuts" if he dictated it?
How about polys, lymphs, ect. Do you give them what they say or are these considered slang and spelled out?
To your answer, no face lift but he dictated like
he did the face lift, 8 months later. The operative notes are supposed to be done in a timely manner. I always thought probably he was just trying to think should he dictate the part he really did or include the ones he didn’t and he went for falcifying my records. These are my legal, permanent medical records.
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