I can tell you that remaining on the same account with same dictators
Posted By: Carlie on 2007-10-06
In Reply to: Please do tell! - jude
helps tremendously. Having to switch accounts and specifics is not the way to make a lot of $$.
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Good dictators only on that account . . .
I get plenty of the stinkers, just like we all do. The accounts I don't share, and sometimes dread, are often short reports filled with lots of dead air in the sound file. They are also 90% ESLs. So don't think I skim off the cream. I don't.
I'm just saying it is impossible to cherry pick an account of all good dictators.
I work my butt off to make it. I'm not sitting here taking only the "good stuff" and leaving the crud for other MTs.
Also linked to dictators and difficulty of account
I used to have an account for which I did on average of about 2000 lines per 6 hours and I did use an expander. I still use an Expander but have a different account, which is very difficult, and I average about 200 lines per hour.
I work an account where ESLs are better than the American dictators ever hoped to be. sm
There is bad dictation all over - you need to learn to cope with what is out there. Don't be afraid of the ESLs - you can only do what you can do, and for even American dictators, there is just no hope for the report coming out flawless if it is a bad dictator. I have 25 years experience, and there is just the fact of the matter that if junk goes in, junk is going to come out, and experiences helps with figuring out the words, but some words are so badly mispronounced, there is no hope of figuring them out. Blanks are inevitable, but that is why we have QA - they are the next level after the MTs get the rough draft out there. It pays to have a second set or third set of ears, and it is part of the plan - it is not all on just you to get it right on the problem dictations.
For this account, I charge 0.12 cpl. It is very easy clinic stuff with good dictators, but ...
I also do tapes which are horrible so I'm considering upping my line rate especially if all this aggravation keeps up. When I first took the work, I thought I was being fair because the work was so easy, but then they asked me to do tapes and then work specific hours, print and deliver work three times a week. I wish I would have addressed more than TAT and line rate in the original contract. I do charge them a $5 per delivery fee because of gas prices, but still I think I'm getting the shaft.
Oh well, live and learn. I am negotiating for a local doctor's office here in my hometown, small one doctor office, and I'm here to tell you I will be negotiated every little detail right down to paper and toner charges!
Isn't that interesting. So much for the identify remaining secret. nm
x
I don't think it is cruel to admit your remaining parent - sm
into a nursing home. Those that think its terrible are just concerned with appearances I think, that and guilt themselves if they ever thought about it. My mom put her mom in a nursing home after she could not care for herself. My grandma actually thrived there. They got her off all her medication and she was felt a lot better, even got engaged to get married again, but broke it off shortly before she died. We lived in PA and her mom in FL. My mom's (adopted) family thought she was such a terrible person for putting her "mom" in a nursing home. My mom's adopted parents did not treat her well at all, would never tell her much about the adoption when she eventually found out about it in the 1950s (smell of scandel somewhere, this was 1935) and my grandparents never really ever wanted children. Needless to say my mom has a less than ideal childhood but she took care and upheld her "responsibilities". Some people take in their parent(s) because they want to make sure the $$$ if there is any stays in the family (or goes to them). I know that is the wheel turning in my DHs brain about his parents, though he says they would never re-marry after the death of the other. His mom has told me she will not remarry, but you never know do you. I think he is wrong about his dad though, I think his dad would do the exact same thing my dad did, i.e. remarry within a year of the mom/wife passing and say bye-bye to any substantial inheritence on a re-marriage. In my case I will "lose" (my husband's thinking) out on about $140K which my husband deeply resents unfortunately. It has caused a lot of distention in the last 2 years between me and my DH that is. I am cool with my dad, it's his life and money; and I have pointed out to him a zillion times that inheritence is a gift, not a right. But yes, to be honest it is disappointing, but as my DH expects to get close to $1 mil from his parents I think we will survive (in a way I hope they disinherit him). Greed can cause all sorts of problems. Along with responsibility comes motive in some cases. I do not want to take in either of my DHs parents, but his fear/greed will induce him to have whichever one is left move in with us probably in the next 5-10 years (they are 76 and 71 right now). Sad.
Not always. Tongue stumblers. New dictators. Speedy and lazy dictators.
D
?? Bad dictators are bad dictators regardless of their mother language.
wonder when people will just get over it and do what they can and move on.
What is the difference between an acute care account and a multispecialty account??..nm
nm
I've never had a problem switching from account to account.
The problem I had was being switched too soon. If I don't get one account spec solidly in my memory with QA feedback on mistakes before starting another, I get confused. The other problem I had with former jobs was inconsistent QA. One person tells you one thing, another person tells you another.
Lately, I don't have a problem with it. Right now, my binder has 8 account specs (some I've never had to use) and I'm picking up a new weekend job for a while. The terminology and report formats stay basically the same. It's just all those little preferences. LOL
what is your account and specialty on the account?
no one is watching. tell us all about osi.
how are they going to get used to all the dictators
if your source says they cherry pick and only do American dictators? Sounds like never. But you knew that.
PS: Are you absolutely sure your source has your best interest in mind with this detailed ratting on another person regarding Indian cherry picking doing non-Indian work?
Dictators who keep....
  
I'm having a bad day with dictators and got this in my
email. It cracked me up. It's a typo in a medical brief that a lawyer filed for a continuance. The typo is on the 2nd page.
http://www.thesmokinggun.com/archive/0916051disk1.html
I have had dictators like that!
when most dictators were from the USA. nm
x
bad dictators sm
I can take an ESL more than I can take an American who speaks fast just to show off to his buddies or because he has a hot date and is dictating from his car or worse yet, if you can't understand him, he has an excuse why his report is incorrect, he can blame you for it. They do it, believe me, and they are the ones who should be shot down. Give me an ESL any day who says thank you very much and is trying hard to learn the language. Some of these fast-talking big shots could care less about us. I had one guy who could fit 15 discharge summaries on one side of a 15 minute tape and everyone would send him to me because I was the outside service. When he was spoken to, he just threw his head back and laughed. Ignorant!
dictators
don't you just love it when you have to turn up the volume to hear what the doctor is saying and then in the middle of the dictation he finally puts his mouth to the mic/phone, blasting your ears; so you turn it down then by the end of the report you have to turn it back up.......no wonder I have ringing in my ears sometime 
Bad dictators
Chewing gum very loudly, blowing bubbles while dictating, drinking something and then chewing on the ice....all in the average day lately. Don't these people stop to think that someone has to listen to this? That they are chomping incessantly into someone's ears. No common sense. Maybe once, someone in authority should remind them that these are legal documents and need to be transcribed as accurately as possible, so no chewing, drinking, talking while yawning, etc.
Bad dictators
I have got to one-up y'all... there is a woman doctor in our group who actually takes her dictaphone INTO THE BATHROOM with her and, yes, that's right, uses the potty right while she's dictating...
ESL dictators
Maybe the ESL docs, knowing that the Transcriptionist must be having a difficult time with the language barrier, should hire an English speaking person to do their dictations. It would free up their time for being a doctor and seeing patient's, give a more accurate transcription, and a better quality report. Wha'cha think???
ESL dictators
Seems many MTs have this complaint. We should be told the correct percentage of ESL dictators BEFORE accepting a job. Imagine all the money a company would save by going over details with each new applicant honestly and thoroughly in the beginning instead of making the job sound good and then have a disappointed new employee, who will quit and the company will have to advertise and hire again. Advertising and training on a computer system is costly, including the time involved etc. The more a company can do to retain its employees, the more money it will save in the long run. Also, pay based on production, not quality of work, is counter productive. Imagine if each Transcriptionist was paid a salary and did quality work and no QA people were needed, except to pull random reports of new employees during the first 30-60 days or so. I feel there is too much QA and not enough emphasis put on quality reports from the beginning. Many transcriptionists feel, the QA people will fill in my blanks, yet they may be able to find the word/words themselves if production was not such a huge factor. But too many employees are trying to meet a line count. With a salary, you can establish a budget and know what to expect in your paycheck. I've transcribed for 25 years. I love my work. Since outsourcing and pay by production have been instituted, I feel pride in transcribing has suffered. Give an employee a job they can feel great about, benefits, and treat them with honesty, fairness, and respect and they will be glad to work for that kind of company. Hopefully, there are companies out there like this It's up to us to find the good companies.
Of note, 10 years ago transcriptionists were being paid around 10-11 cpl and $3.50-$4.00 a page. What happened, outsourcing!! We used to get a higher salary than coders, but not now. We need to keep our work in the USA.
Bad Dictators
I had my share of bad dictators this afternoon too! Is it full moon? I am sure I had your doctor's wife. LOL Can we band together and chart a bus to deliver them to the firing squad?? LOL At least maybe would could let the air out of the tires on their golf carts! Do these people listen to how bad they are???????
Dictators
OH PULEEEEZE spare me the whispering, breathy female docs who sound like they could talk all night on a phone sex line. I don't care what you sound like on the phone. Just TALK lady - spit it out. Am I mad or what? Gads I'm sick of these bimbos.
bad dictators
You ever wonder that when the powers that be become aware that you are making lines on low volume work days, they somehow sneak all the worse dictators your way? I have had bad dictators, none of them in sequential order, and am no where close to my lph this morning.
Dictators
 I could send you a lighter! Seriously, I have considered sending a voice copy to them to play after the fact, a day or two later, so they could see what they could understand of what they said!
BAD Dictators
Oh, you're not alone. They all must have spring fever or something. I have had more dead air than dictation on reports lately. If this keeps up the pay should not be by the line, but by the minutes listened to.
To all the dictators out there
SLOW DOWN! This is not a race. I cannot stand it when these dictators talk so fast that you cannot understand them. You know who you are, especially the cardiac dictators!!!!
Thanks for letting me vent. I get frustrated when my production goes in the toilet!
bad dictators
My huge pet peeve when it comes to dictators is them stopping to flip through the chart and not pushing the pause button. I mean I am just sitting there listening to dead air, wasting money while they find what they are looking for before they start talking again. How RUDE. I think all doctors should take Dictation 101 as part of their medical training before they get licensed. Speak clearly in complete sentences, speak at a fairly fast pace, and for heaven's sake.......hit the pause button if you have to stop dictating.
Bad dictators
IMHO, these are all due to the HIM department folks not training the docs properly. I worked at one hospital long enough to find out that the HIM department heads have total control over what type of dictation behavior is accepted, including the reports that are outsourced. It seems that, if the HIM departments for the various hospitals that outsource to us, or the office managers for the various doctors, would just care about what type of dictation we are getting, they would go out of their way to do something about it. I know they have plenty of time, cause these are the very ones who have no problem picking apart reports and complaining about missing commas!!
Bad dictators
Now my pet peeve.......dictators who say "go back and change" or "forget that last paragraph". You are essentially typing 2 reports and being compensated for only 1. Had 1 report today where CRNP did that 16 times.
Any suggestions welcome!
dictators
If MTs did the kind of job some dictators do they would be fired.
When dictators take a long time shuffling papers I just hold down my foot pedal down while awaiting the next words and check my email or read a paragraph in a book or do some upper body stretching exercises.
Recently I had a doc dictating over the barking of a dog. I wonder where he was? Or where the dog was? 
What is it with these dictators..sm
They'll ...um and ...uh and ...er all through the patient history..wasting more and more of the MT's time than necessary .. with the occasional 30-45 second pause between each item to paper-shuffle (on OUR time). But when it comes to the MEDS and LABS, which are the mainstay of an H&P or consult, as other doctors will base patient care on the meds the patient is already taking or present lab results, they'll race through them at 78 rpm so as not to be understood or able to be transcribed without rewinding 4 or 5 times. Just because they can race-read medications or labs doesn't mean we can type them just as fast... I guess accuracy in these areas takes back seat. (Who cares where the patient moved here from or went to school?)
bad dictators
I think the shoe should be on the other foot. The doctors have absolutely no respect for what we do - we should be the ones giving THEM feedback - They will be the first ones to speak up if there is an error on the report when in fact, it is entirely their fault. We are intelligent, professional MTs, not magicians !!!!
The dictators that....
Have a pager sitting right beside the microphone and it continuously goes off, a shrill BEEP, BEEP, BEEP, BEEP right in my ear and they don't bother silencing it, turning it off, merely MOVING it away from the mic so that my ears are still intact, they just let it beep and keep on talking away.
What are your favorite dictators?
I like the ones who right when they begin dictating, turn around and speak directly into their armpit. Or how about the ones who carry on a complete conversation in English to the nurse next to them, then when they start dictating they sound like one of those auction guys who have had a few drinks?
Favorite dictators
I have one guy, who really seems nice, thank's you each time at the end of the report, apologises if he has to correct something he said, long reports, BUT, he usually dictates at home, while cooking,bathing the kids and NOW, we must have a new dog because we are deciding to train it while dictating .
It's a verbat account so I really should have put in all the "sits, stays, good dog..would have made a fortune.
BUT (again), if it were'nt for the fact that the ER he works in is over 140 miles away, I'd have been in the ER, requesting him, to treat me for my ruptured ear drum, when he must have forgot the doggie treats and this dog started barking, loud, blew my eardrums out, had to crank the volume wayyyyyyyyy down, could NOT hear him, except for the good dog's and sit, I'll play later
SS dictators and LINES.
I HAD a problem with Softscript period. Heard their sever is down again. Look out, line count will be changing again. Horrible communication. Horrible dictators. Never pain on time, NEVER. Dictators from hexx.
dictators on the phone
I agree--I have mentioned this endless times to my supervisor about dictators being on the cell phone, the worse that I have had was a dr at a baseball game, doing dictation on his cell phone, you could hear the other parents in the background cheering--sounded like a little league game and yes I did tell my supervisor and yes it is MQ and of yes, nothing was done
I love the ones that are on their cell phones and then drive thru a tunnel or put the top down
Fast dictators
When are these ******** doctors going to figure out that by dictating 100 miles per hour they are NOT going to get an accurate accounting of their patient encounter???? I feel like I'm being set up to fail. I don't care how much experience we transcriptionists have, if you're going to dictate a three page report if 1.5 minutes, SOMETHING is going to get missed or screwed up. I hope that extra three minutes they saved themselves throughout their busy day is worth it when the patient's chart gets the wrong data and somewhere down the line a big mistake is made. I've had a terrible morning, struggling with Mr. All-Important who dictates vital signs as one long rambling of numbers, never in the same order (one time it will be weight first, then pulse, blood pressure, respirations and the next time it will be blood pressure first, then weight, then respirations, then pulse) -- I've had it!!!!! I've got so many blanks in this batch of reports that I'm embarrased to turn them in.
Thanks for letting me vent. I'm not a bad transcriptionist.
I am so sick of ESL dictators!
 What a lousy day! I am sick to death of getting 100 different doctors a day and maybe one of them speak English. Makes for a very long frustrating day.
If we all would refuse to do bad dictators - what can they do about it?
Let them do them themselves or have their fair-haired Indians do them.
Let the mush-mouthed doctors get back mush-typed dictation. It would be fair.
Tonight I had so many questionable lab values it made me sick. I also got a non-ending stack of bad, foreign, indistinct, unable to speak English doctors --- you know the guys who end up at the bottom on last day of the payperiod.
I have gotten to the point that I want them to say "This isn't right!" and stomp their feet, because I want to go nose-to-nose with these jerks. Just mess with me suckers! I'm ready. I'm premenstrual and I'm ready.
Not yet, but some days I think some of the dictators I get are going to
The dictators are terrible. NM
:
Love new dictators, don't you? sm
Had one spend the whole time spelling everything. Not just meds either. She even spelled lumbosacral and anteriorly.
Very, very clear English spoken very, very slowly as if she were speaking to a child.
She did not, however, give the name of the patient or the date of service. All I knew was that he was a 36-year-old male that took M-O-T-R-I-N.
Gotta love it. Won't be long before she's mumbling while eating lunch. 
ALL dictators should be required to take a
dictation class taught by an experienced MT. This would surely help this problem.
If these dictators actually got verbatim
reports, they would probably have a stroke and need immediate medical attention. It is scary to think that these people dictating take care of us and our families. I certainly hope they are better at treating than they are at dictating.
Uncaring dictators
I'll bet they have an office manager, make an appointment either in-office or phone. Take/sent a typical tape for her to listen which STILL it is different -- to just listen to than transcribe and listen.
I presume you have asked for samples of old reports on all work types and dictators.
Say something like, in a kindly term, in order to transcribe and give you good service and maintain my business name integrity, I need to be able to HEAR. I would like to keep the rates the same, however, it is becoming difficult, I am just not able to generate a reasonable hourly income. I don't like sending in reports with blanks and would be happy to "fill in the blanks" but it would be necessary to charge .50 a minute of time. If left as is, my business name goes down the tubes having blanks left in circulating reports.
I'Please ask the staff to spend some thought on dictating clearly (each time) so I can maintain your current rates.
ESL Dictators-I must be backwards
The more I do the same ESL's, the less I CAN do them. I don't mind doing them as it is challenging, but getting the same ones day after day seems to wear me down and I can't think clearly, so it takes longer for me to finish a report. It used to take me 15-20 minutes to finish a report for a certain doctor, but now it may take as long as 45 minutes! I don't make sense to myself. LOL
The quality of the dictators is SM
pretty bad overall--even the Americans. I would say with most national services, the accounts are about 75% ESL (30% terrible ESL), 20% fast Americans who don't care and 5% really good gravy dictators.
This is for acute care dictation--large hospitals. Another problem is there are so many dictators in 1 facility that you hardly ever get the same ones day after day.
I think in QA you are seeing the low quality of MTs, not dictators sm
If I were you (and I admit I did QA for awhile and hated it, for so many more mistakes than the blanks they had sent to QA for) I would go back to MT. There is lots of money to be made, especially when you become familiar with dictators and accounts. I wouldn't do QA for anything. $15 an hour for QA versus $35 an our for MT. Go back to MT.
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