I think your boss was saying transcribe verbatim,
Posted By: QAer on 2006-01-30
In Reply to: The bottom line is - see message
as in p.r.n before the drug was dictated, and you changed the order. Not to be a witch, but the other poster is not correct - ibuprofen is not capped. You are right that PRN should be p.r.n. - it is a latin abbreviation, but MANY MTs cap stuff like that. One of my peeves...
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No, as an IC, I am my own boss. I contract out my transcribing services, but I am my own boss.
:)
Verbatim is verbatim, but I defintely to the little things to make the doc look better such as..sm
an eye problem instead of a eye problem. I definitely wouldn't change too much. Stick with what they say and only make changes when you absolutely think it is necessary. I took a test last night and have an interview today and this is what I did. FYI, I do clinic work.
Verbatim = verbatim......flag it...NM
x
Best thing - I am my own boss and my own emloyee, worse thing - I am my own boss and my own
:P
Tell your boss
Tell him exactly what you told us - that you were researching for the name and that is what you came up with. You did nothing wrong and I'll bet the doctor will be very appreciative. Good catch on your part!
Per my boss.....
It would be 250,000
Boss?
What happens after the holidays? She sobers up and re-hires all of you?
And, I thought nothing for Xmas was bad! :)
I used to have a boss like that (sm)
She was actually running the company, a new franchise in a big city, and between her other duties, she typed. She would be there at 4 a.m., sometimes 3, and leave at about 9 p.m. every night. That is a sickness. The best part is she didn't need the money - seriously - she didn't even need to work. They were very well off, and her husband had a great job. She finally had a heart attack, but that was after years of those hours; believe it or not, she didn't even go into the hospital for her heart attack - the doctor said it was "mild" so she came to work half days for about a week, cause the place couldn't run without her. Now THAT is sick.
I would think so. You would tell your boss ...
if you worked in an office. I have always let several people know when I am going to be away, just to make sure I'm covered.
Have a great vacation!
Boss
I am sorry to hear this, but I have worked in-house and encountered the same type of boss. I left and did not look back and that same boss is there and things have gotten worse under her administration. My ex-coworker has been transcribing for nearly 20 years and is one of her best employees, but yet she treats her like a dog -- go figure.
Boss
Sounds like she is trying to get you to quit - I went through this with one boss - an MTSO - who was really losing all of her accounts and did not want anyone to be able to collect unemployment. She tried everything, changing people's accounts, denying them bonuses, taking away work and queuing it to other people, you name it - she did it. Thicken up your skin if you like your job, but don't expect her to change. I'm sorry that you have to go through this, as it makes for a stressful work environment -of course at some point that might be able to be changed to a "hostile work environment" at which time you need to go to EEOC. Come to think of it, I would give them a call anyway and report her.
Boss
I bought the Boss too and I love it! I had considered Dyson, but so expensive, and glad i settled on this one - i'm impressed!
boss
I had one that i worked for a little bit longer than you and when I gave my notice she told me she would take my resignation now. Boy doesn't that make you feel like just another #.
I think it might be a boss
Upon further research I think it might be a carpal boss or bone spur because it is very hard and painful, unlike a cyst. I'm going to see my rheumatologist in a couple of weeks and ask him. I have a bad feeling that it might need to come out because my hand is getting stiff. But as long as i can type I'll hang in there.
I think you must have my old boss! Just like you, all of us
Notify your boss
Depending on the company you work for, you might get results. It's very frustrating when you see something that needs changed but are powerless. When working for Edix, I had a patient that had the exact same condition my son has and there was a new treatment that had saved his life, yet her doctor did not know about it and she was at the point of being near death and only in her 20s. I emailed my supervisor and asked them to please notify the doctor of the information I sent and they said nope, no way, against the law. That was nearly 3 years ago and still bothers me wondering how the patient turned out.
Do any of you consider QA/editing to be your boss?
I understand that they critique our work, etc., but I never really considered them to be our "boss". I already have one supervisor, now it looks like I have a few more.
I am my own boss and my own employee. nm
:}
I'd tell me to discuss it with his boss
You gotta be r-e-a-l careful when you're talk state laws. The boss might consider him "problematic." I mean, how much money are we talking about in terms of travel from the boss to the client? If he's getting, say, $10/hour and it's a 15-minute drive ... For $2.50, I would just let it slide.
I'm an IC and work exclusively for one company, which makes me a statutory employee by IRS law. However, I'm making a high line rate, so I'm more than willing to leave things as they are and pay 100% of my social security tax.
This is one of those "silence is golden" situations.
Boss asking for normals
Is anybody working for a company where your boss is asking you to share your NORMALS. Be very careful. My company is asking us to share your normals and come to find out who they want us to share with, overseas. Also asking questions like, who are the best dictators, etc. Also experiencing block of work just disappearing. Several hours just gone. Anybody else.
I wonder if you have the same boss lady as me...
She is terrible. She constantly acuses me of things I am not doing and then when I call her on it, I never hear any more about it. Never an apology. I have tried to speak with her on the phone but she won't and it's always by e-mail which is so frustrating. I have been slammed so many times I can't even count any more. I just never know from day to day whether I'll have a job or not because I never know what I will be accused of next. Oh the things we put up with to make a living in this business
She's the boss, applesauce.
:=
OMG... sounds like you have my old boss! n/m
:)
I'd ask your boss for them or the doctor for -
examples. If you cannot get any that way I'd just use the standard SOAP format for PT.
If you are IC, this person is NOT your boss.
x
Being my own boss is worth that!
x
As employee, you do what the boss (Dr) wants.
x
Apparently your boss is not looking at
the work flow. Next time you are asked, tell your boss that if you could pick and choose you would be doing more work too. The boss needs to handle this, if he/she won't, there is not much you can do.
I would not hesitate to tell your boss
especially since she has asked you why this person does so much more than you. Also, you have proof!
Don't worry about opening up a can of worms - it needs to be open. You need to be honest with your boss when she questions you to cover your tail! I wouldn't worry about the other person - she's made her own bed and now she should lie in it.
Verbatim for ESL too?
Geez, if that were the case on my account (not MQ), you wouldn't believe the crap I'd be putting out - "59 years old pt, denies of chest pain, comes to ER for short of breath," and I could go on and on.
Verbatim
I still don't understand, for example I have a doc who does about 20 lengthy bypass operations a week. I have a 4-page "standard", that I just immediately pull up. He never dictates it the same way twice, I just simply pull up my standard, put ears on, follow along and delete, insert, change and so on as he dictates, and that is as good as verbatim.
Since I am on verbatim also, I use whatever s/he says..
Jim for James etc....however, if the doc is clearly off track, he starts calling Mary by the name of Frank for instance (it has happened) then I flag it.
verbatim
The docs at a big teaching hospital I formerly worked for did not put punctuation marks after the word HOWEVER. That's the way they wanted it and we were marked down if we added the comma.
verbatim, really?
Of course verbatim means typing EVERY SINGLE word they say, even when it's a side conversation, a snide comment, etc. One thing I do that may not help them at all but makes me feel that I've at least let them know that I know - I enclose such words in quote marks to set them off from the real words.
Verbatim
As a private IC there was a prominent heart surgeon from Iran whose dictation I "cleaned up" constantly or he would have been the laughing stock of the community. Sometimes you have to "save face" for the client. If I worked for a national and they QA'd me from saving someone from a drastic error, I would immediately "quit." Another ESL went to hospital admin to tell them I was "his friend," I did not change the meaning but there were several instances when I had to make sense of things for him to cover the hospital's reputation. I was taught never to "change the meaning" and to put certain language "in quotes" although as an IC, I would always call the client first and they usually thanked me. When you work for another service, you can't do this, so it makes it very difficult.I guess you have to go with who pays you, but I would never, never type a senseless sentence.Good luck to those who have "bad QA assessments." They should know better.
verbatim
it's stupid and dangerous to type verbatim. Some hospitals stupidly insist on it cuz they believe we can't think for ourselves. They say "We've always done it that way." Well God forbid you should TRY TO IMPROVE. they say "well, you don't KNOW what he meant." My answer to that is "well, YOU may not know, but I do!" They just don't want to be bothered with having to actually think about it. Any decent trx with many years' experience and worth her salt GENERALLY knows what the doc really means but can't spit out, for one reason or another. I'm married to a doc - I know. But he DOES want us to leave blanks if we DON'T KNOW - better that than making something up, which he does see all the time from Spheris trxs. That's what happens when you hire people with one year of experience and don't monitor them closely, of which Spheris is guilty. And leaving a message for them on ESA doesn't work, cuz the doc won't see it till he goes to sign if off, and by that time, he has no earthly idea what he said. Nor does he care!
IF they got verbatim EXACTLY what they said,
they'd probably be in total shock at how ridiculous they actually sound when they dictate. Don't you just want to give them what they give you sometimes?
Verbatim
The problem is with the client profile. It should not ever have the word "verbatim" in it because the word by definition means "word for word" and we all know all of us from time to time and doctors especially speak garbage and have to be cleaned up. If with followed the client profile and transcribed "verbatim," screams would echo across the country. So I am all for removing that word from all the client profiles unless they truly want reports transcribed verbatim, word for word. We could do that, but it would not be much of a record.
verbatim, no BOS sm
Who are they? I would love to throw the BOS out the window, please e-mail me. Sick of all the new rules which don't amount to a hill of beans anyway at most times.
verbatim
I must be getting old. I'm finding it more and more difficult to "follow directions" as I age regarding this subject. I can't believe these younger physicians don't want us to fix the glaring errors. The real trouble is there's no one who will be the intermediary between the transriber and the doc, maybe, like back in the day. Way too many cooks stirring the broth and complicating what used to be a common-sense and less complicated situation, transcribing, that is.
i do verbatim too, but still BOS has
many points of reference that are helpful. I am one that hated the idea of a BOS, but when i finally succumbed, found there was a lot of useful info in it. Its not a bad idea to have a common reference point.
They may want verbatim, but if they are in
an acute care facility BOS overrides what they want. JCAHO can give/withhold accreditation based on the medical records and they say follow BOS. It isn't that is is an issue of style as much as it is a patient safety issue.
Verbatim
The hospital I work for now is a verbatim account, but we were told to spell out everything in DX, Impression, etc. I spelled out a lab abbrev and it looked so weird, but QA/Trainer told me to spell it out. Very contradictory so if it ever comes back as getting "dinged" for it I am going to tell QA who told me and they better not takes points off my audit.
I manage my former boss's websites (he has 2), --
other than that, sell some stuff I don't need anymore on ebay now and then...did about $200 a month for about a year.....got rid of most everything though I really wanted to dump...have a few things now I need to list so maybe I will get lucky this month!
boss this to me the other day and really has a lot of good info; sm
cancer classifications
stage and grade
Lowercase stage and grade.
Use roman numerals for cancer stages. For subdivisions of cancer stages, add capital letters on the line and arabic suffixes, without internal spaces or hyphens.
stage 0 (indicates carcinoma in situ)
stage I, stage IA
stage II, stage II3
stage III
stage IV, stage IVB
Use arabic numerals for grades.
grade 1
grade 2
grade 3
grade 4
Aster-Coller
Staging system for colon cancer from the least involvement at stage A and B1 through the most extensive involvement at stage D.
The patient's Aster-Coller B2 lesion extends through the entire thickness of the colon wall, with no involvement of nearby nodes.
Broders index
Classification of aggressiveness of tumor malignancy developed in the 1920s by AC Broders. Reported as grade 1 (most differentiation and best prognosis) through grade 4 (least differentiation and poorest prognosis).
Lowercase grade; use arabic numerals.
Broders grade 3
cervical cytology
Three different systems are currently in use for cervical cytology: the Papanicolaou test (Pap smear), the CIN classification system, and the Bethesda system.
The Papanicolaou test uses roman numerals to classify cervical cytology samples from class I (within normal limits) through class V (carcinoma).
CIN is an acronym for cervical intraepithelial neoplasia and is expressed with arabic numerals from grade 1 (least severe) to grade 3 (most severe). Place a hyphen between CIN and the numeral.
CIN-1,CIN-2, CIN-3
or CIN grade 1, CIN grade 2, CIN grade 3
A cervical cytology sample that is within normal limits in the Bethesda system corresponds with a Pap class I or II; Bethesda's atypical squamous cell of undetermined significance (ASCUS) corresponds with Pap class III; Bethesda's low-grade squamous intraepithelial lesion (LGSIL) corresponds with Pap class III and CIN grade 1; and Bethesda's high-grade squamous intraepithelial lesion (HGSIL) corresponds with Pap classes III and IV and CIN grades 2 and 3. In the Bethesda system, the next higher level is labeled simply "carcinoma," corresponding with Pap class V and with "carcinoma" in the CIN system.
Clark level
Describes invasion level of primary malignant melanoma of the skin from the epidermis.
Use roman numerals I (least deep) to IV (deepest). Lowercase level.
Clark level I into underlying papillary dermis
Clark level II to junction of papillary and reticular dermis
Clark level III into reticular dermis
Clark level IV into the subcutaneous fat
Dukes classification
Named for British pathologist Cuthbert E. Dukes (1890-1977). Classifies extent of operable adenocarcinoma of the colon or rectum.
Do not use an apostrophe before or after the s. Follow Dukes with capital letter.
Dukes A confined to mucosa
Dukes B extending into the muscularis mucosae
Dukes C extending through the bowel wall, with
metastasis to lymph nodes
When the Dukes classification is further defined by numbers, use arabic numerals on the same line with the letter, with no space between.
Dukes C2
FAB classification
French-American-British morphologic classification system for acute nonlymphoid leukemia.
Express with capital M followed by arabic numeral (1 through 6); do not space between the M and the numeral.
M1 myeloblastic, no differentiation
M2 myeloblastic, differentiation
M3 promyelocytic
M4 myelomonocytic
M5 monocytic
M6 erythroleukemia
FAB staging of carcinoma utilizes TNM classification of malignant tumors
See: (TNM staging below).
FAB T1 N1 M0
FIGO staging
Federation Internationale DE Gynécologie et Obstétrique system for staging gynecologic malignancy, particularly carcinomas of the ovary. Expressed as stage I (least severe) to stage IV (most severe), with subdivisions within each stage (a, b, c).
Lowercase stage, and use roman numerals. Use lowercase letters to indicate subdivisions within a stage.
Diagnosis: Ovarian carcinoma, FIGO stage IIc.
Gleason tumor grade
Also known as Gleason score. The system scores or grades the prognosis for adenocarcinoma of the prostate, with a scale of 1 through 5 for each dominant and secondary pattern; these are then totaled for the score. The higher the score, the poorer the prognosis.
Lowercase grade or score, and use arabic numerals.
Diagnosis: Adenocarcinoma of prostate, Gleason score 8.
Gleason score 3 + 2 = 5.
Gleason 3 + 3 with a total score of 6.
Jewett classification of bladder carcinoma
Use capitals as follows:
O in situ (Note: this is the letter O, not a zero)
A involving submucosa
B involving muscle
C involving surrounding tissue
D involving distant sites
Diagnosis: Bladder carcinoma, Jewett class B.
Karnofsky rating scale, Karnofsky status
Scale for rating performance status of patients with malignant neoplasms.
Use arabic numerals: 10, 20, 30, 40, 50, 60, 70, 80, 90, 100. (Normal is 100, moribund is 10.)
TNM staging system for malignant tumors
System for staging malignant tumors, developed by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer.
T tumor size or involvement
N regional lymph node involvement
M extent of metastasis
Write TNM expressions with arabic numerals on the line and a space after each number.
T2 N1 M1
T4 N3 M1
Letters and symbols following the letters T, N, and M:
X means assessment cannot be done.
0 (zero) indicates no evidence found.
Numbers indicate increasing evidence of the characteristics represented by those letters.
Tis indicates tumor in situ.
Tis N0 M0
The TNM system criteria for defining cancer stages vary according to the type of cancer. Thus a stage II cancer of one type may be defined as T1 N0 M0, while one of another type may be defined as T2 N1 M0.
Staging indicators are used along with TNM criteria to define cancers and assess stages. These are expressed with capital letters and arabic numerals.
grade GX, G1, G2, G3, G4
host performance H0, H1, H2, H3, H4
lymphatic invasion LX, L0, L1, L2
residual tumor RX, R0, R1, R2
scleral invasion SX, S0, S1, S2
venous invasion VX, V0, V1, V2
prefixes
Lowercase prefixes on the line with TNM and other symbols indicate criteria used to describe and stage the tumor, e.g., cTNM, aT2.
letter determining criteria
a autopsy staging
c clinical classification
P pathological classification
r retreatment classification
y, yp classification during or following treatment with multiple
modalities
suffixes
The suffix (m) (in parentheses) indicates the presence of multiple primary tumors in a single site. Other suffixes may be used, such as the following in the nasopharynx:
T2a nasopharyngeal tumor extending to soft
tissues of oropharynx and/or nasal fossa
without parapharyngeal extension
T2b nasopharyngeal tumor extending to soft
tissues of oropharynx and/or nasal fossa
with parapharyngeal extension
But ultimately the doc is the boss...so you do it their way if they insist they want it a certain wa
d
I'd inform the boss of this and if he refused
to pay, I'd turn him in to the labor board and then I'd quit but just like MT world there will always be someone willing to work for free thus nothing ever changes with making employers do the right thing.
Boss Yelled at me - no apology
 I worked for a lunatic like that once. File a complaint with EEOC for her "creating a hostile work environment". This may change her tune to a sweeter one.
My boss has one. Doctor prescribed it. nm
She said her shoulder pain, sore fingers and wrists are gone. It is highly recommended for those with RSI. She said worth every penny, but did take 2 weeks to get used to it.
An old boss used to make up words (sm)
She was so proud of herself and tried to use "big" words. She would throw her head back so proudly and say things like we needed to make sure we were "oriententated" on "autholization". Yes, she said it the way I spelled them. Those are just a couple of examples. Memorandums were no exception. I took one of them and highlighted in red once all the errors with a big red F. Shameful. In our meetings, I had to look down to keep from making eye contact with anyone. I would get the giggles if I didn't.
I think My boss wants me to quit (vent)
She won't give me my incentive pay. I have typed 1400 to 1500 lines per day for the last six weeks which is up from 1100 to 1200. The deal is, if I can type this consistently for six weeks then I get paid 0.95 per line instead of 0.9. Well I have done that. She says, no you have not typed that for 10 days in a work period. I asked her, "well, how can I when you pull me off sometimes to file because of lack of work. She says, well, I just cannot give you the incentive.
Also, she stuck me in an office with one of the most obnoxious coworkers I have ever had to work with. None of the other Mts, male or female, can get along with her either so she sticks her in an office to herself and then she decides to move me in with her. Obnoxious starts belitting me like she did the others, she acts like she owns the place and I told her to stop. She did not stop so I went to the boss. The boss talks to obnoxious so I got the silent treatment for a while which was better then getting an azz chewing every 5 minutes. But then before I left today she bit my head off again about someone who was buring a candle and it was making her sneeze. I go to the boss, tell her I want to move back in the other MTs. Boss says, your not moving. I don't want Obnoxious to be isolated from EVERYONE! Your going to have to get along.
I know these nationals don't pay as high and I am sure they don't offier as good bennies but they are looking sweeter and sweeter. Help.
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