I transcribe for orthopedic surgeon who utilizes EMR

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Is it correct to capitalize every orthopedic test, such as, Anterior Drawers Test, Alar Ligament Test, etc.

Wheeless Textbook of Orthopedics - online - link below. I find this to be a priceless site. Good luck

when a patient is ready to be discharged, he always says "____ is peeing and pooping normally." Slays me every time! I just find myself giggling like a little kid whenever I hear it! Peeing and pooping are such a great words...embrace them!

I want to get my finances ready before I schedule the surgery. My previous experience with surgeons and disability is "go back whenever you feel ready"...they don't seem to want to comit to a timeline. The last time I had surgery I went back way too soon and had complications, so would like to avoid that this time around.

Thanks to everyone who has replied, this is all good advice and info. I think I will plan for the worst at 6 weeks or so and hope for best at just a week or two. It certaily won't hurt to have some extra money saved.

I had a similar situation a few years ago. I paid and the ins. co. paid, dentist kept both payments. After 3 phone calls to the office, no money. So, I wrote a letter to the dentist, put PERSONAL AND CONFIDENTIAL on the envelope, put a cc to the state dept of insurance at the bottom of the letter (dept of ins. scares them more than the AMA (if dealing with MDs) or American Dental Association).

my son to have his wisdom teeth removed. Charged us $75.00 for the consult. I didn't like the oral surgeon and his office staff were very standoffish can I did not make an appointment with him for surgery, but with another oral surgeon. I had to pay the $75.00 up front - no problem, but they filed the insurance with the money coming to them. It has been 5 weeks now since they received payment and I have called twice asking for a refund. They told me the insurance company had 90 days to come back and ask for the money, but I PAID upfront so what difference does that make, they aren't out anything and they have $52.00 of MY money on top of the $75.00. They said they would issue a check next week, but is what they told me 2 weeks ago. It isn't a lot of money, it is the principle of the thing.

Went to another oral surgeon and they didn't charge me anything for the consult and the amount I have to pay upfront is $300.00 less than what the other office quoted me.

who says what he REALLY thinks about the JCAHO. Funny, I found it on Google when I typed in JCAHO and q.i.d. since I wasn't sure what to do about q.i.d. ........

The Death Star of American Medicine

I wish I had written this (JCAHO Unplugged; registration required), because it gives voice to the feelings that I (and probably 99% of the physicians in this country) have about the Death Star of American medicine -- JCAHO. A few excerpts (emphasis is mine):

That is why it really upsets me to watch the JCAHO people walk through my hospital like they were navigating a toxic waste dump. What upsets me even more is the utter paralysis of normal activity that occurs months before their visit and the huge sums of money spent on mock drills and consultants to prepare for the JCAHO invasion. JCAHO (the Joint Commission on Accreditation of Healthcare Organization) arouses more fear in hospitals than MRSA gone wild, and their "visit" has a greater institutional paralytic effect than circulating a neuromuscular depolarizing agent through the ventilation system.

A few unsigned verbal orders, or an anesthesiologist carrying a syringe of Anectine in his or her scrubs, or not locking up I.V. bottles of normal saline will result in conditional or provisional approval, and failure to take remedial action within 30 days may result in the death penalty, which for the hospital means bad PR, and more significantly, loss of all federal money. That's right, you can get the chair for parking tickets in the JCAHO world.

It doesn't matter that the hospital admits 50,000 patients a year, saves countless lives and performs daily miracles. Write q.i.d. twice and you can get your liver transplant someplace else.

A response by Russell Massaro, MD, FACP, Executive Vice President Accreditation and Certification Operations, JCAHO, follows Dr. Cossman's screed. The only thing I can say about it is that he makes clear that unannounced surveys will be forthcoming in 2006. Oh, joy!

A lot of the press in the past few days has been discussing issues such as oversight, accountability, and clearly expressed legal authority. JCAHO operates without any real semblence of these niceties, and does so with all the subtlety of a bureaucracy run by Darth Vader. Watching hospital administrators lose bowel and bladder control the minute a JCAHO inspection is brought up has always reminded me of Vader's underlings wilting in his presence --- and for good reason. Without the JCAHO seal of approval, they cannot operate an otherwise well-run, caring facility. The organization, as it was originally intended, was designed to ensure a basic level of safety for all hospitals. It has now become yet another "certifying" agency which must come up with new "critical" problems to fix in order to ensure its ongoing existence (those of you who have gone through the most recent mental masturbatory experience of banning QD and QID in orders know what I mean). What is most galling to me, however, is that hospitals must fork over a hefty sum for these frequent torture sessions, and the inspections are done not by practicing physicians or nurses, but by folks who long ago gave up the difficulties of actually caring for patients for the safety of a clipboard to hide behind.

Maybe I have my metaphors mixed up --- JCAHO comes in like the Death Star, but leaves no room for different institutions to solve problems in their own way. The JCAHO mantra can really be translated as "Resistance is futile. You will be assimilated!" As a result, I suppose JCAHO is really The Borg.

*mask* things once (and ONLY once). What a crock! It's like trying to transcribe an auctioneer. I always wondered how the accuracy couldn't suffer with this method. (I guess I was right, considering the government is now using it.) They make less money because there isn't much skill involved in doing it that way. Legitimate court reporters go to school for quite some time and have to learn what's basically another form of shorthand. (It's been years, and I might be wrong, but I believe, for example, the letters PB=N (or something like that. LOL).

I was around when the court reporters in my area went from straight dictation to *the computer.* In fact, I did editing/scoping work for one court reporter who bought the new system, way back when the technology first became available. (She also bought my computer for me to do her work and anything else I wanted to do on it, and part of her *offer* was that after two years, I would own the computer outright!) It's a whole different world than transcribing. I didn't like it then, and I don't like it now. It's easier for the court reporter, who can pull his or her notes right up on the screen when something doesn't make sense and see where the *typo* was and figure out what it actually should have been. So in order to be an Editor for a court reporter today, you basically not only have to know how to read their notes, but knowing how to read their TYPOS is the important thing. This particular court reporter had the wisdom to know when her notes weren't that good, and rather than give me a very sloppy transcript to edit, she'd dictate it instead. She was a great person, and I miss her a lot.

Scoping/editing for a court reporter is a great field to get into if that's your cup of tea. If you're a typist, it's real difficult to get the "rhythm" that you can get when transcribing, and that's what I don't like about it. (Very same thing with VR in medical transcription today.) However, after doing this kind of work for 20 years, I might wake up tomorrow with carpal tunnel and might be forced to pursue it.

One thing about court reporters, from my own personal experience in my area: They are the most generous, easy-going, NICEST people I've ever encountered, considering the enormous amount of stress they're always exposed to. Back in the 1980s, I remember reading stats on suicide rates, and court reporters and DENTISTS were right at the top of the list!!

Is there a way to transcribe a church audio lecture from CD? It is a .cda file. I have "associated" the .cda with Start/Stop and ExpressScribe, but I still have no control with my foot pedal. any suggestions?

a minimum of 2000 lines per day x5 days a week for 8 hours a day, making 9 cpl which equals out to $180 per day. That comes out to $900 per week or $46,800 per year. That is just at 2000 lines per day. This is w/o shift differential and line differential added in. We get a bonus for going over a certain number of lines per pay period and we get a shift differential for working 2nd and 3rd shifts, which then works out to over 10 cpl. Transcribing 2000 lines per day works out to 250 lines per hour. W/o using an expander, I probably type about 100 words per minute and with my Expander it is a lot more. My pay stub shows how many lines per hour I average each paycheck. This week it was over 300 lph. I use my expander to its fullest. I have macros for everything and anything you can think of. I do radiology, oncology, and ER transcription - lots of phrases said over and over. I do not cherrypick. I cannot see what report or doctor I am going to get, the chart just pops up and I type it. Some days are all good docs, lots of days they are horrible but in this profession you take the good with the bad.

Everybody's work habit is different. Focus on what you can do instead of what person A or person B can do. When I first started I set goals for myself. I wanted to be typing 1000 lines by so and so date in 8 hours. When I reached that goal I made the goal higher by 100, 250 and then 500 lines. To me, it's all in the attitude you have for work. I look forward to work each day because every day there is something new to be learned.