I type for three hand surgeons
Posted By: Patti on 2006-06-21
In Reply to: Workers Compensation - Rotten Fingers
I type for three hand surgeons and I have yet to see a WC claim go through without a big, big fight to pay for carpal tunnel surgery. Yet if you use any pneumonic tools, or drive and clinch a steering wheel -- truck driver, they will pay. But they seriously say that it is not the typing that causes it and will find some underlying cause to be the primary cause of it. All three docs agree. I got CT when I was working in the hospital answering phones a lot and clinching the phone and had the surgery -- 20 years ago. Now with typing sometimes 10 hours a day, never have a problem but guess I am lucky. Anyway you can try but it is a long, slow battle for you to climb and you will definitely need an attorney. Watch out if you are more than 15 to 20% overweight also, they will blame it on that.
Patti
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I always type right-hand dominent.
v
I've used Hand-Eze and Thergonomic Hand Aids. sm
They help with the carpal tunnel and keep hands warm for me. They cover the hand and wrist but leave the fingers free. I wear them inside out, though, because the seams rub on the skin too much for me. I've gotten so used to them, that it is more comfortable wearing them while typing than typing with nothing on.
Don't talk about hand, I still remember the one that got her hand chewed up by her pet rat....
had nightmares for 2 days after that.
I sometimes do that with one of my surgeons
She has a very monotone way of speaking and never pauses between sentences. Rarely dictates a period or any other punctuation. Most of the time I can figure out what she is saying, but she also has a sort of stream-of-conscious way of dictating that strings things all along together. If I can't figure out clearly what it is that she's saying I leave it all as she dictates it. Like you, haven't had any fall out from that tactic, either.
After hearing some surgeons
mangle their reports, I vow to never let hm near me with a sharp object in his hand. And when they say "informed consent" I wonder who did the informing and whether the patient could understand it any better than I do.
most surgeons dictate very well sm
That is one of the best things about ops. When I say "dictate well" I mean that they normally know exactly what they are going to say and use the same phrases over and over, which means a better line count for you. Plus, you are much more likely to get normals doing ops than you are consults and H&Ps (especially in acute care). Instead of doing one of these docs who repeat everything, or change everything, or a resident who is all over the report back and forth. That is what slows you down. I absolutely love op notes; they keep you up-to-date on equipment, etc., and the line count is great, but most of them get farmed out to Spheris (gee, I wonder why?) However, if you never type OP notes, they can be difficult at first.
Because surgeons tend to be
fast, succinct dictators. Because there are very few drugs to dictate, and the surgeon is familiar with all of them (as opposed to trying to dictate lists of meds as the patient wrote them in a history). Because surgeons tend to do the same sorts of procedures over and over, and the smart, efficient ones learn to dictate the same reports over and over so they won't leave anything out. That means an MT who gets him frequently can make normals to use over and over and save time. If an MT is fortunate and the software is very, very good, she can put jump codes in so she can jump from one particular spot to the next to fill in details that change. An example would be doing cataract surgery, where the main thing that changes is the IOL specific information. Because surgeons usually hate to dictate, so the reports are often as short and efficient as possible. Because it's not psych (or whatever the MT hates most, lol).
I do tapes too for 5 surgeons Mon-Thurs.
tapes I really do Monday thru Wednesday, Thursday my day off but if there are tapes here, I do them and pass on the day off.....
Yep, there will always be the smaller office or the MDs who like the personal touch of us doing personal deliveries, having just ONE MT do their work.....and these guys are all in their 30-40s.....they will not change because I have had them for YEARS..... and they are all within 8 miles of my home....I'm lucky 
Well, if you broke your right hand and were right-hand dominant, can you see how this might be a fac
It may not be relevant at the time of dictating a physical exam or social history but in the future it would be good to know if the patient breaks the finger(s), wrist, hand, arm.
I have never had a hernia repair either, but I have done transcription for general surgeons for 14 y
They usually tell people to plan on 4-6 weeks depending on the lifting requirements of their job. Have you asked your surgeon yet? They should be able to give you a good estimate.
Brain surgeons and the U.S. President take vacations; so can you. The world won't stop if you do!
Makes sense, I understand that surgeons will dictate the same report over and over, but....
none of my surgeons do them the same way each time. I have let's say an appendectomy from Dr. Smith, I pull up the appy report that I have saved from him....he will change all the words like and, the, or change the subject and verb, and it seems I change most of it anyway. I have tried to enjoy them, but you are right, hardly any drugs, I will keep that in mind. BTW, I love lengthy, detailed psych reports, they are my fave! Thanks for you reply!
French, especially the surgeons. Easiest: Middle Eastern, Korean, Chinese, Indian. nm
x
don't type double spaces. Type single. Then no one will be cheated.
x
I can type with wine, can't type with coffee, though...too jittery.
x
That is, type the code above before and after what you want bolded in the text-to-type box. nm
nm
For me it isn't an account type but a dictator type ...
and that would be oriental. An oriental dictator (hahaha, that kind of sounds funny...hahaha) is the most challenging for me.
No, you don't type directly into ES. You type in Word -
or whatever their platform is, just like you did with your tapes.
Then you do your line count in Word or the platform.
You should type them. I usually type them in parentheses following the diagnosis.
x
remind me, type what they say, type what they say, type....
"He indicated that at the beginning of the year he complained of health problems recently but has gotten better." C'mon doc, which one is it?????
On the other hand....
if you're an experienced acute care MT, you can pick up radiology in a month or two. I just did it earlier this year. Never typed a minute of radiology before and a couple months later I'm "flyin" at it. Yes, there's a learning curve, but it's not brain surgery.
on the other hand...
If you knew the TAT on the account when you took it on, and accepted it as such, then your obligation is to have the work done on time. If your personal life is getting more complicated and interfering with your ability to maintain the TAT, then maybe you should let your employer know so they can replace you with someone who can meet the TAT. Their first obligation is to the client, after all.
On the other hand....
Just the fact that you would be working on only one type of report would tend be for better production.
None I can think of off hand LOL!
xx
on the other hand..emp vs IC sm
status.
Anyone have experience with companies who hire you as an employee, certain hours but don't provide you with the equipment you need? Worked for a company that did that but no medical spell checker on their software, some accounts they want YOU to buy a C-phone for etc. etc. Asked them up front if account I would be working on would have medical speller, told yes. It did not. Also there was some kind of ShortHand program built in that they knew nothing about, we couldn't get to and conflicted with the autocorrect I used in Word. Kept asking and it was always we will ask the hospital and then nothing. Went out bought my own spell check and whatever I needed then three weeks into working, they dump the account.
Start over with a new account, different problems, they want me to buy even more stuff. Said no I am outta here!
Anybody had that problem?
You're right .. and here's 1st-hand knowledge -- sm
I start med school (been an MT for 24 years) August 2006.
One of my classes last semester was Intro to Medical Practices. I especially inquired about pro bono work by all the physicians and dentists who spoke to the class as guests each week. All gave significant amounts of their practice to pro bono work.
One physician in particular impressed me. He is a cardiovascular surgeon. His main area of expertise is doing cardiac bypasses. To make a long story short, because of insurance changes (MCare) over the past few years, he only makes about $650 per bypass for his own pocket and that is gross. Of the $1850 MCare and insurance companies pay him for this procedure, it costs him $1200 in overhead for that procedure. Until last year, he would often do the procedure for free for patients who could not afford it and had no insurance. However, for 2 years he had to BORROW MONEY to pay his OVERHEAD because he did so much pro bono work. He finally decided he just could not go bankrupt doing that. So now, he STILL does HIS PART for free but the patient has to pay his overhead. He tells them to call their family, friends, churches and if they have the $1200 for his overhead, he will donate HIS skills/time/energy for free.
The physician (maxillofacial surgeon) who directed this class said his annual pro bono work runs around $250,000 a year.
As well, while dentists recoup 95% to 100% of the fees charged for their services (they are ALWAYS getting their money up front), physicians (with the exception of cosmetic plastic surgery) only recoup an average of 31% of their fees. For every $1000 they spend on a patient, they will only get back approximately $310 and must write off the rest.
Now that is INSIDE information - direct from the physicians and dentists we had in class. I was shocked. Not deterred, but shocked.
Regarding that lovely cardiologist who gives so much away, take into consideration that the $650 for HIS skills/time/energy for ONE cardiac bypass -- he invests a total of 12 to 15 hours for that one procedure (that is WITHOUT complications happening) including his consult/operative time/followup visits, hospital rounds, etc. That comes out to about $54 an hour -- and plumbers and electricians around here make more than that. My Ford dealership in town gets $76 an hour.
And now, since we are starting to do bypasses endovascularly through the femoral artery, he has to really put the money down for more education to train to do this or he will be out of business shortly.
Interesting huh?! When people make comments to me about my future as a physician as a way to "get rich", I tell them not necessarily so!! LOL I'm not doing it for money! You couldn't pay me enough to go through all this at this time in my life!! LOL
Because I live with it first hand
I do get offensive when someone doesn't like my children simply because of their skin tone. I'm not saying that the OP said anything about my children or even posted about the topic. I was just offended that she can so casually admit to being a prejudice person. Prejudice causes hate and violence. I take offense to that. I think that you should, and everyone should take offense to it so that it can be stopped. If everyone were okay with it or no one ever stood up about the subject, where would we be?
Also, there is a difference between knowing someone as an individual that may be a "bad seed" and be a minority and not liking them versus not liking someone without knowing them as a person simply because they are a minority. 
All I know is, when those of us who are saved make it to heaven, there will be every race there right along with us, as God has created us all in his image.
Don't need hand holding.
I don't expect them to hold my hand, but it would be nice if they at least pretended to be somewhat human! Compassion for another person's loss only takes a second to respond to.... as you said in your post. It only took a second right? Most of the time I am with you, I would rather NOT hear from them. But of course I sent an e-mail to tell her that I would be out for the funeral, she could have replied with a condolence. That's all I am saying. I think that's a bit of a problem with the world in general these days, no one even seems to have time to be kind.  Thank you for your second to respond and give your condolence on my loss!
Hand stress
I've transcribed since 1983. You can lessen hand stress if you observe how you hold your hands as you type. When I was in my twenties I noticed that there was a real difference in the way I held my hands and how the older transcriptionists (they had their wrists up and hands pointing down at the keyboard). I have always had my wrists laying on something and my fingers are going up. I have never had one bit of carpal tunnel or pain whatsoever.
I agree 100%, on the other hand
They are all "red" states, you would think Bush would give them a payback for giving him a job....hey, maybe if we tell him Osama Bin Laden is there he will send some troops.
Two first hand accounts..that's where
Any excuse to blame him...that's okay. Very expected. Very insignificant.
Well, Bush DOES consider himself at the right hand of The Man...
I have Short Hand. Never used the others -sm
You can install ShortHand on multiple PCs. I like it. You can actually have one shortcut for a few things (found that really, really useful). You do have to pick from the list which one you want, but I'd rather be accurate even if it might slow me down a little. It has drawbacks too though. If you forgot to put -ed on the end of a word for instance, and you go back and do that and if ed is one of your shortcuts, it will expand when you don't want it to. You can save your personal shortcut dictionary (which is nice for backup) and install it along with the program on other PCs. You can also convert an old PRD dictionary from WP if you had one and possibly others too.
It works with anything windows and you can have multiple dictionaries for multiple jobs or facilities that might have different rules.
best hand lotion..sm
This stuff is great. It's about $12.00 a bottle..maybe more now..check out Silver Lining.com ... it has MSM in it and I have actually used it to relieve my carpal tunnel pain. It's a great healing lotion. Wonderful stuff!
Help! Does anyone have first-hand experience with VR, and if so,
what about the MONEY? I do not mind learning it and am excited about the new possibilities and where MT fits; however, am I to expect a major pay reduction? I imagine full-time with benefits will no longer be an option?
Please, any substantial information will be very appreciated...I am only interested in the money, so I can pay my rent, my utilities, my groceries. I do not have a husband who supports me, so live paycheck to paycheck.
Is it possible to make any money?
Thanks all!
leg and hand edema
I have had a problem with swelling in my lower legs and feet and also my hands for the past few years now. When this first started I had problems with headaches, went to the doctor and found my blood pressure was high. So now I take HCTZ 75/50 once a day and do pretty well on it. It is a pretty good diuretic and my B/P is very well controlled on it.
In the mornings I have no swelling at all, but I notice though that by the end of my workday my hands and legs are really swollen. My doctor says to just start exercising regularly and elevate my feet whenever possible. I also try to avoid salt. I'm a bit overweight so I'm sure that is not helping either.
I'm just curious if any of you other MTs have this problem also and how you deal with it.
Hand raised...
I too tell my teens to get off the phone, bed by 10:30 usually, curfew and such. It's hard because her friends don't have curfews and she does. It's very difficult to be the "party pooper" but somebody has to.
Want to hold my hand.
I agree, insulting a fellow MT is uncalled for, let alone a PS to imply this is unprofessional. I guess the word "brain" "dense" and "childish" are your words for the week! That makes what now, ? MTs you are wondering whether they have brains or not, are dense or childish. Oh, and please stop YELLING at people posting on this site. We are not children nor do we act like a child. Be kind as if we were your children, because you obviously are not around adults often enough. Geez!!!!!!! PS: Congrats to making fantastic money. I'm sure you are very dedicated.
This post is getting way out of hand--sm
consider dropping all comments now, before some people end up getting banned. just a suggestion.
I'd force her hand. sm
I'd definitely force her to do the deed if that's what she's up to. I sure wouldn't make it easy for her. It sounds like you've done a good job for them all this time. As for the pay, I think I'd be tempted to mention something about how they could afford vacation, but not be able to pay you, especially after you spent your vacation at home. The idea that she'd do that burns me up for you! Furthermore, you know darn well they've got the money. She's just being vindictive. Make sure and update after next week. We'll be wishing you luck with this sticky situation.
I just checked this out, Hand-Eze about twice as sm
expensive. About $20.00 for a pair of Hand-Eze and $11.99 for a pair of Thergonomic Hand-Aids. The only difference I've found is the color and the name.
She only cuts 3. By hand. That's all.
x
Hand Pain Help
You may also try taking magnesium and B6. Magnesium is a natural muscle relaxer, and the B6 works with the mag. Your problem is not exactly the same as mine was, but it could help you too.
Several years ago I developed carpel tunnel syndrome that got progressively worse over a several of months. Magnesium/B6 is what the doctor suggested, and within a week, my pain, numbness, tingling....all the symptoms, were completely resolved!!! I haven't worn a brace since! The dosage I took was 2600 mg of magnesium a day and 200 mg of B6. Adjust the dose as needed.
**Word of warning - if you develop stomach problems (to put it nicely), cut back your dose. Loose stools are a side effect of too much magnesium in your body, but it doesn't mean you can't take it...just cut back the dose until you get to a comfortable level. Good Luck!
hand cramps
My hands were bothering me over the past 8 months or so. Last weekend I went river rafting and even though my wrists were aching and felt weak, I had to row! Bottom line, the next day my hands/wrists were feeling fine. After working one afternoon, I had cramping again but I think exercising in kind of a cross-training way will fix them.
Ok, this is getting out of hand & it's going to stop now.
The OP explained her situation and then elaborated on the situation again. It sounds like she is a giving person by helping other family members and it also sounds like she just wanted some ideas on frugal ways to make a dollar stretch until she gets her affairs in proper order. Should she require the family members pay SOME type of rent to be accountable? Probably. We all know the real estate market is not what is used to be and some people are in a bind with their property right now. The OP is clear that she was not fully informed about the whole transaction and there could be particulars that the OP may not have been privvy too. Maybe mistakes were made by the OP and her husband and it's too late to repair the problem. People make mistakes all the time. As you are reading this, consider what mistakes you have made in just the past 24 hours. The key here is that before passing judgement understand that there could be many variables that you are not aware of.
Hand pain
Help! Both of my hands today are very painful. Sometimes I get the usual aches and pains in my hands and wrists from transcribing, but today they BOTH hurt so bad, especially between the index finger and thumb areas. They feel cramped and the pain is similar to when my shoulders get tense and you rub the knots. It's not a sharp pain, but a pretty intense pain when I put pressure on my hands, try to lift anything or touch/massage them or even stretch them. They're painful in the first four digits on both hands. Has anyone had this and/or have any clues what it is or what I can do to help them. TIA!
hand pain
Heating pad, ibuprofen, some kind of muscle rub with gloves over that, even if you have to cut the fingers out of a regular pair of gloves. Sometimes, the compression gloves make mine hurt worse. Also, a rigid wrist brace with thumb stabilizer helps overnight.
short hand
I've been using it for about two years and love it! Good luck to you.
Hand Pain
Try using typing gloves or wrist supports. You buy them at Wal-Mart for about $20.00. Mueller's are the best ones I have found. Hope this helps!
right hand coldness
I work in my finished basement and in the winter it is normally a little chilly, but not horrible. But, for the past few weeks, my right hand has been freezing cold. I got some gloves and cut the tips off, but that doesn't even help much...my fingertips remain freezing cold. I am starting to wonder if there may be some other sort of problem, especially because this does not happen to my left hand.
Any suggestions as to what might be causing this? TIA.
Right hand coldness
Is your right hand closer to an outside wall or window? Try getting a small heater fan to place near your right side.....this might help,
I have a left ulnar neuropathy, and in fact, had a transposition done a few years ago (which failed). Do you have any arm pain or weakness/numbness?
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