Meds are not given based on transcribed reports
Posted By: sm on 2008-09-25
In Reply to: error in med given - sm
Meds in hospitals are not given based on what is in transcribed reports. There are so many errors with transcribed material that everyone expects there to be errors in meds, either because it was dictated incorrectly or transcribed incorrectly.
Physicians write orders for drugs, treatments, tests, and procedures. They're in a different part of the record entirely. They're either handwritten or they are in electronic form.
That's not saying there are no medication administration errors, but just saying the likelihood of an error stemming from a transcribed report are almost nil.
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They don't remove eyes based on transcribed medical reports. SM
Hate to burst your bubble - we're important, but not that important.
I take great pride in doing great work and doing a bunch of it.
It is 10 reports transcribed for free.
The OP states the account goes through transcriptionists. I wonder why? The OP states later on in the thread they go through transcriptionists.
I'm trying to protect Lisa from getting abused from the get-go. All she has to say is "my charge is" and go from there.
Too bad if they were already transcribed. Does that mean Lisa should take the loss? NO. Absolutely not.
Again, read above where the OP states "they can't seem to keep a transcriptionist."
To the OP: Charge them! You won't regret it. If you are an IC, you have every right to charge them.
Plus, look at rockinMT's post. She bent over backwards for an account and what happened? It turns out she was spending more time than it was worth.
These are all my opinions, and I am trying to give my opinion on what the OP should do in regards to reports that she transcribed and should, yes, be paid for since she was not aware ahead of time and especially because it is a new account.
What do I know? Ya know? I mean really? Just looking out for the best interest of the OP, but hey, that's just me.
The reports that are transcribed get scanned into
the EMR record. They do the same thing with the lab slips, x-ray reports, etc. The transcription is still performed in the usual way it has always been done.
copies of previously transcribed reports
What I always found helped, make copies of reports from the medical record charts. Make a few copies of each doctor and keep them in your desk that way you can refer back to the report when doing the doctor. You will get the hang of it. No hospital wants to go through the money and time hiring someone just to let them go right away. Usually you get about a three to six month probation period.
Let the docs use their reports transcribed in India as a defense! LOL
The doc can sit there while the personal injury lawyer shows the jury a grieving family and the messed up report.
US MTs should not accept sweat shop wages or conditions. We are providing a service to them! We are their first defense!:) :) :)
If US MTs stoped working for low wages, the physicians who value patient safety and their livelihood would pay a descent wage. The other ones can try to explain the report being done in India to the personal injury lawyer tearing him apart.
Line-based vs. hour-based requirement
Hospitals do have an hourly requirement, and generally incentive after a certain line level. MQ only has a line based requirement, which is 12,000 per pay period. The hourly requirement is strange, unless they now plan to convert to an hourly pay plan?
The MR reports were being filed. Referring physicians/medical care providers reports were not.
This is a hospital radiology department with in-house MTs and a clerk who is in charge of the report distribution.
The two sentence normal reports will balance out the 3 page reports.
I am Wendy too
If you have not transcribed using BOS
guidelines that is probably the problem. See which version they are using and get a copy.
and this is how our records are transcribed =(
x
I have not strictly transcribed in about 10 yrs.sm
I work full-time doing medical transcription but I also have other duties that do not involve transcribing so I don't keep up with lines or anything like that; I get paid by the hour. I have worked 3-4 hours in the evenings for one of the national companies for a little over a month but I can't seem to get my line count up. I've only been able to do around 100 lph. I know it will take longer than it would if I worked 8 hours just transcribing. I would like to quit the other job and just work from home transcribing but I'm afraid if I can't get my line count up I won't be able to maintain my current income. I'm not a blazing fast typist, I probably type 75-80 wpm without any kind of expanders. Any helpful advice or encouragement on whether you guys think at my typing speed it is within reason to think I can make it to 150-200 lph? I've done straight transcription in the past but I never had to keep up with lines. I have 30+ years of experience. I just need to decide whether to keep things the way they are now or take the chance on income by production only. BYW, I transcribe acute care for the national.
Your transcribed report would be your testimony, if anybody, for whatever SM
bizarre reason decided your input would be needed. Why the heck do you think you'd get called to court?
I got charged $75 for a copy of my old MRs, even though I transcribed it!!! n/m
:p
QA Help: Earlier I transcribed a report where
the doctor used a really offensive curse phrase. He was actually quoting what the patient said (ER report). He said place this in quotes. It was a really ugly thing to say (mother F word). Even though it's in quotes as what the patient apparently said, I felt uncomfortable actually transcribing it. And believe me I'm no prude. I've heard it all (and said some of it). However, it just seemed really unprofessional and not appropriate in a medical document. It's not like it was a psych report. In fact, it really had no relevance whatsoever, in my opinion, but I could be wrong I guess. So, I left a blank. But now I'm thinking, was that really not my call? Should I have just transcribed it? What would any of you out there have done? QA? What do you advise in cases like this? It's happened before but never as filthy as this. 
Contact the clients you transcribed for
n/m
VA accts transcribed offshore
My first editing job was for a company located in Virginia that has since closed and one of their largest accounts was for a network of VA Hospitals. I always wondered if they (the VA) had any clue that the actual transcription was being done in India.
I have transcribed from handwritten notes
and it was a nightmare. Sometimes the info was missing and my neck hurt like heck looking down and up, down and up. I charged per page. This dr went from dictating to these 5 page forms that he would fill out when he saw the patient. He scribbled and it was horrible. It wrecked my neck, so I gave it up. I was better off straight transcribing at lower pay than when I had to keep looking up and down from a page and no a stand for the forms didn't help because my eyes kept leaving the monitor, so it was hard to get back in gear only to have to take my eyes back to the handwritten form.
MTs by definition are hired to transcribed - sm
what the doctor dictates. We can't be expected to have to catch their mistakes - they're supposed to catch their own. That's why they're being paid the big bucks and we're note. Years back, we weren't expected to know all this stuff -- the meaning of every word we transcribed, the normal/abnormal lab values, what a particular drug is used for, and I could go on and on, and we were paid better, appreciated more & respected more.
I do agree that we must know how to spell medical words and words of English usage. That's what they get for their 7-8-8.5 cents per line. I do NOT believe that we should have to look up doctor's names, on our time, when the dictator has it right in front of him/her and would take him/her only 2-3 seconds to spell it, thus also avoiding any confusion. But I guess that would be too easy.
I didn't always feel this way. Years back, when I was treated as a professional and compensated accordingly, I performed as such. If I want to flag a doc's mistake, I do it for the PATIENT'S sake (but for the grace of God it could be me or a loved one lying in that hospital bed) - and as a courtesy to the doctor. But they really expect too much for too little.
I swear, I just transcribed Bill Cosby! sm
you know that voice that Bill Cosby does, kinda sounds like he's drunk? Well, this doc I just transcribed sounded like that!!! and it's workers' comp, no less. Just had to vent a little! It's still too early for all this! 
Not an MQ employee but have always transcribed via turnaround pool.
The office manager I worked for set it up so they could bill faster, i.e., ERs in 24 hours or less, op notes, discharge summaries, etc. She said it made for a better cash flow for the hospital. That's probably what MQ is trying to accomplish, maybe per client request.
Well, I just transcribed 1500 lines in 3 hours. sm
I work on the same account every day, same dictators, lots of templated reports I did myself and put them into auto correct. I get up early, start at 7 am and today I was done by 10 am. Cleaning the house now. Also, the line pay is slightly higher than most, so 1500 lines is fine for me today.
On harder days when the account is really behind, I get up and vacuum the house after 3 hours of transcribing then come back for 1 hour. If things are caught up, I stop for the day. If not, I will go back in the evening.
I can't sit for 6-8 hours straight. Making $160 bucks in 3 hours is good for me and enough. Tomorrow is another day!
Use templates and short cuts - that will help! I have whole reports in my auto correct, but you have to listen through and change and correct things as each patient is a different case.
I do have to tell you, I do not get this many lines every day in such short a time. It just happened that today was a good day. 
Hope this helps.
Guidelines are one thing, but if your client wants it transcribed a certain way, just do it.
p
My grandmother transcribed part time into her mid 70s.
,
I am filling out a job app and they want transcribed words per minute.
Thanks.
I have transcribed for doctors in the past who have dictated...sm
that the patient is heterosexual. I'm not much on what is politically correct or not, I just transcribe what the doctor dictates.
Pull up the whole period for which transcribed...see more inside
Say July 1 was the first day and July 14 was the last day - are you able to do a date-specific count? If so, get that on the screen, hit the "Print Screen" button (above SysRq next to Scroll Lock). Then open a Word document or go to Accessories and get either Word Pad or Notebook. Do a control C, which is the Word command for copy. This will copy the whole screen shot into that new document. Go to "file" on the task bar, do a "Save as" and name it what you want, say 07012008to07142008 or something so you will be able to recognize it. This will now give you a document that you can email to their payroll period with a nice little message something to the tune of "WHAT GIVES" or other equally professional question - just kidding, but now you have proof of what your total lines were and a bargaining tool. If you can only do it 1 day at a time, you can still use the screen shot method, but you will have a lot of documents to email if it comes to that.
Be sure to question them verbally by phone first as that might clear up any confusion. If not, then you can tell them YOUR line count and ask why your figures are so different. Just a thought. Good luck!
"For 30 years, I've transcribed things by what is..SM
correct." This is where the problem is. Do you know that some of the most stubborn, difficult, argumentative, inflexible MTs I have ever met in the course of my career are the ones who parrot that particular sentence?
What was done or has been done for 30 years is not necessarily the correct way now. Language has changed. With the advent of VR, the way we transcribe is now more of a verbatim way than ever.
These 30-year MTs are still adding 's on to Down syndrome, still typing out the word "centimeter" even though it is no longer accepted as anything but line-padding....get my drift?
We're paying 9 cpl and everything transcribed plus spaces is paid for.
/
Depends. Did you just study or have you actually transcribed lots of tapes as sm
part of your training? If you can't put down on your resume that your home study included multiple tapes in many specialties, etc. you are going to be hard pressed to find a good job.
On the other hand, you might be able to type some orthopedics or pt notes (and then at least have some experience to put on your resume.) Orthopedic doctors have TONS of dictation. Besides their clinic notes, etc, most of them do IME (independent medical evaluations) which are fairly easy to do. You'll need some good ortho books to get you started, but most will let you start without the experience if you can demonstrate you know the terminology. Good luck. Get some experience and the doors will start opening REALLY fast for you. Sometimes, taking a low paying job is okay in the beginning just to get the experience. If you can possibly get in a PCP's office to help out with clinic notes (even offering to to backlog/vacation stuff, you will get good experience and your resume will look great for the future stuff that comes up. Good Luck to You. Hang in there and learn everything you can.
IMO, you violated a patient's confidentiality by even posting about this - that you transcribed t
I know you didn't give any personal info, but even mentioning this in a public forum on the "world wide web" - I don't know, I would consider that a violation of medical record confidentiality. I know some may post a sentence or a blooper or something, but this is probably something I would have kept to myself... I am sure you thought what an interesting coincidence when you show the show, but my opinion is you should have kept it to yourself, and if I was the transcription supervisor at your hospital and I found out you had posted on this.... well I would think that would be reason for discipline. No offense meant, just my opinion.
Here is my understanding of conversions of time dictated to transcribed
I was told once that the ratio of dictated to transcribed minutes was approximately 1:4 for an average MT for average dictation. So, if you've been given 300 minutes of dictation it might take you 1200 minutes to finish it, divided by 60 minutes equals about 20 hours. Obviously this is just an estimate and could very depending on a lot of factors, but this might give you some idea.
Another conversion I've heard is that one 65-character line equals 6 seconds of audio and so 1 minute of audio equals 10 lines. So, if you are charging by 65-character line, you may be looking at 3000 lines or so, which when using the above formula would have you typing at about 150 lines per hour for 20 hours, giving you about 3000 lines.
Sounds like this is very doable, typing for 7-8 hours per day if you have until the end of Wednesday. If it has to be back by Wednesday morning, you will have to work 10+ hours per day on it today and tomorrow.
;)
Christine
Thank you for response. :( I figured it was nearly impossible for transcribed lines.
I think my co. wants me to quit...
Why don't you up the meds?!!!
Your quotes sure are priceless and quite original. You say the same thing, over and over and over again. So go take a shower and maybe the water will help you grow a thought.
Your meds may be the cause.
It could actually be the antidepressant causing the headaches, particularly if you aren't sleeping. Lack of sleep worsens my Wellbutrin headaches. When I was on Paxil, I woke up with severe headaches daily. It's either that or have debilitating depression. Something that antidepressants cause and some folks don't know about is a sort of movement disorder. One of the major complaints is jaw clenching during sleep, which could be one reason you wake up with the pain. I've cracked four molars doing this. I now wear a night guard, but I still have some pain. Do you have frown lines between your brows, neck pain, ear trouble, or jaw pain? Also caused by antidepressants are tics, overall body tension, etc.
meds for
I have been on Wellbutrin for about 4 years secondary to mild depression. The Wellbutrin really seems to have helped that. Then I started seeing a neurologist about a year ago for migraines, and he now has switched me to a different anti-depressant as he believes the Wellbutrin could be contributing to my chronic headaches, not migraines so much being chronic; those seem to have backed off, don't have them nearly as frequent, but I wake up almost every single morning with a dull, but painful, headache. He's had me on Zanaflex for quite a while, and that works okay to help relax me enough to get to sleep but I still wake up with headaches. I told him this at my last couple of visits and that is when he said he wants me to stop the Wellbutrin as he is wondering if that is causing the headaches. He gave me a medication, and I don't remember the brand name (and believe it or not, the brand name isn't on the med bottle where it usually says "so and so generic for ____". Anyway, this is called CDPX/Amitrip 5/12.5 mg. He wants me to taper off the Wellbutrin altogether by taking one in the morning (I take Wellbutrin SR 400 mg daily) and then one of the new pills at night before bed. Well, I started that about a week ago and this new stuff he has me on makes me so tipsy that I have to go to bed right away. It seems to help me sleep better as the Zanaflex wears off VERY early and then I still toss and turn all night (I've told my neurologist this on several visits but he just keeps telling me to "take more mg then.") I have 4-mg tablets and was taking up to 5 per night, but as I said, even that wasn't keeping me asleep for very long. It knocked me out, but then after 2 or so hours I wake up and then hard to get back to sleep. Anyway, back to the CDPX/amtitrip......I feel hung over in the mornings, and am very groggy, with just taking it right before bedtime. It takes me 2 cups of coffee to finally stop feeling hung over and I have never experienced that with Zanaflex. I know when I tell the doctor this he will tell me to take it earlier in the evening (we already had that conversation early on with the Zanaflex issue). But I cannot take it earlier because of mom responsibilities and having to work late hours. The new med (CDPX/ami) makes me start feeling loopy almost immediately, so I am forced to take it just before I literally am ready to fall into bed. I can't find this medication online; all I can find is CDP/amitriptyline (without the X). Anybody know what the "X" stands for? And has anyone else used this med so they can give me some advice? I hate being on so many meds, and am trying to wean myself off of whatever I see isn't working. Thus far, nothing has really helped with the migraines except for Fioricet. He wanted me to take the muscle relaxer at nighttime, thinking that if I was able to relax and get some good sleep I'd not wake up with a headache, but that just does not/has not worked for me. He gives me Fioricet, Lorcet Plus, and Phenergan (for the nausea I get with migraines, but that knocks me out, which, if I have a migraine, is great, but my husband has to be home to take care of the kids because I'm in a coma for a full 12 hours or so and the Phenergan makes me feel hung over as well.) He gives me 30 Fioricet a month, and it seems that if I can take one routinely each morning (I have tried this for a few days at a time) that seems to ease up the "normal" headache I have, rather than try not to take anything, but then I may need one later in the day and since I only have 30 it's hard to make them last if I take one daily, which I don't because of only having 30, but would like to because that routine seems to work. But I'm afraid to ask him to up the # of tablets per month because I type for a pain management doctor who tends to dictate a lot about drug-seeking patients and I don't want my doctor to think this of me!!! I know it sounds crazy, but it's got me so paranoid I'm afraid to ask! I hope this information is understandable....I know I've jumped back and forth...if anyone has any ideas or advice I'm all ears. Thanks!!
meds for
Thanks to you all. You know, I never thought about it being a sleep problem. I have never slept well through the night. I can remember a very few times when I actually slept through the night and woke up refreshed. I have always, always had a terrible time sleeping. I wake up every hour every night, except when I take the Zanaflex and/or the new anti-depressant, and then I wake up after 2 or 3 hours, but then every hour after that. Needless to say, I am so not rested in the mornings. Getting a sleep apnea study is an excellent suggestion. I will mention that to my doctor and see if he can refer me to someone. Thank you all again so much.
You can get meds for that. I know. I am an MT.
x
especially meds
I am in the same boat. I am interested especially in how to use short cuts regarding meds and their dosages. Thanks.
ER psych meds
standard formula given in emergency: Haldol 5 mg, Ativan 2 mg, Benadryl 50 mg
combination of 3 meds usually (sm)
Most hospitals have their own chemo cocktails for mouth sores but most consist of Mylanta/ Maalox, Benadryl and lidocaine or xylocaine anything to numb the soreness of the ulcers.
Okay, bye! Don't forget to take your meds on the way out!
The level of anger and frustration is actually quite sad.
I don't remember how many meds there were, but...
the poor lady was admitted with lightheadedness, dizziness, etc. By the time the doc was done listing the huge list of medications, even I could figure out what her problem was!!! It was no wonder she couldn't stand up straight!
I only add the dosages for very few meds. sm
Toradol 60 mg IM = T60
I found that for most meds that have multiple possible dosages, it just isn't speed-friendly to have multiple macros for 1 drug...like I use "ty" for Tylenol, but having a different one for each possible dose would be like ty325, ty650, ty975, etc., but somehow I'm faster NOT doing this. I only use the toradol one above because I always, always, always here it that way for one of my hospitals.
Other meds..allo is allopurinol, sim is simvastatin, vanc is vancomycin, etc. I tend to use begining syllables for my drug macros.
meds site
Try www.rxlist.com
Thats what I use alot.
Hope it helps! :)
pain meds
possibly...Veregen
(Immunomodulator, topical
Limbrel (osteoarthritis)
Pain Meds
I meant to say
Vergen (immunomodulator, topical)
and
Limbrel (osteoarthritis)
how about 54 discharge meds??
That's got to be a record, at least from my end -- i was thankful when he dictated that reader was referred to chart for most of them -- wow. how can a body handle all that really??
you'd think pronounciation of meds
correctly would be important to the dictating physicians...just had another gem - skilatopram - meaning citalopram....how about a little phonics maybe in med school...
psych meds
you might try the APA site for maybe general info or drugs.com and look under psych conditions, depression, bipolar, schizo-affective, etc.
She's actually taking meds around the clock for it
Vicodin, Percocet, aspirin, ibuprofen, and drinking. She has a rheumatologist, but its so hard to get in to see him. One of her problems is she is really obese, and his first advice to her is lose the weight, taking some strain off her joints. I feel so bad for her, she shouldn't have to live in pain. She doesn't have a quality of life. Maybe it hits people harder than others. But I would be like you, take a more natural approach so you don't get caught up in depending on pain meds.
Has anyone ordered pet meds from Entirely Pets?
My dog has Cushings and is on $200.00/mo worth of meds and we are going broke between them and the $1000.00/year testing needed, not to mention shots, etc. We are paying about $80.00/month for one medicine. I found it at Entirely Pets for $32.00/mo - a big savings. The package they show is the exact same as what we get from the vet, the dosage and the # of pills is also the same. I read the description and it doesn't say anything about it being a generic or anything else that would raise a red flag. I checked this med at 1800PetMeds and it is $60.00/month there.
I'm going to ask my vet tomorrow what she thinks. I don't think she'll have a problem with me getting meds from another source but I'd like to hear feedback from an outside party too.
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