My thoughts

• Small MTSOs using call-in system....sm - Wondering
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While I feel empathy for her family wondering what happened and wanting closure, frankly I'm tired of hearing about the case on the news, and that we have tied up FBI and even the military resources to look for her.  We have people that go missing in the US every day... and people visiting countries disappear - and you only hear about the ones who have families that are rich or well connected with the media. 

In my town there's a college girl who has been missing for over a week and it finally made the newspaper in a small blurb today.  This girl missed a flight to visit her family for a vacation and hasn't been seen or heard from since then, and her family says this isn't like her and that she was excited about the vacation.  Are they getting the attention this chick in Aruba is getting?  No.... because they're an average middle classed family.

I do know how you feel.  There are a few things I've done to cut that type of sress down...

I'm not sure what your company is like, but for mine, we have a primary account, and many people also have secondaries (mine is so busy that I don't usually need back-up work, so I have one major account).  It pulls from several clinics, but with a pool of about 20 or 30 dictators, after awhile, you get the hang of even the hardest ones.  There are some dictators that are just really bad, and I struggle with.  When I can't figure something out, rather than spending 10 hours searching and struggling, I use blanks.  I give it a good faith effort, as best as I can, and then I move on.  Since I usually clip along at a good pace and am pretty confident in 99% of the work I do, I don't let myself feel bad for sending something to an editor, if I truly don't know what it is.  Of course, I do the research, but if I'm looking for something for more than a few minutes, it's been too long.

You may need to look for a different account/specialty or even a new company, if you think that is the problem.  I know that, at one point, I ended up moving from a difficult but high-paying account to an account that paid less, but I was more comfortable with.  I ended up making more with the lower-paying account, because I wasn't having to stop every 2 seconds, and I wasn't tearing my hair out, and ending up in tears at the end of the day.  Of course, people should move up as they feel ready for that, but perhaps you need a workload that doesn't create so much extra work for you.

Those are just some thoughts, but you CAN do it.  Be proactive in finding a situation that works for you.  You are more of an asset to your job when you are comfortable and not stressing and struggling.

Hang in there!

 I would want to know what type of docs run the clinic - whether anesthesiologists, physiatrists, ortho, neurology, etc, as this will guide the typical direction of the dictation.   Because pain med Rx writing is always under scrutiny, there will probably be a fair amount of repetition for every pt on medicolegal issues.  Most, but not all, of my experience is with neuro/physiatry-based pain management.   For both these, I found the doc more likely to do further workup, which leads to much longer and involved reports. In the middle would be those docs who do extensive review of the patient's history and only minimal further testing.   The extreme other side of the coin are those, what I call, in/out pain clinics where the pt shows up every 30 days, re-signs their drug contract, has their BP checked and leaves with a new Rx.   I would always expect the initial H/P to be extensive and the f/u notes relatively brief.  Typically lots of phone call documentation and referral/followup letters or information.   Anesthesiologists lean more toward a lot of injectable therapies, blocks, epidurals, etc., at least initially, putting more of an op bent on their practices. 

As far as interesting, pain patients are very repetitive in their complaints and their needs.  Typically,  by the time a pt gets to a pain management practice, the cause of their pain has already been extensively worked up.  There are true chronic pain sufferers and those who are drug-seeking only.  Things do get interesting with the latter because they are very creative when it comes to trying to con or manipulate the docs.   If I were in your shoes, my first question would be what speciality of docs run the clinic.  As far as job security, it is way up there for legit practices.  More often than not, the average family doc is not willing to prescribe pain meds beyond a certain amount of time/quantity and feel forced to refer the pt to a pain  management practice in order to protect themselves from the medicolegal aspects of the business.    Hope something here helps - best of luck to you. 

Homosexuals as well as other "minorites" have been treated as second class citizens for so long now.  Let them be proud of it!  Do I think they go a bit far sometimes?  I sure do!  But I don't have a problem with it.  If a same sex couple wants to hold hands on the street then let them.  We don't need to stare in disgust and shield our eyes.  They are just trying to have the same freedoms as we have.  Discrimination is alive and well even today.  I know this because I have gay friends and hear about it all the time.  I feel that as long as you are happy and living your own lives then then let them be.  I know many "straight" people who are living in dead-end marriages,  completely unhappy and not doing a darn thing about it.  But their union is so much more sacred?  I think it's hogwash.  We are all different.  Let's celebrate those differences, not put others down because they aren't "fitting the mold" of what's acceptable.

I'm looking forward to Rosie being on The View.  I don't think she'll slam her sexual orientation down our throats at all.  She has very precise views, yes.  And she will talk about them.  She's VERY political and I feel that has nothing to do with her orientation.  SHe's given and helped raise MILLIONS for children and others who are less fortunate than her.  So why is it any time Rosie comes up people automatically make fun of her being gay?  Get over it people.  SHe's a person just like you and me.  jeesh!!!

My 15 YO daughter has a part-time job...she works 2 days a week at a local fast food restaurant.  Her best friend, on the other hand, doesn't work.  Her mom thinks she shouldn't work until she gets out of high school. I say, that's up to her, but I think it's to her daughter's disadvantage.

It was my daughter's idea to get a job, we didn't push her into it. She likes going shopping, movies, Starbuck's, and loves having her own money to do it with.

Now, her BF just turned 16 and her parents (she has 4 of them...my daughter only has 2!) bought her a car and set her up with her own checking account to pay for the gas. She has no responsibilities whatsoever, which drives me up the wall!

Oh BTW, she just got her license YESTERDAY...and last night, she was driving around to Wal-Mart, Target, Starbuck's...ALONE...with her 10 YO brother in the car with her...and we live in a small, but very busy part of town...you know, one main road that leads to everything! Is it just me or is this crazy?

Opinions please, as I know y'all have 'em!

I had no formal training.  I lost my job and my future mother-in-law was an MT with her own business.  I asked her to train me and she did.  For three years I drove over 50 miles one way 3-4 times a week to work in her office.  I feel it was better training that I could have ever gotten from any school. 

My MIL has told me she had many people try doing transcription without experience and I was the only one who worked out.  She even had people with training who didn’t do as well as me.  I believe it truly depends on the person and you should know right away if she will work out or not.  You have to have an ear for it and that can’t be trained.  You have to have good English skills and you have to be willing to work very hard.

It is possible.  It will take a lot of work on both your parts.  My MIL knew from the beginning that I would work out compared to what she had seen before.  You should know this too and be prepared to cut your losses if you feel she isn’t the right person for this field.

If you get your own accounts the charge is usually less than that of a large nationals or even semi-large nationals and that is why they will lean towards you.  You don;t have the overhead of a large national and can charge less and still make great money.  Also they sometimes like having only one person handle the account.  You learn that account, make your shortcuts and you can really produce the lines.  Since I don't have the overhead of an outside office, employee benefits, etc. I do pass those savings onto the doctors and I still make a great living.  (Hitting over 5K this month and that is just me not my IC's)   And yes it is possible as in the past two months I picked up two accounts and just heard about one yesterday and these are tapes with pick up and delivery but the pay is very good and I will take them.  As for taxes, all the nationals do is to hold out your money for you to pay your taxes (with the exception of your 7.5 SS) and you just have to plan for that and budget and be strignent about putting the money aside.  With all of the write-offs I have so much more usable income with by husiness and being an IC than being an employee.  It is not MORE EXPENSIVE.  You are just in charge of holding out your taxes.  Go for it but I do not think you should go into it thinking you will get the 18 to 20 cpl that nationals charge.  But that is me. 

Patti

Depends is it all digital, will you be picking up and delivering, printing or what.  If it is all digital and you don't have to print or deliver I would go probably 12.5 to 13.  Once you get the doctors down and you macros, templates, auto correct or whatever shortcuts you use, it will be good money.  Also is it gross or cpl, character line.  I pick up and deliver, print, and start my accounts out at 12.5 but this is Portland and I count gross lines.    Just don't tie into a written contract that prices cannot be negotiated or raised within a certain amount of time.  It will take you a while but bet even at 12.5 to 13 you will be up to $40  to $50 an hour fast.  So I think you are in the ballpark.  Don't want to go too high but not too low.  So if you can get a lot of shortcuts and once you get used to them you should be able to do 300 to 400 lines per hour which is good money.  Good luck. 

have reason to question my returns! 

If he is going to be fairly easy to do after a while and you can easily get your lines per hour up to about 250 to 300  and perhaps more if you can get his exams down and save them and insert them as he dictates them.  I would charge around 12  to 12.5 cpl per gross line.   Even with pick-up and delivery it is only once a week  20 miles is perhaps a gallon of gas a week or less which is only $3.   My toner in my printer lasts me 6+ months and I run approximately 600 - 700 sheets per month  This could very well work out to $35 to $40 per hour.  Of course it could turn out to be the other way but they usually don't for clinic notes and even even the worst dictator  if you have him every day you do get used to them.  But I would not overprice to start but do gross lines at 1" side margins at a Courier 12 font and you will do fine at 12 cpl.    If he wants a different font used, and most of my accounts do, I simply change the document back to Courier 12 and my margins and do that for my line count.  I use sticky paper and so as to not use so much use .5 margins on the side.  Good luck.  

I think a pool should consist of priority down, by reports, and whatever you draw as a report that is what you transcribe.  This picking and choosing sucks.  The work should be done oldest report done first, and in that order.  No one should be stuck with all the crap!  I work nights, and this is happening to me because everyone on days picks and chooses and they get the easier reports.  I'm working the shift that no one really wants to work, and guess what I get to choose from the bottom of the barrel.  I'm switching to days!

I am constantly reading on this board how you cannot make any money and how terrible this profession now is, but in my opinion, we - or let me rephrase - I am still making darn good money!!!  I have no problem getting 2000 lines in 6 hours a day (which is about 200.00 - do the math) and my experience has been that the in-house positions are not where any money is!  I have been offered two in-house positions in the last 6 months - one offered me 14.00 an hour (with 15 years experience), topping out at 17.00 an hour and 75% ESL dictators!  The other offered me $10.00 an hour! 

I agree that we deserve more money for what we do - I agree that we are still being paid the same or less than we were 15 years ago when I started this - but I do not agree that going to work at Wal-Mart or McDonald's is going to pay me the same money that I make. 

So in my opinion, yes it is worth it!

You say:  *Years do not give you a leg up in this business, knowledge and application of it do.*  But where does the knowledge, verbal and technical, come from if not from years of working on different accounts in different environments?  No school, no matter how good it is, is going to teach you everything you need to know by graduation.

I cannot understand a service owner wanting to turn her back on a class of workers (long-time transcriptionists) in a market that cries about a shortage of skilled workers and uses that as an excuse to offshore.  It's no different from saying you don't want to hire based on gender, ethnicity, national origin or religion based on your preconceived notion of any of these things.  Why deny yourself access to any portion of a supposedly limited talent pool?  Is it a pain in the tail to have to wade through resumes, perform testing and do interviews to try to find the right person?  Sure it is, but that's part of the owner's job just like transcribing a disorganized, Klingon-speaking dictator who is barely audible is a pain in the tail part of a transcriptionist's job.     

I have to wonder how many experienced, valuable, long-term transcriptionists who might be looking to make a change in their situation have been turned off by this MTSO's comments and now would not consider working for her because of her perceived attitude.  Those who know her personally may be able to look beyond it, but others won't.  If her service is as good as you say, then it appears that her comments may lead to an unfortunate lose/lose situation all around. 

in my church the preacher makes statements and the congregation says amen.  he doesn't amen himself making himself in agreement with himself.  if you don't agree with yourself, why bother to make the statement?  just sayin....