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Serving Over 20,000 US Medical Transcriptionists

Physician Letter

Posted By: HS on 2008-12-08
In Reply to:

Opinions on this please:   Most of my physicians dictate where they would like new paragraphs to start in their letters to other docs.  However, I'm just starting with a new person and she didn't specify.  She told where she would like periods, quotations, etc. but she never even once dictated that there should be a new paragraph. 


 


I'm tempted to just put the breaks where they seem correct, but I'm not sure if that's the right thing to do.


Any suggestions?




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If it's a business letter you use a colon. if it's a personal letter you use a comma. nm

:


Per my physician....
"All the antibiotics in the world will not clear up your sinus problems because you need to dry your sinus passages out." Get those little red Sudafed tablets and take the maximum dosage for several days. Also, try avoiding dairy products to see if that's a trigger. I can't even eat Ranch, mayonnaise or gooey cheese anymore because it triggers postnasal drip with that irritated ticklish throat and cough.
This is a physician saying this
The patient was tooken to the operating room. OMG, please keep me from screaming!! Where did you go to school, or did you finish?
Get another physician
NM
Not OUR job, it is the physician's and/or
x
EMR physician
I need quick advise. I worked for 4 physicians, one used EMR (partially) the others still use tapes. The EMR physician does not like to read his dictation and the three mouse clicks to sign his documents is too much. The physician has a high school graduate opening up the notes, reading them, editing them at her discretion and then SIGNING them. I informed them that to the best of my knowledge this was 100% illegal but they are still doing it. I have been doing this for some time, but did not think the rules had changed.
see what I mean? LOL ... physical not physician...
x
Your own physician tells you that you know too much. nm
//
I saw an xray the physician had
that showed a Gator-Aid bottle up this guy's rectum. The wife wanted to know if he had accidentally sat down on it. He had to have it surgically removed. And then again, there is the one I typed on where the person was an alcoholic, had drank dog shampoo and when arriving at the ER was blowing all kinds of bubbles.
Physician Websites

Here are a couple good ones:


www.healthgrades.com


www.doctorpricing.com


The physician put his comment in
quotes and it should have been transcribed. I would get more offended about incorrect dosing of meds you hear in reports if I had the option to pick my battles, but the fact is, you are a Transcriptionist who is being paid to transcribe what the physician says. You really have to leave your personal stuff out of it. And, if you are the patient, and you are crass enough to be so rude and foul then you deserve to see it in black and white.
This sounds like an ad placed by a physician's
I cold called thinking they may consider an at-home MT, which yes they would be fine with, but they thought event $1.00 per page was pricey since the in-house MT could easily type 20 reports an hour, so they were doing the math.  They figured by my charging per line that I would make way too much. Of course, I told that person very politely that I would work for no less than $3.00 per page if that's how they were looking at it and that I charge for production.  So maybe this office expected the same thing your hospital does.  However, if you type 3 MRI reports, then you're done for with the expectation of 20-25 reports per hour.  All I can say is the hospital advertising this way must have a lot of normals and only perform plain x-rays and not any kind of special procedures or MRI/CT.
A physician shared this one

with me...


The patient was in a cute dress... (medical Transcriptionist error....)


Physician Finder - a useful one

you can search using different criterias, might be helpful for u ppl


use the link below


http://doctor.webmd.com/


Try the AMA Physician Finder
You can do a "sounds like" search by state, and by specialty. Somewhat tedious, but you can generally find them when all else fails.

Here's the link:

http://webapps.ama-assn.org/doctorfinder/html/patient.html
Exactly why I quit using my last physician.
I would wait close to an hour in the waiting room only to feel ignored once I got into the exam room. My doctor spent more time on the computer than he did with my exam. I finally got tired of this and changed doctors.

How do you know the physician hasn't
reported it. No, I do not believe it is our place to do so.
are you sure the physician HASNT sm
reported it? I don't think (I am quite sure) that our scope of duties does NOT involve any of that. Would be real tempting to report though wouldn't it?
Actually, throw out the BOS and use the physician's preference.
I learned that disc is eyes, disk is computer disk, and disc/disk for back is up to the account preferences.  The doctors do not care what some stupid AAMT BOS book says because it's THEIR notes and they aren't regulated by the AAMT.
Work hourly for physician. Need help..
I wonder if someone could tell me how they created an invoice when being paid hourly doing transcription. I tried using MP Count but it only calculates using line counts. Thanks for any help.
I worked at a 25 physician multispecialty

clinic as an audit clerk to the transcriptionists (counted lines by hand back when we used typewriters).  I picked up some terminology by reading clinic notes as I was counting.  I took a terminology and anatomy class and my boss let me take tapes home to practice on.  When there was an opening, I tested and got in!  I also worked for an ENT doc (who was desperate for a transcriptionist) part-time in the evenings while I was learning to transcribe. 


Then the dictating physician needs to spell it out instead
of expecting us to be psychic. I used to waste so much time at my old job trying to find the proper addresses for these yahoo CC physicians. In the meantime, the dictating physician mispronounced, didn't spell, and didn't even give a clue where the other doctor worked. I had to check the company physician list, the hospital physician directory, Anywho.com, then Google. And that was even if I could spell it properly! One physician in particular couldn't pronounce properly. He would put extra Ns and Rs throughout the name. How was I supposed to find it? And I got chewed out by QA for not being psychic enough to figure it out.
I worked in a physician's office as well.
Normally they get paid only a percentage of that.  If your mother has insurance she can pretty much disregard that initial bill.  The hospital my parents used also chopped off a large amount due to their fixed income.  The worst part about this system is that people with no insurance and who do not qualify for the indigent write-off have to cough up the whole thing. 
Are you seeing a sleep physician or just thinking
If you're having a rough time with sleep, make sure you see a sleep medicine doctor (if you already have, please excuse the following). Family docs are great but a sleep doc will know much, much more about it. There are a lot of things you can do to improve your sleep routine and they can do a sleep study or have you fill out a questionnaire that will tell them more about your sleep habits. Provigil should only be tried as last resort with a diagnoses of narcolepsy or when all else has failed. Plus, there are a lot of different wakefulness-promoting meds, such as Ritalin mentioned above, and Provigil may not even be the right one for you.

If you already are seeing a sleep doc, you can ask to try something else if you are leery of Provigil. Sorry for being presumptious, but I just want to be sure you are not jumping to medicine first because it's wise to try other methods before resoring to an Rx.
Seek another physician as fast as you can sm
the one you have obviously does not have your best interests at heart, nor does he care. Any good physician with an ounce of brains knows exactly how addicting OcyContin is and should not keep any patient on it for the long term. You should also seek a rehabilitation clinic for addiction problems. You can't do this by yourself. I think they have outpatient clinics, but you need help and you need to get it soon. Good luck.
be sure to give this feedback to the physician.

If you transcribe for a private physician and he wants
cc then use that. However, most MTSOs and facilities go with Joint Commission recommedations or BOS. You only need to find out what is required by your employer. If your employer wants you to use cc it is fine. You do what they want. mL is the correct abbreviation for milliliter. I have been doing this for almost 30 years and you would not believe some of the changes AAMT/BOS have made, but we just have to go with the flow.
Need physician locator website!

I've been using the NCIH website when I have to search a specific state for a provider name, but that website is now gone and apparently is not going to be back.  Argghh.


If anyone has any good websites to do physician or provider search by name by STATE (not city, too often don't have that information), I would be grateful if you could share it!  TIA.


You should make it clear to the physician that
there will be an editing charge for any changes or additions once a report has been completed and submitted. I charge an hourly rate for such.
Instructions for physician dictation
1. At the beginning of the dictation, take the deepest breath you possibly can and then try to dictate the entire report before you have to inhale again.

2. When dictating a particularly difficult word or phrase, please turn your head and speak directly into your armpit.

3. If you have to sneeze or cough suddenly, please remove your head from your armpit and sneeze or cough directly into the microphone.

4. If you must eat while you dictate, please stay away from foods such as marshmallows, bananas, and pudding; apples, pretzels, and celery are much better choices.

5. Please do not stop dictating when you yawn; it throws off our rhythm.

6. Do not stop dictating in the event of a minor background noise such as an office party, the janitor’s vacuum cleaner, a screaming infant, etc.; again, it throws off our rhythm.

7. Talk as fast as you possibly can. Fair is fair, after all, and we type as fast as we can!

8. Dates of admission and discharge are not important for old H&Ps or discharge summaries.

9. Abbreviate whenever possible. Everyone loves a mystery and we are trying to learn new skills, such as mind-reading.

10. Finally, be sure to wait until the end to tell us what kind of report you are dictating, or to "scratch" this dictation since it was already dictated.
Find Physician Link

Hi All--Wanted to share


Just as above, the physician said the patient fell
and ordered CT scan and the doctor absolutely checking for confusion. The doctor repeated and I listened back to it, intensely. That was said, VR picked it up and how would a newbie know (brain, confusion, could be in some cases, right) it was contusion they were looking for? I did, changed and finally the physician said the correct word, contusion. I also have the VR putting in Dr. Pannicus and the like. Yep, you need to know what things mean, not just typing in words.
Working for a physician's office.

I am currently working for a small company as an IC. I need some extra work and I'm thinking of trying to get hired on with a local physician's office (if I can find any that are hiring and are willing to hire someone who is a recent graduate) and was wondering how do you charge them for your work?  Is it per report, by the hour, so much per line, etc? Is there anyone out there who could give me some pointers as to how I can go about doing this? Thanks.


E


 


Obtaining "medicines" and seeing a physician are
Of course medicines are cheaper there because the govt doesn't allow private sector (pharmaceutical companies) to price their own drugs.... the govt prices it for them!!

On the downside, physicians are fewer and fewer and yes, patients wait MUCH longer to see a doctor. Canada has a terrible shortage of physicians due to govt control of the healthcare.... fewer physicians, longer wait time for patients not to mention less and less procedures, even those that may be necessary, because govt has decided who they will ration the healthcare out to....

Obama is shoving this garbage down our throats as fast and furious as he knows how....without answering ANY questions as to how to fund this because he know he can't fund it. There will therefore be rationing of treatment. Govt will decide FOR YOU what you can and cannot have for treatment. If you though private insurers are bad enough, just wait for the "too stoopid to get out of the rain" govt to ration it out to ya....
Do you take over the counter medication or from a physician. Which seems to work well.
:
You're the transcriptionist, not the consulting physician.
I know it is difficult sometimes but he went to school a bit longer than you or I did!
Reminds me of my favorite dictating physician..
         Really miss transcribing his 8 page reports (no sarcasm implied) Have a great day everyone.
A physician won't care if you're certified and neither will his... SM

office manager.  When will MTs learn that certification means absolutely, positively nothing? 


Butr I digress.  I would make the rounds if I were you.  Handout business cards, talk to office managers, have brochures ready, and follow up conversations with a letter of thank you and "please keep me in mind."  It's hard to say exactly what a physician is looking for regarding transcription.  I have found it depends a lot on the age of the doctor.  Older doctors are more old school and like the control of having an in-house person typing for them.  Younger doctors are technology driven and like the idea of an electronic record and having an MT type outside the office and electronically transfer it in.


Another thing I do is always carry business cards with me to doctor's appointments.  One of my accounts is a dermatology practice.  I was referred for a mole removal and got to talking to the physician about what I do for a living and she asked me to leave a card with the receptionist on my way out because they were needing more help with their transcription.  I did and then sent a letter with another card praising her bedside manner and her office staff and then reminded her that I had left my card and if she ever decided to get some extra help, to please give me a call.  She had her office manager call me and it is my main money maker. 


Good Luck to you!


This is for a physician office that uses that program. I am not familiar with it. We are trying to d
.
The lies from physician put on my medical records
I posted on this before- had plastic surgery done, 2-3 things done at 1 time including tummy tuck, face and ? forgot but anyway, the face not done. Went home, no bruising, no swelling, went and looked at my records, not done, went to the office and told the physician he had not done, he forgot, gave me an IOU on his letter head. Bottom line, I asked for the return of the amount of the facelift only, he refused, was hostile, he was personally calling my house, threatening like, I had to have my job (at same hospital where he practiced)-I just said Karma will take care. Long story short, he did not dictate my operative report until EIGHT (8) months later, then falsified, and put the biggest facelift report in there you could image. My name is French sounding, unusual, and I know that was done intentionally. Big, big lies. I told lady over medical records falsified, she said I could just put an addendum in the chart.
Have you contacted the office manager, physician, etc.(?)
x
Letting Physician hear her own dictation
I had two bad dictating Rads, one who said "period paragraph" in the middle of a sentence throughout the entire report and another who threw up the films while dictating, as his handset was placed on the counter. There was no OM to talk to, it was me and after asking them repeatedly to fix the problem, they tried with no improvement. So I typed the report exactly as he dictated it and gave it to him for signature. He never said a word to me about it, just redictated clearly and never did it again. With the other, I walked into the reading room and played the tape for him and asked him if he wanted me to send the dictation to the referring physician so that he could figure out what he was saying. You would be surprised how quick these guys got their act together. But they really did not think there was a problem until it was presented to them. Maybe she needs to hear what it sounds like. She may not think its so bad. I say copy and send the bad dictations with the letter. Leaving out those things mentioned above.


Misplaced pride. The physician is documenting something, Or trying to. NM
nm
Organizing a referring physician list
If you have Excel, just copy and paste it into Excel. You can even export it into Excel from Word, but I usually don't even bother.

Once you've put the list in Excel, you can sort by column B or whatever is the last name field. Be sure to select ALL the text when you sort, or you'll JUST sort the last names.

If the last name and first name are in one cell, you can break the text into 2 columns easily, just look in Excel's help, it'll tell you how to do it.
Web sites for locating physician names?

Anyone have a favorite web site for locating physician names?  Thank you! 


What to charge a physician group for transcription.
I was asked what I charge for picking up and dropping off. I don't want to quote too high a rate. I do, personally have a call-in dictation system they could use. I was thinking of charging 13 cents per line for the use of that, or 15 cents per line for paper and gas for drop off and pick up. I am in the Chicago area. Is that too high?

Thank you for your anticipated response.
This story involves a rude physician, as well.
He was dictating along, never pausing. I heard a door open and then close, a clunk (toilet seat being lifted) and well, the sound of rushing stream of water. He never stopped dictating, even while zipping up and leaving the restroom.

Like you, I was highly insulted, especially since he seemed to have a smile on his face when he was dictating - like he knew I would hear this - I never made eye contact with him after than unless he asked a question.
PHYSICIAN SUED FOR DELIBERATE HIPPA VIOLATION

Anyone know what the penalties are for docs violating HIPPA?   I know of a case where a person was damaged from a new nonsurgical cosmetic procedure and about to settle with a company to pay for the surgical repair.  Prior to the settlement this patient saw a physician who sells these same nonsurgical services with a possible financial interest in the company.  This physician filled the patient's face full of temporary cosmetic fillers to cover the damage and then WITHOUT THE PATIENT'S PERMISSION released the patient's records to the company and wrote a letter stating there was nothing wrong with the patient.  The company subsequently canceled the pending deal to pay for the damages.   The temporary fillers wore off and the damage returned and this patient is now suing the company AND ALSO  the physician that released her records.  This physician has caused an already traumatized patient much more stress (a subsequent long legal battle) from this HIPPA violation.   What are the penalties?   Any criminal charges?


 


Thanks!!!


 


 


 


 


Our agreement with our clients regarding referring physician names
When we accept a new client, we request a listing of all referring physicians and their addresses. We enter those names and addresses into our address database which can be accessed by the MT at any time while transcribing the report. They can search by first name, last name, partial name, city or state. We also instruct the physicians/dictators (and their staff) to SPELL physician names if they have not been provided on the initial list. If the dictator dictates a name not found in the database or does not spell a name, the MT has permission to leave a blank (or spell phonetically with a flag for the dictators staff). Our clients print their own work and can make changes/corrections to documents at their end. Therefore, it is THEIR responsibility to fill in the blanks if the dictator uses a name not provided or if he/she does not spell the name. QA staff does not have TIME to look up addresses, and in my opinion, doing so would be a huge waste of our skill. We edit hundreds of reports daily and if we had to research names and addresses in each report, we would never meet our turn-around time agreement. Additionally, we have a customer service department at our home office who can assist MTs with issues such as this. Check with your supervisor/QA staff to confirm what your company policy is regarding names and addresses. Perhaps blanks are acceptable for physician names. As we all know, even if the dictator dictates John Smith, it's possible the name is spelled Jon Smythe. There is no possible way for you to know that; therefore, it should be the CLIENT'S responsibility to confirm the spelling and add the address.
I had an occasion to personally ask a weight loss physician...
about all these cortisol products on the market.  She said FORGET IT.  It's a waste of money.  If you read the bottle, they all say that you must follow a sensible diet and exercise regime.  In my belief, you'll lose weight without the pills if you watch what you eat and exercise.  I've lost 8 pounds since January 1.  No pills, no special diet food, no membership fees, nothing.  I try to eat food that comes in the form that mother nature provided.  No white bread, pasta, or rice.  All brown forms of those foods.  Lots of salads, vegetables, fruits, lean meats.  No cakes, cookies, pies, or other such junk.  I have some occasional fat-free candy like Mike N Ike just to keep my sweet tooth happy.  It's working.  Slowly, but it's working. 
I worked in a rural physician's practice for years.
He eventually ended up joining a group.  He still has his office in the same place, but is financially part of that group.  Unless they join some sort of group/organization so that they can get group rates on lab, insurance, etc., it is really hard for them to survive.  The community lost its hospital several years ago.  You said your community has a hospital, but is it a full-service one?  Our next nearest town with a hospital is about 35 minutes away.  Now the 2 hospitals in that town each have satellite physician clinics in our little town.  When I was working for this physician, we had a total of 4 doctors in town.  Now, through these satellite clinics, we have a good number.  Before this physician joined this group he recruited numerous physicians over the years.  Unfortunately, he was not able to assure them enough of a salary and benefits to keep them.  There is simply not enough money coming into these small clinics.  They have to satisfy Medicare and insurance regulations, just like the big clinics.  The recruited physicians all eventually left for greener pastures after being actively recruited by other facilities.  One physician I remember tripled his salary when he left there.