This is extremely dangerous reasoning. SM
Posted By: Sarah on 2006-02-12
In Reply to: It means don't believe everything - Still making good at MT
It isn't what the "suits" are saying, it is what they are doing. These are two totally different and separate entities. My God, are you so complacent that you cannot even take a look around and see the face of the future? No one is telling anyone to not just "be happy." A little foresight and present thinking is imperative, not only in the MT world but in many other areas of business, especially IT. It's all going over to Asia and it's all same-same there.
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Not to mention extremely dangerous for your pets - sm
especially the flea collars, shampoos, etc. Totally agree. Awful products. Should be banned completely.
reasoning
I am talking about my own experience, but that is not all I am talking about. I would like to know where you got your information as to the "industry as a whole" because I strongly disagree with that statement and suspect you are also speaking from your own experience. I know many people such as myself who hold a CCA credential and are working in coding depts in major hospitals and other settings. Also, where did you get your 70% failure rate info and where on the AHIMA web site does it say there is a problem with employers accepting the CCA? The failure rate is actually somewhere around 40%, 2006 was about 46%. Much of that is because people attempt to take the exam without the requisite experience. The CCA was designed specifically because before testing for the CCS credential it is recommended that a person have 3 years of experience. CPC may be something more common in whatever area you live but I can tell you that in the area I live, which is a very large metropolitan area, we do not have CPC-credentialed coders in our hospital coding areas. If you check the AHIMA journals and read ads for coders, you will find that the great majority require AHIMA credentials (CCA or CCS). Same is true for Advance for HIM, etc., as well as local hiring practices in this area. We do find the CPC in clinics and physician offices but not med rec depts, and oftentimes they are hired with the caveat that they will earn an AHIMA credential within a given time period. Yes, my experience, but don't discount it just on that basis. It represents what is happening in my locale.
No reasoning with an idiot, so I won't try.
lllll
You see, there is no reasoning with an idiot. nm
x
Now there's some convoluted reasoning.
All professions expect to be paid. If you didn't pay your doctor or dentist and then asked for an appointment, you would be refused until your bill is current. Your trash doesn't get picked up if you're behind on the bill, the car gets repossessed if you're not pay on it, etc.
The idea that you should do work so that the patient doesn't suffer is just ridiculous. The patient had their appointment and paid for it. They got what they needed/wanted and you can bet the doctor was paid.
You should IMMEDIATELY cease working for this office until you are paid, period. By continuing to work for them without them being current only shows them that you are a push-over, not a professional at all. Get some backbone and contact this office immediately.
Warn but give no reasoning.....
x
I don't see the reasoning for 15c for ops and 12 for acute care.
discharge summaries and consultations when PAs and physicians are shuffling papers, trying to find lab data, etc. Once trained on ops, it's the best moneymaker work type an MT could have. DS and CON = wasted air time and should be paid higher than ops, IMHO.
Your reasoning does not make illegals ok, still
x
and you could have just as easily skipped my posting by that reasoning
Okay, Message Board Police. Next time I decide to express my opinion I'll run it past you for permission first, okay?
Amazing
and all that is in your post to back that up is a red face for reasoning?
??
Just give up...no point in reasoning with an individual who does not want to understand. nm.
nm.
Dangerous as far as what? NM
x
Not sure. I just know enough to be dangerous.
x
Is it dangerous to buy used?
Used may be cheaper . . . but is it safe? I hadn't really thought of getting used because I'd hate to get a "problem" computer. However, if it were just as good as new . . . maybe . . .
dangerous abbreviations
It really depends on the account. Some facilities/doctors really don't care for the new set of guidelines and want their work verbatim precisely. But employers want it practiced just in case for some of the more confusing abbreviations.
dangerous abbrevs
Pharmacies make plenty of mistakes on prescriptions and I have never heard of one being shut down. They aren't any better or more careful at their job than anyone else in health care these days - which is to say, the consumer/patient needs to be on their toes at all times because you simply cannot trust anyone to do their job properly.
Yes, sloppy writing is responsible for some of these mistakes, which is one of the reasons why many elements of the AMA, the pharmacist associations, and the pharmaceutical industry are pushing for all drugs to have an individual number assigned, so that medication errors can be eliminated or at least greatly reduced. Thousands of people are injured, make sick or even die from prescription errors every year.
I have been doing MT since the 1970s and I have seen huge changes in health care. Most obvious change is that it has become a BUSINESS rather than a human service. Most if not all involved in health care delivery care foremost about the bottom line and their own "bottoms." Like one of the posters below, I too have noted how long the disclaimers are at the bottom of the H&P and Consults, particularly by the surgeons and interventionalists.
When I started MT, almost no report was more than 1 page long. Now, I sometimes transcribe reports where the "disclaimer" section with risks, benefits, alternatives, possible outcomes explanation is half a page long. This information is already contained in the consent forms that are signed by the patient, so it is redundant to include it on the dictated report, but more and more MDs are doing it. I have also noticed, or perhaps it is just my perception, that all dictators are including more information about patient attitude, knowledge and compliance regarding their (the patient's) regarding their medical condition. Personally, I think that is a good thing - people need to take more responsibility for themselves and stop expecting the doctor to solve all their problems.
Dangerous Abbv. below
I want to know how come a hospital says they are compliant with the list and AAMT guidelines but tell you transcribe ver batim even if incorrect? Can't have it both ways seems to me. I got caught by QA between a rock and a hard place about this but stood my ground. I did ver batim because that was the hospital's wish even though I knew it was wrong dictation. At least I flagged it for QA but it caused a problem. No one seems to have the answer. Next time, I'm not flagging it.
Not just lazy...DANGEROUS
This is how patient care errors are made. I know they hate dictating, but it is very disrespectful to their patients when the doctors won't even attempt to dictate clearly so that their patient's lives are not in jeopardy. They should be chastized by their hospitals and not allowed to dictate like that!
Dangerous Abbreviations
Q.D., QD, q.d., qd (daily) = Mistaken for each other = Write "daily".
I woud say this should over ride anything BOS has to say, but we aim to please the client. As transcriptionists though we should be aware of these dangerous abbreviations since it can affect a patient's medical record and how it is interpreted.
cc is not correct, mL is. cc is a dangerous
x
PO is not a dangerous abbreviation (see msg)
Go to this website:
http://www.ismp.org/tools/errorproneabbreviations.pdf
IV is not a dangerous abbreviation.
For Pitocin it is WAS given.
Dangerous Abbreviations
"IV" isn't on the Joint Commission list of dangerous abbreviations. Don't take this as an indication that you're getting old--the confusion surrounding those darned abbreviations can be aggravating.
Here are some reasons for the aggravation. You might have seen it on a facility's list in the past or you might have encountered it as a recommendation from a consultant or in a journal article. Before The Joint Commission solidified its list of dangerous abbreviations, there was a lot of confusion about this--some groups banned any and all abbreviations.
There is an abbreviation that is banned because it can be CONFUSED WITH "IV." It's "IU," the abbreviation for "international unit." While it's OK to use IV, some facilities do not want you to use it, reasoning that if IU can be confused with IV, then IV can be confused with IU. And then some would want you to avoid using IV, until they discover that they have to pay extra for you to transcribe "intravenously."
Here is a link to the whole list. The document on The Joint Commission website was broken, so this link is to another website, but it is the same thing. http://www.aapmr.org/hpl/pracguide/jcahosymbols.htm
q is a dangerous abbreviation.
x
If you suspect something dangerous, then
for heaven's sake go and visit a doctor.
Why do you suspect a pulmonary embolism? I dounbt tht you wiklk be able to cough it up. Are you producing some blood when coughing?
It might just be some mucus or phlegm that you cannot lodged in you lungs.
Does your cough produce blood?
Here are the symptoms tht indicate a pulmonary embolism
(blood clot in the lungs):
Google:
'Pulmonary embolism symptoms can vary greatly, depending on how much of your lung is involved, the size of the clot and your overall health — especially the presence or absence of underlying lung disease or heart disease.
Common signs and symptoms include:
Sudden shortness of breath, either when you're active or at rest.
Chest pain that often mimics a heart attack. The pain can occur anywhere in your chest and may radiate to your shoulder, arm, neck or jaw. It may be sharp and stabbing or aching and dull and may become worse when you breathe deeply (pleurisy), cough, eat, bend or stoop. The pain will get worse with exertion but won't go away when you rest.
A cough that produces bloody or blood-streaked sputum.
Rapid heartbeat (tachycardia).
Other signs and symptoms that can occur with pulmonary embolism include:
Wheezing
Leg swelling
Clammy or bluish-colored skin
Excessive sweating
Anxiety
Weak pulse
Lightheadedness or fainting (syncope)
Fever'
If you do not have these symptoms, take an aspirin, drink hot tea with lemon juice and honey, you might just have a cold.
Thoughts on dangerous abbreviations
You're partly right. Joint Commission has no jurisdiction over a private office setting; however, this was adopted by Joint after it was first given to the national pharmacy assocition. When a doctor has his/her nurse phone in a prescription or writes one himself regardless of private office or inpatient setting, s/he better follow these guidelines.
Having worked in a pharmacy, I understand how critical it is to be able to know EXACTLY what the doctor wants the patient to have presribed. Pharmacy is going down the same path as MT work. Notice how many insurers allow for your prescriptions to go to a mail order company who will fill up to three months of your prescriptions at a time. The first line of defense these companies have (well, really just one anymore as they are becoming the MQ of pharmacies), is to scan the prescription. If it is not written clearly, a body must contact that physician. Addtionally these mail order companies allow MDs to relay prescriptions online. These guidelines better be followed or they will be contacted.
Depending on which division within the mail order pharmacy you work, a tech may fill more than 100 prescriptions an hour. If ONE of those prescriptions is filled incorrectly, it is reported to the State Board of Pharmacy who requires a monetary penalty be forwarded by the company depending on the error classification. If there are too many errors in a given month, the pharmacy is shut down, the supervising PHARMACIST receives (typically) a $5000 fine and a one month to five year suspension of practice, all actions of which are published and distributed to all 50 states in a monthly newsletter.
To say this is all AAMT's fault is ludicrous. To say the doctors are not going to change their ways because they have god complexes is ludicrous. This happened because too many mistakes were being made through haste, bad handwriting, lack of time to thoughtfully write prescriptions, etc. This is today's reality. If you do not adapt, you do not survive. Just ask a Cro-Magnon.
d~
JCAHO dangerous abbreviations
Do physician offices/clinic notes need to comply with this list? I thought JCAHO was joint commission for hospital compliance.
Is p.o. considered dangerous abbreviation?
nm
DANGEROUS VIRUS COMING....
Subject: Big virus coming, confirmed by McAfee and Norton and Snopes
Subj: Big virus coming, confirmed by McAfee and Norton and
Snopes
Big virus coming, confirmed by McAfee and Norton and Snopes
http://www.snopes.com/computer/virus/postcard.asp
Hi All, I checked with Norton Anti-Virus, and they are gearing
up for this virus!
I checked Snopes (URL above:), and it is for real!!
Get this E-mail message sent around to your contacts ASAP.
PLEASE FORWARD THIS WARNING AMONG FRIENDS, FAMILY AND CONTACTS!
You should be alert during the next few days. Do not open any
message with an attachment entitled 'POSTCARD,' regardless of who sent
it to you. It is a virus which opens A POSTCARD IMAGE, which 'burns' the
whole hard disc C of your computer. This virus will be received from
someone who has your e-mail address in his/her contact list. &nb sp;This
is the reason why you need to send this e-mail to all your contacts It
is better to receive this message 25 times than to receive the virus and
open it.
If you receive a mail called' POSTCARD,' even though sent to you
by a friend, do not open it! Shut down your computer immediately.
This is the worst virus announced by CNN. It has been classified
by Microsoft as the most destructive virus ever. This virus was
discovered by McAfee yesterday, and there is no repair yet for this kind
of virus. This virus simply destroys the Zero Sector of the Hard Disc,
where the vital information is kept.
COPY THIS E-MAIL, AND SEND IT TO YOUR FRIENDS. REMEMBER: IF YOU
SEND IT TO THEM, YOU WILL BENEFIT ALL OF US.
Snopes lists all the names could come in.
Thanks! I have the dangerous abbreviation list
I was just afraid I was missing something buried in the book somewhere. I just didn't want to be making a mistake. Thanks again.
cc is on the dangerous abbreviation list and should be converted to ml.
x
Here's a link to that dangerous abbreviation list
This is the site the BOS recommends visiting, so I did. It is a long list of stuff fer sure! Here's the link...just copy and paste it into browser.
http://www.ismp.org/Tools/errorproneabbreviations.pdf
Hope it helps!
would you like a copy of the DAL(dangerous abbrv. list).
Just so happen my supervisor sent it to me today thinking that a report was mine with a dangerous abbr. listed in it. Let me know if you would like for me to email you a copy.
Lord, preserve me from Sam's Club! That place is dangerous!
That is THE most dangerous thing I think I've ever heard. You don't understand it?!
We have been told to use mL for all, regardless if dictated cc. Dangerous abbrev. blahblahblah nm
x
The Joint Commission's Dangerous Abbreviation List... SM
applies to written entries on a patient's chart, i.e. nurses' notes, doctor's orders, etc. For some insane reason, someone somewhere decided to apply it to transcription as well which is just silly. I work for a facility that has decided not to force transcription to strictly adhere to the dangerous abbreviation list and Joint Commission has not counted it against them in the last three audits.
I will say most MTs where I work do not use qhs, qac or qd. We expand those out because WE (the transcription department) decided that we should for clarification purposes.
My dangerous abbreviation sheet doesn't list...sm
q. as a dangerous abbreviation. It lists q.d. and q.o.d. and q.n. but not just q. by itself. ?
There are so many variables at play that it's dangerous to compare to others along these lines. s
I know that there have been occasions when I've had a run of one of my more familiar docs -- one for whom I have a lot of canned text and who tends to dictate with a great deal of regularity, and quickly -- and I've been able to break the 500 lph barrier, but only briefly. Otherwise, working a large hospital account as I do, with dozens of regular docs and a hundred or so others who just crop up now and then, I can't conceive of anyone averaging anything close to that ... I'm luckly to average above 250-275 lph on a typical day, and some days -- when it's resident and ESL heavy -- that can go down to 150-200.
But, again, it's really pretty silly to compare lph between different MTs unless the variables are the same.
Make money? I'm not making any money because of my decision. You read my reasoning
You can agree with me or not, but don't make false assumptions please.
One of those radio financial guys said debit cards are the MOST dangerous to use.
s
Extremely helpful - thank you!!! nm
nm
It was extremely perverted.
Be grateful they took it off. I would repost whatever you had to say.
this is extremely sad. I started on with MQ
0.0775 cpl. You're only going to get desperate newbies with that pay. If you want an "experienced" MT as you say, pay them what their experience is worth.
They are extremely close.
From what I know of both companies, oddly enough it is MQ catching up to changing its operations to par with Spheris with the new Rewards Plan.
However, while Spheris has already had their compensation/benefits package settled for a while, they seem to be aggressively pursuing purchasing other companies and increasing their offshore entities.
MQ seems to be focusing on it's US clientele.
MQ has ASR and if Spheris has it, I haven't heard of it yet. I would imagine ASR came in with a recent purchase if Spheris has much in the way of it right now.
You are welcome.
ok now I see it - extremely annoying. NM
x
I am extremely careful
Geesh, June. I am extremely careful, and my girls have been told not to open the door unless they know the person on the other side. You know children do not always listen. I had been down the hall using the bathroom, and my 13yo thought the 16yo had stepped outside and locked herself out. Since it was a soft knock and a familiar one, she thought she knew who was on the other side. When she realized it wasn't who she thought it was, she shut the door right away and came and told me there was a man in our garage. We've lived here for 10 years, and this is the first time anyone other than family has knocked on that door. There isn't a lot of crime in our area, and we leave our garage door most of the time. We never have any problems. I know...there's always a first time....never say never and all that...but I am careful.
A couple of weeks ago, religious solicitors walked up to our door. I was working, and my 16yo opened the door to them because they were women. Not anyone she knew, but she opened the door because she didn't find women to be intimidating. That's why I say children don't always listen to what you say.
After those Missouri boys were abducted in rural areas, I've talked to my girls again about being careful, beiing aware and watching out for each other.
My hubby thinks I'm paranoid. I'm the type to keep my doors locked at all times, day or night, and he thinks it's silly because we're in a rural area and probably fine. When I dispute the point with stories from the news, his rebuttal is that a locked door will not keep out someone who wants in. Maybe not...but they'll be a lot more noisy trying to get past that locked door than they would an unlocked door.
It works extremely well for me. sm
I am in a very, very rural area as stated; all woods. I was also told it works as good as your cell works. Our cells are "patchy" in this area, but are fine in our home and we have all metal roof too, which usually causes outages but not in our case. I was constantly frustrated with Wildblue and no signals on bright sunny days even. Like I said, in 3 months I have not had one problem with losing a signal and I am on the net 24/7 almost literally, lol. I know in my case, they gave a 30-day refund in case it didn't work out for you. So I would say give it a try first and if it doesn't pick up well for you, then look into HughesNet. The wireless was the BEST move I have made period and I am extremely happy. I did call tech suport on it when first setting up and the hold was very minimal and tech was very helpful. I was fixed and up and running within 5 mins with AT&T. Now I will say my first bill was also about $170 as they bill in advance so I had to pay first month and then 2nd month, but to get started all I paid was for the USB thing itself. Oh, if you do go with wireless, don't get the "cards", get a USB one that way you can change it from different computers and be mobile with it rather than just working in 1 computer. Say if you have laptop and desktop you would switch the USB between computers and if you got a "card" it would only work in one of the computers, the one which you bought it for. 
Anybody else notice extremely low IC pay?
I have always worked as an IC acute care transcriptionist. My line rates have always exceeded what an MT can make as an employee, which is only logical because as an IC, you have to pay your own taxes, no benefits, etc. I always peruse job listings on this and other boards, just to see what's out there. Lately, I have noticed a disturbing trend. It seems like most MT companies/MTSOs are only offering .08/line for IC. Unless that is for a gross line (and goodness knows gross lines are a thing of the past), that is outrageous!! When you consider that an IC has to pay approximately 15% of his/her income in self-employment taxes alone, that means a net rate of about .068/line! While .08/line for employee status is still low (in my opinion), at least social security and medicaid taxes are paid, and there are usually benefits, PTO, etc.
If I were an MTSO, I would be embarrassed to offer .08/line to any quality IC MT. For a newbie, sure. But for any MT worth his/her salt, .08/line for IC is an insult.
I know that competition with overseas firms makes it seem necessary for American transcription companies to lower their MT pay in order to be competitive. However, American MTSOs will never be able to compete solely on price; overseas transcription companies will always be able to do it cheaper. It is a slippery slope that has already lead to the failure of many American transcribing firms. The question for American transcription companies should not be can we do it cheaper, but can we do it better??
In today's market, American MTSOs need to stand their ground and quit underselling themselves and undervaluing the value of their American transcription workforce. American MTSOs need to start marketing themselves differently, stressing quality, accuracy, dependability, security, and good old fashioned patriotism. I don't care how low the overseas companies can bid a job. There is no way they can compete with the quality and accuracy of American transcriptionists. I myself have worked for an MTSO who lost a contract to a firm in India, only to have them beg her to take them back a few months later because the quality of the overseas work was so horrible. I am quite sure this is not an isolated incident.
While there are always going to be hospitals that will try to get by on the cheap, there are also hospitals and doctor's offices who realize that they get what they pay for and will put quality first. If you compare transcription services to cars, overseas work is the Hyundai while American transcriptionists are the Cadillac. Cadillac would never slash its prices to compete with the cheaper imports. They know that they have to cater to their own market, people with more discriminating tastes.
I am fortunate enough to work for a company that realizes the value of its services and takes the stronger, wiser stance. They are not after contracts at any cost. They will pass up work if they have to bid ridiculously low just to get it. And guess what? Any bid that only allows you to offer your IC transcriptionists .08/line IS TOO LOW!! And any quality MT is not going to stick around at those rates.
I find it is extremely so! sm
THe other thing is, unless you are ultra fast or so wonderful you are in high demand, you won't make a living at it. I know some cake decorators and it is high pressure. I could make and decorate 3 cakes in a day, of the 2 or 3 layer variety, but they wanted 10 or 12 just the decorated part. I found that daunting myself.
I can only make one of my signature cakes a year (heart shaped cake covered with handmade, real buttercreme roses...think about 150 to 200 roses) about once a year and I need to have time off of work to recuperate anymore. My hands ache and ache!
I get extremely car sick
I posted on the gab board and while I was typing this message moved, so am copying my reply here too in case the other message gets lost -
I get extremely motion sick in a car. I cannot read at all. I can't even read maps to help husband in areas we don't know (can't tell you how many arguments we still have over this and it's been 25 years), and if there are a lot of road signs I can't read them, therefore I would imagine that if you can't read due to motion sickness typing would be hard, because as an MT I am always reading what I type to make sure there are no typo's or I don't hit a wrong key. A couple years ago we took a drive to the Mendocino coast in California. Lots and lots of curves. I thought maybe I had grown out of it (motion sickness), but my DH had to keep pulling over. I was so sick it was awful.
If you take a product like dramamine it will make you drowsy (I should know cos I'm the Queen of Dramamine) Taken enough of it at different times and I end up sleeping through the trip if I take it. I'm not sure if they have any non-drowsy. A lady did tell me once that I should eat a little carbohydrate before I travel and that might help. Again, a big "might" and I don't want to take that chance.
I think the biggest problem with typing while a vehicle is moving is the constant movement of the keyboard. If you go over a bump or hit a rock or swerve, your sure to hit a wrong key. I'm not sure I know of any employer who would allow this. I'd be more apt to be looking at the scenery rather than concentrate on what I'm typing.
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