rural hospitals
Posted By: pdqtrans on 2007-05-29
In Reply to: On-call transcription in a small hospital - Jamie
If this is an extra job I would certainly make it worth my while. I worked at small hosp. for 5 yrs that did not want to work us from home. Kept saying they could not but I knew better. Eventually I went off on my own and have been home since. We had 3 FT. They hired 2 in my place and 1 PT for wknds. I type at night now to catch them up. They still had 1 PT and 4 FT, but I charge them 15 cpl. I clear in 5-8 hours what they all 4 do in 1 day, literally. Still did not want to put me or others at home. Want me to drive 45 miles 1 way to type, after I've pulled my reg. 8. Now what I do, whether they know it or not, I dial up on my C-phone into thier system and type at home, save it to disc (they monitor email + HIPPA) drive over for about an hour and transfer work into thier system. So if they have a phone in line you might check with them about on call stuff being typed at home, especially if this is stat work. It will certainly get back to them quicker. This is just fear of the unknown. This same hosp. has now, instead of firing those not doing work and hiring a good worker or paying them OT will pay me double the amount. They have also moved the weekend girl to FT and are letting a file clerk/PT IC do the weekend x-rays and still want me to help. That's 5 full time typist and 2 PT for a 43 bed hosp. Thier may reason was not to put thier network on home computers, which they all ready do. Won't give me network access but have given it to the weekend girl. Plus they are paying a consultant out the wazoo to tell them why this is not working!
If you are going to be on call, make sure you have set days or hours that you will be on call and that you are compensated. Don't let them just pay you for the work you do. Your time is worth money also. In other words don't sit home all day 3 nights a week waiting for a phone call and get paid for 1 hours. I have done this in the past where I worked and was on call on weekends for x-rays. There might be 1 or 21 or none. I got paid by the hour. If there were none I got paid for 1 hour for showing up. Ask an x-ray tech or someone who gets on call pay. They get a flat rate for being on call and then they get paid for the individual call.
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Yeah, but hospitals are already largely using VR in hospitals. (nm)
(nm)
I worked for a rural doc. So much fun! :)
We even had a patient in the waiting room one day that brought in a paper bag with baby chickens in it as it was too hot to leave them in the car. Nobody in the waiting room gave it a second thought.
It was great fun to work there. They called it a "medical center" but it was in an old house with less than state of the art equipment. The country folk swore by "Doc" and "Doc" didn't think twice about going out at 3:00 a.m. to make a house call.
He never would have dreamed of asking for a co-pay up front and even let one farmer's wife pay with fresh baked pies.
They sure don't make them like they used to.
P.S. We still had typewriters back in 1994. :)
I have the same problem and we are not THAT rural....sm
It is very frustrating to feel so limited in your job choice b/c of something like that. I have never really had any major problems with my dial-up and have been told by two different techs. that I have excellent connection speed considering it is dial-up. Frustrating though....
Actually, I live in a rural community sm
and left a hospital where that was very good pay. Starting wages for MT was $8.00 an hour with a 25 cent raise every year if you were lucky. $11.50 would be like gold for the transcriptionists that work there.
Just moved to a rural area
Have a satellite dish, no cable. The phone company out here does not provide ULD. One job I would like you need ULD, and the other you need internet access, no satellites accepted. Does anyone have any ideas? Is there a way you can get even dialup without having to use long distance?
Rural America wages
Last year interviewed for two transcription jobs. Neurology office $13.50, hospital $16.00. (the most I have ever been offered) I was offered the neurology position, but declined and the hospital job was given to someone with less experience, i.e. less $$$, they were hoping to add an addition MT on, but did not. I have over 15 years multispeciality office transcription experience including running my own business for 10+ years. I basically learned on the job, sort of fell into transcribing 20 years ago. I am also a Certified Medical Assistant (silly me, actually went to school for that), I have worked in physicians office over the past 20 years part-time doing medical assisting and transcribing and worked my way up to $11.50/hr. Unfortunately in the office MAs are being replaced by regular high-school graduates, $7.00 per hour, etc, and of course they can do transcription too.. ha ha. Since I live in a rural area the opportunities are limited and each position would require a lengthy commute and with high gas prices that is just crazy, so I decided to go employee with national. Since I get paid by production I can make more $$$ that way overall but the cpl rate is not nearly what it should be, you just keep working harder for the $$$. I would not recommend anyone get into this field by choice as technology will eventually whittle us away to almost nothing. If you want medical, go for the top.. doctor, RN, nurse practitioner, PA, etc. Decent wage and some respect, too.
Rural doctor situation...
I hate going to the doctors office. My daughter has had a sore throat for a week and went in to see doctor this morning, sat there for three hours. We have gone through six different pediatricians/primary doctors in 11 years. How are they suppose to know if there is something really wrong. Doctor looked at her (daughter, 17) throat and asked why she had not had her tonsils out. Did not ask her history. She has not had a throat infection in over 10 years. As a toddler she had frequent throat infections and naturally large tonsils and doctors never once stated they should come out. Now, she is worried. She is a vocalist and does not want to that to effect her singing. Anyway, I'm getting off the subject here. We went in to see the doctor in clinic to find out he quit Friday and there is an interim doctor (who we've seen in ER and who has filled in for other M.D. in the past and like a lot better than current M.D. Too bad he is not staying). Is it that inconvenient for doctors to locate a practice in a rural area? Our area might not have much but we are only 30 minutes away from one medium city and 45 minutes away from a moderate one. Our little town is now down to one doctor when at one time it had 4-5 family practices. We have a hospital, but no doctors. LOL.
Thanks for letting me vent, but this is really getting riduculous. The doctor today did inform me that he was trying to recruit either some doctors finishing their residency or maybe some middle aged doctor from the N.O. area that would like to start over. We have great facilities, just no doctors.
I give, where in rural Georgia
are you talking about? I think I could put up hearing that more than I can with what I hear out of the Atlanta stations, at least it is not butchering the English language - just maybe their own language like I had mine from moving from Tenn. I understand that nexted above- I have heard that and even worse. I have a daughter-in-law who is parapro right outside of Atlanta (Jonesboro) and supposedly they are not to correct children when they speak incorrectly- she says heck with that and does. Can we say ebonics?
I'm not in a rural area. I'm in a big city and everything is SM
outsourced. My beloved company, run by a very decent man, was bought out by Edix. I thought they were bad until Spheris took them over. God help us.
Then there is the large community hospital, who has a "sweetheart deal" with another outsource company. You would not believe the garbage that goes on in this field.
Regarding unlocked doors, rural or not
My sister once left this true-crime book at my house and I read it, I guess because I wanted to have nightmares for a week. It was about serial rapists (WHY does she read this stuff?) Anyway.... one thing I noticed was that almost ALL of these perps walked into people's houses thru their unlocked doors, usually in the middle of the day. Sure your husband may be right about if someone wants in they'll get it, but just like anyone else, criminals prefer to do things the easy way. Why help them?
I'm an IC for a mid south rural hospital...
Although I get paid per minute of dictation, I have done the math and I make 10-11 cents per line. Patti is right, it doesn't matter per line or per minute. Its what you make per hour. I do radiology and the basic four every day with the same dictators with a new one thrown in every now and then and have been doing so for 13 years and make anywhere from $20-35 an hour working average 5-6 hours a day. Did not ask for a rate increase until my 8th year in which they balked at and began looking elsewhere. Two years later asked for another rate increase in which they readily agreed to but keep better track of what I do. Better to start low and become valuable to them than start too high.
IC working for a small rural hospital
I have worked for a small rural hospital as an IC for 9 years, this year I asked for a raise. Hospital thought about going to a national until they found out how much they charged. They contract their transcription themselves.
In 1995 I was making 12 cpl for a small, rural
Changes were gradual. First, we were allowed to start working at home at 12 cpl, instead of the hourly wage. We still were employees and had the same benefits. This saved the hospital money in overhead and we were all happy. Then they started using outsourcing services for holidays and weekends. Gradually, the whole MT dept was phased out and we had the option of going with the service handling the hospital transcription or finding another job. The service kept us at this rate of pay for a short time and then gradually started implementing "incentive bonuses" and lowering the line rate of pay. It evolved over the years to what it is today. Starting line rates were lower and incentive bonuses done away with. Health insurance is contingent on production, but their platforms crash regularly (as do many, many others) and we either have to work extra to make up the loss or just eat the financial loss altogether. The services overhire to make sure that their TAT is met, which means unstable availability of work, which in turn affects production, in turn affecting benefits.
The logic today behind all the changes is the "lack of experienced MTs in the U.S.", thus the need to hire people outside the country, who have even LESS experience with the English language and slang medical terms, at half the price of hiring American MTs. The MT field in general has to be able to compete and so must lower their rates to keep clients from going offshore at half price. And now with the advent of VR, the MTSOs using it try to justify the cut in line rate to the fact that we're no longer "typing", we're "just editing." It's been a gradual evolution, but not in a positive direction.
And in all of this, AAMT has not come to the aid of the transcriptionist. It has furthered the promotion of offshoring and has developed ways to enhance the MTs adjustment to VR instead of enhancing the MTs value and amount of worked involved in VR. When the AAMT doesn't step up for the very ones it says it represents, why would the ones using the services respect, understand, or value the MT either?
It is pretty rural where I am too, but the sprawl is coming - sm
My friends in the area (been here 8 years now) are people from the old school my kids went to, now a couple parents at the new PS they are going to and my neighbors. I am lucky in that I live on a private road with 14 houses on it. It is our own little world/community and we all get together now and then and have about 2 big parties a year (Daytona and 4th of July). I am close friends with one neighbor. I don't really have a "best" friend here (they are back home where I grew up in PA who I see 3-4 x a year) that I go shopping, etc. with, though Mary and I do things now and then with our kids. See if you can get friendly with your neighbors, good to have a local support system in place if you need it. Maybe a local library or club. Our area is slowly building up, have a supermarket now 5 minutes away versus 30, a local library, 2 dance studios, martial arts, a couple restaurants, Curves, movie store, etc. Try to get involved in some local club or activity, great way to meet people, or voluteer down at your local elementary school 1 day a week or something, they can always use some help. I keep very busy with work, Curves, taking the kids to dance (there are adult classes too), library trips in the summer, etc. I am pretty social though I don't mind being by myself either; so I try to keep a happy medium, but getting out and involved in something is the key to meeting new people. Give it a shot.
Do you think a company pays less for rural pay than city?
Does not make sense to me.
I am am in a rural area with lots of trees - sm
so when I had Bluesky (or what ever the name it) come out they said too many trees for the satellite. My one neighbor just got Directv high speed.....she also has lots of trees. So I may be looking into that (have Directv now just not the internet hookup). But I currently use a Sierra Wireless Aircard 875U. Unlimited and costs me $67 a month. It is through AT&T but I know Verizon has it too, as well as Sprint. You need to make sure it works where you are first though, but their websites can help you there. I love it. Not as fast as DSL but a huge step up from dial-up. I have it set up to use on my desktop, laptop, my backup desktop, and my daughter's computer. The only thing I have with it is it does not work everywhere...when I try to use it on my laptop...unlike the commercial where they show the guy in the middle of Africa or wherever he is. But I have been very happy with it.
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.
just some information for MTs in rural areas where high speed is not available
Hi all,
Was just on the Sprint website a little bit ago and checking out wireless cards for my laptop since I will be moving to an area that doesn't even have landline service available yet. Sprint is now offering a wireless card that is a USB card and apparently will work with both a laptop and a desktop as long as you have an available USB port on your computer. Might be something to think about 
Yep, I agree 100%. I live in such a rural area, though, that my neighbors, the natives, think I'm
NUTS cause I keep my dogs in the house, and actually still walk them on a leash in my yard. We all have about 2 - 5 acres minimum each of woods in our neighborhood, and no real dog laws at all! Dogs run at large 24/7, which is no picnic for me with my dogs on leash, either! And they ALL keep them outdoors, tied up with the chain and the smelly old dog house. I think they just look at dogs strictly as deterents? Not sure really, come to think of it! Cause even if they were getting robbed, Fido couldn't get off the 6 foot chain! Oh well! I used to be sad all the time for the plot of the dogs here, but I can't save them all! Only my guys!
You must live in a metro area because rural areas pay even less per hour.
Of course you can buy a big house for 130,000 in a smaller town and the same amount won't buy you a pot to pee in, in a place like San Diego or the D.C. area. It's all relative.
Opinions please! I have been asked by a small rural hospital to do their overflow. SM
It is clinic notes that are pretty easy to type. Some of the work is digital and some is still on tapes. They want me to come in and pick up tapes, and they want me to print and deliver reports when I pick up the tapes because they don't know much about setting up a remote printer. I made an introductory offer of 12 cpl for the first month and then 15 cpl if we both feel like continuing to work together. I felt that since I am going to be out the cost of gas and ink, my offer was more than reasonable. Well, they countered with a flat 12 cpl period with a one year contract and then we reevaluate at that time. While I was mulling that over, she called back and asked if I would be interested in doing some radiology for them in addition to the clinic work. So basically this account will keep me very busy and is not going to be just overflow.
So now I'm back to thinking 15 cpl and because they balking, not offering the introductory rate anymore.
What does everyone think?
The phone line has to support DSL signals. Most rural lines don't due to distance from central of
x
I live in a small rural area and they housed some evacuees at a nearby military base
crime went UP in our little community that previously HAD a ~very low~ crime rate. It is a FACT. I'm not saying all NO residents are like that, but MANY seem to be.
My mom was raised in conditions like this poster describes. Mom's parents died when she was 7 (father) and 9 (mother). Her teenage sister (newlywed) raised her and 4 other siblings. They had next to nothing. Not ONE of them turned to a life of crime. Not ONE even graduated high school but they still made good lives for themselves. Life was rough for them, but they didn't blame it on everyone else and cry around about what the president should be doing for them. It is all about RESPONSIBILITY and taking what life throws your way. IMO.
Most hospitals have ......
contracted their work out to the national service, a practice I hope comes full circle eventually and hospitals reopen their own departments in the name of confidentiality and quality control. I only know of 2 hospitals out of about 8 in my area that have their own department (I work for one of them). It is by far the best MT job there is, or that I have ever had. I am at home, but a regular employee. The hospital is only 20 min from my house (we have to live local). I have worked for the big nationals and saw nothing but a decline in pay. Now I get regular raises, good hourly pay, production incentive pay, benefits, and vacation time. I wish more MTs could find my situation. I have hopes for the future once the industry figures out that they are cutting off their nose in spite of their face.
Do All Hospitals
In Tennessee pay that well? I have been considering moving to Tennessee to try to get away from the hurricanes.
VA Hospitals
I did the VA Hospital dictation here in Portland and it was all contracted out to companies, no employees. But you might contact your local VA Hospital but if it is as an employee 95% chance you will have to go into work and not do it at home, if it is at home it will be as an IC and no benefits. Just what I know about it. If you think your ESL's are bad at a regular hospital, this is worse as there is a lot of ESL's there on their rotation and they could care less how they dictate as they are only there for 6 to 8 weeks. Changes that often.
The hospitals are not going to get
dial into. They'd be better off hiring MTs and paying benefits than doing that. And if you dial directly into the hospital, instead of into the MTSO's dictation system, then the MTSO has no say in 800 lines. The truth is, hospitals usually do not want to just turn all of their dictation over to a service and they certainly aren't going to pay for long distance incoming calls in addition to what they pay the service.
just sometimes it is the hospitals...
they are actually told to hold back dictation at times, due to costs. sometimes the hospitals sneak around and try other services, or voice recognition.
in the future, there will not even be any voice dictation...just templates where information is added, like data entry...
Not that many hospitals.......
still have their own dept. That's how Medquist and Spheris and all those huge nationals exist... They have whole hospital accounts. Out of the 3 large hospitals in my vicinity, only 1 still has their own department. I trolled their website for months before I found an opening, but I eventually got in. Some hospitals don't have their MTs at home, mine does. It all depends. Most hospitals have a website, so fine the one you're interested in and check out their job opportunities, and then check it almost every day and if they do have a dept, they'll eventually have an opening.
Well - believe it. Hospitals pay that. I can tell you
at least hospitals in the Philadelphia area pay up to 24 cpl. MQ charges 23 cpl. I have one small department of a hospital at 17 cpl. It is out there - pull your head out of the sand and go looking.
I wonder if hospitals know
There are American transcription companies opening up here in the US that actually work for companies in India? I had a job offer from an American company and they let it slip that they were actually getting paid by Focus Infomatics. I thought about this and what an idea! You open up a company in the states, the facilities think they are getting American work, then you actually have the work done overseas.....hmmmmm
hospitals
do hospitals now go by minutes instead of lines in regards to productivity? if so, what is the usual they are asking for an 8 hour day?
thanx!
All hospitals are different. Concerning
your "past," if it has been exspunged from your record, then basically it never happened. This happened to my BFs son and his attorney told him that since his record was exspunged, nothing ever took place, so he does not have to mention it on any job application. You might want to call your local court house or your attorney on that particular question.
I would say go ahead and apply. Good luck.
All hospitals are different. when I sm
first started, ERs did their own stuff too. But as the years went on, ER combined with the MR departments and was considered part of acute care. It is not as detailed but you get some of the same language in an abbreviated from by doing ERs, even some OP reports. I don't like ERs either though simply because the docs are usually in a hurry and they are motor mouths. I do think though that MTs now should consider ERs as part of acute care especially if they don't like ERs.
Some MT companies do split them up though and hire folks for just ERs.
SM hospitals
It's been years since I have heard of any hospital that has ANYbody working in-house.
What hospitals?? I'm soooo there
No, even the hospitals don't want to hire new MTs.
Doctors don't want to hire newbies. In office, at home, it doesn't matter. It's not about being a stay at home mommy, as you are so assuming and generalizing yourself. Everyone wants to hire experienced workers, but nobody is willing to train them. As I said, every other industry in the country trains their workers. MT seems to be the only one where people are expected to walk into it knowing everything. It's not an assumption; it's an observation. Just because my experience and observations are different than yours does not make me wrong. You're not the know all, end all to the MT world. I do have business management experience and education, so don't dismiss my observation as lacking just because it doesn't match yours.
Hospitals being sued
Seems to me the hospitals must not be very worried about being sued or they would require fluency in the English language as a pre-requisite for staff privileges. Secondly, any doctor who doesn't read what he signs pretty much deserves what he gets. Transcriptionists make mistakes....so do doctors. Thirdly, maybe hospitals should re-think how their work is contracted out. Far fewer problems when transcription was done in house.
i am sure you are aware that there are still hospitals out there
that have not yet adopted these rules. I type for one major hospital that still wants the patient's name typed in the report. Another still wants cc instead of mL. Had this person tested and changed it to the "correct" form, who is to say that she wouldn't have gotten marked off for changed verbatim. Nervous MT2, hang in there, and if you test again make sure you ask up front whether they want you to follow BOS or type it verbatim that way you know ahead of time.
but what percentage of hospitals allow that?
From what I've been reading ... the home-based service MT is averaging 8 cpl, for those dictators which make you run screaming from the room. And, I don't forsee things improving. Then again, some are lucky enough to make a line rate worthy of their skills, without worry about the dictators from Hades.
This is a bit out of date: http://www.bls.gov/oco/pdf/ocos271.pdf
My nearby hospitals pay around $10 as well (sm)
I make 22-25$/hr at home. I live in an area where average pay is low, but likewise cost of living is reasonable.
I miss the hospitals too.
But things are so different there now that the online companies exist. It changed the way transcription is handled in most places. When I went back to working for a hospital last year, the supervisor wanted a certain amount of lines per day versus minutes per day like the old days. It was an outrageous number and with no Expander or medical speller or anything.
Hospitals oursourcing
HIPPA is all about smoke and mirrors, designed to keep the masses feeling "secure." If the powers that be were concerned about privacy and the state of the world, they would have built that provision right in there from the beginning, but powerful special interest groups designed HIPPA and left out this all important factor. I personally know hospitals that directly outsource overseas, and maybe, just maybe it may have to do with the fact that the owners (doctors) are foreigners living in this country and have colleagues in India. Wheh I questioned an administration about HIPPA and what they were doing, I was told, "Not to worry, they take the same precautions and follow protocols we do here for HIPPA." I say, yeah, but who can see from here what potential dangers lurk overseas, especially with so much concern of volatility in those areas of the world. Terrorists live in India, Pakistan, the Phillipines, etc. and all it would take is a nasty vendetta against our nation and POFF!!! There goes our medical records! Now we have to be concerned that the United Nations may take over the supervision of the internet!!
Nationals: Sometimes the hospitals have their own MTs sm
and pull the MTSO off the account when work is low to keep the hospital employees busy. This probably happens more often than one might think these days. IMHO
You have 911. There are local hospitals
with free nurse referral lines. That's just for starters.
You just take the cake for stupidity with your original question and now your silly offended replies.
Hospitals Using Outsourcing
Really not so unusual for all hospitals in one city to contract out transcription. Little Rock, AR for example where I used to live, did just that, save for one hospital (Baptist), so I moved east to Memphis, because I could not stand working out of my home to land a hospital job to work in. Cost-cutting measures you know.
that would be because MDs/hospitals adore.nm
.
in hospitals it seems always ASAP - SM
I work rad (employee) in a hospital, and they are always ALWAYS working to improve TAT. From the time the exam is done to complete dictation, they want 3-4 hours. That means if your doc delays the dictation, they want transcription NOW because the doc took so long.
However, in the situation you describe, checking back in 1-2 hours should not matter that much. You should just let them know the deal - they probably know how that radiologist is as much (or better) than you. Maybe they/he could call or email when he is done?
My hospital has a contract with a sister hospital to do their radiology - they have radiologists that do this exact same thing. We told them when our staffing is available. If they do not dictate during that time, then their reports are delayed -- no question. they have to deal with it.
Doing it yourself, your situation is different, of course, but hopefully they would work with you to let you know when the work is available so that you don't have to be "on call" for them.
As far as line rates, I can't say an average. I have another rad account that I do at $.15/line, but this is 3 days a week for a mobile service (TAT is 1-3 DAYS here...) I would charge more if they needed it "now", especially if they wouldn't work with me as to when "now" might be!
Long answer - hope it helps.
Feel free to email with any more questions if you want.
Hospitals in town
I hear sometimes that there are still hospitals doing their dictations with their own transcriptionists, and I'm lucky that I found one through their website... but wondering, just how do you find out who does the hospitals in your city? No one ever advertises in the newspapers anymore and most hospital websites have nothing about transcription. I live in a pretty big city with lots of hospitals and clinics and outpatient surgeries. Surely they're not all outsourced to the Big Greedies.
Try hospitals and/or clinics-
I don't know about other places but in at least 3 of the major hospitals in my area they have people work both in house and at home. Everyone works in house to begin with and has to prove themselves before going home. Some people (like me) just prefer working in house, so it works out.
Why would hospitals have a list of
transcription companies, doesn't make sense. If you want your own clients you should come up with a brochure to send to local doctors/clinics. A doctor may ask in medical records who does their medical transcription, but it isn't the roll of the hospital to provide them with a list of providers.
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