Medical dictation 101

Apparently some doctors need some training in how to do medical transcription.  Tonight as I’m typing all their dictation I’m pondering on why they don’t teach these things in medical school.  I think if doctors had to dictate a report, swap dictation and type someone else’s maybe they wouldn’t be so cavalier about how they do it.  Maybe, just maybe they’d take 2 minutes extra and make the thing understandable. 

I’d like to do my part to make sure that your medical record is transcribed correctly.  Mistakes in your medical record can make life very unpleasant as far as insurance goes.  Trust me on this one. 

Anyway, the suggestions rules:

1.  Do NOT chew gum, eat your meals, chew cud, eat ice, or whatever it is you do when you’re dictating.  Keep your mouth clean of debris and your dictation will sound like the English language.

2.  Do NOT belch into the telephone.  If it’s unavoidable, could you please excuse yourself?  You may not realize it, but there really is a human being on the other end of that phone and I really would appreciate it.  Especially if it sounds like you need to wipe the phone off.  Ick.

3.  Do NOT take your hand-held recorder into the bathroom with you.  Please. I don’t want to hear my own husband in the bathroom, it’s a sure thing I don’t want to hear you.  That’s all I’m going to say about this one.  Your mother should have taught you better. 

4.  Read the chart BEFORE you dictate.  Seriously, if I were sitting in a hospital making $20 bucks an hour doing transcription I really wouldn’t care how long you have to review the chart after you dial in and before you begin speaking.  But I’m not.  I’m sitting at home making less than 10 cents a line and I really don’t want to waste time sitting here listening to papers being flipped while you frantically try to remember who this patient is.  In the 5 minutes you waste during your dictation I could do 2 good reports.  I’m not kidding.

5.  Just because you know what you’re saying does not mean WE (transcriptionists) know what you’re saying.  Maybe you’ve dictated a tonsillectomy 10,000 times.  Maybe this is the first time we’ve ever worked for your hospital and we don’t know what you’re saying.  I had a doctor at one of my hospitals could dictate a T&A in 57 seconds.  Could I understand him?  No.  But I worked for that hospital only and I learned that he said the same thing every single time.  So it really didn’t matter.  But when I’m in Yahoo, Nebraska, and you’re in San Diego, California, working in a hospital with 800 doctors chances are I have never transcribed a report for you.  Please slow it down.  You know, malpractice insurance is expensive….

6.  If a name is hard for you to pronounce, it’s probably hard for me to spell.  Could you please spell names, especially doctor’s names, in reports?  And if you want a copy sent to Dr. Smith in New York City, do you think you could possibly give me a first name.  That would be nice. 

 7.  If your beeper goes off while you’re dictating please don’t hold the beeper up to the mouthpiece of the phone while you read it.  I’m probably going to lose my hearing early from doing this job anyway, you really do not need to hasten the process. 

8.  Do not tell jokes, yak with the nurses, or answer another phone while you’re dictating.  I know there’s a pause button for you to use.  I really don’t want to hear the details of your son’s Bar Mitzvah or your golf game this morning.  If it’s not part of the medical record can you wait until you’re done dictating? See #4. 

9.  I love dictators who tell me thanks at the end of dictations. Especially on holidays.  We don’t want to be working either.

10.  Enunciate.  Don’t be afraid to open your mouth.  Slurring is only acceptable when you’re drunk.  And if you’re dictating I hope you’re not drunk. 

11.  Don’t whisper.  If you’re dictating where everyone and their uncle can hear you, you probably shouldn’t be dictating.  If the people around you can’t hear you, chances are I can’t either. 

Okay, that’s it for now.  I do love my job.  Really I do. 

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22 Comments

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22 responses to “Medical dictation 101

  1. Natalie

    Thank you for that! I too sit at home making less than 10 cents a line typing for 4 hospitals/surgeons listening to some of the worst dictators of all time.

    “How To Dictate Properly” along with “Dictation Protocol” should be taught in medical school by people who can actually dictate. ALL MEDICAL STUDENTS should have to transcribe their own dictation for an entire month so they can see how bad they really are and can improve on their weak areas. This way, by the time they actually become doctors, they will know how to dictate.

    As far as thanking us for making them sound intellegent, usually the only ones that thank us after each dictation are the ESL doctors. Most, but not all, of the American doctors just hang up without saying a word.

    Medical Transcriptionists are some of the most intellegent people I have ever met. They can make sense of some of the garble that comes out of dictator’s mouths.

  2. Suzanne

    Well, well, it happens on the other side of the world too !!!

    Greetings from your sisters down here in Australia with the same problems.

  3. I’m glad to know we’re not alone up here! Greetings!

  4. Jaclyn

    oh, I just love it. It seems dictation is getting worse by the minute. It is quite annoying, I only make 8 cpl. and work my fingers to the bone. I have been doing this almost 10 years now, only make 8 cpl. and struggle everyday. I am completely stressed out.

    I sit here all by myself everyday and start to believe I am the only person who feels this way, but after reading this, I feel better that I am not alone.

    Thank you

    Thank you !

  5. Hello:

    I would like to recommend an audio transcription company that could help you out tremendously. There are so many out there to choose from though. Have you tried a service already? I would like to recommend WeScribeIt.com. They truly offer great service.

  6. Ashley

    Hey, medical student here. Just want to say I agree that they should teach us how to dictate in school! Instead, they shove charts at us and say, “There’s the phone” and we have bad doctors rambling into a phone to learn from.

    I appreciate you transcriptionists and I often tell our hospital’s that I feel sorry for you for having to put up with the things you do! And I’m learning, but I know I’m really slow and get things out of order. So, thanks for putting up with us and thanks for the rules. I will gladly follow them!

  7. Patricia Potter

    I am taking a transcription class at this time. Of course, the speaker dictates quite plainly. Ppl complain about not being able to read the drs’ hand writings, sounds like their dictation is just as bad. Bummer.
    PS, how do I go about slowing the dictation down, that I am listening to thru the headphones? Thank you!

  8. Emily

    You probably have figured that out already but it depends on what transcription program you are using. I use FTR Gold (free) and it has the speed slider is on the right side as you look at it, but, like I said, it depends on what you are using. I loved what you posted, Angry Minnow, back in 2006 and I second your feelings/advice. So frustrating, isn’t it?

  9. Debbie

    So ture! Thank you to all the doctors who actually try to help us out and take their time. To those who are ESL, maybe you could consider letting someone who speaks a little better English, it will free you up in the end. Just a suggestion! 🙂

  10. kathy

    THANK YOUUUUUUUU!!!! I only wish the doctors were reading this. I have another one, though. How about those fools who dictate every single sentence going UP AT THE END. He was taken off nasal CANNULA and did well on ROOM AIR. I’ve listened to six REPORTS TODAY where every single flipping doctor SPOKE THIS WAY all the way THROUGH every single flipping REPORT. It’s highly ANNOYING. AAAAHHHHH! Something else I love is the comma comma comma and period period period dropping. I KNOW where to put commas; I KNOW where to put periods. You’ve putting them in the wrong places ANYWAY. Yes you ARE. I think you really need to STOP THAT. (God help me, I wanted to work at home and do this, but I’m enormously rethinking, having to listen to these intelligent dopes all day long. Oy vey.)

  11. LB

    I can’t believe this blog has died off. Where are all the MTs…..I have been doing this for 7 years. I got my CMT after 3 years and was making 9 cents/line, but my company merged with another company and in order to keep my accounts, which by this time were good clinics, I had to take a 2-cents/line cut in pay. So here I sit with my credentials in hand, putting up with nonsense for 7 cents/line. One of my doctors yawns through the entire dictation. I have left numerous blanks and notes saying dictation is inaudible due to yawning. It didn’t help! This same doctor used to dictate giving just the patient last name, Ms. Smith, nothing else…I think we should be able to write doctor reviews. I know I certainly would not go to this doctor for care; obviously her concern for her patient’s health record is minimal. That same clinic has a doctor that sounds like she is 13 years old, holds the phone against her lips, dictates one continuous sentence a paragraph long as fast as she can, then stops for about 15 seconds and goes again. What is with the younger women now having such childish sounding voices. Has anyone else noticed this? This is an excellent blog and I certainly hope it starts back up. Good water cooler for those of us who are “shut ins.” LOL. Thanks for listening.

  12. Soofie

    How many sniffles is too many? I have a doc who has chronic post-nasal drip and sniffles 30+ times per document. We’re talking long wet sniffles that get chewed and swallowed. He also yawns and talks at the same time, talks >20 pages per hour and never spells anything.

  13. Betty Moderno

    Frustrated here with the poor quality of dictation, and then hearing them complain about the finished product. What’s the old saying? “Garbage in, garbage out.” I would LOVE LOVE LOVE to teach a course in dictation. Do doctors have to take continuing education every year? A course in dictation would be ideal, and easy as well.

    Okay, some of my pet peeves are: Please don’t use your cell phone to dictate, especially when you’re driving. Yes, I’ve actually had a report done from a doctor who was clearly in traffic. Scary. The sound quality when using a cell phone leaves a lot to be desired, especially when it is done in the “hands free” mode. Dictation should not be a speed contest. Slow it down. I don’t care what your excuse is, because there is none. And if you must speed speak, then please take the time to read over your report completely. It’s you who has to sign the report, not me.

  14. kate

    I really hate medical transcription. I hate it.

  15. kim

    A small percentage are fine…10% maybe. Half of them (50%) are okay and the rest of them I’d slap them as soon as look at them after an hour of this. The one I am doing now is from New Zealand, and he smacks, chomps, slurps and cuts the beginnings of his sentences and ends of his words all off and mumbles and rambles, I could just strangle.him. STOP EATING WHEN YOU DICTATE YOU MEDIZOIDS. He needs to be tied down with very strong ropes and have me smack and crack, slurp, chomp, drool, chew, and in general make very very wet noises like a smelly mangy old dog thoroughly cleaning its itchy naughty bits verrrrrrrrrrrrrrrrrrrrrrrry leisurely for a few hours straight with no relief, so he knows what it feels like to have to listen to someone’s eating noises and puzzle out what he is saying line by line for such a meagre living. I’d take this over waterboarding any day for extracting a confession, actually…

  16. Kerri

    You summed up very neatly what I’ve been thinking about (and ranting about to anyone who would listen) while transcribing both in a hospital setting and from home for 20 years. It’s amazing how such well-educated people can mess something up so badly. Good on ya’!

  17. Jody

    While I was studying to become a medical transcriptionist, I was, and I still am, absolutely “appalled” at the speech patterns of most doctors giving dictation! They virtually, and literally, hold the lives of their patients in the palm of their hands, and they can speak no better than this?! It’s preposterous! If the powers that be spent as much time sticking their noses into things like this as they do trying to come up with more ways to rob us blind, maybe the health industry wouldn’t be in the shape that it’s in! I never would have believed that I would be transcribing dictations given by people who went to school for as long as they have, yet they are still incapable of enunciating the English language any better than they do. It “is”, in fact, part of their job to speak clearly, especially when they are dispensing medications that, taken in the wrong dosage, can kill a person graveyard dead. I’m a musician. I chose medical transcription because I like to type, and I thought that all these years of listening closely to records trying to decipher the lyrics would be an asset. I’d fare better if James Brown was giving the dictations. Him, I can halfway understand!

  18. TE

    Very amusing. Love the bit about dictating in the bathroom. However I have to say that I do dictate very fast but that’s because I write very long reports and do a lot of editing at the end. I can also touch type and I am almost as fast as a transcriptionist – I just don’t want to spend all my time doing just that. I just want to get the details down quickly and have someone else format the headings.

  19. Lisa

    Loved this…..and now I don’t feel so alone in the wee hours of the night typing (trying to) letters from a doctor who has a cold and has “croaked” her way through 16 dictations that I could then barely understand GRRRRRRRR. We have poor dictating docs here in Australia too.

  20. Long-TimeMT

    Yes, I understand with a lot of the docs, it’s speed, speed (greed, greed, greed), no regard of whether or not the MT/Editor can understand what he/she is spewing forth. I had a lady slurping from her straw during a dictation yesterday. Wanted to choke her, really. In fairness, there are some good ones though, some I could transcribe/edit all night till the proverbial cows come home. There are others I certainly would not want to be in the same room with, much less place my health and well-being in their hands. So these posts started way back when I was making 8.5 cents a line, and it’s now almost 2015 and they’ve cut us down to 4.5 cents per line. I’m no dummy. I’ve been doing this 25 years and it breaks my heart to see what has happened to the MT industry. I’ve had to file bankruptcy, I barely can make ends meet, no Christmas for me this year….Again…But that is nothing new. We are intelligent minds who do this work, we are people on the other end who must care about what we do because why else would we sit here 12-14 hours a day/7 days a week trying to earn a living, for barely minimum wage, and we get to use a voice recognition engine that does not learn. In fact in the year and a half I’ve been on this particular program, it still doesn’t know how to put a period after Mrs or Mr. So Docs, do us a favor, work with us as a team, speak clearly, not from across the room on speaker phone, take a little time to slow down. And for you ESL’s learn to speak PROPER English. It’s simple as that. Then maybe, just maybe we can edit our reports in half the time it would take to transcribe from scratch, which is the farce that was told to the hospital administrators by the vendors that sold them these pieces of trash they call a VR program.; I’m sure the HA’s know by now that is not the case, that it takes just as long if not longer to edit a word salad that these incompetent software programs spit out, but I sure they don’t care,

  21. Jens

    Hi all,
    I’m not familliar with medical dictation. However I would like to know what Natalie meant (in 2006!!) when she wrote about a “dictation protocol”. What is that?
    Thanks!

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