Wednesday, May 28, 2014

An Open Letter to Medical Dictators - Tips!

Dear Doctor/Mr./Ms./PA, FNP, CNM, etc:
If you spend what seems like an inordinate time dictating, I am sure you spend an equal amount of time wondering how you could improve the lives of the folks listening to you on the dictation poor medical transcriptionists.  I know your time is valuable, and so is ours, and I know you think for the most part we do a good job and you are aware that improving things on your end would make it easier for the MTs to do our jobs...but try as you might, you have until now not figured out how to do that.
It’s probably safe to say you’ve never had an MT sit down with you and tell you how to improve your dictation.  Well, here’s your opportunity - listen and learn!
The first thing is the “pause” key.  You know those times when you have to sit and think in the middle of the dictation, or maybe search for lab tests in the patient record?  Most dictators think the pause key is the way to go.  That way, the MT is not sitting, waiting, fuming, during minutes of silence until you come back on to continue the dictation.  Well, I’m here to tell you to NEVER use the pause key!  MTs would much prefer the silence - it gives us time to give ourselves a manicure, for instance.  And those of us who get paid by line - don’t give a thought to how you are stealing money out of our pockets with dead air space when we could be making lines.  I mean - really, we didn’t really need to pay the mortgage this month.  I’m sure the bank will understand.  Bonus points for this:  If your phone rings and you let the dictation run and pick up the phone and carry on a private...I mean PRIVATE...conversation that we can listen to - that really makes our day!
I know you sometimes like to dictate on the cell phone while doing other things.  That’s great!  There are a few times you must absolutely be sure to dictate on a cell phone - when driving (don’t worry about running over that kid on a bicycle - the emergency room needs the business) - and at sports games, because the guy next to you, who never heard of HIPAA, has really enjoyed hearing the private medical details of his neighbor’s hospitalization.  And yes, some MTs are sports fans and we love to hear the games too.  If you’re not at the game in person, just dictate while you watch the game on TV, and make sure the volume is turned way up.  The same effect applies to the news.  MTs are so busy, we miss a lot of news, so we can listen vicariously through you.  Just make sure the volume of the TV is higher than the volume of your voice so we can stay informed.  Thanks!
Speaking of volume, if you really want to make MTs swoon, eat while you dictate.  After all, we know you’re too busy to do just one thing at a time, and we love to take turns trying to identify the particular food you are consuming, since we hear every bite so clearly.  After all, we get bored listening to your voice over and over.  Throw a few potato or corn chips in the mix, and it gives us a break from your monotone delivery.  Now regarding chips, you do know some are louder than others, don’t you?  We prefer the really crunchy kind - they make the loudest decibels in our ears.  And you get extra credit if you rustle around in a plastic bag to retrieve them!  Makes me giddy just thinking about it.  If you don’t have chips handy, there are alternatives, such as popcorn, crackers, and celery.  Use your creative imagination and surprise us!  Or, if you don’t feel like crunching on a certain day, go with...
Hard candy.  Mmmm...that sucking sound is out of this world.  And it even gets better while you try to talk through the sucks! Who cares if there are blanks in the medical record?  It’s worth it because YOU SUCK!
You silly dictators - always trying to please us in the most charming ways.  Sharing your mealtime and snack time with us is so nice!  We love to try to distinguish what you are saying through all the dietary intake.  Bonus points if we can hear you actually swallow liquids- and double bonus points if we can hear you make other bodily noises down below!  (Going into the bathroom?  We feel honored to come along!)
We know there are some times when you have the sniffles.  Aw, Mr. or Ms. Practitioner - we feel for ya!  Sometimes if we’re really lucky, you will sneeze or blow your nose DIRECTLY INTO THE PHONE.  Oh, yeah!  Some people might find that disgusting, but it just gives MTs a  reason to visit the ENT doctor for burst eardrums - after all, we need regular medical care for our ears, as they are our most valuable asset, right?  Thanks for giving us the impetus we need to go for a checkup!
We know how hard it is for you with all these foreign-sounding names these days, too.  When you admit a patient with the last name of Klzyakchkzn, please don’t bother to spell it or even give us the first letter.  It makes it like a treasure hunt for us!  Gives us a much-needed break during our shift.  Be sure not to give us any clues like a birthdate - clues are for sissies.  We want to spend the next hour  trying to find the correct patient - but if we accidentally put it on the wrong patient, that won’t really matter, will it?   Hey, things happen.  It’s our fault anyway - everybody should know how to spell Klzyakchkzn!  Bonus points if you say your dictation is on “Baby Boy Smith” and the real name of the kid listed in the electronic medical record is Chester Anderson Grobenoff III.   Just because his mom’s name is Smith, just go ahead and assume it’s the same for the kid. Your time is too valuable to double check that; please, let us do that for you.  
There are some words that sound so alike if you talk fast and/or slur:  Regular, irregular.  Hypertension, hypotension.  Incomplete, complete.  But that’s OK.  What difference does it make whether the patient has hypertension or hypotension anyway?  I’m sure the nurses know what’s what - they certainly don’t need to see it in the medical record correctly.

I think I’ve about covered it all.  If you want more tips, we MTs are always happy to give them to you.  After all, that telephone line is a direct communication link between you and us - and the whole communication involves the entire health record of thousands of people.  I know we both want to do things right.  Right?  (Or left?  Oh well, it doesn’t really matter, doesn’t it?)

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