Yeah, but do they charge full price?

I must say this surprised me. A new survey shows that about half of American doctors say they regularly give patients placebo treatments — usually drugs or vitamins that won't really help their condition. Also found is that many of the doctors aren't honest with the patient about what they're doing. Well duh, doesn't that sort of defeat the purpose of a placebo?

I type a lot of reports where the patient will have 15 or 20 medications and never once have I come across one that says placebo after it. It seems this might be a dangerously deceiving practice to me.

"It's a disturbing finding," said Franklin G. Miller, director of the research ethics program at the U.S. National Institutes Health and one of the study authors. "There is an element of deception here which is contrary to the principle of informed consent."

I'm not so much worried about the deception as I am about whether the doctor is charging regular price for these placebos. I'd be pissed if I found out I was paying regular price for something that didn't actually do anything.

{source}

When labor distracts from the dictation

I'm sitting here typing this report and curious why doctors can't go somewhere nice and quiet to dictate. It doesn't seem that much to ask. Heck, sit on a cell phone in the bathroom and dictate if you need to, but please, please, please leave the room that's next to the laboring woman.

I'm sure we've all had those dictations where the doctor is dictating away while a woman screams and moans in labor somewhere within what seems a 2 foot vicinity. Uhmm, I didn't want to hear myself when I was in labor, I sure as hell don't want to hear some perfect stranger sound like she's being ripped apart or having sex, which disturbingly it sometimes sounds like. It sorta creeps me out.

Dictating in the ER should also be a no no. I hate hearing a screaming kid in the background who is obviously in pain, fear or both. It's distracting and disturbing and there needs to be some sort of rule. We need to start a grassroots effort here. Take a stand and start quiet dictation standards, or at least dictation standards where a doctor has to dictate in an environment that doesn't involve the TV, screaming kids, moaning labor and delivery patients, pets or major hospital construction.

That's it, now I'm back to my own personal moaning patient here. Yikes!

Doctors succeed in making me paranoid sometimes

I often wonder if there are really, really bad transcriptionists out there that are giving us all a bad name or if some doctors really think we're idiots. Maybe it's a little bit of both. I'm sitting here typing this report and the doctor keeps spelling really odd things. Like the patient has packing in his nares. He spelled p*a*c*k*i*n*g and n*a*r*e*s. Okay, granted it could have been just one nostril but not sure what word might have taken the place of packing. He also spelled perfused, bowel, and bike for me. Yeah, I've been able to spell bike since I've been able to ride one but whatever. He also proceeded to make sure I had the proper abbreviation for EMS, PACU, and PMI.

All of these odd little make-sure-I-get-it-right things makes me wonder if doctors do this because they've had someone who actually got these sorts of things wrong or if they're just having a pissy day and want to take it out on whoever may be typing at the other end of the dictation. By the time I get to the end of these types of reports where everything has been spelled out for me (but they fail to spell out the things that may actually be helpful) I begin to get paranoid that I'm spelling things incorrectly or using the wrong abbreviation and that I'm going to be the cause of his next spell-everything-out tirade. I start to feel like I need to add a shot of Irish Cream to my coffee and it's only 8:30 in the morning. Sheesh, I think I need a pee break.

A male MT speaks

Physican bloopers video.

A little dictation humor for your day

TRANSCRIPTION HUMOR.... DICTATION GUIDELINES FOR PHYSICIANS

Adherence to these guidelines will assure the highest quality transcribed reports in the shortest amount of time.

At the beginning of the dictation, take as deep a breath as you possibly can. Now, try to dictate the entire report before you have to inhale again.

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

We charge per character, including periods. An effective way to cut your cost is to dictate your entire report as one sentence.

It is not necessary to repeat the same sentence multiple times in the same dictation. If you have to sneeze or cough suddenly, please remove your head from your armpit and sneeze or cough directly into the microphone.

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.

Please don't stop dictating when you yawn. It throws off our rhythm.

If the patient's name is Alan Ratzlaffenhasenphepherzinsky, please have the courtesy to spell "Alan" - there are several possible spellings, you know. For the last name, simply state "the usual spelling".

It is not necessary to repeat the same sentence multiple times in the same dictation.

Please note - the phrase "well-developed, well-nourished white female" is only three syllables.

Cardiologists, it is not necessary to dictate at the rate of your patient's atrial fibrillation.

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

Be sure to place the emPHAsis on the CORrect syLLABLE, especially if enGLISH is your SECond lanGUAGE.

It is not necessary to repeat the same sentence multiple times in the same dictation.

Talk as fast you possibly can. Fair's fair; after all, we type as fast as we possibly can.

Please speak as quietly as you can.......we want to be able to hear what's going on around you.

If you need to pause for 5 or 10 minutes between words or phrases, pounding the receiver on the desk or repeatedly saying, "still dictating.... still dictating..... still dictating.... still dictating..... still dictating......" reminds us that indeed, you are still dictating.

Just because you need to use the restroom is no reason to stop dictating. Time is money!

Don't dictate so loudly that you disrupt your fellow physicians' football game in the doctors' lounge. In fact, you really should whisper all of your dictation, since the information is confidential.

Similarly, if you are going to watch TV while dictating at home, please watch a war movie with lots of bombing, and be sure to have the volume high enough so everybody in your living room can hear above your talking.

If you need to correct yourself -- sorry, correct an error, please do not rewind the tape -- sorry, do not back up and record over the error -- sorry, wait, the mistake -- just continue with the sentence -- wait -- go back -- with the paragraph and fix the error -- er, the mistake.

Please go back and just delete that last guideline.

When dictating on your cell phone from your car, be sure to go through as many tunnels as possible. This will ensure confidentiality of the information.

You (y-o-u) do not need (n-e-e-d) to spell (s-p-e-l-l) obvious words (w-o-r-d-s) for us (u-s). It is our job (j-o-b) to know (k-n-o-w) how to (t-o) spell words that (t-h-a-t) we learned (l-e-a-r-n-e-d) in third (t-h-i-r-d) grade (g-r-a-d-e).

One last thing, it is not necessary to repeat the same sentence multiple times in the same dictation.

Thank you, your friendly neighborhood MTs

Again with the counting

Sheesh, I just griped about this like last week but here I am annoyed by it again. Doctors, it goes 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, read it, memorize it, live it. How it is a doctor can honestly go 1, 4, 6, 2, 2, 4, is it really that hard to keep track of what number you are on?

They can remember the medications, the patient's entire medical history and that of their family, but can't remember numbers? Just say next instead of trying to number, that annoys me far less than having to try and keep track of your stupid numbering.

Thank you, this has been a public service announcement for the annoyed MT network.

Okay, another request here to go along with learning to count. If you are a physician and you dictate can you please, please, please not eat while dictating. This includes sandwiches, chips, chocolate, and even sucking on hard candy.

While I understand that it's extremely throat drying to dictate for minutes and minutes and minutes, it's also extremely disgusting to have to listen to it on my end where I generally have the volume turned up so I can hear all the wonderful words doctors tend to mumble. To suddenly be blasted with chomp chomp chomp, slurp, gulp, ahhhhhh is so unexplainably gross.

Just out of common courtesy, save the food until after you are done dictating or at least pause the dictation and return when you're done. Just a thought.

What year of medical school do they teach counting?

Why oh why can't some doctor's count? I mean seriously, it's not a hard concept. If it's too terrible hard I would think a piece of paper with the numbers written on it in front of you should be sufficient to jog your memory. I mean I have a little piece of paper taped to my desk with the alphabet on it so I don't have to stop and go m,n,o,p, q, r....trust me it helps in a lot of situations, and yes, I'm blond.

I hate when I do a report, especially speech recognition because it doesn't catch it, when the doctor cannot count. He/she'll go from 1 to 3 and then back to 2 then say 2 again then 5, 6, 4, 7, 8, 10, 10, 10, 3. I understand that they have a lot on their minds what with saving lives and all, but if you can't count then don't, just say next or paragraph or whatever, don't number because when you number incorrectly it forces me to think and I really, really hate to have to think, it messes up my flow of typing.

This has been a public service announcement by your friendly neighborhood MT. Thank you for listening.