Tuesday, November 16, 2010

Daily Report: Sow's Ear Now Silk Purse

My new account at work... I went through training yesterday and there was one aspect that I found pretty dismaying: The account requires that I constantly go to outside sources to pull in information for medical records I'm typing. It is rather time consuming.

A doctor will often say, "Insert the medication list I dictated on May 9th for this patient." I have to go to the external source, search for the document, load the information, copy the few medications (sometimes even just one or two drugs), paste them... all in all, a process substantially slower than just typing out something the doctor could just read into the phone.

Then I told my new team manager how for years I had specialized in transcribing oncology and hematology reports. She immediately started throwing that kind of work my way... and I was amazed:

"Mrs. So-and-so is back to my office today. Uh... just copy the report I dictated from last Tuesday. Change the laboratory values to read x, y, and z... Change the vital signs to read a, b, and c... I'll see her back next week."

(Cancer patients obviously visit their oncologist quite often... and, well, things don't change much from week to week. Before, when I did this type of work, doctors would just say "nothing has changed" or something, then hang up... or they would dictate that readers should just refer back to a prior report. But they never did this: They never just copied and pasted vast quantities of old report into a new one.)

So anyway... The doctor says copy the old report. I open up the other older report, copy $3 worth of text, paste it into this week's visit, type the new information for another minute, and then submit the job. Bada-bing, bada-boom.

Granted, not every job is like that, and those pesky little medication lists crop up just as often. However, on my first day on the new account with the new software and new manager, struggling, stumbling, stopping to question, stopping to study, stopping to get quite angry with some malfunctioning software, stopping to call the help desk to get it fixed: in all that chaos, I managed to do the same amount of work in the same number of hours that I used to do on my best days on the old account with the old software.

At least as far as work goes, it's the good ol' days all over again. Hot damn. I thought my income would go up by 25%? Nah: Double it.


Anonymous said...

A possibly lucrative business. Teach doctors how they can save money on their transcriptions.

Mike Farrell
Cagayan de Oro

kris said...

"Bada-bing, bada-boom", earning $3 by copying & pasting. Fair enough, if that's how it works, but you still haven't learnt after your company kicked you out of the Philippines after the post they "forgot" about you, have you? Better keep this kind of info to yourself, I would think.

Jungle Jil said...


Yes, absolutely. Like I said, one of my ideas was going around to medical clinics in the area and saying, "You know your transcription costs? I can eliminate them completely. Allow me to come into your office, install speech recognition software on your computers, and teach you all how to really use the software well." I'd tout my transcription experience, and a decade of listening to doctors speak incorrectly.

Jungle Jil said...


Yeah... they didn't forget about me: That was nothing but wishful thinking on my part, I'll admit. But, in my defense, my immediate supervisors were also of the opinion that the issue was settled when they got back to me and said, "Oh, sorry... the issue is not settled."

Nope... I'm not worried that somebody finding out about this account's copy-and-paste habits might be a problem. (a) I don't mention names, but more importantly; (b) the account is one of the largest accounts my company has, and my company created a rather large piece of external proprietary software specifically so that this company could copy and paste information into their reports. It's just the way they do things. It wasn't just the oncology doctors who are doing it... but they do it more often than any other medical department so far. But, 100% of hundreds of doctors on this account are using software specifically designed to copy and paste information to do exactly that. Nothing scandalous in mentioning it.

In my opinion, their method of keeping each of various aspects of the patients medical details separate, and then conglomerating those aspects together in reports (which is the function of the software) is in itself a bit of cleverness, and saves the doctors ton's of time in dictation. More importantly, it lets one doctor make a change to a medication, or add a diagnosis, or make a recommendation, and (unlike in other hospitals where each medical document stands alone and complete) immediately, all other doctors' reports will reflect this change.

Let's put it this way: Would you rather have your $800 per hour oncologist spend 8 or 10 minutes dictating (and billing) a report about you, or would you rather have him cut that time by 90% by just saying "copy this" and getting off the phone, and charging you just $5?

And, at the same time, if you were this doctor's patient, would you rather see the medical record of your visit (that cost you or your insurance company a thousand dollars) just say "ibid", which cost you $2? Or would you rather see a full-blown summary of the visit and details of the care and condition outlined for $5?

All in all, beneficial for the doctors, beneficial for the patients, and most definitely beneficial for me.

Anonymous said...

A story that has stuck with me for 40 years, although I have no proof of it's validity.

Early in the 1900's a young accountant went to a company and sold them an idea that would save them on their income tax. His price? One per cent of their tax savings per year, for the life of the company. They agreed.

Cookies were taxed as a luxury. Biscuits had a greatly reduced tax as a necessity.

The product remained the same. However, the company name was changed from the National Cookie Company to the National Biscuit Company. (NABISCO)

One per cent made him a multi-billionaire.

I have a personal story about that technique, but I'll save it for another time.

Mike Farrell
Cagayan de Oro

kris said...

I'm not saying there's anything at all with the copy/paste business, I'm just saying, better let sleeping dogs sleep.

kris said...

Come to think of it, if I were your employer and read this post, I'd reorganise the system, pay you a 5c flat fee for any copy/paste operation, charge the customer the full rate and pocket the difference.

Jungle Jil said...

Heheh. Well, Kris, like I said, my company is fully aware of the details of the way things are done with one of their largest and most important clients.

And, it really would not be possible to separate the copied/pasted pay from the typed pay... in an automated way: Somebody would have to to through and manually count/calculate pay rates. It would be a huge headache.

But the fact is, this account is so quirky, the client so finicky, and the way they insist on doing things so counterintuitive, I think that my company throws in the "copy and paste bonus" as an incentive to keep their more experienced transcriptionists (like me) on the account.