Articles regarding Medical Transcription
We hope you enjoy this collection of articles we have put together for you. Remember to contact us if you have any additional questions or if you'd like our free e-book on medical transcription!
How to Choose a Good Medical Transcription
School
Attributes of a Good Medical Transcription
Program
Ethics and Confidentiality
Your Professional Image
The Future of Medical Transcription
Types of Hospital Medical Reports
Verbatim vs. Light Editing
Proofreading and Editing
Your Reports
Practical Rules to Remember When
Transcribing
Basic Word Structure
Sounds Alike Words
Comments From Actual Students
Medical transcriptionists understand that the medical record is a legal document, and handling such sensitive information requires the utmost of professional ethics and confidentiality. Because of the confidential relationship between the physician and the patient, each medical record must remain absolutely confidential.
As a working MT you should never relay patient information to outside parties. It is very important to take the security of the patient record seriously. This means that even if you are transcribing your best friend's reports, the fact that you do so should never be discussed.
Most facilities and MTSOs (medical transcription service owners) require the transcriptionist to sign a confidentiality statement upon hiring, and violation of this is cause for termination and possibly legal recourse. Make it a practice to transcribe your reports, proof and edit them, and then forget about them. Most confidentiality has been broken because transcriptionists talk to their friends about an unusual problem she has encountered in a medical record. The problems that could occur with this are:
A. Somebody could overhear you, and that somebody could be a relative of the patient.
B. Your friend could know the patient in question and spread the news even further.
C. You portray a less than professional image when discussing contents of medical reports.
(Of course this does not include asking transcription-related questions.)
Ownership of the healthcare record belongs to the facility, but the patient is entitled to copies when a written request has been issued. Unless it is your job specifically, the medical transcriptionist should never make copies for the patient when requested directly by the patient or a family member. Remember, your job is to keep the records confidential at all times.
There are new guidelines concerning medical records in a set of laws called HIPAA (Health Insurance Portability and Accountability Act.) Parts of the HIPAA laws discuss the handling of medical records, and this could affect MTs that work at home. MTs who work at home are being encouraged to take measures to protect any information on their computers or on floppy disks. Some of these measures include password protecting your computer, keeping your virus definitions up to date, and locking any floppy disks that may contain confidential information in a file cabinet or box. It's also important not to let anyone have access to the part of your computer that contains vital patient information and diagnoses. One transcriptionist I know was haphazard about doing so, and her husband's boss's medical reports were discussed. This type of thing is in direct violation of HIPAA Federal laws and could have serious consequences. Therefore, always protect your information on your computer (and shred any trash with patient names) once you begin working on the job.
Many MT services are now using “encryption” to send/receive medical records through e-mail. Encryption is a process that uses special encryption software to protect the electronic transfer of medical records. One of the more popular types of encryption programs is Cryptext which is inexpensive and very easy to use. We will explore this software and more later in the course.
Electronic signatures are popular methods of signing medical reports
by the dictating physicians. This means that the physician’s typed
name on the report is sufficient instead of a physical signature. Electronic
signatures, however, open the door for errors that would not be caught
because the physician is not reading or signing the reports. Because
of this, it is vitally important that the medical transcriptionist have
a complete understanding of the dictation they are transcribing in order
to ensure they are transcribing exactly as the doctor dictates. That's
just another reason why a good MT course is important to your career!
When we talk about professional image usually the picture that comes to mind is dressing professionally and conducting yourself well in an interview situation. Since it is common for MTs to work at home, you may never actually meet your employer. So what does professional image mean in this context?
MTs need to be trustworthy, dependable, and competent because we deal with confidential medical records. From the first contact with a prospective employer it is important to begin projecting these characteristics immediately.
How can you project trustworthiness and dependability? You can do this by simply doing everything that you agree to do. In other words, if an employer wishes to schedule a telephone interview with you and you set up a time to talk at 2 p.m., make sure that you are on time and prepared for the interview. You could have a list of questions to ask or a list of your qualifications to discuss over the phone. This will project both trustworthiness and dependability. (In Module 30, we cover this in much more detail, including how to get business on your own.)
How can you project competence before you are hired? Competence comes through in your resume. Is it neatly arranged? Is it perfect grammatically without typos, misspellings or grammar errors? Also, most companies will give you a transcription test to complete before making a final hiring decision. You will be evaluated on how quickly you complete the test, neatness, organization, style, grammar, punctuation, and a basic knowledge of proper formatting procedures. (Don’t worry -- in Module 30, we cover these items completely.)
Also, many MTs forget that following the instructions for the test (example: how to download, instructions for formatting, instructions for sending it in, etc.) may be as important as the test itself. Employers want to know that you are able to handle all aspects of the testing process with ease and confidence which exhibits the trait of competence.
Also, it is important to note that there are differences between the work environment of MTs that work in a hospital or clinic and those that work at home. MTs who work at home can dress casually or even not get dressed all day. Whereas, MTs who work in facilities such as a hospital or physician’s office would need to pay attention to how they dress, wear their hair and makeup, etc. to project a professional image. The at-home MT does most of their image projecting over the phone and through personal correspondence like e-mails, faxes, etc.
As mentioned earlier, at the conclusion of your training at MTACC you will work through our employment and technology modules. These modules will explain how to prepare proper resumes, interviewing techniques, and testing procedures. We'll help you to prepare a professional resume if you don't already have one. Additionally, by the end of your studies with us, you will have a professional image already in place, and your skill level will be more than competent. We also help you with job placement! We believe in our graduates and will do everything in our power to help you to excel in your new career!
The Future of Medical Transcription
Right now some MTs are concerned because some work is being sent overseas, especially to India. These MTs fear that they may lose their jobs because there is not enough work to go around. Also, because the MTs in India charge such a low line rate (.03 cents per line) some MTs are afraid that the line rates in the USA will drop and they will lose money. These concerns have not proven to be the case. First of all, the work coming back from overseas is riddled with errors such as wrong words, grammatical errors, typos, and many misspellings. In most cases, an American MT must go through and edit the reports before they can be sent to a facility. So, let’s say a national MT service decided to try to “save” money by shipping some work overseas to be transcribed at .03 cents per line, and then they find that the work needs extensive editing, and they must pay an American MT .06 or more per line to edit the document. Now the service has spent at least .09 cents per line for that one document! It’s just not proving to be a cost effective way to do business after all. Secondly, new laws are going into effect all the time in regard to patient medical records. It may be the case in the future that laws are passed that make outsourcing confidential medical records illegal. Lastly, there is still plenty of MT work in the US for a good MT.
Another concern some MTs have is the advent of voice recognition software. This is software that allows the doctor to speak into a microphone and the software translates the voice into text. This is not widely used for many reasons. First, the equipment is expensive and takes time to “train” to the doctor’s specific voice. Secondly, many ESL dictators commonly mispronounce certain English syllables and sounds, and that would make voice recognition unusable. Lastly, no software can be sensitive enough to distinguish between sound-alike medical words like “Xanax” and “Zantac.” If voice recognition is ever perfected ten years in the future, MT editors would still be needed to edit the final documents.
There is a law called HIPAA (Health Insurance Portability and Accountability Act) which includes some provisions in the handling of patient medical records and the security of them. Basically, there is some confusion about how HIPAA guidelines will affect work at home MTs. Right now it is thought that simply password protecting your computer, using encryption software (will explain more on this later in the course), and locking up floppy disks that contain patient information in a file cabinet will be sufficient. You will learn much more about HIPAA in module 30.
MT services are switching over from the old “tape and transcriber” method of transcribing medical reports to using Wav files/Wav pedals and the Internet to send and receive dictation. This is a very efficient and inexpensive way of doing business! You will learn in our course all about how to use a WAV pedal to transcribe Wav files. Basically, in brief, a WAV file is a computer sound file that can be played on your computer using special software.
Learning Digital Dictation
Digital dictation is a way to send/receive dictation using your computer and the internet. It involves the use of either call-in systems or hand held recorders. You will learn more about this in the presentation that follows. Because digital dictation is easier, faster and cheaper than the old cassette tape/ transcriber system, many companies use some type of digital system.
As a medical transcriptionist it is important to understand how digital dictation works. Employers want to hire computer literate MTs. The presentation that follows is short and concise explanation of how digital systems work.
Don’t worry if you don’t completely understand everything in the presentation. You will get actual practice during the transcription portion of the course using a foot pedal, FTP software and downloading dictation from our server. Sit back and enjoy!
Types of Hospital Medical Reports
History and Physical (H&P): This report is usually dictated by the admitting physician or resident when a patient is admitted to the hospital. It usually begins with a chief complaint. The “history” includes a history of the present illness, past medical history, social history, and family medical history. Smoking can go under the heading of either Social History or Habits. There is usually a review of systems and a complete physical examination from head to toe. The report usually ends with an admission diagnosis and a plan for the patient’s treatment. (Click here to see a sample H&P report)
Consultation (Consult): This report is usually dictated
by a physician to whom the admitting physician has referred the patient.
Therefore, the consulting physician is usually a specialist in an area
other than the admitting physician. Sometimes consultations are requested
for second opinions. Consultation reports usually include a brief history
of the patient’s illness and a specific physical exam depending
on the particular type of consultation requested. The report may also
include laboratory or x-ray findings. The report usually ends with the
consulting physician’s impression and plan, and sometimes a comment
from the consulting physician thanking the admitting physician for the
referral.
(Click here to see a sample Consultation report.)
Operative Report(OP): This report is dictated by the operating physician and contains detailed information regarding an operative procedure. Included in this report are preoperative and postoperative diagnoses, the type of surgery or surgeries that were performed, the names of the surgeon(s) and attending nursing staff, the type of anesthesia and the name of the anesthesiologist, and a detailed description of the operative procedure itself. Depending on the operative procedure, information regarding instrument counts, sponge counts and blood loss are also dictated. Often the report will end with disposition or where the patient was transferred when he left the operating room (usually recovery room) and the condition of the patient at the time of transfer. (Click here to see a sample OP report.)
Discharge Summary (DS): This report is dictated by the admitting physician at the end of the patient’s stay in the hospital. It includes a summary of everything that occurred from admission to discharge, including laboratory data, x-ray data, and pertinent physical findings throughout the hospital course. The report usually ends with the discharge diagnosis and a detailed plan for the patient. If the patient is transferred to another institution (such as a nursing or other hospital), the name of the report is usually changed from discharge summary to transfer summary. If the patient has expired (died) during the hospital stay, the report is usually called a death summary. (Click here to see a sample Discharge Summary report.)
Radiology Report: This report is dictated by the radiologist upon completion of a diagnostic procedure and includes the radiologist’s findings and impression. Examples of radiology reports are x-rays, CT scans, MRI scans, nuclear medicine procedures and fluoroscopic studies. (Click here to see a sample Radiology report.)
Pathology Report: This report is dictated by a pathologist and describes findings of a tissue sample. The focus of the report is on the microscopic findings and the pathological diagnosis of the sample. (Click here to see a sample Pathology report.)
Laboratory Report: This report describes findings of examinations of bodily fluids such as blood levels and urinalysis. Laboratory reports are rarely dictated separately but are often included inside the H&P, consultation or discharge summary. (Click here to see a sample Lab report.)
Miscellaneous Reports: Other miscellaneous hospital reports include cardiac catheterizations, electrophysiology studies, phacoemulsification, autopsies and psychological assessments. (Click here to view some sample miscellaneous reports.)
You may be asking yourself what happens when a dictator makes an obvious grammatical mistake in his/her dictation. What do you do if a dictator makes an obvious mistake in subject/verb tense or even starts out talking about a male patient but later in the dictation says the word “female?” What do you do if a dictator is talking about a left leg injury but later says “right” leg? These are all good questions and the answer will be contingent upon whether you are working on a strictly verbatim account or one where you may light edit.
A verbatim account will require you to transcribe exactly what the doctor says regardless if it’s incorrect. An MT may not edit at all on a verbatim account. On the other hand, if you are working on an account and are allowed to edit lightly then you could fix the errors that were described in the above paragraph. The cardinal rule of light editing is to never change the meaning of the sentence. Below you will find an interesting article written by an experienced MT about verbatim vs’ light editing. Enjoy!
Verbatim = Using exactly the same words; word for word. No matter how stupid it sounds, no matter if they are an ESL (English as a second language) doctor with their sentences backwards, no matter if the sentence is three paragraphs long; you type it exactly the way it is dictated. Granted there are a few, and I do mean few, doctors that have an excellent command of English usage and know exactly where and what punctuation they want, but generally most dictators tend to string random thoughts and partial sentences into one long run on sentence.
You might ask yourself, why would anyone want their transcription to look that way? I’ve asked myself that same question many times. You will encounter verbatim typing almost anywhere, including services, clinics and hospitals. The question of “why” is somewhat of a mystery. Is it easier for the transcriptionist? The answer would be most assuredly it is. Who then has to take the ultimate responsibility for the sometimes incomprehensible dictation? The doctor signing their name at the bottom does. I’ve found over the years that this style of transcription leads to numerous edits. Once the doctors read over their dictation, that is IF they read over their dictation, they will inevitably want to change it, which, of course, leads to the transcriptionist having to spend twice as much time fixing it. This ultimately leads to longer turnaround times and frustration for the transcriptionist.
Thankfully, most of the places I have worked allow the transcriptionist to “light edit” or edit “on the fly,” versus full blown editing of the entire document using an English usage checker etc. Light editing is checking sentence structure and the proper use of tenses. Some of the other things you will be checking for include positions. For example, if the doctor is talking about a patient’s right arm and then starts saying left arm, the transcriptionist should be able to figure out which arm the doctor really means by what the rest of the dictation says. The same holds true for body parts, and this is where all that studying medical terminology comes into play. For example, if the patient is in for a foot problem and the doctor is talking about the patient’s metacarpals, you should know that the doctor means metatarsals. Another common error by dictators is the "he/she" error. They start off talking about “he” and wind up talking about “she.” Your job as a transcriptionist also includes catching these types of errors and correcting them.
You will find that after doing transcription for a while you will start to make these types of changes automatically or “on the fly” without having to read through your dictation to find the errors. I’m not saying you should not read through the document you just transcribed, but you will find yourself spotting and correcting these types of errors as they happen and proofing will become that much easier.
Courtesy of Glenn LePine, Medical Transcription Supervisor, St. Croix Regional Medical Center, St. Croix Falls, Wisconsin
*Acknowledgment: Bio for Glenn LePine: I have worked in the medical
transcription field for over 20 years. I have worked at one if the largest
radiology centers in California, a large teaching hospital in Minnesota,
many small clinics and services in California, Minnesota and Wisconsin.
I had my own transcription services for two years before taking a position
as the supervisor at my current location. I have been the supervisor
here for three years. We have a crew of 15 transcriptionists, 8 of whom
work at home. We are a clinic and a hospital and we do all specialties.
We currently utilize an electronic medical record system for the hospital
dictations and a shared network drive for the clinic dictation.
In conclusion of this section we will leave you with a few examples of light editing as follows:
As dictated: The patient come in today for a physical exam.
Light edited: The patient came in today for a physical exam.
As dictated: Mrs. Jones came in today for a routine physical exam and upon palpation of the left breast a soft mass was found so she will be sent for a mammogram and she will follow up with me in 2 weeks.
Light edited: Mrs. Jones came in today for a routine physical exam and upon palpation of the left breast a soft mass was found. She will be sent for a mammogram and will follow up with me in 2 weeks.
As dictated: During the exam the patient mentioned that he had been having headaches while reading, so patient was advised to try aspirin 325 mg b.i.d. to see if that would alleviate the headaches. He is to follow up in 2 weeks' time.
Light edited: During the exam the patient mentioned that he had been having headaches while reading. Patient was advised to try aspirin 325 mg b.i.d. to see if that would alleviate the headaches. He is to follow up in 2 weeks' time.
Proofreading and Editing Your Reports
As a medical transcriptionist you have to be able to transcribe dictation that contains background noise (crying babies, bathroom, driving, watching TV- yes many physician’s dictate while doing these things!), fast dictators, and ESL dictators. This can be very challenging but you will get all the practice you need in the course, especially in the advanced transcription portion!
It is important to develop a good eye for proofreading. All of your work as an MT should be proofread before sending it to your employer. During the course, you should take special care to proofread all of your reports several times before submitting them to the on-line grader.
What should you look for when proofreading your own work? You should look for typos, grammar, punctuation and spelling errors. Also, check for formatting and style errors too.
Tip: Sometimes when using a word expander it is easy to hit the wrong shortcut and have the wrong word inserted into your document. Proofread all documents very carefully before submitting them.
Proofing Your Document – Quality Counts
Although we will go over this again and again throughout the course, here is a basic checklist for proofreading your documents:
-Re-read instructions for the account if any (margins, style, etc.)
-Transcribe your document paying particular attention to sound-alike words. With many terms sounding the same, it is important to use the correct term.
-Spell check your document. Remember, the spellchecker will catch misspelled words only – it will not catch words that are inappropriate if they are actual words. Example: A student inadvertently typed “now” for “not.” This changes the entire meaning of the sentence and could be detrimental to patient care.
-Look over your document for accurate formatting, type and font size.
-Check for proper subject/verb tense.
-Re-read your report without listening to the dictation to make sure that every sentence makes sense.
Every MT at times has to “clean up” a dictator’s sentence. It is important to learn the difference between light editing and transcribing verbatim.
TRANSCRIPTION TIP: You will begin learning the anatomy and physiology of the human body before you will do any major transcribing. We suggest that when you get to that part of the course that you come back to this module and review what you have learned here to make sure it is fresh in your mind before you start transcribing. Of course, any part of the MT Advantage course is available to you for review at any time you need it, but this module will be particularly helpful to you if it is reviewed again before transcribing practice begins.
Practical Rules to Remember When Transcribing
1. Doctors ALWAYS make mistakes. Don’t ever assume everything is right. Doctors are wonderful practitioners but usually terrible spellers. Never, ever trust their spelling. When in doubt, look it up or flag it. The accuracy of the medical record should always be your #1 concern.
2. Doctors will not always dictate correct punctuation or English. Some doctors love commas and will dictate “comma” after every third word whether it is needed or not. When transcribing, you should completely disregard all punctuation the doctor dictates and use your own training and expertise. When you are learning to transcribe, use your best judgment concerning punctuation and proper English usage unless your employer tells you otherwise.
3. Remember to proofread your document before turning it in. A badly proofread document will reflect on you both personally and professionally as well as being a potential danger to the patient whose record it reflects. Begin good habits early on by proofreading your work before it is submitted to your employer. Eventually, you will learn to proofread as you type which will save you even more time, but this comes only with practice and should not be attempted early on as a student.
4. Learn as much as you can about punctuation and the English language. If there are any rules with which you are not comfortable, ask your instructor for clarification or post the question on the Student Forum. Make sure you are comfortable with all possible situations that could occur regarding incorrect punctuation usage, and know the rules for correcting it in your document.
Tip: Many MTs misuse the word “followup.” An easy way to remember how to write this word is that when followup is used as a verb it’s written as two words: follow up. In every other instance it’s written as one word: followup.
There are five possible parts to a medical word including a prefix, suffix, root, combining vowel, and combining form. A root is the foundation of a word. The prefix is what comes before the root, and the suffix is what comes after the root. All medical words have a root and suffix. A combining vowel is a vowel that is used to combine medical words. Let’s look at some basic examples:
psychology- psych (mind) is the root, o is the combining vowel, and logy (study of) is the suffix. So we know the word psychology means the study of the mind.
electroencephalogram- electro (electricity) is the root, o is the combing vowel, encephal is the second root (brain), o is the second combining vowel, and gram is the suffix (unit of measure.) So, we know that electroencephalogram is a way of measuring the electrical impulses in the brain.
electrocardiogram- electro is a root (electricity), o is a combining vowel, cardi is the second root (heart), o is the second combining vowel, and gram is the suffix (test). So, we know that electrocardiogram is a test to measure the electrical impulses of the heart.
The terrible two’s
It is possible to have two word roots in one word, and to use more than one combining vowel per word. Look at the word electrocardiogram - both electro and cardio are root words and are combined by using the vowel o.
Prefixes
A prefix is at the beginning of a word and is not a full word itself. Let’s look at some examples:
epiotic - ot (ear) is the root, ic is the suffix (pertaining to), and epi is the prefix (above or on.) So, we know that the word epiotic means above or on the ear.
supraorbital - supra is the prefix (above), orbit is the root (eye), and al is the suffix (pertaining to.) So, supraorbital means pertaining to above the eye.
antibiotic - anti is the prefix (against), biot is the root (life), ic is the suffix meaning pertaining to. So, the word antibiotic means pertaining to destruction/against life - in other words, it’s an agent that kills other microorganisms.
Combining vowels
Let’s talk more about combining vowels. Combining vowels link the root to the suffix or the root to another root. If a suffix begins with a vowel, then a combing vowel would NOT be used. Look at these examples:
enteritis - enter is the root (intestines), itis is the suffix and begins with a vowel so no combining form would be used. How would it look to type: enteroitis? It just wouldn’t make sense.
pancreatitis - pancreat is the root (pancreas), and itis is the suffix. Since itis begins with a vowel, we do not need to add a combining vowel. We would not want to type pancreatoitis.
Exception to the rule! If a combining vowel is used between two roots and the second root starts with a vowel, the combining vowel is retained. Let’s look at this example:
pneumoencephalography - pneum is the root (lung), o is the combining vowel, encephal is the second root which does start with a vowel (so we KEEP the combining vowel), o is the second combining vowel, and graphy is the suffix (test.)
What is a combining form?
There is one other word part that we need to discuss called the combining form. A combining form is made up of a root plus the combining vowel. Let’s look at some examples:
otolaryngology - ot is the root (ear), o is the combining vowel, laryn is another root (throat), o is the second combining vowel, and logy is the suffix (study of) , and the combining forms are ot/o and larnyg/o.
hematology - hemat is the root (blood), o is the combining vowel, logy is the suffix (study of), and the combining form is hemat/o
TRANSCRIPTION TIP: Don’t worry if learning these suffixes, prefixes
and root words seems a little confusing at first. At the beginning of
each module you will be going through lists of prefixes, suffixes, roots,
and combining forms for each specialty. So you are going to get plenty
of practice with breaking down medical words into their component parts.
In the meantime, just know that learning these things will help you
immensely in your transcription career, so make sure you do learn them
and review whenever you need to
Sound-alike words pose a particular challenge to transcriptionists. For example, there is a vast difference between the drugs Zantac and Xanax. It would be a crucial mistake to type the wrong word into a medical report. The best way to avoid problems with sound-alike words is to understand the context of the dictation. In the above example, if the dictator was discussing a patient’s stomach problem the word would probably be Zantac, but if they were discussing the patient’s nerves or stress levels it could be Xanax. When in doubt FLAG IT.
One good thing about sound-alike words is that they are helpful when trying to understand what a dictator is saying. For example, say that you think you hear “metatarsal” but the doctor is discussing carpal tunnel syndrome, then you could think to yourself “what sounds like metatarsal but has to do with the wrist” and hopefully you would come up with “metacarpal.”
You do not need to memorize the lists of sound-alike words and medications. However, do read through it and say each word out loud so you can hear how two completely different words can sound just alike. In the Grammar module you will learn all about sound-alike words so this is just a brief review!
Tip: Be very careful when dealing with a sound-alike word. Remember
that ileus with an “e” sounds just like ilium with an “i.”
Also, of note here is that common English words can sound alike too,
and you must be careful when transcribing to make sure that you do not
mix up words like accept/except, too/two, and your/you're.
*When comparing courses, ask if they teach laboratory, pharmacology, pathology, computer skills, advanced Microsoft Word, computer and Internet training and FTP skills. Don't be swayed by expensive courses -- read the fine print!
Comments From Our Student Forum
Regarding Transcribing Verbatim:
I have an interesting note regarding transcribing verbatim versus even mild editing.
A sentence was dictated, “The patient was also told that if her pain increases or continues that she may need further imaging.” I had left the second "that" out as a redundancy, but my editor put it back in. When I asked her about it, she replied, “I agree. It is very redundant. Having been an English major, it almost killed me to put that back in, believe me! The reason I did, however, is that I am just trying to keep the dictation as verbatim as possible as that is what the company has stated we should do. Another reason is that if for some reason you ever have to go to court to testify on a dictation you may have transcribed (heaven help that) where the doctor claims he dictated it but it was not entered, the first thing the opposing lawyer will say is ‘Ms. Transcriptionist, have you ever knowingly left words out of your transcribed document that were dictated by the doctor?’ It would not matter what words, it would just be that you had. The doctor would probably win the case. It’s just little technicalities like this. You can judge for yourself, but I always like to play it safe and put everything in that is dictated.”
After I asked my editor for permission to share this with you all, she added the following, “One very important thing I need to mention, though, is that if the client gives you editorial privilege, and if it is okay with them that you ‘clean up’ the dictation (make sure it is in writing somewhere), then you are covered and do not have to be concerned. There will be some that do. There will be some that do not want anything, including the misspelling of words that the speaker may dictate, changed. Always, always, always be very sure of account specific instructions. You should check those before you ever type one single word of dictation for them. They come first, over and above everything else. And I can guarantee you, every single account will have something different in it! I wish they'd just all say ‘follow the AAMT Book of Style’ and it would be so much easier!”
I had never considered the courtroom aspect of this, so you can be sure that wherever I work, I now know to ask more specific questions about the extent of any editing privileges extended.
Regarding Our New Chat Room
Calling all students,
When I was in college, we students would often study together. We would be study partners or study buddies. This was a good idea because since we were studying the same subjects, we could put our minds together to ask questions, solve problems, handle glitches, offer encouragement, and keep each other up to speed right there on the spot. We also would relieve the boredom of studying by having some great collegial discussions. I found this group study to be one of the greatest memories of my college experience.
We have this right here at MT Advantage via our Chat Room.
When you are studying, why not keep the Chat Room on in the background? You can log on, minimize it by clicking on the minus sign in the upper right hand corner of your computer screen, and go about your studying. If someone else enters the Chat Room, s/he will see your name and click it on. The minimized screen on your taskbar should beep and tell you that someone is calling you, even if you are on a different web page. You merely click on the bar at the bottom of your screen and get back on the Chat Room site and meet your study partner. Cool, right?
You can even have private discussions with one or two students in the group if you don't want to bother all the students in the room with a specific question. You can call for a specific student; it's like sending a private message.
This feature would be a great background screen to minimize first thing when you begin to study. Just log in and forget it. Keep it as a background until someone calls you. Please do this at first until the concept catches on. See how effective and efficient studying together can be. Most all college students and every graduate student I ever knew partnered up. It is the best way to go. The old cliche holds: Two heads are better than one. Well, a large group should be even better than that! Let's give it a shot!
Q&A About Expanding an Abbreviated Word
Q: The physician dictated, "ADMISSION LABORATORY: Hemoglobin 14.4, white blood cells 6.9 with 66 segs, 19 lymphs, 5 monos, 9 eos, and 1 baso. Platelets 295,000. Profile showed an alkaline phosphatase of 141, AST of 29, total bili of 0.5...."
The key said to expand the bili to bilirubin, but it allowed eos and baso. What is the difference here?
A: I'm going to venture to say here that eos and basos have come to be acceptable understandings of the words they represent whereas bili still represents slang.
An example would be the telephone. We call it phone which has become an acceptable abbreviated word for telephone. The only other example I can think of that may represent a sort of unacceptable abbreviation is auto for automobile, but that's just one example.
Let me know if I've confused you more than helped!
About Hearing Medical Bloopers
In a surgery dictation, while dictating the placement of the patient on the operating room table, the physician said, "Care was taken to make sure that he was level and perpendicular to the floor."
And I just deleted some doc bloopers I received yesterday! Certainly
some of you veteran MTs must have some in your personal files.
Ooh, I just remembered one (guess my age is not too advanced for some
recall, eh, Mary Lou?!):
Patient died at age 05 of unknown cause.
Patient is under car of physician for physical therapy.
Dictator Doesn't Make Sense
Q: The physician dictated, "This 47-year-old white male had a long history of ankylosing spondylitis with associated Marie-Strümpell disease."
I thought Marie-Strümpell disease was another name for ankylosing spondylitis, so I'm not sure what he is saying. Can anyone figure it out?
A: You are exactly correct. Both are names for the same thing: one is a descriptive name of the disease process, other is eponymic. A specialist in rheumatology or in orthopedic surgery probably would not make this small error.
The disease process is somewhat rare. If a doctor did not take an elective in rheumatology in medical school, and he spent his entire practice life in an unrelated field, it is possible he would be a tad vague about the fact that the two names describe exactly the same disease process. There is a slight trend for rheumatologists to call it by the eponym (rheumatologists do not do surgery) and surgeons (orthopedists) or Occ Med (occupational medicine) specialists to call it ankylosing spondylitis. So, if the dictating doc is looking back through pt's record, and comparing the entries of rheumatologists and orthopedists, it is quite possible that superficially it would appear from the notes that the processes are only related, not actually identical.
Our School Photo Gallery
Be sure to check out our school's photo page! Just click on the word "Gallery" at the top of the page, then choose "Our Members' Album" and click on Slideshow to watch! I put a couple photos up there and quite a number of other students have too.
Please feel free to add your family or pets, but remember to put in the caption whose family or pets they are! We can't wait to "meet" you and your family!
Voice Recognition and EMR
Q: Just by chance a couple nights ago I happened to be informed that the clinic I was referring to previously in this thread is going to be eliminating the need for medical transcriptionists and having the medical personnel enter the information on the computer. I don't know if this is actually true, but I have heard that other clinics are doing the same thing. What do you know about this type of data entry and what is your opinion on the impact it will have on the MT profession?
A: This is a very good question and one at which we should all be looking closely for answers. The process that you are talking about is called EMR (Electronic Medical Records) and/or VR (Voice Recognition.) EMR and VR are starting to come into play more and more as clinics are searching for ways to reduce their costs of transcription.
There are several pros and cons to EMR and VR. One of the biggest objections I hear (and the reason many of our clients choose not to use it) is that is takes an inordinate amount of time from the physician. The demos show otherwise, but we have had a couple offices switch back saying it just takes too long for a high-priced, time-deprived doctor to fill in the blanks in the forms. I don't see how anyone other than the doctor could fill in the forms either unless they were present in the exam room, which simply adds back to the expense the clinic is trying to eliminate.
Another con I've heard is the cost. Not only is the cost of the software in the thousands, but it takes awhile to get set up and teach the doctors. Most of the smaller clinics of 1-4 doctors just aren't able to put out the tens of thousands of dollars needed to get this set up.
A couple other cons I heard at a recent trade show where I experienced a demonstration of how EMR works is that the software doesn't have provisions for out of the ordinary reports -- for example, something that you don't see everyday in an office note. Those things have to be typed in by the doctor separately.
One other comment I heard from the coding point of view is that the EMR software may not allow the clinic to report the highest value for insurance reimbursement purposes. This would greatly affect the clinic's bottom line, and I was shown numbers on how this would be detrimental to the clinic if the physician wasn't aware of coding principles and how it greatly affects the payments by insurance companies.
For the pros of EMR, one cannot deny that for routine office visits (such as normal GYN exams or normal x-rays) EMR and voice recognition software can absolutely save time and money for the clinic as long as the conditions above aren't inadvertently affecting the profit. I know of one of our clinics that switched to EMR and said they were glad they did and that everything was working out well. Their total reimbursements at year's end will tell if it was a wise decision or not.
We have had a big radiology department switch to a combination of voice recognition and EMR for MOST of the dictators which works out to their benefit. However, ESLs (foreign dictators -- "English as a Second Language" dictators) usually have pronunciations such that computers still cannot decipher between words. For these physicians, the hospital still has to use regular transcriptionists. Computers also don't have the smart technology of common sense like the human brain does.
On the other hand, we lost a big clinic to VR last year and recently received a phone call from them saying they were "fed up with this junk" and had thrown the equipment in the trash!
When I was working at the hospital 20 some years ago, we were worried that computers would one day take over our jobs. Dictaphone or Lanier (can't remember which) was working full-time researching and developing the voice recognition system that was to eliminate the need for MTs. Even as little as 10 years ago, I remember worrying about the same thing thinking that time is getting close! Well, that period came and went, and still to this day they cannot create a product that works across the board without multiple headaches and problems.
What I DO see happening is that MTs are going to remain in demand, but their DUTIES will evolve just as technology evolves. For those practices that are able to use VR, the best of the MTs will become editors. For the practices that use EMR, the need for proofreaders and coding personnel who understand reimbursements will become more popular. For the rest of America in the smaller practices which make up the majority of doctors' offices, nothing will change since price and time are of paramount importance there.
That's my opinion in a nutshell. I'm keeping my eyes open for technology
changes too because I have a lot invested in the MT business with this
school and my several services. Believe me, if I thought anything was
going to put transcriptionists out of business, I wouldn't be in the
business of training them!!! You can find more information from the
AAMT and JAAMT magazine, but I believe the consensus is pretty much
what I've described above.
A #2: Basically, from my limited perspective, I agree with everything Marge has said. The EMR was already being launched in Northern California Kaiser when I retired. Before my retirement I already had a considerable interest in medical transcription. I listened to the plans as presented by our Administration, namely the fact that the Kaiser planners reputedly were expecting to hire, and pay for, no MTs at all either in the US or abroad, within a short period of time. That goal seemed to me to be a complete impossibility. First of all, you still have some elder docs who "grew up" in the years when keyboarding was not as widely required in all careers as it is now. Second, you have some docs with physical or neurological inabilities to keyboard effectively; federal law requires these doctors to be accommodated in the workplace with adaptive adjuncts as needed.
I have seen several of the EMR "work products." Actually, they do indeed look spiffy. The vast majority of a note (say a gastroenterologist's description of an upper GI endoscopy or a colonoscopy) is, in fact, very repetitive. For completeness, a large amount of very routine ordinary stuff must appear in the note to document exactly what the doctor saw and did not see. Notes such as this lend themselves VERY well to "template production," in which the physician is asked serially to select the phrases that apply. Whenever the physician's exam deviates from the options available on the template, the physician may key in the unique phrase he wishes to add. Even the diagnoses are mostly by template, and, I believe, correlated to the DRGs and to the ICD-9-CM codes, to allow for easy but "maximal" coding by office personnel who are NOT that familiar with coding nuances.
The fastest MD cannot out-type an MT, especially without built-in short-cuts. Of course, each enterprising MD, if adequately motivated, could add his own shortcuts to make things easier for himself. And maybe the keyboarding necessary will be "lubricated" by inserting generic short cuts, "one size fits all."
Another factor is the "pocketbook" issue. If the pay for MTs comes from a hospital's budget, rather than from the doctors, it stands to reason that a hospital administrator would jump up and down and click his heels together at the idea of potentially "cost-shifting" the expense of document preparation from MTs, whose payroll the administrator is responsible for meeting, to the MDs themselves, whom the hospital administrator, for the most part, does not employ or pay. (There DO tend to be a few hospital-salaried MDs on hospital staffs; but if the administrator could wave a magic wand and cause even the salaried MDs to prepare their own printed documents without allotting them any time to do it, and certainly no additional monetary compensation........well, I think you get the picture! )
It doesn't seem too likely to me that hospital and department administrators will be able to lay off MTs and extract the necessary "pound of flesh" from the MDs. Trying to get docs to go along with a single plan and all do the same thing is like trying to "herd cats."
I will be fascinated to see what develops over the next "30" years. But if I were young again, and if being an MT were a good "match" between my aptitudes, desires, and personal/family needs, I would not have the least hesitation to launch into that as a new career even starting now.
Staying Motivated
Q: I'm interested in finding someone that I can sit down with on a regular basis and compare studies, compare accomplishments as far as assignments and what not. Basically someone whom I know is there, someone that I know if I start slacking off they're gonna be there encouraging me not to fall behind and vice versa.
A: You're not unusual with your motivation this time of year! Quite a number of students have written me that they're taking the summer off or taking an extended "vacation" while their kids are out of school.
It would be good to have a study buddy though. One great feature of our student forum is the ability to go into our chat room here and set it so that it 'beeps' when someone else enters. You can just set it and leave it and go browse elsewhere, or begin your studying, and it will notify you when someone has entered.
One thing I'd like to remind new students of is our Thursday evening chat sessions. We're doing this on a regular basis in addition to our Medical Trivia room (which is a LOT of fun by the way!! For those who are interested, we meet in the chat room every Thursday evening at 9:00-10:00 PM EST. If you can come for the full hour, that's great but if not, at least plan on a few minutes. Every week we discuss various topics that students have questions about or whatever's on your mind. Most weeks the instructors have a prepared agenda and some weeks we even have guest speakers. Either way, you are guaranteed to learn at least ONE thing from the chat sessions. I've heard many students say they love the sessions and they are glad they could attend to learn some new information that they might not have learned until much later in the course. Later down the road, we may want to extend the chat sessions to twice a week or even nightly.
We regularly have chat sessions regarding the AAMT Book of Style (BOS) rules. We're also working on AUDIO recordings for our students which outlines a lot of the most important BOS rules. In addition, we're planning to put together an "Instructor's Lecture" forum where we discuss one particular item thoroughly, and I'm sure a lot of this will be the BOS as well.
In the meantime, please use the student forum to ask any questions.
Don't be shy! Also anyone who wants a study buddy, please post below.
There's no reason why you can't have 2-3 study buddies as well! You
are able to PM (private message) each other, so go for it!
Talking Medical Dictionary
I have found the medical dictionary on CD that came with the course to be very helpful in that I can double-click on a word and it will be pronounced. One particular instance I can think of is that it helped me to know that even though the dictator said "Vilms' tumor," the correct spelling was "Wilms' tumor." I did a wildcard search on "* tumor" and came upon "Wilms' tumor." When I double-clicked on the word, it was pronounced "Vilms' tumor," which was just what I was looking for.
An Interesting Little Read from One of Our Instructors:
Someone sent this to me and I found it quite interesting to read:
Typoglycemia. Don't delete this because it looks weird. Believe it or not you can read it. I cdnuolt blveiee taht I cluod aulaclty uesdnatnrd waht I was rdanieg The phaonmneal pweor of the hmuan mnid Aoccdrnig to a rscheearch at Cmabrigde Uinervtisy, it deosn't mttaer inwaht oredr the ltteers in a wrod are, the olny iprmoatnt tihng is taht the frist and lsat ltteer be in the rghit pclae. The rset can be a taotl mses and you can sitll raed it wouthit a porbelm. Tihs is bcuseae the huamn mnid deos not raed ervey lteter by istlef, but the wrod as a wlohe.
Amzanig huh? yaeh and I awlyas thought slpeling was ipmorantt.
Some Funny Dictation
The patient has eaten some food but no bowel movement.
She blacked out two weeks ago. She was ion her closet at the time and subsequently saw you.
Halcion has made him crazy.
Abnormal treadmill. I think this is due to being a woman.
He has pain when reaching for his wallet.
SOCIAL HISTORY: A 5-year-old with a 2-year-old at home. Her parents are both in the emergency room.
The lungs are ion the axilla.
She feels like her left shoulder is approaching the place where her right shoulder was and the patient would like to know what she can do about it.
Please see the copy of the enclosed knee for complete details.
Bilateral shoulder examination shows no difficulty removing his shoulder for examination.
He was also prescribed diabetes mellitus, which also did not help with his shoulder.
Over the past few weeks he has had one episode where he went in to take a nap in the afternoon and again his wife found him very difficult to arouse.
It is best most of the day when it is not worse.
I do not see any sputum on the chart.
He has had labial hypertension.
Exam of the legs shows the right leg to be 1.0 cm long.
Time to Be Silly! A Frog Joke
I was sitting down by the lake last summer and a frog jumped into my lap. He said, "Listen, if you kiss me I will turn into a handsome prince." I took the frog and stuck him in my pocket. He was confused and yelling, "Hey, don't you want a handsome prince?"
I told him that at this stage in my life I am more interested in having a talking frog. (Corny, we know!!)
More on Using Voice Recognition
Q: I know a lot of us have wondered at times if voice recognition software would relegate the MT job to the trash bin. Well, at my externship some of the dictations have been done with that software and we just have to edit them. Most of them have a HUGE number of mistakes, and some of them have so many bad ones that I think it would be faster to just type the dictation from the voice!
The very first one I got in my queue that had been dictated on voice recognition had as one of the first sentences, "According to Dr. Burke he smelled the patient, and also endorsed anxiety symptoms."
Just thought you might be interested!
A: Tee hee! I love it!! LOL! was the correct word "examined"
instead of "smelled"? I myself am extremely interested in
the area of VR, although I have had no direct experience with it other
than dictating into the computer then editing myself what is produced.
My former medical partners in Kaiser Northern California are transitioning
to an "all electronic" record. I am waiting with bated breath
to see how it works in actual practice, rather than the optimum way
that a few techno wizards, even among MDs, are capable of making it
perform!!!
What I think I understand is that the more "experience" with a given dictator the computer has, the more accurate will be the product. The program has the capability to study the "edits," then refine its understanding of the speaker's unique pronunciation quirks, his linguistic habits, and even his vocabulary. If a doctor says a ten-cylinder word that the computer cannot get, then the physician enters the correct spelling, the computer will be able to recognize that same ten-cylinder word when the doctor presents it again. But this aspect of continual "refinement" of the computer's understanding of multiple specific originators is not present among the basic software programs. In the more basic programs, only one operator is involved in "teaching" the computer what is what. Although it seems like a laughable proposition to me, I am aware that some MTs take the audio tapes of various MDs, REDICTATE exactly what the doc says, phrase by phrase, into the MT's OWN VR system. Then the MT edits the record. After a very short while (because the same voice, that of the MT, is the ONLY one dictating into the VR, the number of errors produced by VR diminishes very quickly, and some MTs are better able to meet production goals using this technique, although it certainly seems redundant. The key rests in the speed of document preparation by VR PLUS the almost error-free result when the computer is provided so much experience with a single dictator. It strikes me that for MTs who are very knowledgeable, yet maybe not the fastest typers, this might be a good way to go as an independent contractor. Also, for excellent MTs who develop arthritic fingers or carpal tunnel syndrome, VR would offer a way to stay in the profession and remain economically competitive.
I would love to know how long the VR program has been in operation there. If it has been there only a short time, or if it lacks the capability to "learn" unique lessons from every single document originator, then discouragingly many (for the doctor himself) errors will occur, although that same plethora of errors may be quite encouraging for the MTs hired to edit the documents. As a general rule, doctors tend to be VERY impatient with proof-reading and editing. I'm sure you have already observed that already (unless very talented QA's are intercalated into the process); docs would rather sign the report than read it through and make corrections. They are generally willing to help out with one or two items that are "flagged" by the original MT, or by that MT's QA. But docs seem to be VERY reluctant to go looking carefully for unflagged errors within the document. At least, that is my experience.
Finding Time to Study
Q: I am still somewhat new to the school. I joined in mid June. I am having difficulty staying on a "school schedule." Here is my situation: I am able to do some school work while at work (reading and online modules). After work I pick my son up from school (summer program) and do the usual dinner, bath time, play, clean up. I am usually exhausted and asleep by 9. My biggest concern is when I get to the modules where we start to transcribe. I will not be able to do that at work since I am basically a receptionist. At home, our computer is in the living room so that doesn't allow any quiet time. I have a small townhouse and this is the only area that we can have the computer due to lack of phone outlets (only 2) in the house.
What are some realistic goals or other helpful hints you might have in regards to completing modules. I am currently working on Module 3. I took a little less than 2 weeks "off" from school because I got frustrated. Not at the school or the work, but because I couldn't find the time to concentrate or complete a task without being interrupted.
A: My best friend hit
upon this solution that worked out great for her family, teaching job,
and study needs. (She was my college roommate; back in college her style
was to sleep til the last minute before a class, jump up, yank on clothes,
and run across the campus at top speed to the class, so she did not
come upon motherhood knowing this technique I'll describe, but she worked
it out for herself by necessity.)
She, too, found herself exhausted at the end of the day. After a period
of unproductivity in the evening, she started going to bed even earlier
in the evening, immediately after she finished bedding down her little
one for the night. She set her alarm for 4:30 or 5:00 a.m. depending
on how much studying she felt she needed to do or could reasonably expect
from herself. At that time of the morning, she was fresh and the house
was quiet and conducive to studying. Her child at times would wake up
and want to interact with her, but she was determined to keep this time
for herself alone, so she instructed the child to go back to sleep,
or entertain herself quietly in her own room, or if she was hungry for
breakfast, she could go ahead and fix it for herself, "Mommy is
going to be tied up with studying til 7:30. If you need my help then,
to fix you a different breakfast, pack your lunch if you haven't done
it, my attention will be all yours." It didn't hurt a bit for her
child to see her so committed to her own studies and her advancement.
She often said she was able to accomplish about twice as much as usual,
relative to the time spent, when she was well-rested and undisturbed.
A #2: We all know what
you are talking about! Scrunching in bits and pieces of study time are
how most of us are managing to move (at a snails pace mind you) through
the course. I started in Jan and am only in Module 8. I have found that
doing 'at least a tiny bit' every day is better than doing nothing.
For Instance, if you aren't going to be near a computer for on-line classes, read ahead in the book (or do exercises at end of chapter), and if you don't feel like carrying it, take your flash cards. Drill yourself while waiting at a soccer practice or while waiting for a bus or when waiting on the phone... ANYPLACE, ANY LENGTH OF TIME and even interruptions aren't troublesome!
BTW- I re-did my medical flash cards (they tell you to put them in "bundle of 20's", but it doesn't work well cuz you wind up with a lot of words (starting at A of course!) out of random medical areas and it doesn't reinforce what you are actually reading and trying to memorize!), So I suggest to go through the cards, sort out ALL the prefixes, and suffixes in to two piles (start learning those now cuz they pop up in ALL medical disciplines)...then pull out all the roots and words you can find pertaining to the chapter you are working in. As you enter a new Module, you add a new bundle and your practice pile just keeps getting bigger. I found that learning those and practicing those before bed each night has REALLY helped me a lot!
As for the actual transcribing the sentence clips starting in Module 6... they aren't long and you could do them while receptionist-ing (if it's ok with your company) but if you are going to get the most 'practice' out of it, you really need to have those research resources that MT Advantage sent you available to answer questions as you go (like the AAMT BOS, the Sloane's Medical Word book, and Merriam's dictionary ), they are GREAT to leave open on your desktop to help figure out the word you are hearing and/or to see why some things are hyphenated and some are not! (grammar rules still seem kinda random to me!)
I work in a public area too and use a set of head phones plugged into my speakers to hear and to block out room noise. ...and I can listen, type, replay, type replay etc... as much as I need without driving everyone crazy! It works GREAT! Sometimes I just sit at the family computer, can be with 'the family' and work at the same time while they watch TV...I am in my own little world!
Hope This helps! Feel free to email if you have any questions!
A #3: I used Margaret's
idea very successfully when in college. I had a major problem finding
time for study in a dormitory with 500 other girls as roomies! I found
that I was constantly being interrupted for things that were fun, but
not productive in terms of school, and I really wanted to keep my grades
at a high level.
Finally, in desperation, I put a "Sleeping: Do Not Disturb!" sign on my dorm room door between the hours of 8 pm and 1 am. People respected that and very seldom did they bother me.
I set my alarm for 1 am.
Then I got up, had a cup of coffee, and studied! It worked out really well for me!
Of course, at the time, I was 18 years old, and I could still get by
on 5 hours of sleep a night! That was good, because I was also working
as a clerk-typist, full time in the SMSU Graduate Office. In addition,
I was very lucky; my roommate liked to go to bed early! She didn't mind
if I studied in the wee hours of the morning because the light I used
didn't bother her and studying is quiet! I know this wouldn't have worked
for everyone, but it did work for me, when nothing else had!
Perhaps you can use some variant on that system to your advantage? Keep
us posted, OK?
A #4: I totally understand
the feeling of a "filled" schedule. I remember in college,
a single mom at the time, not ever getting enough sleep and always being
stressed out. I was not the type to go out partying, anymore , but I
did have to rollerblade everywhere and workout consistently. I do not
know what I would have done without my "blades." I loved school,
so that was my motivation, but I had to hold off on it due to getting
married and then pregnant.
It was still a very stressful time in my life, due to having four kids, my husband going out of town a lot, and working at the YMCA and Church. However, at least I was able to go to school online. That was my motivation. I was just so thankful. I did have my ups and downs on study time, but I also kept a great GPA and somehow got through it all. I just kept kicking and then when I looked back, I realized that I did a pretty good job.
Now, I am doing MT for myself and my family. It keeps my head thinking and learning. Also, I can work at home with my family. It is not always easy to stay on schedule, but I do know that it will get easier. It will be a part of our life. How cool is that?!
The moral of this story is do not be too hard on yourself. Steer the course, leave room for human error, choose a hobby or interest and allow yourself to do it often, enjoy learning, and go for it girl!
A #5: I am a mother of 3 small children and work part time outside of the home. I have a hard time finding time for "school" too. But what keeps me motivated is that one day I hope to be able to work at home and ditch my part time job and be here with my "babies" and hubby all the time .... and probably end up making more money as well!
It's frustrating for me because I want to learn every bit of this ..... and it's a lot (a whole lot!) of great information. At the rate I'm going it will probably take me a year to complete this, but it's going to be worth it, I know. Hang in there! 11:00 pm is usually my time to start studying or get on the computer ....... when everyone else in the house is asleep! I drink my coffee and go to it!
A #6: Another way to motivate yourself is to remember than in a year you ARE going to be another year older. (That's our goal anyway!) The question is...are you going to be a year older WITH an MT diploma or WITHOUT one?
Keep on plugging along! Even baby steps are steps in the right direction.
A Poem from A Student on the Religion
Board
Stand Firm
Standing firm on the ground
while looking up high,
trying to reach
as if touching the sky.
Bringing down the clouds
and the heavenly trees
making the world look different
than one usually sees.
Still standing firm
strong in our faith
having to bring down the clouds
to catch a glimpse of our fate.
The beauty is there
it is who we are.
The challenge is focusing on the little bits
that creates the brightest star.
When one sees a road that looks scary and grey
look at it with the clouds down, in God's way.
He sees with such perfection, He knows what is right
It is through faith and prayer that we see with God's sight.
Appreciation by Current Students - Actual UNsolicited comments (We LOVE those!!)
"Thank you so much for keeping me posted. I am very impressed with the school. I took a long time to choose the school that I thought would best serve my needs and I am not disappointed."
"Just a quick note to thank you again for letting me take the MT course. I am enjoying it a lot. You have done a wonderful job!!!!!"
"I just wanted to see if you needed any help with anything, no strings attached. I know you help others and you have your hands full. If you need anything, let me know. You deserve it. I just felt the need to ask."
"Thank you for getting back with me so soon! Thank you so much for your help!"
"One of the reasons I chose your school was because you were new and you had the same things to offer that other schools did, plus I like to play with new toys and new ideas. You are doing a great job and keep up the good work."
"I have found answers to a lot of questions just by reading the other things that have been posted, that is what I usually do when I first have a question. I am finding the course enjoyable."
"I received the box of books you sent me. Thank you so much!! I think I'm going to just read through all of these! LOL! They look like super books, and I love learning with the aid of CDs."
"Isn't this fantastic?!!! I LOVE this program! It's GREAT to see results like this!"
"Thanks again for your help and encouragement last night! You are a gem!!"
"I must say that I am most impressed with the fact that you are exceptionally forthright and honest. My first impression of your website was good and I continue to be more and more impressed."
"I really appreciate you and the school. It is so nice to feel like I am not working alone, as I felt with my previous school!"
"Thank you both for your quick replies and answering so honestly. I love my course and plan to forge ahead!!"
"Thanks for all your hard work….I truly appreciate it."
"I wanted to thank you so much for your prompt response to my inquiry. I also wanted to take this opportunity to tell you how immensely I am enjoying your course."
"...which I'm loving every minute of!"
"I am currently on Module 6, and I am loving it. I look forward to studying everyday. I'm even having trouble pulling myself away from my studies long enough to do my housecleaning!"
"It does not matter to me what kind of incentives that you all
offer; I will ALWAYS refer people to your school, incentives or not,
because I am happier than I have ever been with my career and I owe
that to you. If there is anything else that I can ever do to help out
with the school please let me know."
"Just letting you know I am FINALLY on Module 5!!!!! Yeahhhhh!!!!
I'm very excited to start this part of the course! So far I don't have
any questions or concerns, but if anything comes up I'll let you know."
"I am very happy with the program thus far. You and your staff are very quick with responses and help is never far away. Although I have only been with the school for a little over a month, I have only had good experiences. Thanks again for your help. You are all doing a great job!"
"Thanks for the quick reply! And thank you for your straightforward advice about the income side of things."
"Thanks for taking time to answer, and to set this all up with me!"
"I researched MT schools for almost a year but when I found MT Advantage, I knew this was the right choice for me and have not regretted it for a minute. I looked at both on-line schools and traditional schools. MT Advantage had everything that I thought was lacking from the other schools (even the so called big three online schools). I started the beginning of September and am currently finishing up Module 10. I have learned so much in such a short time, I amaze myself!"
"I find myself so absorbed in the course, I can’t wait to study. My husband even bought me a new computer because I was “hogging” the family computer."
"I take my MT education very seriously; I know that I’m only going to be as good as my education. I am 42 years old and have been a stay-at-home mom for the past 10 years; I don’t want to waste my time. I want to have a successful career as an MT. Thank you for creating a fun, yet satisfying way to learn."
Thanks for reading some of our posts on our student forum and from satisfied students and graduates. But instead of reading, why not come on over and join us? You won't find a nicer group of people anywhere! The one-on-one support is amazing and when that's combined with an excellent curriculum, more and more students every day are finding MT Advantage is the right place to be for their medical transcription training.
Contact us today!
