Monday, September 28, 2009

Sometimes I still think about medical transcription

Doing medical transcription was what I did before I stopped working because it was too difficult. Medical transcription is the job of transcribing doctor’s dictation into medical records. For example when you go to the hospital, there is a record that the hospital is legally required to keep called a discharge summary. This tells about what happened when you were in the hospital, all the tests you took, your condition, etc. Or when you have surgery, a record called an operative report is required. Also sometimes histories and physicals, where the doctor tells about the history of your illness and your results on physical examinations. There are also other types of medical transcriptions including clinic things and workers' comp reports which are easier than the hospital transcription.

In 1985 I was unemployed and having a hard time making a living. It was recommended that I undergo training with the state of California department of rehabilitation which is designed to help disabled people find work. They recommended that due to my typing ability I go into medical transcription. I was treated very badly by the department of rehabilitation I have written about this elsewhere and it does not need repeating here In spite of what these bastards/bitches did, I was able to find an entry level gig in medical transcription. It was as an independent contractor doing hospital transcription for a transcription service.

I was paid on production (standard way of paying transcriptionists) a low rate $.06/line, a line being 65 characters. I probably made about $1.50 an hour when I was first doing it.
In addition to male transcriptionists being a very small minority, the work was incredibly difficult. It involved having to know tens of thousands of arcane medical words and phrases and knowing how to spell them properly. Some of the doctors were from foreign countries and had accents that were horrifically hard to understand. Even some American doctors would slur their words, mumble and often be unintelligible. I knew I had an uphill battle if I were to be able to be a hospital transcriptionists, but all my life I have worked hard and given everything my damndest in spite of this horrific disability.

The pay was solely on production, though the work was not uniform. For example a person could make a substantially higher rate of pay from much longer reports than from shorter reports or if the doctor dictating the report was clear and easier to understand than other doctors. Some of the jobs were independent contract rather than being an employee, so you had to pay double the social security tax, there was no workers’ comp insurance and no paid vacations. Most ironic of all there were no benefits, so a person doing work indispensable to the medical profession sometimes had no employer provided medical insurance. There were other expenses that I had to incur later on, but more about that later.

The work at my first gig slowed down and then I tried to find some other things and I was fired from some places but managed to find a few places that would allow me to work for them. I was tired of making a poverty wage, so I tried to find something better, in spite of my lack of experience. I was fired again from various places. I had no idea how people were able to transcribe these unintelligible doctors and do this job correctly. Eventually I found a medical group which was clinic work and somewhat easier than the hospital stuff. There was an Indian doctor there who I had a hard time with and he insisted the other transcriptionist there do his work. I had some trouble with a few other doctors and got fired from there after about a year and a half. I had various other jobs and came very close to giving up the ghost.

After a succession of jobs I acquired an independent contract job doing hospital work, though fortunately no operative reports in which my experience was limited. I worked at home for the first time rather than in an office and I had to provide my own reference books. All of the necessary references books cost between $400-500. On top of this I had to put an additional telephone land line in my home and pay for it and I obtained the work through a device called a C phone. I had to rent this from the people I contracted for, for about $30 a month. The other option was to buy one new for $800. I had to do this work through the telephone lines and no toll free number was provided by the hospital. Fortunately it was still feasible to do this work as the hospital was a toll free number from where I lived. After being fired from this job, then reinstated, I learned I was required to buy my own C phone as supposedly the people I worked for could not legally rent one to me as I was an independent contractor.

Used, this was about $500. I had no idea where I could have obtained one more cheaply. I was able to do more lines at this job than at the others I had and my gross pay was probably $15-16 an hour or maybe more on good runs. Of course you had to deduct about 5% of that for the additional social security tax I was forced to pay as a legally self-employed person. Eventually this gig ended when Kaiser Permanente (I did the transcription for one of the chains of hospital this HMO giant has) acquired a new "health connect" system which cut our work by about 50% or more. I was not able to find another job and keep it.

As my regular readers know I have retired and for the past two years since I have retired I have been trying to qualify for SSDI which I am not likely to ever receive. C phones have become largely obsolete and transcription is now received through digitized .wav files. This meant that I was stuck with a $500 investment that I could not recoup anything on. I did try to sell my reference books on Craig’s list for a while but had no success.

I remember hearing about how Temple Grandin was claiming that medical transcription was among one of the bad jobs for an autistic person because of hearing sensitivity issues. I had to laugh at that, because albeit not perfect it was a good job for me, because I could do all the work without having to interact with others most of the time, especially when I worked at home. The joke was on me when I met Grandin last year at the 2008 ASA conference in Orlando, Florida and told her what my former profession was and how it had not completely worked out, and she reiterated her old saw about how I had entered a bad profession for an autistic person.
Of course, one can look at the perspective of the glass being half full. I did work a good portion of the time although it was difficult, but I did better at this than anything else and this did allow me to work for a period of time, although not until I would be old enough to receive retirement social security.

Though retirement has its nice aspects, I do miss working a bit. Working certainly helps people with self-esteem and self-worth. Lately I have been trying to pass the time by writing a novel. Actually I should be working on the novel instead of this blog post. However, I will post more about this in the future, maybe tomorrow, stay tuned.


bullet said...

If you're writing a novel have you thought about doing the NanoWriMo this year? I start it on the first day and write a novella. Historical murder mystery. But many people carry on from a bigger novel and just incorporate their quota for the challenge into it.

biogeek said...

Hi your post...don't know what to say...feel good and bad at the same time...bad because of the problems you had to face and good because you give me inspiration to fight on...I am also in the MT industry since the last 5 years and doing well in this...just wanted to tell you that you have got a fantastic writing style and you should use it to write articles on blogs and sites like Associated Content (pay per view site), Squidoo, Hubpages, Gather, etc. where I have heard people earning close to $1000 dollars monthly, not a big deal considering your excellent writing abilities...God bless..thanks

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