Dictation gone terribly wrong
I came to work in the emergency department yesterday morning and found taped above our communal desk. It concerned a chart I had dictated the day before.
The note, from the transcriptionist, said:
‘If it were possible to rate with a minus, this dictation would warrant it; this dictator clips words, chops off sentences and changes thought direction in mid-sentence, leaving intent to the imagination of the hearer.’
It is, I must admit, an eloquent description of the difficulties the transcriptionist experienced. If I it were possible to rate the transcriptionist’s comment with a plus, this comment would warrant it!
So hey, color me embarrassed! I think I may have been speaking to a couple of consultants on the phone during my dictation. It was a busy day of admissions.
However, I’m not known for my skill at dictation. It has been my consistent observation that virtually every chart I dictate has a blank that I later have to fill in by hand. Maybe I mumble, maybe I hold the phone too far from my mouth. I know that I have a habit of speaking too fast. Combined with my native West Virginia inflections and my adopted South Carolina ones, it’s a prescription for unintelligable communications. My heart goes out to the ladies and gentlemen who have to decode my rambling.
Still, I feel I have to respond to some of the comments. First, I’d like to say thanks for the term ‘dictator.’ While I understand it was being used in the context of a medical chart, it does give me a feeling of power, a sense of total dominion, that I actually don’t feel in my day to day life. If I were a dictator, practicing modern medicine, rest assured heads would roll. But that’s another discussion altogether.
Now, regarding the allegation that I leave intent to the imagination of the hearer: I am a writer. Imagination is very important to me! If the hearer or reader finds himself or herself transported to a realm in which they can try to picture the scene in the ER, or where they have the singular delight of trying to construct mental scenarios of why patients did some of the tragically silly things I report, then so much the better. Imagination is useful and powerful. And frankly, imagination is what I frequently employ when the history and physical are so lacking in reality or actual findings.
But most important, before closing, I want to say this:
I ap..gize for any…I may have…. Sometimes, banana (?) I get comfuzzled in the ring/rang fluffy. Of course, if I cood have brean any cleaner, it wouldn’t have hurried along, but the bunnies were running in the field (!) before Mr. Johnson fell down yesterday at 3 PM resulting in an intrauterine pregnancy which, when Pompeii was covered in lava made the transcriptionist appear to feel, or be, angry, whose vital signs were stable, or unremarkable, and not psychotic or delusional.
I remain, yours, confusedly and with obfuscation,
Egwart Leeapt, ND
Dear Egwalt
o=Obviously as the dicktatore u shud get an EMR
Mebbe voice recognition software would be better…it won’t curse you or answer back
I read one that went “and due the patient’s head injury, a butt hole was placed in his head…”
It’s worth it to make sure it’s not an equipment/software issue.
Most of our dictating equipment requires us to press a button on the handset, then talk. Part of the problem can, of course, be with the user as far as ear-mouth-brain-hand coordination, but sometimes the aging handsets’ button switches don’t work so well, and there is either a delay or an intermittent on-off of the system. This isn’t the fault of the dictator. Likewise, some mikes inside the handset don’t work so well and distort the sound or require one to yell to be recording clearly.
Also, there may be software problems. These days it seems most of these transcribing systems have gone digital, so there can be problems with some voices depending on digital sampling rates and audio frequency components of the speaker’s voice.
In the end, it may still end up being mostly your fault, but it’s worth looking into if the feedback about your dictation isn’t consistent.
And sometimes you can dictate perfectly and things still go wrong. Hence my enlarged prostate:
http://tiggersdontjump.blogspot.com/2006/03/unexpected-findings.html
Greg…
It’s NEVER the fault of the dictator…heads will roll for even SUGGESTING that…all will bow!!
Congratulations on having a transcription staff that feels comfortable enough to provide some feedback. Most of the time, they probably sit and stew….
Great post!
Our are outsourced to India. They often return with glaring and also hilarious errors. Sometimes they change the whole sentece structure around to sound like an English learner. No way do I have the time to correct them. So if I ever show have to show up in court having to read one of them I will just have to say that is not what I meant.
As a fellow MT, I must say how encouraging it is to visit a physician’s website. I miss being able to interact with physicians. There is a lot lost in communication with current technology. Thank you Dr. Leap for your fabulous website. It is wonderful to see you as a REAL person. Thank you as well for the job security!
Very interesting… as always! Cheers from -Switzerland-.