Honesty is the Best Policy

Well, I guess I did manage to let the holiday season get away from me, but I am determined not to let the entire month of December go by without a post.  Then again, I guess the good thing about blogging is that you can do it when the mood (or time or thought or energy or lightning bolt) strikes you.

That PA I worked for back in the 90s, as it turns out, was probably the nicest medical professional I ever had the pleasure to work for, because he was also the most forgiving.  His office had called me asking that I pull a chart note on one of his tapes and get it faxed to him as soon as possible, which of course I did.  Now I should have just finished the entire tape, but I had a couple of older tapes that needed to be done first, so I put that tape aside to get the older dictations completed.  I almost always returned everything I had on my desk the next day, but I wanted to be sure I did get the older notes done just in case I did not get everything done.  Tapes to be transcribed were on one side of my desk; the completed tapes were placed in a separate area.  It was very rare that I would get a call to pull a chart note off a tape to get done ahead of everything else, so as was my usual practice, when I got the note done, printed and faxed, I took the tape out of my transcriber and placed it in the to-be-deleted pile of tapes.

I finished up the rest of the dictations for that day and then did what I always do—erased all the tapes.  The interesting thing is that the very minute I did that, I remembered I had not finished that one tape!  Gee, it sure would have helped had I remembered that little tidbit before I erased everything. I think every single muscle in my body tensed up when I realized what I had done.  The one good thing, if there can be a good thing in this situation, was that only 7 patients were seen that day.  It could have so easily been a day of 20 or 25 patients.

I could have taken the easy way out and said it was a bad tape or that there were no other dictations.  But really, that is not taking an easy way.  That would be taking a very unprofessional  and dishonest way out of a difficult situation.  Honesty is truly the only way.  I can tell you it is very hard to dial a phone, even a push button phone, when your fingers are shaking and the muscles in your hand are pulled so tight you can barely breath.  Please, let the line be busy, let the line be busy, but alas, the line was not busy.  The PA was with a patient when I called, so I told the assistant what had happened, apologized profusely, and said I would not charge for that day’s dictations.  About an hour later the phone rang. There was no way I could make my line sound busy, so I answered.  What did I hear?  “Patty, you don’t make mistakes.”  My reply, “True, but when I do, they are real doozies!” 

Any of you reading this who is a working MT knows what it is like to have to deal with a difficult doctor or any health care professional.  The MT angels were looking out for me that day, because this PA could not have been kinder or more understanding.  He actually realized that all of us are human and make mistakes, even the real doozy kind.   I can think of a handful of docs that had they been the receiver of such news, I would have just quietly thrown my computer away, closed up shop and headed for parts unknown, never to be heard from again.

I was not expecting this story to be quite this long, so I think I will save those other opportunities I mentioned previously for my next post.  I promise I will talk about the few things that came my way that I never wanted to do, but they fell into my lap and really wound up being pretty great experiences.   In many ways, I am glad I did erase that tape.  Obviously, if I could have avoided that experience, I absolutely would have.  The thing is, because I put forth my best efforts every single day on the job and worked very hard to develop a good working relationship with my clients, when I needed a favor (or needed forgiveness), I got it.  When you run into difficult times in your job, and you will if you have not already, never take any road but the honest and professional road.  Following that path, even on the very ordinary days, will always lead you in the right direction.

I wish all of you a very prosperous, challenging, exciting, and always, a very Happy New Year!   Thanks again for reading. 

Understanding the Language of Medicine

I mentioned before that I was hoping to take off a few months when I moved to Idaho.  I was actually hoping to take off about 6 months. I thought I wanted that time to just get used to living in a new city, especially so far away from family and friends.  I had been working just about nonstop since I was 17 years old, so taking an extended “vacation” sounded like the perfect thing to do as I adjusted to Western living.  Joe still marvels that I got our entire belongings unpacked and our house organized the way I wanted it in less than 2 weeks.  Well, when you have no phone, no car and no TV, what else is there to do?  I do love to organize things to the point of almost being obsessive about it, so those 2 weeks I had a ball figuring out where to put things.  I am very lucky that my husband does not care how I organize. I just need to let him know where everything is (and then usually have to remind him from time to time where to look). 

Almost to the day that I got everything in its proper place and ready to just relax and enjoy, I got the call from Joe’s office that they needed help, and thus began my local service in Idaho.  Of course, I could have said no, but I really don’t think I could have gone 6 months without working.  When you love what you do, and I have for most of my career, it really is hard to stay away.  Working for Joe’s office was also a great way to get to know his co-workers, some of whom are still my friends to this day, so it was definitely a win-win situation for me. 

I have also found it interesting how different physicians can be in their dictation habits.  There were 5 docs in this practice when I first started.  Fortunately they were all pretty easy to understand, so it was not too much of an effort to get settled in to their style of dictating.  A couple of the physicians did sinus surgery, and that would include CT scans of the sinuses.  The one doc was very organized and methodical in his dictations.  He went through the findings of each sinus in the same order every time, and it got to a point where I could almost transcribe ahead of what he dictated.  The other doc was the complete opposite.  He was very unorganized which came through in his dictations with jumping around the sinuses and often losing his train of thought with things like “The ethmoids, no wait, the frontal, no, go back to the ethmoids or did I mean the maxillary, yeah, the maxillary….”  It was kind of like putting a patchwork quilt together each time I transcribed one of his scans.  

I constantly emphasize to my students that it is so important that we have a good understanding of what we are transcribing.  This doc was a prime example of that, because I was able to put his reports together in the right order with the right information under the correct sinus area.  That paid off, too, because one day he caught me in the hallway and thanked me for making sense of his CT scan reports!  MTs don’t often get compliments or thanks for their work, so that was a moment I will never forget.  

One of the other docs (the one who also dictated on CT scans and was wonderfully organized with his dictations) was also usually very long-winded with his chart notes.  He would also dictate letters to insurance companies when payment was denied or there was some type of error or difficulty with a patient’s documentation.  I wish I had kept at least one of those letters because he had such a great way of more or less telling these insurance people they were utter idiots but without actually saying that.  These letters were almost always at least 2 pages long, but I so enjoyed those dictations.  You would think transcribing insurance letters would be the epitome of boring, but not so these letters!  I often have wondered if any of the recipients of those letters really got what this doc was really saying to them, but I would venture to guess they never did. 

Over time, this practice opened an office in Elko, Nevada, and I eventually did the transcription for that office.  Joe and one of the docs, along with a few medical assistants, would fly down to Elko once a week to see patients down there.  There was also a PA (physician assistant) who ran that office full-time, and it was his dictation that I started to do on a regular basis.  It was also my very good fortune that this PA was one of the nicest guys I ever had the pleasure to work for, because there was a time when I made a mistake that could have resulted in one very severe tongue lashing or quite possibly losing the account. 

I’ll talk about that next time, along with those handful of opportunities that came my way that I was hoping to have avoided but wound up being great experiences for me, both personally and professionally.  In the meantime, I hope all of my readers have a very Blessed and Happy Thanksgiving.  It sure seems to be early this year, but I guess that means more time for Christmas shopping!  Enjoy your day and your holiday!