Confidentiality – Is It Really Crucial?

Isn’t this always a burning question? Depending on how long you have been involved in the medical field, perhaps, but the longer you are in it, the quicker your response comes back: Yes, it IS crucial! The problem today is that so many of our medical records are being transcribed in so many different countries, none of which have the rules and regulations we have here in the United States relating to confidentiality of personal medical information.

In the 1990s, I had the questionable privilege of teaching at a Vocational Technical School, teaching medical transcription to juniors and seniors in high school. It was challenging, since it was obvious that senioritis was and is a definite, and sometimes debilitating, condition (and should be categorized as such). Unfortunately, there is no remedy for it but graduation!

Like many idealistic new teachers, I went into the project thinking it would be wonderful to teach these young people and delighted in fantasies of them eagerly accepting my pearls of wisdom, yada, yada, yada. The reality was like a bucket of cold water to the face! My class that year consisted only of female students. Do you remember high school? Do you remember how impossible female junior/senior girls can be? Were you one of them?

Be that as it may, the realization that transcription was beyond their years came with the class on Confidentiality when one of the young women, a junior, looked at me pityingly (and superciliously, I  might add). As she glared down her nose at me, she sniped, “Well! (huff in voice and a fluff in her chair) EVERYONE tells secrets!” Stunned, I stood there, rather stupidly I admit, and thought; “Oh! This can’t be real. Someone please get me out of here!” That very afternoon found me in the director’s office rearranging the curriculum and turning the class into a (remedial) Basic Medical Office/receptionist class. And I was out of there! The thought of teaching those boringly basic skills to people who just didn’t care was too much for me to handle.

Alternatively, there were the adult students who delighted me with their variety of presentations on Anatomy. One woman dressed our Bucky Bones (skeleton) in a dress, high-heeled shoes and a beautiful scarf, then proceeded to tell us what muscles this Senorita would use when she went dancing.  Would it surprise you to learn she received an A for that class?

I sometimes wonder where those students are today. There is only one with whom I have any contact and she has developed into a lovely wife and mother, and yes, she does transcription – for her local police department! And confidentiality is just as much a prime consideration today as it has been for many years.

It still bothers me that our transcription industry is being outsourced to other countries, mostly because of “the bottom line” so I smile when one of my medical practitioners uses their own computer, even if most of it is templates. At least I know it is local and not going out of the country.

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An End And A New Beginning

Three years ago, I moved to Florida to care for my mother. One of the main reasons I learned medical transcription was to become a medical advocate for those I love. Thankfully, mom accepted that as part of our relationship. I became the liaison for mom and her many physicians. We spent at least one week every few months just making the rounds for regular checkups, getting lab tests, and making sure she had all the necessities to make her life comfortable and possible. It was a relief for her to have someone who could explain what the doctor said – in lay language. I felt like a translator, and that’s what we seem to do at times; translate from one language to another.

When you’re in the hospital, in the OR, ICU, lab, transcription – no matter where  you are, there is a language that only someone on the inside can understand. It is really important to make sure those in your close circle can count on you to speak lay language with them. Having any kind of illness, condition or disease is scary enough. You and I can help ease some of the fear by speaking to them in their own language.

Think how you feel when something goes wrong with your computer and the repair geek starts talking in code (aka gibberish). He/she understands exactly but to the rest of us, it’s a foreign language and we need someone who can still speak OUR language! It’s the same with medical terminology. You and I know what the word means, but your mom or dad, your sister or little brother have no idea and it is up to you to translate; to ease their fear – just a little bit in any case.

When Mom decided to discard her body and leave this life, it was time for me to think about what I want, where I want to live, and what I want to do. Once again, the answer was clear: Seattle – my Heart Home. Seattle is wonderful! On the one side, the vistas of the Puget Sound and beyond. On the other side, not just mountains, but medical facilities all over the place. Renowned facilities where things are happening – new terminology is being formed, new equipment tested and named, and where the very air is a mixture of sea and hospital – my two favorite aromas! I walk into a hospital and suck in a huge breath – and sigh contentedly. How I love being part of a hospital. Then I open my windows to the boats and ships in the Sound, to gather the sea air to me – and sigh contentedly, loving Seattle.

And now it’s time to get on with creating The MedSpeak Game! Remember, you can earn 1 CE per hour played at any function sanctioned by AHDA (Association for Healthcare Documentation Integrity). Just get your organization to purchase the game, or buy your own copy for some fun and challenge as you improve and increase your medical terminology skills!

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Becoming A Radiology Tech And A Teacher

As a young adult, I became a Radiology Technologist. Oh, how I’ve always loved medicine and everything related to it! Just before my graduation from Massachusetts General Hospital, my chief tech, whom I adored, respected and modeled myself after over the years, attended an international radiology conference. He returned with the news that I had a choice of two different positions: one in Passau (which was, he said, a little medieval town on the Danube River) or Munich. I was 26 – the choice was clear!

Shortly after graduating, ticket in hand, off I flew to Munich, Germany to begin my career. I had six hours of German tutoring and could say 6 phrases or sentences. While waiting for the train, however, I purchased a cup of coffee and simply held out my hand so the cashier could take whatever she wanted! I had no clue as to German money, culture, or anything else, except that my closest friends at home were German and I wanted to learn the language so I could understand them at parties!

The surprise to me was the realization that medical terminology is pretty much the same no matter what country you’re in or what language you are speaking. Medical terminology is based in Latin, after all. Pronunciations may differ, but the words are spelled alike and carry the same meaning. The biggest challenge was to learn conversational German. This became clear during a ride to a radiology conference when the two people in the front seat carried on an animated conversation about the weather, the cows in the field, activities they shared, and I understood not one word. The woman from whom I rented a room (and who worked at the same hospital and in the same department) and I made a deal. In our conversations, I spoke German and she spoke English until we both ran out of vocabulary, at which time she would switch back to her native German and I to my English. This worked excellently! We both progressed in our lingual abilities and soon enough, I was considered “almost German.”

During my years in Munich, I also taught Anatomy & Physiology to radiology students. More fun, though, was teaching English at an evening school. The biggest problem was that I wanted – and needed – to keep practicing my German and the adult students all wanted to learn English, of course. We all had a great time in those classes!

It was the result of a motorcycle accident that I learned medical transcription. Those were the days when the doctor dictated onto a 78 record! In German, of course. Part of my job entailed translating medical journal articles these doctors were writing into legible/readable English.

Then, five short years later, I returned to the States. Although I didn’t come back very willingly, the trip was great! We traveled via freighter from Lisbon to New York and gleefully rode out a storm in the middle of the ocean, doing our best to get as close to danger as possible without being swept away.

That was many years ago now, but I still feel the excitement of that storm! Perhaps that is some part of what draws me to live where I can see the Puget Sound all the time, and where I can watch the many small boats and huge freighters coming and going.

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Favorite Medical Books

What are your favorite medical books? I have a few that have me feeling (and acting) pretty possessive about them, even when they’ve become ‘outdated’ because a newer version is out.

My list includes

  • Dorland’s Medical Dictionary – I absolutely love this book! Some people read the telephone book for entertainment; I read Dorland’s.
  • My favorite word book is The Medical Phrase Index. Oh, I felt so smart as a transcriptionist with only two or three years behind me – but able to find words the more experienced MTs couldn’t find. It didn’t always make friends for me, unfortunately. But what a treasure of a book. I can find almost everything in that book – in fact, I can’t remember a time when I didn’t find exactly what was needed. What a book!
  • Another favorite became the Monthly Prescribing Reference. Every month that little Reader’s Digest-sized book would arrive in my mailbox – but I found it impossible to toss the old copies, so they just stacked up and stacked up. Thankfully, this book is online now so you can even download it to your Blackberry or iPhone. Woohoo.
  • For teaching transcription students, Chabner’s Language of Medicine was super! I loved the way it was structured. Having the CDs for students to self test made it easier on me, too!
  • Then I was introduced to A.D.A.M. interactive. You could view Adam, and Eve too, with or without fig leaves – it was your choice. The program takes you 1 mm at a time through the skin, fascia, tendons and on down to bone and then into the cells and atoms. It was SO cool! The animations were fun and made it easy to remember how anatomy and physiology work together.

Even though we can find everything on the internet these days, having those books in my hands brings me real joy. There is such a comfort and tactile pleasure when holding a valued book. Kindle is great, but it doesn’t bring me that sense of ….. hmm, can you believe it, I’m at a loss for a word! Help!

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Language Arts

There really is an art to language, isn’t there! I love the book: Eats Shoots and Leaves, and all the jokes that go with it. You’ve heard the one about the Panda going into the bar, right? Cracks me up!

Anyway, I have friends and acquaintances who speak in what can only be called colloquialisms. You know what I mean. A good friend’s mother had an infection of her toe one time from some weird organism/bug. When she told us about it, however, it came out that she had “an orgasm” in her toe. We laughed about that one for a long time. This same friend’s father pronounced the word ‘put’ as ‘putt” (as in golf). To this day, I continue to ask “Now whar’d I putt that thang, anyway?” It’s impossible for me to ask that question in any other way – it’s just too much fun to say, “Hey! Whar’d I putt that thang?”

Oh! And trying to pronounce some of the names of towns around Washington State! Wow! It took me almost two months to be able to pronounce Puyallup correctly, and I continue to pronounce it in my head the way it’s spelled. And I still don’t know how to pronounce the name of the town near here called Humptulips! As of the 2000 census, there were all of 216 people living there. I wonder how many of them pronounce it correctly?

You probably have a bunch of words, phrases and sayings that have become favorites, or at least memorable. How about sharing some of them in the comments of this blog? It is all about language, after all.

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Design for Game Box

I’ve been working on the design for the game box for some time now and finally have it! Of course, you will want to comment and let me know if you agree or not, and/or what changes you’d like to see made to it.

I’m envisioning the box as glossy black, but would matte work better? What do you think?

The people playing the game keep giving me good feedback, and some of those are sending me great terms to include in the game. I’m trying to offer a fairly even distribution of beginner, intermediate and advanced terms. The problem is that I’ve been in the medical field so long, some of the beginner terms seem so “given” that I hesitate to include them. Rather I did hesitate until some actual beginners participated in the game and were totally lost. As a result, those basic words have now been included. When you play, however, if you are more than a rank beginner, you leave those words alone and play at your own level, you hear!?! Give those beginners a chance, okay?

Oh My Gosh! While sitting here writing this, I happened to glance down at the paper on my desk and found this: “Past Medical History: The patient has been on “Homo 2” for some time.” Hahaha!! I’m going to die of laughter before my book ever gets written!!

Okay, back to the game. I have some really exciting news! We played it at a transcription regional convention recently and AAMT authorized 1 CE for every hour played! Woohoo! How’s that for a great (and fun) terminology tool! So now you can get your local AAMT chapter to play this game, have a blast, and get a FULL CE while having a blast. Let’s see what other groups we can get on board with this, too!

Oh, the design! Here’s a draft copy of it. Tell me what you think.

The MedSpeak Game(c) Box Design

The MedSpeak Game(c) Box Design

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Humor in Dictations

Humor in Dictations

What a hoot! I’ve been reading some of the bloopers sent in by various people, to me and to Advance for HIM magazine, and had to shut my office door to prevent anyone from thinking I’d completely lost it. They know I’m not terribly ‘proper’ anyway, but it’s a good thing to maintain at least a little sense of dignity, right? Hmph.

Anyway, would you like to hear/read some of these? Here’s a few from recently.

  • *”If he were to have a repeat urinary tract infection or reocurring episodes of UTI, we’ll have him see a podiatrist.”  Hmm, ♫♪and the pubic bone’s connected to the toe bone! ♫♪
  • *“Severe right-sided chest pain and poor appetite secondary to fracture of right 7th and 10th ribs with confusion of the lungs.”  “Wait, I can’t breathe…or can I?  I’m so confused!”
  • *“The patient was bitten by a dog today. The dog was guaranteed.” Guaranteed to what? Bite?

Here are a few questions sent to me or a list I’m on.

  • What is a ‘gap smear?’  (Pap smear)
  • Pathology: “The specimen was submitted ala-cart” (aliquot)

And here is a classic response from one from one of my favorite people!

Q.  Hi. I am just curious. I have been typing the phrase, “respiratory embarrassment” a lot lately. I was just wondering what that was…? Thanks

A.  PC (politically correct) for a belch – a very loud and long one, in conjunction with verbalizing your love for your mother, grandmother or sweetheart, usually in a public place.  DK (been there, pimp-slapped the kid that did it, haven’t heard “I love you” belched at me for some time now…)

Hope you’re having a great day/week/month! Send me your humorous dictations and bloopers and let’s play word games.

* Selections from multiple copies of Advance for HIM

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What’s in a Game?

Oh my! Do you have any idea how many medical terms exist these days? Long gone are the times when 100 or even 1000 words would suffice to cover conditions and diseases. Today, there are literally millions, going on a billion words just in the medical language area! And if you are studying in any medical field, you know you are required to learn what feels like all of them.

Fortunately, there are some tools for you to use in that endeavor. You have probably already learned about composition words and how to put terms together, how to dissect them and reconnect them, etc. That makes some words easier to learn and remember, but what about those weird infectious disease names? And how about medications! Is it a brand name or generic? How can you tell the difference? And what difference does it make? Are the generics really as good as the brand name versions (but then, that’s a completely different discussion than what this blog is about, so we won’t go there right now).

Having dealt with many, many medical transcriptionists, I’ve learned there is a condition called “transcription ears.” You know, the dictator says one thing and the MT hears something completely different? Sometimes (most times, in fact), the words the MT heard are very funny; funny enough that I created a Blooper Scooper to record them and then began writing a book about them, giving definitions that had me ROFL – and quite a few others got some laughs out of it as well. In fact, one of my ‘definitions’ was published in the food column of a newspaper from another state, so others found it pretty funny, too. But I’ll tell you more about that book later on. It’s almost ready to release. Happy Day!

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Medical Terminology is Fun??

I know… been there, done that. Medical terminology is one of those necessary, and sometimes boring, facts of life when you are learning any type of medical profession. So what could possibly be “fun” about it?

When I first studied Anatomy & Physiology, we had a skeleton in the classroom. I spent many intimate hours with Bucky Bones, fingering his fingers, his toes, long bones and cranium. And the rest of his bones, as well, of course. That was a fun time, believe it or not. I was in my early twenties and had been passionate about medicine since I was old enough to make myself understood. At age 3, I received my first doctor bag and played nurse to all the kids in the house when they had croup, measles, etc. Girls didn’t become doctors in those days, but in my heart, I was Dr. Jan.

Now many years later,  I find the love of medicine and its many facets still has the power to thrill me and make me laugh or cry. While teaching my share of students medicalese, including doctors, it became clear that a little levity would be helpful. To help lighten the burden of sheer memorization and mental boredom, The MedSpeak Gamec was developed and played with gusto by personnel from a variety of medical fields to rave reviews.

I recognized as well the myriad of medical terminology books and tools available, but none seem to be used with such animation as The MedSpeak Game, so my work continues.

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