Medical Transcription: How do you walk away?
Medical transcriptionists often find themselves completely absorbed in their profession. In the last few weeks, I’ve heard from many MTs who talk about working more than one job, trying to juggle involvement in their professional life, and somewhere in between all of that, trying to take care of their family. If you are on Facebook, MTs posts are often full of posts that say something like “I have to get more work done tonight” or “I’m taking a break but now have to get back to work so I can get more lines today.” Then there are those posts that say “No work today, it’s time to look for a second job.”
For the medical transcriptionist who works from home, this is an ongoing challenge. It’s so easy to just go back to the computer for “a few more lines.” And somewhere you realize it’s been three hours and you’re still not done. I’ve often heard children whose mothers were a medical transcriptionist working at home say all they saw of mom was the back of her head as she sat at the computer.
Who Controls if we Walk Away?
This week I’ve been particularly aware of what we do to ourselves when we get sick. If you’re in an office, I think it’s a bit easier. You can’t take your germs to work and expose your coworkers, so you have to call off, stay home, rest and take care of yourself. That’s often not the case when you work from home. You work anyway, because you’re home, because you can stop and start when necessary, because everyone expects it, and well, because those bills need to get paid. For me, this has hit home this week as I was told the first of the week that I could have pneumonia. (“Could” being the operative word since, with no insurance, I declined the $500 chest x-ray.) And yes, I have continued to work, simply because I work from home and things have to get done.
Today I’m wondering why we do this to ourselves. This is a profession where it’s simply hard to unplug. Or is it? Is it really that hard, or is that something we do to ourselves? Or is it something that others have grown to expect from us so now we can’t let go? Even when I had a corporate job in my last position, I worked from home and I worked when I was sick. In eight years, I took off twice, once for major surgery (I was out two days before I was checking email) and once because of a doctor-prescribed time off with migraines (it was just too hard to see the computer with those migraines). At the same time, what I experienced, even in a company where the mission statement said human resources were valued, etc., even if I was sick, I still got those phone calls at home.
Once you set an expectation that you will be around no matter what, people begin to expect that from you. It leads to situations where even in times when you probably really need to walk away, you can’t.
I understand sometimes it’s a financial thing. Many MTs work as independent contractors, which means no benefits and no paid time off. And no paid time off often means work or the bills don’t get paid.
This doesn’t just happen when someone is sick. It’s the same thing with vacation and time off. Many MTs just don’t do it.
The Benefits of Walking Away
There’s a real benefit in walking away from your job now and then. It allows you to come back refreshed. It can give you new perspective. And if you sick, it gives you downtime to heal and get well. Make an effort to take some time away from what you do, it can make all the difference.
How about you? Do you struggle with walking away? What tips can you offer on how to walk away when you need to?
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Related posts:
- Medical Transcription: Why Choose It?
- Medical Transcription: 4 Pros of Working From Home
- Medical Transcription: Do We Accept the Status Quo?
- Medical Transcription: Where do You Make Your Investments?
- Medical Transcription: Professional Organizations
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I have found that there are times of what I call “feast or famine,” and although my bank account might feel the pinch when there is no work (or less work than I’d like), there is really nothing I can do about that. With the account I’m current working on (as an IC), I am responsible for all of the dictation for one doctor. On any given day, he may see from 0-40 patients, and I generally have until 5 p.m. the next day (or in the case of a Thursday p.m. clinic that I don’t get until Friday morning, it isn’t “late” until after 5 p.m. the following Monday). At any rate, I really have NO control over what work I GET. I also know that “my doc” is taking off January 17, 18, 19, 20, 21, and 24, so for those days, I am going to be transcribing only ONE clinic for a doctor who I cover the Thursday p.m. clinic for, and that will be my “income” for 6 entire days. Thankfully, my husband has a good income, so as long as he is employed I’m not too worried. I honestly don’t know how single moms or single women or women whose husbands might be unemployed are able to handle being the breadwinner in an industry that doesn’t make it easy for us to even sometimes earn “minimum wage.” When you work for a relatively small transcription service (when compared to certain others that I won’t name, I mean) and you basically don’t have “secondary” or “tertiary” accounts, even in the best of times “making a living” can be impossible without a LOT of outside help, shared expenses, multiple incomes, etc. For me, I’m grateful that I don’t get sick often, but I’m more and more lately having a problem with headaches again. I’ve known people who in their entire LIVES have never had a single headache, and I’m envious. But I began having migraines back in my very early 20s, and they can be 100% incapacitating for days on end. I will say that at the first sign of ANY kind of headache, I will let my coworkers know that I have to take something and go rest for a while to try to get rid of my headache before it becomes a screamer. (During that time, if a request comes for STAT transcription of any of my doctor’s dictations, someone else can cover it for me…and I’ll take care of the rest when I’m feeling better…and we all cover for each other that way.) If I can’t get rid of it (my headache) early, then there is no hope of getting rid of it in less than 2 days minimum. The BEST thing I can do in order to meet my work requirements is to take those pills, rest, and let them kick in. When I have even a minimal headache, it is IMPOSSIBLE to concentrate well enough to let those “voices” that I hear get past the pressure I feel in my head, around my eyes, even associated with my ears…and every little sound that I hear (which becomes magnified about a thousand times and is very painful).
You have two choices here in my opinion: (1) You can try to work through it, in which case whatever is ailing you might make your concentration go down the tubes, which may cause you to make and not catch errors that you normally would not make or that you would catch before hitting that “send button” or (2) you can be someone who uses her head and doesn’t get in her car to drive to work just 5 minutes before an all-encompassing blizzard from hell hits your entire county forcing a total standstill for longer than if you had just had the common sense to hole up until the storm passes…I hope you can understand the analogy I’m trying to make here. I guess it all boils down to this: Use your common sense and make decisions based on “what in the long run is best.” If you work when you are not well and all you can really focus on is the fact that you feel like crud and your work actually becomes substandard to what you usually turn out, what will it do to your accuracy and professional reliability as someone who does excellent work? Aren’t you better off taking a day off (or even a few hours off), taking your big-girl pill (or whatever other medicine you should take), and allowing yourself to recover and THEN resuming work when you can be there fingers AND brain 100%? It doesn’t matter to me that I work at home and can’t “spread germs” to other people so I should stay home. What matters to me is the quality of my work,and if I can’t give it my all because I can’t see or can’t concentrate (or I can hear the blood flow in my head 50 times louder than I can hear the dictation), then I need to try to heal the problem before I do irreparable damage to my reputation for putting out good quality work.
I hope that makes sense.
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Kathy Reply:
January 13th, 2011 at 9:32 am
Sherry, it does make sense. What I wonder at the same time is our tendency to not say wait, I’m doing this (taking care of myself) for ME. I just think working from home sometimes makes it harder to stop and do that.
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Oh boy, did you ask for it
I can’t talk now, but later on today I will be back because everything you have talked about I have gone through this year. Don’t know that I have stellar advice, but I have certainly been there, done that (as the saying goes) and came out the other side still walking 
Nae
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Kathy Reply:
January 13th, 2011 at 9:32 am
I know you have, my friend, and will look forward to you adding to this one.
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Very interesting topic and even more so the response. I can relate to excruciating headaches Sherry, migraines can be a *show stopper* for sure! I have heard from others who are MT, pretty much what Sherry said, feast or famine. Seems to be a line of work one would choose because they like it and not for the money. I am currently in training and already seeing the pros and cons to working from the home. I am even more excited and determined to make this a success for me, not necessarily expecting big bucks but rather being successful in the sense I can do a great job with the satisfaction at the end of the day that I did my very best!
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Kathy Reply:
January 13th, 2011 at 9:34 am
Suzanne, you bring up a really interesting point and one that I’m working on for a new post, which is why do we do this anyway! I think it IS often about the personal satisfaction one gets from what they do. More to come on that soon!
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Sherry Evans Reply:
January 14th, 2011 at 4:20 pm
Suzanne:
When I mention “feast or famine,” I want you to keep in mind that a lot of people work on larger hospital accounts and generally, except for holidays when work may come to pretty much of a standstill, it’s generally NOT the “feast or famine” that those who work on smaller specialty-clinic accounts (like I’m working on right now) face. There is a HUGE difference between working on an account where there are like under 10 doctors versus many hundred that will work in a larger hospital setting, and also…there’s the chance that even if you work on a hospital account there may still be at least ER notes that need transcription while doctors themselves might not be scheduling surgeries, etc. during the bigger holidays. There really is SUCH a variability in workload depending upon the size and type of facility you work for. Don’t let what I said earlier discourage you at all…it wasn’t intended for that.
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Kathy Reply:
January 14th, 2011 at 11:35 pm
Sherry, good points. I also know of hospital MTs who just this last month were told they had to take their vacation to “save” their jobs because the workload was so low. When a manager asked me why that would be upsetting, I said, I get it. If you’re afraid, and we all have a bit of fear in us when the workload drops, then you want to hang onto that vacation time because it might be what sustains you if you get laid off. It’s a challenge all over sometimes.
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You described my MT behavior almost perfectly, Kathy. This is so true – “once you set an expectation that you will be around no matter what, people begin to expect that from you. It leads to situations where even in times when you probably really need to walk away, you can’t.”
Unfortunately, it is often feast or famine with medical transcription. Fortunately, we often can make up for the famine times by taking more work in the feast times.
I haven’t taken a real vacation in years. My last vacation was a week in the hospital a few years ago.
I work long days all the time, so when I take time off, I have to do double to catch up. Many years ago, I tried to find MTs to cover for me for a vacation. That NEVER worked out well. So it has become my habit to forget taking a vacation because all I think about is how hard I will have to work to get all the work done that waited for me to return.
I could definitely use some tips on how to break this habit. Even as I sit here writing this, I just got an IM about a report needed asap. Gotta go.
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Kathy Reply:
January 13th, 2011 at 3:45 pm
Lisa what you just described here is often the “norm.” I remember with my last job deciding to take a cruise. It was a once in a lifetime opportunity to do 10 days in Western Europe. My cell phone didn’t have international service and I was pretty much disconnected during that time except for the two times I actually checked email from the ship (didn’t do that too often because of the cost). It was perhaps the most relaxation I had had in years and I absolutely believe we all need that now and then. I’m sure this is a topic we need to discuss more in our profession!
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I, like many others, find it very hard to walk away from work when I am not feeling well. I say to myself “just one more report and then I will log off for the day.” Then I look up and an hour has passed. This profession is one of “feast or famine” and I know how guilty I feel if I miss any much-needed work. Hopefully, knowing what we are doing to ourselves and the quality of our work we can make a few changes in how we handle it. My goals this year are to listen, learn, and grow and I think I will REALLY start to listen to my body, learn from others suggestions, and grow to where I can say “enough is enough” and walk away from the work.
This has been an eye-opening topic for me today and I really appreciate the wisdom that is always shared here.
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Kathy Reply:
January 13th, 2011 at 3:46 pm
I think we often forget the “what we are doing to ourselves” when we get in this mode. And once we get into it, it’s tough to get out!
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“Unless you tell me No and mean it I will push to get as much work as I can out of you in as short a time as possible.”
The MTSO I have worked with for a little over 15 years said that to me on the first day I came to work for her. It took me years to figure out she meant that literally, and I have never forgotten the sort of steely glint lurking in her expression at the time (Carole probably puts the steel in the southern expression “steel magnolias), but like all new MTs I was green and eager for work on any terms. I sort of chose to blank that out of my mind at the time.
It has taken me years to understand the unique pressures and pitfalls a small MTSO faces, the concessions they must make to stay operating … and the compromises at-home MTs will cave in to in order to keep working at home. I imagine most of the MTs who work for smaller services eventually learn these lessons, especially ones working for services with very low staff turnover.
I have been extraordinarily lucky in that the MTSO I work with and I have developed a close friendship. We are able to share and talk about those business-related issues that many employers/employees never discuss. Yet, when all is said and done, we still maintain a worker/owner relationship of sorts and I never forget that the bottom line is her call … if there is no work, there is no work, no matter how long one has been with the company.
For the last 2 to 3 years I have struggled to make the move from full time to part time for a variety of reasons, family illnesses/time responsibilities, increasing difficulty keeping my fanny in the chair because of degenerative joint disease, arthritis. We all have our reasons, but sooner or later the sheer physicality of the job catches up with us no matter how much we want to think that we will be one of the lucky ones still plugging away at 80.
There was always been a reason the “timing was not right” for me to have made the move, new accounts that needed seasoned MTs only; loss of other MTs due to moving, divorce, sudden illness, death; inability to add new MTs to the staff because of ever decreasing line rates; low work loads … always a perfectly sound, understandable reason, and, frankly, I am a team player in that sense, it is easy to “guilt me” into working against my body screaming at me … nooooo, it is time for you to cut back. I grew up with the “loyalty for those writing the paycheck” mentality from my parents, so I kept struggling to maintain that full time work load, to be a team player, to do what the boss wanted … just hang in there a couple more months, a couple more weeks, I promise I will start trying to hire and train someone to share the load; maybe the hospital will let me add another part-time person soon … that is what I would hear, and I could always be counted on to work hard, work long, work days and days without breaks if that was what was needed; work sicker than a dog. Employers love staff like that. I have worked with Carole for year through the hiring/firing/loss of MTs while trying to find those select few who will end up being “keepers.” Small businesses live and die by the time/quality of staff loyalty and nothing can change that bit of reality.
There was always the issue of money as well. Our needs are pretty minimal and, luckily, in this economic environment everything we have is paid for, but the escalating cost of insurance (health, life, house, cars, commercial liability for his business) is a harsh cost for all of us in one way or another … and it means working at least part-time no matter how much I would wish otherwise. A week ago I had to have that final conversation with my service owner … as of today I can no longer guarantee you an 8-hour day, this is how long I can work and that is it … lucky for me this time she accepted that with no argument, but it took me a couple of years of “discussing” to get my nerve up enough to say that’s it, mean it, and accept that she just might say sorry for your luck, I need full time or nothing. Hopefully others will have the strength not to dither over it like I did when the time comes.
It always gets me in trouble when I say this, but I have not recommended MT to anyone who is single and must pay the bills by themselves in years, especially if those folks have children to support. Sure, there are those who have “done well,” but, quite frankly, in my experience the numbers of those who do well are increasingly smaller and smaller compared to the many, many struggling MTs who are lucky to keep the power bill paid so they can even boot up the computer. Sort of like playing basketball or football, only a very select few make the big bucks in the big leagues and we rarely hear about the struggling ones who never get their face on national TV.
I think MT is, and has been for a good many years, a second-income job. I also think that is a reality our profession prefers to pretend does not exist.
Nae
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Kathy Reply:
January 13th, 2011 at 3:48 pm
Nae, I believe you have nailed what happens to many MTs. And we DO have that loyalty built into our make up, which often makes saying no even harder. And by the way, nobody will be “in trouble” here for saying what you think!
If we can’t have dialogues like this, I think we’re really missing something.
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Linda Kirvel Reply:
January 13th, 2011 at 11:44 pm
Nae,
I really appreciate your straight up mannner of talking. I like the way you tell it-either good or bad-but always honestly. I always enough reading you post when you visit here.
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I think for a lot of us it isn’t a matter of not being able to turn the computer off but rather of needing to pay the bills. I know a lot of MTs only making 4-5 cpl on SR editing but have such horrible reports to work with they struggle to stay at even the minimum speed and bring in minimum wage. Fortunately that isn’t the case on my account but I still end up spending a lot of time at the computer, not because I want to but because I have to. Some of that is my own fault. I take a break, check e-mail and am still sitting here. If I worked in a more focused manner I could get in and get out and be done faster.
I agree with Nae 100%. MT was WONDERFUL for me when I was a secondary income. If we had a smaller family even it would be okay. I would certainly be fine on my salary if I was single (maybe), but I cannot keep my family of 6 afloat as an MT. I know some MTs personally, and have no reason to believe they are not being truthful, who bring in 4K + a month and sometimes more. Every month I swear I am going to make a number that high, it has yet to come close to happening.
I’ve only been working a year and a half so I remain optimistic, but in regard to why I sit here all day the answer is a very simple “because I have to.”
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My husband is retired on a meager Social Security benefit, and I am and have been the major wage-earner for many years, so there’s a lot of responsibility on my shoulders. I work on site, and get great benefits, two being all holidays off and generous vacation accrual. I am generally a healthy person, thank goodness – haven’t even had a cold in 2 years, even being around grandkids! My boss says if I call in sick, she KNOWS I’m deathly ill because I’m at work every day. (As in this morning, when my husband and I were out at 4:15 a.m. in the dark shoveling over a foot of snow in our 50-foot driveway, so I could leave at 5 a.m. One day last year the snow was so bad that we got stuck in the driveway trying to get out, tried to back up, and got stuck in a snow pile in the yard, and had to pay $80 for a tow to the street – but I made it to work, albeit 30 minutes late. I told everyone that day that I paid $80 just for the pleasure of coming to work!)
I take my job seriously and work my butt off for the 8 hours I’m there, then I go home and forget about it for the most part. When a slow period comes up, like the week after Christmas, I’m the first to volunteer to take a few days off. Sometimes it happens on the spur of the moment, and my supervisor says, “OK, you can take off the rest of the week, or take off tomorrow, or whatever.” I always have plenty of time in my vacation bank and enjoy using it sometimes for a couple of days here and there just for a break. I strongly believe everyone needs time off to recharge, especially with the stress of this job. I’m really lucky I have the benefits.
I have one rule: I can’t work when I’m nauseated. Just can’t concentrate.
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Sarah Reply:
January 13th, 2011 at 11:11 pm
Carol, do you like working on site? Have you ever worked from home? There is a local hospital that is known to be an excellent employer that is hiring an MT right now. If I applied I have a foot in the door because my dad is an admistrator. I would love to need to leave the house each day but then there are all the costs associated with working. It probably wouldn’t be right for me at this phase in my life, but I was just wondering what you think of on-site work versus at home if you have done both.
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Carol James Reply:
January 14th, 2011 at 5:50 am
Sarah, I have never worked at home. I keep thinking about it, because I’m essentially an introvert and don’t enjoy the socialization of an office, but so far it hasn’t happened. I want to keep a presence there so they don’t take me for granted and so I can keep in the thick of things as far as knowing what the heck is going on. Also if I worked from home I’d have to have a PC and I only have Mac, so I’d have to make room for a new computer. Also, my “office” at home is rather chilly in the winter and warm in the summer, and I rather like the hospital paying for my heat and A/C! A big plus is that the hospital has a wonderful salad bar in the cafeteria, and I get a big chef’s salad every day for lunch. I’d really miss that. The final plus is that in Maine, everyone dresses very casually so I don’t spend a lot of money buying clothes. For instance, we can wear jeans as long as they are any color except blue. One of our receptionists in Medical Records actually came to work in a hoodie sweatshirt with writing on the front – !! I like to dress up and look a little more professional than that, but very casual is still acceptable.
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Sherry Evans Reply:
January 14th, 2011 at 4:41 pm
Sarah:
I have worked both in a hospital setting (2 hospitals actually–strictly doing radiology transcription and the other doing everything BUT radiology transcription). At that time, I was making $13.XX/hour, getting wonderful insurance benefits, and having payroll taxes taken out (of course). I wore either what one might consider “business casual” or “dressy casual” (but never allowed to wear things like blue jeans, even though I worked the last shift, which was 3:30-11 p.m. M-F). It was about a 20-minute drive each way on good highway between 2 relatively small towns, so the travel was never really an issue even during rather wicked weather.
I will say that the two things that weighed AGAINST working on site was (1) the “hospital politics” and (2) the union. The hospital had 2 unions, and membership was NOT optional. As a transcriptionist and union member, when the amount of work dropped for us significantly, my position was cut. Although I had been in the department for 11 months, a girl that transferred INTO our department and had only been there 3 months was NOT laid off because she had 3 months more HOSPITAL/UNION seniority than I had. (Department seniority didn’t matter at all.) At the meeting where I was told my job was cut, I was told that there was one other employee at the hospital (in the Food Service area) who had less seniority than I did, and I could bump that person from her job and I absolutely refused.
When you work at home but work for a service, you may still face the same issues, but they will appear in disguise because of the fact that you work online. In a manner of speaking, there are still some “politics” involved, although it’s difficult to describe in words…to me, it’s almost more of a “feeling” than something I can put into words. It is possible that you may at times not have work; then again, as I said in another post, it’s entirely possible that based upon the type of account you are on, you might NOT have periods of famine. There are just so many variables! It’s nice working at home, but you still have “good days and bad days.” Maybe you have young children; they will affect your work and possibly your work availability. Maybe you have no children; maybe you have health issues yourself and between things like headaches and doctor appointments, you may have to take things like that into consideration before making specific work commitments. Maybe you will work for a service that only hires on an employee basis (not hiring anyone on an IC basis), and they make schedule “demands” that can be VERY strict…again, if you have children, you could find yourself talking to your supervisor about some compromises or even needing to change who you work for if the situation just doesn’t work out for you due to circumstances at home. In some ways, although working at home can have innumerable benefits, sometimes having a reliable schedule that gets you out of the house and among other adults during X-Y hours of the day 5 days a week can be a sanity saver.
There are good and bad points to both work situations. You just have to weigh them for yourself and see what seems best for you at the time, and don’t be surprised if “what seems best for you” changes over the years. I’d be surprised if it didn’t!
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