Dear Esteemed Sirs and Madames:
Like so many, I see the value of what you do. The more and more I type for you, I see what an asset it is to have a physician assistant or nurse practitioner available. It's very convenient for patients to be seen quickly with you on staff. I am honestly amazed by what you all can do and your good judgment calls. I think PAs and NPs should be a fixture in any clinical practice environment.
I have to say that most of you dictate better than physicians as far as documentation and overall enunciation. However, there are a few things that bear changing:
1. As part of an emerging field, most of you are fresh out of school and younger than me. This means you can probably type A through Z faster than you can put your signature on a prescription form. Therefore, when you say, "Oops, cross that out," what exactly do you mean? I'm TYPING, not chiseling. I'm not that old.
2. There is no such thing as increased "laxicisty." It's laxity. Anterior and posterior drawer signs indicate laxity. I went with laxity. If you meant increased elasticity, get some more underwear from your drawer and go with those tomorrow or order the patient new TED hose.
3. The word "larynx" is pronounced "lair-inks," not "lar-nix."
4. The word "pharynx" is pronounced "fair-inks," not "far-nix."
5. What, pray tell, sensation does smoking have? Cessation of this word in that context is requested.
6. There is actually a word called "or." It really does get used quite a bit more often than "nor." Either/or, neither/nor.
7. Are infusions of the knees common with laxicisty?
8. I'm sure COPD is an exasperation for people who have such. Those exacerbations are a real SOB.
9. Please pronounce "hepatomegaly" like this: hee-pat-o-meg-al-lee. "H'OH-megly" takes us a bit to figure out.
10. Please pronounce "splenomegaly" like this: splen-o-meg-al-lee. "Spl'megly" takes us a short time less, because you've usually already done "hepatomegaly" wrong and we've kind of figured out what might come next.
11. Please pronounce "hepatosplenomegaly" like this: No liver or spleen enlargement. Thank you. If it's in the abdomen and it sounds remotely like "he-pete-she-steena-ugly," we'll probably get it. Maybe. "No liver or spleen enlargement" works just fine.
12. What is "tope-ick-el?" What does that mean when you use that with steroid cream? Is this a new route of administration?
Please understand that we know we don't have your level of education, but it is still our job to make you (and your speed-demon doctor) quality documents. As more of our work goes over to India, the above gaffes are certain to leave your dictation full of blanks or just plain wrong when those speaking English as a second language can't convert. Voice recognition will do the same thing to you.
Thank you,
Your Friendly Transcriptionist
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If you really, really care:
My poor children are 12, 14, and 16. They are out of school. They like to stay up late.
They don't understand that our bedroom is on the ground level, next to the living room, with no door to the other exit of the room, which leads to the laundry room.
It really sucks when we're in the mood.
You try telling them why they need to go to bed. I hear the two go upstairs, but they come back down to tell me they're not tired.
Hub is not happy. I'm kind of que-sera-sera about it tonight, but it's a problem. It's hot up there, so that's all they do is sleep after turning on the window units and letting them run for an hour.
If they'd observe the rule that no one comes in after hub goes to bed at 9:30 p.m. or so, we might get away with a quickie, but, of course, everyone needs Mom at every hour of the day. If I don't answer an IM right away, in they come.
Frustrating.
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