Time for voice recognition software...

I...I hate people.

So I dictate my clinic notes, because it's marginally faster and is sort of the quickest way to get something into the patient's record. They get transcribed reasonably quickly, and then in theory we correct them and sign them, and all is well in the universe. Except...I'm not always the most conscientious about the correcting and signing step, because it often takes me almost as long to correct the damn dictation as it took me to dictate it.

The short version of this story is that I went into this weekend with sixty some dictations that needed attention, some from as far back as October. I've been neglecting them because, well, I have a crapton of other work to do, and it's in the medical record, so, is there really a time crunch on this? Apparently, there is, if we want to bill for it. So I've been getting all manner of nasty emails from my attendings that are like, sign your damn notes already, kid!

I'm down to 20. I've been doing them like five at a time because it takes so damn long and it pisses me off. Apparently we outsource our transcription to some little old ladies in India. Sometimes the syntax is off, in sort of the typical ways you'd expect from non-native speakers. That's fine. It amazes me, really, how many random typos are typically in these things - extra letters, too many spaces, line breaks where there shouldn't be, etc. But, fine. What actually gets to me is the crazy things that end up in the medical record that make no sense whatsoever, when, if whomever was transcribing took a minute to think about what they were typing, just a second, really, they'd figure out what they'd just said was ludicrous. I've been cutting and pasting some of the worst offenders...

"He is currently working on reading the Tail of Two Cities." (Hmm, I think I missed that one in high school...)

"He says he has been helping his dad with some construction projects, and supervising the construction of his grandmother's edition. " (Addition. Although...)

"He had begun calling her and taxing her incessantly." (Uh, that would be "texting". He is not a government official)

"The patient is handling this very well, and being very supportive of his friend, the deceased girlfriend." (That was supposed to be, "the deceased's girlfriend. It's different.)

"His family recently took a vacation to Cozumel, I believe, in the Caribbean." (They went to Cozumel, Belize, and the Caribbean. I know Cozumel is in Mexico, dammit!)

"He will go to the transplant percipient class, at which point he will go on the list for a kidney transplant." (From Merriam-Webster Online, the definition of "percipient" (n): a person on whose mind a telepathic impulse or message is held to fall. Um, please stop reinforcing my patient's psychotic delusions!!)

"She is concerned that this has gone largely and addressed." (Me, too)

"He presents today meeting a bridging prescription for his lithium." (Steve? Lithium. Lithium? Steve.)

"They have has no other complaints today." (That is was sure a good thing idea, there, hey.)

"She also has done two sits in rehab." (Hmm, maybe that's why it didn't work...)

"It was the first Thanksgiving without his grandmother, who recently passed out and that was a little difficult for the whole family." (Until grandma woke up, six feet underground because the rest of the family thought she'd passed ON.)

"He says that as long as he is alerting he is okay." (Well...then...carry on.)

"And that she particularly likes school because they are free, contained no clipart" (I have no idea what this means...)

"The idea of writing the letter but not sending it was discussed and she seemed to devaluate that." (Devaluate isn't even a word! It's like "ironical". And furthermore...I really just have no clue what the hell word I actually used there...)

"His property is routinely searched for code violaceous." (I hate it when that happens.)

"He is feeling like this man is 'how to get him'" (How is that, exactly?)

(In a continuing description of my patient's car accident, where he was driving on the straightaway with his dim headlights and missed the fact that the road was about to end, so he ended up in a ditch) "...and that it was very dark and his headlights particularly bright. He came to T in the road, coming on the strayed away, and crossed over the perpendicular road and went into a ditch. He severed only minor abrasions to his left hand."

"He also had surgery on his finger in 1992 after a crush." (Injury. Crush injury. That's an important distinction!)

"We will continue with Remeron 45 mg p.o. q.h.s. He is given a prescription for 50 mg tablets." (You've just got to shave 'em down a little, it's no big deal.)

"If her panic attach become more frequent, we will consider something like propranolol." (Or possibly a crowbar.)

"He says that he is not happy with his current physician, that he is a "kangaroo psychologist"." (Yep, that's exactly what he said. No, I still don't know what that's supposed to mean. But perhaps if he stopped going to veterinarians, he'd get better mental health care?)

"He states now that that was primarily over the mounting is fair." (I...um...huh?) (You know what I think that was, originally, actually? "Mounting despair". Yeah, different...)

"He notes that he is 'still measurable.'" (Well, thank God! No one likes an unmeasurable patient. Especially not one who's, say, MISERABLE!!! Really, people, this is not that hard!)

"There is heavy alcoholism on both sides, and his paternal uncle is a aeronautics." (Wow, he must be confused about why all those AA meetings are required for the space program.)


Idiots.

Um, but then there were the dumb things I actually did say...

"...and was initially initiated on amitriptyline..."

"The patient has a somewhat impulsive and minimally jerky kind of gait that his mother reports is at his baseline." (I...guess it gives you a picture of how this guy walks?)

"I will fax a copy of his lab report to Dr. X at [fax number], as well as the copy of his lab report." (Right before I fax him the lab report.)

"The patient denies any suicidal or homicidal ideation; however, she does note that she once considered throwing a plate of food at her father this week." (Hey, they say it, I just put it in the chart.)

"The patient was counseled that he should probably stop smoking marijuana." (Yeah, you know, sometime, when you get around to it...)

"She says that her symptoms have maintained at about the same level, although she does also state that her symptoms are significantly improved since starting the Celexa." (Honestly? I think she really did say both, but...)


And then...sometimes, maybe it's a little of both...

"The patient agrees that he probably needs to stop watching U-tube."


Oy. I still have 13 left, but, they're going to have to wait...