Consciousness Raising Exercise #4

For the past five years, SMAC Transcription has had a full-service contract with CHF Hospital. All dictation is transcribed by professional medical transcriptionists who sign a contract prohibiting them from having direct contact with the agency's clients. Many of the transcriptionists are concerned about an ethical dilemma which has been thrust into their unhappy hands.

Dr. X is an internal medicine specialist with staff privileges at CHF Hospital. He is a notorious procrastinator who dictates very rarely.

On those occasions when he does dictate discharge summaries, Dr. X's thought processes are quite hazy. Often, it will take him 22 minutes to dictate a one-page medical report. His rambling dictation, total lack of coherence, slurred speech and occasional moments of snoring make it impossible for the medical transcriptionists to produce a patient record that has any clarity whatsoever.

Since they are being paid by the line, medical transcriptionists lose money while working on Dr. X's reports. In comparing notes with each other, many of the MTs who have attempted to transcribe Dr. X's work have come to the same conclusion: Dr. X only dictates when he is drunk.

When these MTs reported their concern to the agency's transcription manager (who lacks transcribing experience), he chastised them for daring to make such accusations about a doctor and refused to believe them.

These medical transcriptionists are so concerned about Dr. X's sloppy dictation that they are searching for a way to report his behavior without getting fired from the agency. One medical transcriptionist has suggested making an anonymous call to the State Medical Board.

In a 500-word essay, explain how the ramifications of such a phone call would impact:

• The medical transcriptionist who made the phone call.
  

• The transcription agency that has a contract with CHF Hospital.
  

• The risk manager at CHF Hospital.
  

• The medical record director at CHF Hospital.
  

• The State Medical Board.
  

• The local medical association to which Dr. X belongs.
  

• The local media.
  

• Dr. X's patients.
  

• Dr. X's private practice.
  

• Dr. X's professional colleagues.
  

• Any patient who is thinking of suing a physician for malpractice.