Tuesday, September 25, 2007

Trivial Pursuits

In the popular 1983 film entitled “WarGames,”Matthew Broderick plays a teenage hacker who, having gained access to a military mainframe, launches a computer game entitled “Global ThermonuclearWarfare.” What the adult (professional) computer people in the film cannot understand (but what Broderick’s character can) is that the computer is simply trying to play a game. Today’s digital divide has created a similar rift within the workplace among those who use computers as an integral part of their jobs.

Those who have been slow to adapt to today’s new technology may still be struggling to learn the basics of multitasking. Some of these people find it extremely difficult to concentrate with several programs running simultaneously. Because they can only remain focused on one thing at a time, their linear approach to what they do is starting to work against them. How so? These people did not grow up playing video games. They don’t do well fending off attacks from Space Aliens and evil thugs in one screen while trying to enter data in another. Their professional pride is easily offended by the “rock’em, sock’em” approach evidenced by younger workers who couldn’t care less about detail and have limited spans of attention. The younger generation’s idea of long-range planning is sometimes best summed up with the words: “You mean, like, Friday? Kewl!”

Those on the “kewl” side of the digital divide know how to use the Internet for all kinds of purposes while dividing their attention between fun and work. What allows them to make it through an eight-hour day with such ease? The fact that they’re being paid an hourly wage. The fact that they view a computer as a source of entertainment as well as a professional tool. And the fact that they may have no plans to turn their current job into a career. Time flies when you’re having fun.

In May, 1999, a strange and curious phenomenon took place. Due to the huge number of workers who were expected to call in sick, many businesses in Silicon Valley were forced to shut down on the day that “Star Wars – The Phantom Menace” debuted in movie theaters. News reports showed geeks and nerds camped out on line in order to get tickets to the initial screenings. Diehard Star Wars fans boasted to reporters how happy they were to be among the first to see the film (even if it meant being fired once their bosses saw them on TV, talking to the media). A friend who has worked in human resources for many years warned: “What we’re witnessing tells us how little work actually gets done on a day-to-day basis at these companies.”

Recent articles have bemoaned the huge number of employee work hours lost while people use the Internet to check their stock profiles, read personal e-mail, send jokes to friends, play video games and download porn. But today’s employers are caught in a curious bind: Do they crack down on employee use of the Internet at work? Or do they risk losing good employees? Do they tackle the additional costs of recruiting and training new employees? Or do they look the other way and accept the distractions available on the Internet as an integral part of today’s work environment?

The Wall Street Journal reports that, shortly after Thanksgiving, 22 people were fired from the New York Times’ business office in Norfolk, Virginia for using company e-mail to distribute sexual images and jokes about blondes, Ebonics, men and women that were deemed to be intolerable in the workplace. Other large corporations are struggling to find more enlightened, employee-friendly solutions to the problem. Ford Motor Company and Delta Airlines recently announced plans to give all of their employees home computers (perhaps hoping that, while on duty, their employees would stick to using company computers for company-related tasks).

Surfing the Internet during work hours opens up a Pandora’s box of contradictions for medical transcriptionists. For many, the Internet provides the answers needed to complete a doctor’s mangled dictation. But as employees or independent contractors who work on a production/incentive basis, the amount of time spent on the Internet can quickly eat into their earnings. Caught in a web of Catch-22 choices, some feel damned if they use the Internet and damned if they don’t.

Why should MTs be using the Internet as an integral part of their work? First let’s talk about research. Traditionally, a medical transcriptionist’s key resources have been hard-copy drug indexes, medical terminology word books, telephone directories, medical dictionaries, etc. But due to the high cost of printing new editions, these reference sources are often out of date or filled with scribbled notations about new medical terms and drug names. They also cost money.

Where are updates more current? And often free? On the Internet.

Being wired to the web doesn’t guarantee that the time spent searching for a medical term (or some physician’s address) will be a cost-effective use of a medical transcriptionist’s skills. And professional MTs must struggle to control their knee-jerk response to look something up – even when they know that doing so will only lead them on an electronic wild goose chase through cyberspace. Should curiosity kill an MT’s earnings?

  • Not if a physician dictates a letter to Dr. Smith in Pennsylvania. Don’t even bother trying to look up the address!

  • Not if a physician can’t be bothered to spell the patient’s name correctly.

  • And what if -- even with the help of a powerful search engine -- an MT can’t find a new medication in less than two minutes because there simply may not be any documentation available on the Web? Read my lips: Surrender, Dorothy!

When a physician screws up his dictation because he is mumbling, unintelligible, doesn’t know what to say (or is simply too lazy to deliver the data needed to create a meaningful medical record), that physician’s failure to communicate is not the fault of the medical transcriptionist who is trying to convert speech into text. Voice recognition software isn’t going to fill in the blanks with any more accuracy than the Psychic Friends Network. Neither should an MT.

Let’s change course for a moment to talk aboutusing the Internet for continuing medical education. How do you keep current on new drugs, new terminology, new software tools and industry trends?


  • You could wait for the traditional publishing cycle to bring information to you via snail mail. Or you could spend your time online learning from those peers and professional colleagues who subscribe to the KAMT-list mailing list, Usenet’s sci.med.transcription newsgroup or Arleen McGovern‘s excellent, informative website at www.mtdesk.com.. In many situations, the answers to your questions can be found online 24 hours a day, 7 days a week.

  • You could spend several hundred dollars to register for a conference hosted by a professional organization like AAMT, MTIA or AHIMA (let’s not forget to add in the cost of hotels, airfare, meals, and time lost from work) only to receive the information that was designed for the program at that particular conference. Or you could spend anywhere from 5 to 60 minutes a day (in the comfort of your own workstation) surfing the web, focusing on material that is more time sensitive, and researching topics of greater interest to you.

  • If you’re desperate, you could try to find out what’s wrong with your hardware or software configuration by waiting on hold for 30 minutes during a pricey long distance phone call to a technical support hotline. Or you could go to the vendor’s website, search for answers that might be contained in an FAQ, or seek help from a user’s group on the Internet.

Last, but certainly not least, let’s talk about professional networking. In today’s harried world of 24/7 availability, we feel the pressures of time more severely than ever before. Many of us don’t have time to travel to/from meetings because our lives have become too busy. Some have family obligations, others are running small businesses. Some have hobbies and creative pursuits; others need peace and quiet. Some have killer migraines; others are working out at the gym.

In the strangest ways, the Internet allows us to steal tiny increments of time throughout the day in order to accommodate our personal and professional needs. When professional time spent online doing research keeps interrupting an MT’s work (and pushing back deadlines), we’re often forced to ask ourselves: Am I being less productive? Or more productive? Am I broadening my education at little or no cost? Or simply wasting time? Am I keeping up with what’s happening in my industry? Or am I really procrastinating, having fun, and just looking for an excuse not to get back to work?

Sometimes the Internet allows us to mix business with pleasure in curious ways. Last summer I bought a Logitech QuickCam for my computer and discovered a very popular teleconferencing program which can be downloaded at http://www,icuii.com, Without going into the lurid details of what some people will do in front of a camera, let’s just say that teleconferencing offers new ways to “reach out and touch someone.” I’ve also met several physicians within ICUII’s community of subscribers and, as part of our online banter, we occasionally chuckle about our experiences in the field of medicine.

Readers of this column may remember a story I shared last year about the Asian plastic surgeon who once dictated “The patient comes to the emergency room following motor vehicle accident with segmental pussy all over his face.” On the day that I had to transcribe that report, I enlisted the professional ears of four seasoned medical transcriptionists. We all took turns listening to the doctor’s dictation but, despite nearly 100 years of shared experience as professional MTs, not one of us could decipher what the physician meant.

I’ve been haunted by that puzzle for nearly ten years. But several months ago I found the answer in the strangest way imaginable! I was in video chat mode on ICUII with a tall, handsome, hairy-chested ophthalmologist in Great Britain when I related the above-mentioned story. A look of stern confusion crossed Rod’s face as I typed the words “segmental pussy.” That look was quickly replaced by a cynical smirk as the good doctor typed his reply.

That’s palsy, u bitch!”

Some answers just can’t be found in a Stedman’s medical reference book!