Thursday, January 19, 2012

Day in the life: Rotations

Appendix of the testis slide from webpathology.com
Yesterday morning my group went to a conference with one of the staff PAs and the second years where the second years presented interesting cases they've had recently and gave background information on the disease associated with the specimen. It was very interesting and we learned some things we wouldn't have learned otherwise (I can't be the only person surprised to learn about the appendix testis, right?). And while we didn't have an autopsy we saw a case signed out, and one of the autopsy PAs let us see the organs from the case from the day before which had some interesting findings.

Today we had brain sign out, medical terminology and rotations. Surgical pathology is fun and honestly learning the format for dictations here at Duke is the hardest part of doing smalls so far. For some reason I'm trying to say one word (like quote) and another one pops out of my mouth (colon). No idea why, but it is driving me batty! At least we're picking up speed and getting to do a wide variety of small specimens.

Derms are done in a way completely different from what I am used to, which means that so far the only advantages gained from three and a half years of grossing are 1. I can pronounce the word nevus correctly without thinking about it and 2. I know when to call something a macule and when to call it a papule. In the future I may also demonstrate some decent knife handling skills, but for right now this is what I've got :-)

14 comments:

  1. Speaking of dictation format...
    One thing I never do while dictating is say punctuation words like "period," "colon," "open parenthesis," "comma," and things like that. I can see how this may be necessary for people who dictate very quickly in foreign accents, though. For them, it's a necessity to do this; otherwise, the medical transcriptionists would go nuts. But if you speak clearly in English with the necessary pauses to indicate a new sentence, then the transcriptionist should pick that up and go with the flow.
    Just my two cents on dictation etiquette...

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  2. I'm surprised the places you have worked have been okay with you omitting all punctuation like that. I try to be as unambiguous as possible, but you are correct in that a good transcriptionist can usually fill in what should be there.

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  3. Why wouldn't they be okay with me omitting punctuation in a dictation? It's really not a shock. In the hundreds of dictations I've done so far, not once has a pathologist or transcriptionist ever come to me because of formatting or grammar issues. The only time I had to say something like "next paragraph" is when I had to dictate an FNA. That required its own separate formatting (i.e. on-site evaluation passes as adequate or inadequate). You probably haven't gotten to that level yet, but in any case, provided that you speak clearly, you shouldn't have to say "period" or "comma." Transcriptionists should know three things: medical terminology, spelling, and rules of grammar. If they're really good in those areas, then they shouldn't have a problem. And let me tell you...they should be getting paid a lot more for the work they do. A lot of them do so many other side duties than just transcribing.

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    1. This seems like one of those subjects where we will have to agree to disagree. I dictate punctuation because my name is going on it and I'm the one who gets called if something doesn't make sense. A good transcriptionist is invaluable, but I don't want someone else making assumptions about what I mean.

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  4. That's interesting Dr.D. Every Pathologist I've worked for added punctuation in their dictations.

    And I agree with you Thatgirl, SurgPath is a TON of fun!

    BTW, what kinda word verification word is "fartion"?!?!?

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    1. Me too. All the pathologists I worked under always stated punctuation words in their dictations. That's really not surprising though, since every pathologist I worked under was foreign and spoke with an accent. Even the medical transcriptionists had to come to me occasionally just to decipher what the pathologists were trying to say!

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  5. If my memory serves me correctly, I've worked around 15 Pathologists and only 2 were foreign. These were mainly in Academic centers and maybe that makes a difference.

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    1. In the practice I left to go to school there are currently 18 pathologists, and I worked with five others who have since retired/relocated. One of them had a noticeable Southern accent, one had a slight New York accent, but none of them had a foreign accent. And of the pathologists and pathology residents I've met at Duke (I haven't really been counting... but maybe 6 or 8 so far) no one has had a foreign accent either. Maybe it is also a regional issue?

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    2. Yep, that's probably the reason. In my private lab jobs, the dictations were all done by hand on specifically formatted sheets, so I didn't have to vocalize anything. But for the hospital positions, I worked in community hospitals serving underserved populations. That makes a huge difference compared to academic centers.

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    3. I'd forgotten about those but that sounds exactly right, community hospitals serving the underserved are filled with foreign Docs in ALL specialties.

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    4. Yep! It's amazing, isn't it? I really should go to medical school in about 5 years. Among the many reasons for doing so, one of them is to cut down on the outsourcing of foreign physicians into this country. I believe that we need more U.S.-born physicians practicing medicine here in the USA (whether the U.S. citizen gets the degree here or in a foreign med school, doesn't matter), especially in pathology.

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