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Finding the Best Medical Professionals Using the Internet in Six Steps

Image of Medical Professionals Research Spreadsheet

Introduction

This topic is close to my heart. There are those I love who really really need to get medical attention but have been frustrated by the ineptitude of some medical professionals. I’m writing this for you – yes, I really mean you! Pretty Please???

I’m also writing this to you, passing traveler on the information highway, because I want to see you find the medical care you need as well. I know you may be frustrated by multiple negative experiences, but I hope you’ll try using the method I outline below – I have been repeatedly satisfied with the results.

1. Finding Medical Professionals Covered By Your Health Insurance

The first step is to pull up your health insurance website and find the directory of providers covered by your insurance.1If you don’t know the website of your healthcare provider type it into a search engine like Google or DuckDuckGo and it should appear in the results. Here are links to those directories of providers on several of the largest health care insurer’s websites:

To get accurate results you’ll need to enter information about the health insurance plan you have (see your health insurance card) as well as the geographical locale in which you live. You should see a list of providers once you have provided the necessary information. Found it? Great!

2. Creating a List of Medical Professionals

Your next step is to create a list of medical professionals covering the sort of care you require. At this point I recommend creating the list without concern for who will be best or worst – instead, look at how close they are geographically to where you live.

I find that it’s best to add all of these individuals to a spreadsheet, and I’d recommend using Microsoft Excel,3If you don’t have a copy of Excel available, you can use the free online version. Google Sheets, or AirTable. I’ve created a list provider spreadsheet template/example you can use.

Image of Medical Professionals Research Spreadsheet

In the first row you can place your column headings, which describes what will go in that part of the listing. I recommend starting with Provider Name, Distance (from your location), and Location (city).

Once all of the potential medical providers are listed in the spreadsheet, we are ready to move on to the next step…

3. Adding Health Professional Reviews to Your Spreadsheet

The next step is to go to a search engine (Google and Bing both work well) and to type in the title and then name of one of the providers followed by the city they are located in. This helps ensure that you get results for the correct practitioner – oftentimes multiple providers share the same name – even unusual ones!

In the image below you can see the results I received when entering “dr michael looney delmar” into Google. Notice how there are stars next to some of the results? These are the ratings the people on these review sites have given Dr. Looney–just like a product review on Amazon! You can visit the sites to see more details, but usually what we need is available right on the search results page. We are looking for the name of the review site, the rating the provider received, and the number of reviews the average is based on.

Image of Google Search Results

Now the spreadsheet you’ve created will need additional columns- two for each health review site we want to use. I have found the following to be among the most helpful review sites:

  • Healthgrades
  • Vitals 
  • Zocdoc – The nice thing about this one is that you can set up appointments through the web and there tend to be numerous reviews for doctors who participate in Zocdoc.
  • RateMDs
  • UCompareHealthCare
  • Wellness
  • PatientFusion – Good resource, but reviews seem to be largely limited to practitioners who use PatientFusion.
  • WebMD – They got into the game quite late, and while I expect them to continue to grow in quality, it’s hit or miss whether there are reviews of any given practitioner.

Here is a screenshot of the example spreadsheet I mentioned previously:

Image of Medical Professionals Research Spreadsheet

Note what I’ve done:

  1. I’ve shrunk the size of each column relating to the review sites as small as I can. This allows us to see all/most of the relevant rating info at once instead of needing to scroll right and left.
  2. I’ve shrunk the names to fit within the columns by using an abbreviation.
  3. I’ve created a column on the far left that explains the abbreviations I’ve used, for example, HG means HealthGrades.
  4. For each review listed on the Google Search results, I added the rating to the first column for that review site and then the number of reviews to the second column for the same review site.
  5. I also created another column that covers sites that I’ve found don’t usually have reviews of practitioners, but when they do can be a helpful source of information – in this case Facebook and Yelp.

I usually look at the first 2-3 pages of results to see what review sites/ratings show up. You’ll note that a number of the review sites columns are empty – this is because the review site/rating did not appear in the search results I’m seeing. That is perfectly okay!

You’ll then repeat this process for each provider on your list.

4. Picking the Best Medical Providers from Our Spreadsheet

Once we have our spreadsheet filled in we can begin to analyze the list of providers. Look for those with the highest scores across the most sites and from the most people. Soon you should have a few stand-out choices. If you don’t come up with any good choices, you can go back to the health insurance site and look at other providers further away. I know that isn’t what you want, and in most cases you shouldn’t need to, but it does happen sometimes – especially if you live in rural areas.

A couple tips on choosing the best providers:

  • I like to bold scores / number of reviews that are particularly high, this helps certain providers to stand out – especially if they have good reviews across several sites.
  • I like to italicize reviews that are particularly low, especially if they come from a high number of reviews. Again, the providers who have consistently poor scores across sites should begin to stick out as well.
  • While searching you may notice news articles or other helpful sites outside of review sites about a given provider, these can be of significant value.
  • Because you are looking at the consistently highest rated providers you may run into a few who have full schedules or for some other reason can’t see you, that’s okay, just move to the next person on your list.

5. Additional Things to Consider When Choosing Healthcare Providers

  • Don’t abandon the tried and true ways of finding a provider – talking to friends, family, co-workers, and neighbors! Their advice can be golden and you can then validate their recommendations by adding them to your list. You may find there is significant overlap between who people local to you recommend and who seems the best based on online reviews.
  • Don’t forget to talk to any medical providers you currently have that you do like. They are often more than willing to make referrals to other providers who can meet your needs. Once again, you can validate the recommendations by adding them to the spreadsheet and comparing them to the providers you have looked at on your own. Hopefully you’ll see significant overlap!
  • Remember that we humans tend to review services we feel strongly about – positively or negatively. Just because a doctor has some bad reviews doesn’t mean they are a bad provider overall. This is why I recommend looking across multiple review sites. In general, the more data you have, the more accurate the results (which providers are best) will be.
  • In my experience, some professions have generally lower scores than other professions. For example, you may find pediatricians who have 5 stars on multiple sites from multiple reviewers, whereas for psychiatrists or oncologists you might find that the highest scores are 4’s. There are various reasons for this, one being that some professions deal with more intractable problems than others.
  • Just because the reviews say so, doesn’t mean the medical provider is perfect or infallible. Use your own best discernment to determine whether the provider is a good fit for you.
  • Some really good practitioners are eccentric or abrasive. You have to decide if their particular type of eccentricity / abrasiveness is something you are comfortable with. For me, I don’t mind a practitioner who lacks social graces and is a bit abrupt at times, but this may not work for you – and that is okay.

6. Getting the Care You Need at the Appointment

Some medical professionals will walk you through the care process from beginning to end. Others will do so only if you specifically point out to them the issue you are having. Yet others will be effective in their particular niche but won’t provide any sort of overall support when multiple providers are involved. I think all of these types of providers can be good providers – but the way you approach them needs to be different. Don’t assume that the doctor knows what you need or want, tell them the information you believe is relevant (try to be as concise and specific as possible).

If the provider recommends a medication or treatment and there is another you’d prefer, tell them so, and ask them if that would be okay or if there are specific reasons they are recommending one course of treatment over another. Providers oftentimes have a “go to” treatment/medication that they have seen success with, but if you mention another treatment of equal quality, they’ll oftentimes be willing to start you off on that medication/treatment.

Don’t be afraid to leave a provider that you feel is not meeting your needs, or who is not willing to work with you to get those needs met in some practical way–even if other people have had a good experience with that provider. Sometimes things just don’t work out, and that’s okay–but it shouldn’t hold you back from receiving the care you deserve.

Your Thoughts?!

What are your thoughts on this article and process? How do you find quality medical care providers? Is there anything unclear in the article? I look forward to your feedback!

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Turmoil in the Medical Transcription World – A Career Path Full of Potholes and Dead Ends

Photo of a Pothole in a Road

In my last post I discussed working from home in general.  In this post I’d like to delve a little more specifically into what it is like to work in the medical transcription field.

Many people are familiar with the term medical transcriptionist.  We are also known as medical language specialists.  I think that is actually a more accurate title, because to do this job well requires so much more than typing.  You have to understand what you are transcribing and have a really good grasp of anatomy and physiology as well as medical terminology, pharmacology and grammar.

The medical transcriptionist listens to and then transcribes recordings of physicians describing their interactions with patients.  These may include clinic visits in cardiology, gastroenterology, neurology, psychology, orthopedics, physical therapy, etc.  You may type emergency room visits or descriptions of surgical procedures.  If you were to work for a local physician, say a neurologist, you would type mainly neurology reports and you would quickly become proficient in neurological terminology.  When working for a transcription service you must be proficient in all the specialties and familiar with all the medical terminology that goes along with them. In addition to that you will have a very large number of physicians you will be typing for, which often presents a challenge as you strive to learn all of their varying accents and idiosyncrasies.

With the advent of new technology the transcription of reports is frequently being replaced with editing of reports.   Computer software translates the physician’s spoken words into text which the transcriptionist then must edit while listening carefully to the dictation.

I personally prefer typing over editing, finding editing too monotonous, but I know people who love to edit.   You can edit more lines per hour than you can transcribe, but don’t get too excited – the companies also pay less per line for editing!  For transcribing dictation the rate may be 8 cents per line but the editing rate will probably be closer to 4 cents per line.  Yes, as a transcriptionist you work for pennies!  These pennies really do add up though and it is possible to make a good income as a transcriptionist or editor, but it takes a lot of skill, determination and self discipline…and often a good dose of luck as well, as I’ll explain  in just a bit.

There are, however, many drawbacks in the field that make it difficult to earn that good income. “Back in the day” it was a lucrative career, a profession.    Today it can be quite difficult to make even a decent wage in this profession.

I am currently sitting here typing this article instead of working at transcribing reports because there is no work available this morning.  I was tired, but got up with the 4:30 a.m. alarm to prepare for my day at work.  Settled in at 5 and ready to begin my workday when the all-too-familiar message appeared on my screen “While your queue is empty, work arrives continuously.  Please contact your QManager.”  Well, 1 hour and 20 minutes later and still that continuously arriving work is nowhere to be found!

I didn’t even bother to contact the QManager this morning…choosing instead to write this article. The days I do contact the QManager I either get a message back saying “keep waiting, work is slowly coming in”…in other words, there is no work, sit tight and eventually there will be some.  The other option is that the QManager will find another account and have me begin work on that.  This can be a frustrating process as new accounts mean reading through pages and pages of instructions about what the client (hospital) expects.

There is so much variation from client to client. For example:

  • Some want their headings in bold, all caps while some want them in bold mixed case while others want all caps, but no bold.
  • Allergies in caps or not, bold or not.
  • Number all lists.  Don’t number lists.  Only number medications.
  • Patient names allowed in the report.  Patient names not allowed in the report.
  • Remember Dr. So and So; he wants to make up his own rules which you need to remember too.

You are expected to study these rules and remember them (or have notes everywhere as reminders!).   This is something that is done for every hospital or clinic you type for.  I currently have 4 hospitals I type for….so 4 sets of rules to keep straight.  You might type 3 reports for 1 hospital, then 2 for a different hospital, back to the first hospital for 1 report, onto a different hospital for 2…so you have to keep all these rules for all these different clients straight. So, sometimes I would rather be out of work and not typing than wading through trying to learn all these new rules for a temporary account.

One of the big downsides of being a transcriptionist is that we are only paid for those lines produced which means the time you spend studying those client expectations, time spent reading emails from your supervisor, time spent researching medication doses or unfamiliar terms or the name of the taco joint in St. Louis, Missouri the doctor mentions that the patient works at….all the time you spend doing any of these things you are not compensated for. The time spent waiting to see if any work comes into your queue isn’t compensated for, either (I know of one company that will pay you for up to 15 minutes of out of work time per day; not very helpful if you are out of work for 2, 3 or 4 hours!).

How many other professions are there where you are expected to report to work on time and not get paid if when you get there they have no work available for you to do?  This policy seems like a real injustice to me, but it is the norm in the medical transcription field.

Some companies require that you stay near your computer and “keep checking back” throughout our shift for work.  Some employers offer “flex time.” If you come to work and there is none available you can request flex time.   This is helpful in a way as you can then go do something else for a while and work again later in the day when there is work available again.

But what if your schedule isn’t flexible?  I’m currently caring for my elderly mother who needs my full attention during the day…I get up early in the morning to work, before she is up.  If there is no work I don’t have the ability to come back 3 or 4 hours later to see if there is some available.  The result?  No pay for the hours lost.  This can make budgeting difficult and this lack of having a consistent dependable income is one of the biggest problems that I see for the medical transcriptionist.

There is another practice in the medical transcription field which I really don’t understand or like, because it means two transcriptionists with equal skills can be earning very different income based on the accounts they are doing and the rules of those accounts.

Let me explain.  We are paid by lines…so for example for every 65-character line we might be paid 8 cents for typing or 4 cents for editing.  I recently had been working at one company where my accounts were all straight typing, which I loved!  I had one account which had many macros (pre-typed text you can copy and paste into the report; this only takes seconds, but you get credit for all those lines just as if you had typed them) and it also had text often plugged right into the report, so before you typed anything at all you might already have 30 or 40 lines to your credit.  Other accounts never did this, so my line counts were always much lower when I worked on those accounts.

There are also varying rules for each account regarding how many blanks you can leave.   The transcription companies put a lot of weight on how many blanks you leave and it counts against you if you send in too many reports with blanks.  The problem comes when one account might allow you to have 3 blanks in a report and not send it in for corrections while another account allows no blanks.  So it’s harder for the medical transcriptionist on the account with zero blanks to keep her submission rate low than it is for the transcriptionist on the other account, but there are no allowances for this (at least not at any companies I’ve worked for).  Since this is often tied to the amount of money you make it really can be more of a situation where luck of the draw (which account you are on) determines your paycheck more than how good a transcriptionist you are or how hard you are working.

One company I know of will reduce your line rate to a mere 7 cents per line for straight transcription if you send more than 5% of your reports to QC for corrections.  Many times these submissions are not the transcriptionist’s fault.  I have had to send in reports when there was no dictation, the attending physician’s name was not dictated, or some other similar situation which couldn’t be avoided…these reports counted against the QC submission rate and can result in a significant decrease in pay.  All rewards for 100% accuracy and high line counts disappear if the QC submission rate is deemed too high.   We are always told not to guess, to flag anything we are unsure of – but if we do it just one too many times we can pay for it, literally.

I actually had this happen to me (I went from 11 cents a line to 7 cents a line) because I was 0.1% over the quota for that pay period…and I know that I had 2 reports during that time that were no dictations; it was almost certainly one of those reports that caused me to exceed the limit and lose several hundred dollars in pay that pay period.

I am writing this article not to discourage anyone from becoming a medical transcriptionist, because there are some positives things about this career, but there are also many downsides and I hope this article helps you go into it with your eyes wide open.  The charge for tuition to learn transcription is significant and learning this trade also requires substantial investment of time.

I went into this profession expecting to make very good wages and be appreciated for producing quality work.  Neither has happened, in nearly 12 years as a transcriptionist.  One of these days I will go back to school and finish my degree and get a better job.  But for now, I type on.

If you choose this profession I wish you well.  I hope you are one of the fortunate ones who can find a company that rewards your efforts and skill appropriately.

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Infographic: How Childhood Trauma Affects Adult Life

I believe that childhood trauma has a significant and formative impact on who we become as adults. The impact can be mitigated by a supportive community during and following the trauma, but such support seems to be the exception rather than the rule. In adulthood we can work to heal the wounds trauma inflicted upon us in childhood, but in my experience, there is always a scar that aches and perhaps tears at times.

The danger when talking about the effects of childhood trauma on adult life is two-fold: (1) We may assume of ourselves that we are inferior to others and (2) others may assume that we are inferior to them.

It is true that we may be changed by what we have experienced, but that  sword is double-edged – we may be hobbled in one area, yet ahead in another. One of these days I need to read Wayne Muller’s Legacy of the Heart: The Spiritual Advantages of a Painful Childhood as I suspect he will flesh this thesis out in detail.

Example: During my childhood there was the necessity of separating emotions from actions. This has resulted in a struggle in adulthood to feel, experience, and express my emotions – both negative and positive. Yet the strength that has grown out of this trauma is my ability to remain reasonable within difficult situations. This allows me to function well during a crisis in which action is required or in conflict where I am able to remain calm in the midst of being (verbally) assaulted.1At the same time, my ability to do so doesn’t mean that I should always do so. There is a cost I pay for such restraint and it manifests itself after the conflict is over, often physiologically. Now I choose when I use this ability and when I don’t – knowing the cost.

With this danger acknowledged, and with the hope that others will recognize the strength within their wounds and the strength of others in their wounds, here is the infographic “The Impact of Childhood Trauma on Adult Disorders”:

 

 

Infographic Depicting the Impact of Childhood Trauma on Adult Disorders