Macro building 102

The AutoCorrect feature in Word is my bread and butter.  I literally type in shorthand.  The best way to use this feature is to make your entry something easy to remember:

pnt = patient

The next step is to build on this foundation:

pnts = patients
pnts’ = patient’s
attpnt = according to the patient

Notice I put the apostrophe at the end of the shortcut… that is because my brain will type the shortcut first, then remember to add the apostrophe for the possessive afterward the fact.  Any commonly used phrases should definitely be included in your shortcuts.

Another building trick is to “stack” the shortcuts:

rt = right
lt = left
br = breast
ch = chest

rtbr = right breast
ltbr = left breast
rtch = right chest
ltch = left chest

I also utilize numbers in with the shortcuts:

1deg = first-degree
2deg = second-degree
3deg = third-degree   ….and so on….

th4 = therefore
no4 = notable for

Next, I build on macros that have different endings:

xfm = transform
xfmd = transformed
xfmg = transforming
xfmn = transformation
xfmns = transformations

Make sure to include any acronyms to avoid the shift and caps lock keys, and then add “x” to expand:

cabg = CABG
cabgx = coronary artery bypass graft

aaa = AAA
aaax = abdominal aortic aneurysm

Something else I do… I shorten some words with their “phonetic” spelling:

cof = cough
flem = phlegm
cud = could
wud = would
shud = should

It takes some time to build your shortcut database, but once you do, be sure to BACKUP your macros at least once a week!  Trust me on this, I speak from experience (a day I shall long remember).

MT Daily used to have an entire list of ready-made shortcuts that you could import into your AutoCorrect, but I can no longer find it… perhaps they took it down?  In that case, I will attempt to have one on here that is accessible, but that may take me a bit.

Until then, the best shortcuts are the ones you create for yourself.  Be sure to:

• Include any commonly misspelled words in your AutoCorrect so you don’t waste time changing them constantly.
• Include brand name drugs with the capitalization already set up to avoid pressing the shift key so much (or trying to remember whether or not that weird name was brand or generic)
• Include any hyphenated words.
• Set up any homonyms like so:  ileum/ilium for both words — to double check that you’ve transcribed the right body part.
• Set up any commonly transposed words like “to” typed as “ot” as ot****.  Since OT is a legitimate acronym, your spell check may not catch it.  The stars will flag you to double check yourself.

Have fun macro-building!

Macro building 101

Okay, so they’re not really “macros” in the sense of “hot keys” to perform functions like the tilde macro from earlier, they’re really more like typing in shorthand. I have over 3000 shortcuts in AutoCorrect and AutoText in Word myself.

As I’ve said before, I have never used an “outside” word expander program because, when I started transcribing, the platform I worked on did not have the capability to use them. So, I learned to do without, but I think I’ve done quite well without one, averaging 250-300 lines per hour. If you use a word expander program, I’d like to hear your input on how it enhances your production, and if it’s any better than utilizing AutoText and AutoCorrect using the techniques I describe below.

The first company I worked for did provide a sort of “standard” shortcuts already embedded in the program. If you don’t want to be bothered taking the time to build your own shortcuts, MT Daily has a list already made up that can be accessed here and copied into your word expander program or into MS Word AutoCorrect.  This can be a good starting point if you need some inspiration.

However… my opinion is, if you don’t have a system that works for you, you’re not going to remember the shortcuts someone else has made.

Word is the most common platform currently in use, and it’s the one I’ve worked with the most, so for the remainder of my “macro training”, I’ll be referring to Word and the features of AutoText and AutoCorrect.

One of the first things you have to realize is that AutoText and AutoCorrect differ in two ways: One is how the shorcuts are generated and the second is how they are applied across programs.

AutoCorrect is a “quick shortcut” as a default (plain text option). It only has a limited amount of characters available and will not carry over any formatting (i.e. bold, italic, underline). However, once an entry has been made in AutoCorrect as “plain text”, that shortcut is available in ALL Office programs — Excel, PowerPoint, Outlook, etc. This can be very helpful as once you get used to typing in shorthand, it will eventually aggravate you to have to type things out longhand in other programs.  The shortcut is also able to be edited easily through the AutoCorrect window.

AutoCorrect will expand a shortcut as soon as the space bar is pressed or punctuation is provided after a shortcut that Word recognizes. For example: If my shortcut in AutoCorrect for “musculoskeletal” is “msk”, then every time I type “msk” then press space or punctuate, the word “musculoskeletal” will appear. The formatted AutoCorrect entries have no character limitations and will carry over any formatting assigned. The “Replace text as you type” box must be checked in the AutoCorrect window to use this feature (Tools, Autocorrect).

AutoText entries are actually templates that are saved in “normal.dot” in Word. These entries (along with formatted AutoCorrect entries) are NOT compatible across Word Programs.  Also, because AutoText entries are considered templates, they are not as easily edited as AutoCorrect, but this can have its advantages. AutoText also has no character limit and is saved with all formatting assigned.

An advantage of having templates AutoText is that it’s more difficult to “overwrite” them by accident.  A second advantage to using AutoText is that Word will give you a “flag” with the first few words of your template to allow you choose whether or not to insert that particular template, provided the “Show AutoComplete suggestions” box is checked in the AutoText screen (Tools, Autocorrect, then Ctrl-Tab to move between tabs to get to AutoText).   AutoCorrect does not have this feature, requiring you to remember more macros by heart.

When I type a physician’s dictation for the first time, I store that note as a template in AutoCorrect.  I highlight the body of the  note, press Alt-F3, then name the note so I can remember it.  For example, if it was a followup note for John Smith, M.D., I would name it smithjfup, an initial consult - smithjcons.  Then, the next time I need to type a note for that physician, before I even start transcribing the note at hand, I type in smithjfup.  The ”flag” will pop up with the first few words of his followup, and to accept that template suggested I simply press “enter”.

One thing to note: the AutoText flag may pop up every time I start typing “Smith” in a note… if I don’t need the template, I just keep typing and ignore it – and it goes away. I have complete control over whether I want to insert the template or not.

To re-make that saved AutoText template for Dr. Smith as a “generic”, I’ll take the time before transcribing the new note to read through the template I have just entered and replace any gender specific items, any vitals or lab test values, and any patient-specific information that will change constantly with a tilde.  I then save it like I would a new one, giving it the same name as before. I’m then prompted to choose whether or not to overwrite the existing template – this helps prevent boo boos. Once I have my generic Dr. Smith template, I can do more reading and less typing by moving around in the note using my tilde hot key to insert the needed information while keeping all his “usual” blather. It takes a little time to build up generics for each physician, but it pays big in the long run.

If you would like to read more about AutoText and AutoCorrect, check out this link: http://word.mvps.org/FAQs/Customization/AutoText.htm

I’ll be telling you all how I build macros in AutoCorrect next… so stay tuned!

Optimizing production – De-mousing

Before I get going into how I build macros so I can remember them (I have thousands), the first thing a new MT MUST do is learn to de-mouse yourself.

“But why?” you ask?

Because of this very important rule:

In this business, every time you take your hands off the keyboard, you are losing money.

Once learned, you will find that using keyboard shortcuts is a heck-of-a-lot faster than grabbing the mouse.  One of the first things you will definitely want to do is learn to use your Alt and Ctrl keys.  Also, find out what function keys are specific to your transcription platform program — write them down on a 3 x 5 card if you need to until you get familiar with them.

Remember that, in nearly every program out there (at least all the ones I’ve ever worked with), when you see a drop-down list, a letter will be underlined… that letter is set up to work with your Alt key (you can try it now… Press Alt+F to see the File menu drop down — the press Esc twice to exit the menu).  Once the menu has “dropped down”, you no longer need to continue pressing the Alt key to activate the items on the menu, just be sure to notice what other letters are underlined because, while that drop down menu is open, those letters are “hot keys” to the function you want to use.   Also, many of those functions will have the corresponding Ctrl key listed next to it, usually saving you a keystroke.  I cannot stress enough how important it is that you learn the Alt and Ctrl functions for the menu items you use every day.

The next thing you will want to do is learn how to move around in your documents without ever touching the mouse.  Such as: Ctrl+End will take you to the end of the document, Ctrl+Home will take you to the beginning of the document, Shift+End will highlight the text from the cursor to the end of the line, Shift+Home will highlight the text from the cursor to the beginning of the line, Ctrl+Shift+End will highlight the text from the cursor to the end of the document, Ctrl+Shift+Home will highlight the text from the cursor to the beginning of the document (those last two are great for generating AutoText entries, but more on that later).  Two combinations that I use most often is Ctrl-Z for Undo and Ctrl-Y for Re-Do… those are awesome.

The best thing to do to learn these quickly is to print out a list of keyboard shortcuts:

On the Tools menu, point to Macro, and then click Macros.

In the Macros in box, click Word commands.

In the Macro name box, click ListCommands.

Click Run.

In the List Commands dialog box, click Current menu and keyboard settings.

Click OK.

On the File menu, click Print.

Once you have your printable list, you can actually streamline it a little by deleting the entries that are irrelevant to what your needs are, then print that baby out.  Make it a goal to learn at least one new shortcut a day – highlight them as you go… before long, it will be second nature and you won’t even have to think about it.

I have learned recently that it’s actually mousing that contributes more to carpal tunnel syndrome than keyboarding.   To combat this, I actually recommend moving the mouse to the LEFT side of the keyboard… and here’s why: I started having problems with overuse syndrome with my right hand because I used the 9-key pad a lot AND moused (when I needed to) to the right.  I decided to learn how to mouse with my left hand and switched the mouse buttons through the Control Panel.  It took a few days, but now I have no problems mousing with my left hand.  I no longer have problems with overuse syndrome with my right hand, and it freed up some space on my desk since I’m right-handed.

You’re going to have to use the mouse from time to time… sometimes it really is quicker just to grab it to pinpoint a certain area in a large text, but for the most part, keeping your hands on the keyboard is all about working smarter, not harder, and keeping those production numbers on the rise.

Happy earning!

Ahh, Stedman’s, an MT’s must-have

Any seasoned MT will have a shelf full of books of all the colors of the rainbow. These are Stedman’s Word Books and they are the holy grail of a transcriber. Personally, I have 11.

Every time I started a new specialty, I bought the corresponding word book. These saved my bacon many times over during those first few years. I still use them on occasion, but not nearly as much as I used to. I would recommend to any newbie that, as soon as you know what specialty you will be working on next, get the book. Yeah, it can get expensive buying so many books up front, and you haven’t made that much money yet, but believe me (and I’m sure the other seasoned MTs will give me a here, here!) it is worth the investment.

Stedman’s Word Books

I know what you may be thinking… buy used and save some dough. I have two things to say about that… 1) Used books may be hard to find since most MTs hoard their Stedman’s like the precious jewels they are, and 2) New words are being added all the time, and if you buy an old book, you may be short-changing yourself.

Now, I’m cheap (well, frugal is probably a better word), but when it comes to my profession and being professional, that is one area I make sure I don’t get cheap. I make sure I’m getting a quality product for my money, but I make sure to never, ever purchase second-rate stuff because it tends to cost more in the long run.

Happy researching!

What kind of Headphones?

If you have signed up for a school that provides you with equipment, you probably received a set of headphones that look like this:

I used this type of headset since I started in this industry, right up until six months ago when I got my first pair of noise-cancelling earbuds, and I must say, I LOVE LOVE LOVE them!

I did not realize just how “noisy” my typing was until the first day I used these babies. I have an ergonomic keyboard that is supposed to be “quiet”, but I don’t care how quiet they claim to be, you’re going to make noise with every keystroke. Add to that the neighbor mowing his lawn, the kids watching TV, dogs barking, cars driving past with stereos blaring, etc., etc., etc. Ambient noise is the bane of the MT, it makes us waste time re-listening to stuff which slows down our production and costs us money.

I was amazed at the clarity of sound the earbuds provided. Personally, I think having the headphones sit in your ears causes a sort “static friction” with the foam covers and can make it difficult to hear the dictation clearly (although there are some voice files that are just beyond help). With the earbuds, you get the sound sent directly into the inner ear with the provision of blocking out ambient noise. I definitely leave a lot less blanks now and I’m not wasting time re-listening to things because I can actually hear them right the FIRST TIME.

Now, these earbuds are normally geared for iPods, MP3 players and such, and tend to have rather short cords, so you’ll need to make sure you know the length of cord you’ll need before making a purchase.  There are a variety of different types of earbuds, the ones I currently have are made of foam; however, they tend to get a little yucky after using them a while. I intend to replace them with silicone earbuds that I can clean easier fairly soon anyway since my cat decided they were a toy and they’re a little worse for the wear at this point.

To see exactly what I’m talking about, you can click the link below. I love mine… and I can pretty much guarantee you won’t regret getting your own pair.

Noise-cancelling earbuds

Happy listening!

The Catch-22

For those thinking of starting a career in medical transcription, those who have started training, and those who have just finished their training, a word of advice… getting a job is harder than “they”make it out to be. 

You just finished training, you’re excited about your new career, you have determination, drive and ambition… now to get started working… you’ve hit the job boards, checked in your local paper, and taken every online test imaginable, but it keeps coming back…. they want more experience, the ONE thing you don’t have.

How do I get experience without getting a job?

How do I get a job without having experience?

If you’ve read My Story, you know how I finally managed to start working from home after two years at a multidisciplinary clinic.   The training course I took did not have job placement assistance, something that every good instructional program should have….

So what is my advice to you? 

I would actually very strongly recommend you work in a hospital or multidisciplinary clinic with other transcriptionists first.  Why?  For the simple reason that you will learn SO much more from working with experienced transcriptionists by being physically able to ask them for help and advice.  Plus, it will give you a local support base.  Working from home is great, but your co-workers tend to be spread from coast to coast.   Having a network of colleagues locally can help combat the feelings of isolation that inevitably crop up after being home by yourself so much.   Once you’ve established yourself as a quality MT and wooed your supervisors to write wonderful recommendations for you, finding a job with a national company should be a piece of cake.

If you truly want to work from home right out of training, unless your training program has job placement assistance, it’s going to be much harder to find a job that pays more than peanuts and your options are very narrowed.   I know of one company that would hire newbies and pay them 4 cents per line… that’s HALF the national standard for starting MTs.   Be careful who you choose to work for, and do your research on any company you are considering.  Google them, check the message boards at MT Daily and MT Stars to get a feel for their reputation (but keep in mind that only unhappy employees post complaints), call the Better Business Bureau and see if they have any customer complaints against them (this can give you an idea of their business ethics).  

 I know, it can be depressing.  You’ve invested time and money into a career that you can do from home for any one of a vast number of reasons only to find out that the road is blocked.  However, don’t despair.  It takes a long time to go from newbie to professional, but if you’re committed, it will be well worth the effort.