I am a community pathologist and our group is based in a hospital. We were told by one of the hospital administrators that they have been approached by the gastroenterology group about taking the biopsies they perform in the hospital to their in office pathology lab and processing them there. Has anyone experienced this or have any advice for us? I didn't know if there is some contract that the gastroenterologists sign with the hospital, in the wording of the contract, stating that the pathology would be performed by the hospital pathologists? I will investigate this further. Any helpful or constructive advice would be appreciated? I know I should have chosen a different specialty. So, there is no need for snide, snarky or sarcastic remarks. Thanks.
Gastroenterologists want to take hospital biopsies to their in office labs
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It's not in your contract to get the work? They can't do that.
A urology group tried to muscle a hospital near me into sending all the outpatient clinic work to their in-office lab. The group said they wouldn't work for the clinics unless the specimens were sent to their in-office lab. I dont know how that ended up being resolved. The hospital was desperate for a urologist, since the town urologist had packed up and left. Unfortunantly the only ones around are in that group. The town is VERY rural and no one wants to live/work there so it's impossible to recruit anyone without a criminal record.
The Medicare payment website for that in-office lab were very interesting I must say.
A urology group tried to muscle a hospital near me into sending all the outpatient clinic work to their in-office lab. The group said they wouldn't work for the clinics unless the specimens were sent to their in-office lab. I dont know how that ended up being resolved. The hospital was desperate for a urologist, since the town urologist had packed up and left. Unfortunantly the only ones around are in that group. The town is VERY rural and no one wants to live/work there so it's impossible to recruit anyone without a criminal record.
The Medicare payment website for that in-office lab were very interesting I must say.
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Are you employed by the health system or are you another independent group? If you're an independent group, what does YOUR contract with the health system say? You would want your contract to say that you've got exclusivity to perform pathology from specimens taken at the hospital or at least the first rights to them. What is your current relationship with the GI group? Do they have problems with the quality of your work? If they are another independent group, they need to learn to play nice in the sandbox with the hospital and other independent groups. Who reads the pathology at their lab?
Even if your contract doesn't say you have exclusivity, the hospital should not want to loose those ancillary services either. Loosing specimens may mean loosing a histotech which may affect your ability to effectively process other specimens if you loose staff. You'll also want to frame your argument about what the hospital is loosing by loosing the specimens. The GI group cannot just take, take, take from the hospital, they also need to support the services there.
My understanding of the in-office ancillary exception is that the biopsy, processing, and interpretation have to be performed at the same site, at least if the gastroenterologist wants to globally bill. But like WP said, it would be unusual if your hospital contract doesn't stipulate that you get all of the AP work.
We are an independent group which contracts with the hospital. According to my partner, our contract states that we have exclusivity to perform pathology on the specimens taken here. The GI group has been running an in office lab at their practice for many years. There is a surgery center here in town where all the biopsies that the gastroenterologists performed go to their in office lab and are processed and looked at by a pathologist that the GI group employs. As far as I know, the GI group doesn't have any problems with us. We feel this is soley related to the recent changes in the technical fee reduction and now they are looking for ways to recoup their loss. The administrators want to "keep the peace" i.e. the gastroenterologists are saying they will take cases to the surgery center and to other facilities.
So the pathologist interprets the biopsies at the surgery center, which is at a different location from the endoscopy center where the biopsies are procured? If the gastroenterologist is billing globally, then this is already illegal. The "consultants" who engineer many of these arrangements will push the limits of legality, and they usually have a legal opinion that says "sure, this is ok". But if you describe some of these arrangements to an OIG or CAP lawyer, you will get a different opinion. I know of one instance where a GI group sends wet tissue from Medicare patients to a pathology group for complete workup, and the pathology group in exchanges staffs their in office pathology lab for all non-government payors. The OIG has said this is an illegal inducement, but the "consultant" lawyer says it is not. Unfortunately, the relatively small amounts of money involved aren't enough to get CMS interested, particularly since they don't really care that much whether the GI doc or the pathologist collects the charges. I guess my point is, depending on how the billing is set up, it likely wouldn't be legal for the GI docs to put the biopsies in their pocket and take them to their own lab. Get your hospital compliance department involved and try to make them nervous.
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Are you not a partner in this group?
What is your groups relationship with adminsistration? I'd want to be able to keep the 'exclusivity' in your contract but wouldn't necessarily want to set a precedent by allowing them to take their biopsies out of the hospital. I'm surprised the hospital's legal department or compliance department would not be all over that. How does this arrangement "keep the peace" with your group? I'd certainly take Pongo's arguement about trying to get the compliance and legal people involved in it also figure in what the hospital is loosing our from the technical part of it. On the other hand, are their biopsies a significant proportion of your work?
My group does have a exclusivity on specimens from the hospital but I am surprised at the things the GI group in town will send for a second opinion consult once they see the outpatients back in their office and can client bill a surgical pathology consult. It's never anything of significance...hyperplastic polyps, Candida esophagitis, etc.
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If it's in the contract, I say f*** em.
Sounds like the surgery center is separate from the lab.
Let me guess, the local orthopedic group, ENTs, and others decided to be entrepreneurs and set up a surgery center.We have had these surgery centers pop up all over the place. Usually starts with some pied piper ENT or orthopedic douchebag. GI docs saw that they could make some serious cash by doing procedures there and send the specimens to their in-office lab.
What kinds of patients are they even seeing at the hospital? Isn't it mostly uninsured, medicaid or out of network patients for the surgery center? That is how it works where I am at. The hospital mostly gets patients that you can't collect. Gotta love people getting different care based on their insurance, or lack their of. They need to teach more ethics in med school. I am really ashamed of physicians anymore. The people going into medicine would be better served going into business.
Sounds like the surgery center is separate from the lab.
Let me guess, the local orthopedic group, ENTs, and others decided to be entrepreneurs and set up a surgery center.We have had these surgery centers pop up all over the place. Usually starts with some pied piper ENT or orthopedic douchebag. GI docs saw that they could make some serious cash by doing procedures there and send the specimens to their in-office lab.
What kinds of patients are they even seeing at the hospital? Isn't it mostly uninsured, medicaid or out of network patients for the surgery center? That is how it works where I am at. The hospital mostly gets patients that you can't collect. Gotta love people getting different care based on their insurance, or lack their of. They need to teach more ethics in med school. I am really ashamed of physicians anymore. The people going into medicine would be better served going into business.
Webb Pinkerton you are correct. The surgery center is a stand alone facility. It was established before I arrived here. I don't know the history of all that but I am sure you are correct. It is my understanding that the GI group does the biopsy there. The biopsies are couriered to their office where they have a "pathology lab" set up in the back. The tissue is processed, slides cut and etc and the pathologist looks at the slides there. I will talk with the compliance department. It buys the peace for administrators in that the GI docs still do procedures at our facility.
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Are the majority of their cases being done at the surgery center already? What's left? I'm surprised they would want the hospital specimens at all. Like I said, they usually do procedures on the unprofitable or out of network patients at the local hospital. I've watched many specialists do this over the years.
You will like this story. The local docs, who set up a surgery center in town, actually had the nerve to sue the hospital because the hospital's insurance plan made the surgery center out of network for hospital employees. LOL.
Glad to be leaving medicine behind soon. Have fun playing in the cesspool. Remember don't let it corrupt you. Don't follow any pied pipers.
You will like this story. The local docs, who set up a surgery center in town, actually had the nerve to sue the hospital because the hospital's insurance plan made the surgery center out of network for hospital employees. LOL.
Glad to be leaving medicine behind soon. Have fun playing in the cesspool. Remember don't let it corrupt you. Don't follow any pied pipers.
D
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i had a urologist who tried to do this and to my unending surprise, the admin told him in no uncertain terms to knock it off. he did. if you have an exclusive contract (which you should), if worse comes to worse it should be a slam-dunk tortious contract interference lawsuit and that can include punitive damages.
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An exclusive contract is an exclusive contract. Moreover there are technical/ethical issues like the histologic processing is included in the drg or lump sum payment from the insurance company. Surely the in office lab would try to bill for the TC meaning the govt or insurance company would be double billed for processing.
Personally urology has to be one of the slimiest of the medical specialties.
Personally urology has to be one of the slimiest of the medical specialties.
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nosler01- If you are a partner then worst case you lose some income. If you're not a partner you may have more concerns depending on the volume you could possibly lose. That's the only reason I asked.
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I would like to know the outcome of this, keep us informed. Read your contract, without your express written permission you will easily be able to win damages should they decide to go ahead.
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Just wanted to let everyone know we have undergone some changes in our hospital administration and I haven't heard anything recently on this issue. We are still receiving biopsies from GI at this time. I will let everyone know when more info. becomes available. However, now we are being assaulted on another front. Currently, we use in house transcription which handles the gross and final signouts. In addition, they prepare all cases for sendout consultation, legal cases, tumor board, etc. They are hospital employees. Basically, we have been told that we will be moving to voice recognition transcription and these positions will be eliminated. There will be a secretary type position which will handle sendouts and etc. Have any of you dealt with this before? Any advice would be appreciated.
You may be able to buy a little time on that gi tissue until your current contract is up, but when it is I wouldn't count on keeping that tissue....the hospital system is going to be sure to do whatever it can to keep the gis and Uros happy, and if that means creating an arrangement to somehow get their tissue they want to their in office labs they will do it next contract.....it's a heck of a lot more important to appease them than pathologists(from their perspective), and so it is what it is.
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The hospital system I work with has a very strong and organized leadership. Not only do all biopsies performed in the hospital go to the hospital pathology lab (as should happen everywhere), but the private GI docs have to come to the hospital endoscopy center to do procedures on some patients with commerical insurance. The hospital partnered with a large health insurance provider that requires all GI procedures to be performed in the hospital to be considered "in network." Any GI procedure performed a private endoscopy center is "out of network" with higher out-of-pocket cost to the patient. This was an extraordinary achievement and the GI docs are livid about it.
The largest GI group where I live has 2 equal-size endoscopy offices. Because the IOAS lophole in the Stark Law requires that doctors work primarily (>75%) in the same building as their in-office lab, this large GI group couldn't build an in-office pathology lab without building 2 of them (1 for each endo center). So far, the GIs have settled for client billing their biopsies with smaller kickbacks.
I'm also seeing increased numbers of GI procedures performed at the hospital endoscopy center by internal medicine doctors, FM docs, and general surgeons (especially screening colonoscopies in healthy patients). All 5 pediatric gastroenterologists who work in the hospital health system are hospital-employed physicians. My hospital system has also hired two adult gastroenterologists as employee physicians for one of their hospitals in a smaller community.
In the hosptial, we see increasing numbers of endoscopic ultrasound (EUS) cases, about 7-8 per week now. Again, the GI docs tried to perform EUS cases in their free-standing endo center, but on-site cytology support is not available and many EUS cases require anesthesia support. The GIs tried to get EUS cases perfrormed at a local physician-owned hospital. Becuase the physician-hospital owners wanted kickbacks, the GIs are left performing EUS cases in the hospital system.
No doubt the GI docs have a lot of power and they will continue to self-refer for profit. But with a strong hospital system, the GIs are vulnerable.
Lmao....yeah vulnerable to find another hospital system more amenable to their desires(in the area or not).....hospital systems who refuse to play ball with gi and uro(and other such specialties) are playing a dangerous game.
Our hospital also moved from in house transcription to voice recognition about 6 months after I was hired. I actually like it better than using the in house transcription. I sign the case out immediately after it's dictated rather than waiting for someone to type it out and if I'm working late for some reason, it's always available. We use Dragon Naturally Speaking and it's actually quite good and gets better the more you use it. It can be a little cumbersome in the grossing room, but we have a PA that does most of the grossing and he seems to have gotten used to it.
I don't like self-editing my reports using voice dictation.
Here's one study that the radiologists did that suggests it is far more error-prone than secretarial transcription services.
http://www.medscape.com/viewarticle/750691
I find it unfortunate that pathologists are adopting this flawed technology, mostly in the name of hospital "right-sizing".
Would a surgeon accept a new device with that much of an increase in errors? Why do we?
Here's one study that the radiologists did that suggests it is far more error-prone than secretarial transcription services.
http://www.medscape.com/viewarticle/750691
I find it unfortunate that pathologists are adopting this flawed technology, mostly in the name of hospital "right-sizing".
Would a surgeon accept a new device with that much of an increase in errors? Why do we?
At our hospital, it was pretty much hospital wide, pathologists, radiologists, surgeons, hospitalists...we weren't singled out. I do come across some op notes that are dictated in the medical record, but it is now 3-5 days before those are transcribed if they don't use voice regonition.
Indeed. I would gather that the impact on patient care would be greater for pathologists and radiologists, whose work is 100% distilled into the report and are the predecessor for interventions to come, vs surgeons and other primarily clinical physicians whose notes are merely a retelling of interventions already undertaken.
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Many of our clinicians use voice recognition and the notes border on being completely unintelligible sometimes. In training one institution tried to switch over to voice software and there was a revolt, it just added so much time to each pathologists day compared to when actual trained transcriptionists were doing the work. Hopefully my group continues to avoid this.
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Same old song and dance, different dance hall.
Tombstones and graveyards in pathology.....slow walking and sad singing.
Tombstones and graveyards in pathology.....slow walking and sad singing.
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We are in a similar situation as yours, as a contracted group in a hospital/health system. Realize that the motivation from the hospital administration standpoint is to cut the department FTE's. So the department is already in the cross-hairs from a financial aspect.
Voice recognition/dictation now increases the pathologist time it takes to gross and sign out a case. The reduction in FTE's from a staffing standpoint now shifts towards the pathologist. Will your hospital contract reflect this increase in pathologist work hours to absorb the loss of staff FTE's?? The hospital admin will likely just want these staff hours to "disappear."
Our health system decided to implement Voicebrook, which used an outdated version of Dragon (version 10). We use version 12 at our outpatient lab, and have significantly better voice recognition. In my case, I don't use voice recognition at all, since Voicebrook was slowing me down. I'm faster at typing up my cases than dictating and correcting them. Also, the processing speed from dictation to it actually appearing on the screen is so slow, that you can't dictate continuously (although this may due to our outdated network connection). The majority of my group uses voice dictation with a mix of manual typing.
Voice recognition/dictation now increases the pathologist time it takes to gross and sign out a case. The reduction in FTE's from a staffing standpoint now shifts towards the pathologist. Will your hospital contract reflect this increase in pathologist work hours to absorb the loss of staff FTE's?? The hospital admin will likely just want these staff hours to "disappear."
Our health system decided to implement Voicebrook, which used an outdated version of Dragon (version 10). We use version 12 at our outpatient lab, and have significantly better voice recognition. In my case, I don't use voice recognition at all, since Voicebrook was slowing me down. I'm faster at typing up my cases than dictating and correcting them. Also, the processing speed from dictation to it actually appearing on the screen is so slow, that you can't dictate continuously (although this may due to our outdated network connection). The majority of my group uses voice dictation with a mix of manual typing.
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I find this difficult to believe. We use Dragon and it is super fast and efficient. Makes the daily workflow much smoother than using transcription, and you can sign out the case immediately and get it off of your desk. Particularly when it comes to using the commands for tumor staging templates, etc. I would never go back to transcription.
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In that calculation, I'm not counting the hours in between dictating and receiving a transcribed report. I'm taking about the time it takes to proof your dictation, formatting and correcting your report.
I agree that voice recognition software does decrease overall turnaround time, because you don't wait for the transcribed report. However, think about the amount of time you are spending in front of the computer versus the amount of time dictating into a microphone and submitted a tape/cassette.
Edited to add: When it comes to templates and synoptic reporting, our LIS uses an interface with Word, and you can build your own templates/Autotext entries. Many other LIS systems use similar keyboard shortcuts.
I agree that voice recognition software does decrease overall turnaround time, because you don't wait for the transcribed report. However, think about the amount of time you are spending in front of the computer versus the amount of time dictating into a microphone and submitted a tape/cassette.
Edited to add: When it comes to templates and synoptic reporting, our LIS uses an interface with Word, and you can build your own templates/Autotext entries. Many other LIS systems use similar keyboard shortcuts.
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We have dramatically decreased our FTE's with dragon implementation and I personally can work almost twice as fast as before, which was already fairly expedient. One must know how to use it correctly. Once this happens general speaking, we will see another 20-30% pathologists on the chopping block.
Caffeinegirl, were you working with your group prior to the implementation of this system? Did your group try to resist this change? We are trying to argue (from every angle that we can think of) that this will be a bad move for all parties involved. Our system is very efficient with our current setup utilizing in-house transcription. We have basically been given a few months to learn the system. But, trying to argue with someone who has made the decision already is really a waste. They are looking at this solely from a dollars and cents perspective.
Have you tried using the system yet Nosler? With a few macros for common stuff, you can learn to be super effecient with Dragon. I will admit that it slows me down a lot when I am grossing, but I'm much more efficient when signing out cases in my office.
Voice recognition without transcriptionist editing is, in my opinion, malpractice.
http://www.ncbi.nlm.nih.gov/pubmed/21940580
http://www.ncbi.nlm.nih.gov/pubmed/21940580
Maybe for a bunch of idiots it is. There are so many tools on Dragon that completely eliminate mistakes and save time it is astounding. The tools that wrote this paper obviously did not use the software to its capability. Just another cartload of BS academic paper that means nothing.
It is quicker for me to type than to use dragon and perseverate over it for mistakes. It's even quicker for me to dictate it into a tape and for a secretary to type it out.
Using dragon is a very dangerous precedent in that it transfers technical/admin work onto the pathologist without pay, if contracted/salaried. It cuts into your time if FFS, but this must be balanced by the cost of hiring transcriptionists. In my experience dragon cuts into income more than transcriptionists do, but YMMV.
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Baloney.
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Yes I was working with the group prior to implementation of the system. We tried to resist the change, but as I mentioned, the department was already in the administration's cross hairs from a financial perspective and they were trying to cut as many FTE's as possible. We were also given a few months to learn the system, and then we are on our own. There really is no point in arguing....but in your negotiations make sure that you ask for as much as you can from the implementation....all the synoptics, training (including on-site), customer support, fast network speeds, hardware, etc. As I mentioned, try to argue to get an increase in your contract or hours, because those FTE's do not completely "disappear"...the secretarial burden is on the pathologist now.
As for the other comments above..I agree with voice recognition/Dragon that it decreases turnaround time, and if implemented appropriately can be quite efficient. The OP I think was mentioning about decreases in staff/in house transcription and my original comments were to aid him/her in negotiations with the administration. Regardless, the pathologist does do more, even if isn't as much as in house transcription. And grossing is a total pain. As I mentioned, I am in the minority in among my colleagues since I can type faster and more efficiently than dictate. The majority use voice dictation.
As for the other comments above..I agree with voice recognition/Dragon that it decreases turnaround time, and if implemented appropriately can be quite efficient. The OP I think was mentioning about decreases in staff/in house transcription and my original comments were to aid him/her in negotiations with the administration. Regardless, the pathologist does do more, even if isn't as much as in house transcription. And grossing is a total pain. As I mentioned, I am in the minority in among my colleagues since I can type faster and more efficiently than dictate. The majority use voice dictation.
Consider yourself paying the price of ignorance. I consider it useless to attempt to help those who remain in ignorance.
Thrombus and 212115,
As you both know and I am finding out there are lots of steps involved in the process of generating a final report besides what we do as pathologists. Our transcriptionists currently correct mistakes such as, i.e. correcting the spelling mistakes of the surgical tech/nurse who entered the patient's clinical history, correcting errors such as the patient having 2 medical record numbers, ensuring that the reports are electronically copied to whomever they need to get to (cancer registry, consultants, etc) and on and on. Who handles this type of problem at your institution? When I ask administration who will do this when our transcriptionists are gone, they do not have an answer. This is my issue with this whole idea. Using the Dragon to dictate is not too difficult. It is all the secretarial type work that I do not have the time to complete.
As you both know and I am finding out there are lots of steps involved in the process of generating a final report besides what we do as pathologists. Our transcriptionists currently correct mistakes such as, i.e. correcting the spelling mistakes of the surgical tech/nurse who entered the patient's clinical history, correcting errors such as the patient having 2 medical record numbers, ensuring that the reports are electronically copied to whomever they need to get to (cancer registry, consultants, etc) and on and on. Who handles this type of problem at your institution? When I ask administration who will do this when our transcriptionists are gone, they do not have an answer. This is my issue with this whole idea. Using the Dragon to dictate is not too difficult. It is all the secretarial type work that I do not have the time to complete.
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I feel for you nosler01. In our situation, they cut the majority of transcriptionists, but left one admin assistant behind to check billing, enter the report headers, check the copy to physicians, etc. There cannot be a pathology department without at least one admin assistant to answer the phones, deal with sendouts, etc. The workflow is such that after grossing, the admin does those steps prior to the slides coming out and pathologist dictating the diagnosis and signing the report. All I can say is in our situation, albeit we are early on in the process, the pathologist spends more time now grossing and dictating reports than before. Given that the rest of our duties have not been decreased makes it a very busy workday.
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Just hire a 6 Sigma blackbelt and you can find a way to make it work. 
I don't even want to imagine not having transcriptionists. They play such an important role where I work.
These hospitals will waste millions on parking services, concierge services, salt water aquariums every 100 yards, bird aviaries, motivational speakers, retreats and other crap and they can't keep workers like transcriptionists.
I don't even want to imagine not having transcriptionists. They play such an important role where I work.
These hospitals will waste millions on parking services, concierge services, salt water aquariums every 100 yards, bird aviaries, motivational speakers, retreats and other crap and they can't keep workers like transcriptionists.
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We have administrative help that corrects things like duplicate MR numbers and ensuring reports get to the right place post sign out. But we proofread the report to check spelling ourselves. If you have transcriptionists correcting accessioning errors and doing send outs and post sign out report distribution, etc, then they are performing additional duties that are not meant to be replaced by Dragon. We still have people who do all those things, but just not transcribing.
Just hire a 6 Sigma blackbelt and you can find a way to make it work.
I don't even want to imagine not having transcriptionists. They play such an important role where I work.
These hospitals will waste millions on parking services, concierge services, salt water aquariums every 100 yards, bird aviaries, motivational speakers, retreats and other crap and they can't keep workers like transcriptionists.
Lean is such a ridiculous concept. It's like a cult. I've never seen it work.
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Then you haven't been around enough businesses. Six sigma, Lean, etc, whatever, works. There are Harvard B-school briefs backing this up.
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Lean works if you are building a facility from scratch and have carte blanche with your floor plan and essentially your budget. I inspected a lab a few years ago that did this and it was amazing.
However, most people are used to seeing lean 'attempted' in spaces that have not been designed for it and have space and utility limitations. Which typically makes for a delightful clusterf$%k
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I think six sigma was "invented" so people could give themselves flambouyant titles with different color belts. None of it seems like anything new to me.
The success of it I am sure is tied to how well the "experts" know the concepts of six sigma and understand the industries they are working in.
The success of it I am sure is tied to how well the "experts" know the concepts of six sigma and understand the industries they are working in.
Caffeinegirl,
Did you ever try approaching any of your clinical colleagues to see if they could maybe help in swaying the administrators decision? Was this discussed at a medical staff meeting or medical executive committee? There are a few surgeons and clinicians here who are way more influential than us lowly pathologists. We have thought of talking with them and telling them that this is going to slow down how fast things turn around. I'm not just talking about how fast reports are generated but everything else. I'm grasping at straws, I know.
Did you ever try approaching any of your clinical colleagues to see if they could maybe help in swaying the administrators decision? Was this discussed at a medical staff meeting or medical executive committee? There are a few surgeons and clinicians here who are way more influential than us lowly pathologists. We have thought of talking with them and telling them that this is going to slow down how fast things turn around. I'm not just talking about how fast reports are generated but everything else. I'm grasping at straws, I know.
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Nosler01,
There was no point approaching colleagues on this matter...the administration had already made their decision, and medical staff has nothing to do with that decision. We were in the middle of massive cost-cutting site-wide, and this was but a drop in the bucket. It is unfortunate in our case that pathologists weren't even consulted on the decision..but it reflects the lack of sway that we have (which is due to many factors). When the administration is run by those who care more about $$ than quality of care, or when decisions are made based on $$ without concern for downstream effects, this is what happens... in our case even the surgeons/clinicians would not have affected the decision. Just beware that this may be the beginning of more drastic changes for your department.
There was no point approaching colleagues on this matter...the administration had already made their decision, and medical staff has nothing to do with that decision. We were in the middle of massive cost-cutting site-wide, and this was but a drop in the bucket. It is unfortunate in our case that pathologists weren't even consulted on the decision..but it reflects the lack of sway that we have (which is due to many factors). When the administration is run by those who care more about $$ than quality of care, or when decisions are made based on $$ without concern for downstream effects, this is what happens... in our case even the surgeons/clinicians would not have affected the decision. Just beware that this may be the beginning of more drastic changes for your department.
Caffeinegirl,
You said in one of your previous posts that grossing is a total pain. We are very concerned with trying to use dragon while grossing. Several colleagues are afraid they may cut themselves while trying to look at a computer screen. To get it to work in the gross room, we feel that we will have to use templates and just plug in a few variables. Is this your experience? The way we do it now is that each pathologist dictates differently. We have some that are verbose and some that are succinct. But, we all dictate differently. I just don't know if we will be able to stand in the gross room dictating like we do now when we have dragon. We don't have PA's.
You said in one of your previous posts that grossing is a total pain. We are very concerned with trying to use dragon while grossing. Several colleagues are afraid they may cut themselves while trying to look at a computer screen. To get it to work in the gross room, we feel that we will have to use templates and just plug in a few variables. Is this your experience? The way we do it now is that each pathologist dictates differently. We have some that are verbose and some that are succinct. But, we all dictate differently. I just don't know if we will be able to stand in the gross room dictating like we do now when we have dragon. We don't have PA's.
