Now here is a message for all physicians about to update their practice: someday soon you will be convinced that your present human transcription service is obsolete and you will feel the need to modernize and enter the world of computer speech recognition. Many of you already have- physicians at prestigious medical centers such as Johns Hopkins, University of North Carolina, Cleveland Clinic as well as large multi-disciplinary private practice groups and small single doctor primary care practices to name a few. If you get this desire, let me urge you, with the greatest sincerity...
Take a pay cut. Volunteer to take more call. Take a CME course in outpatient hemorrhoid banding. Whatever you do, do not do it. I know. I was coerced into abandoning our wonderful transcriptionist who made my reports sound like those dictated by Osler and embark on the computer voice recognition pathway. I was thrilled. I was excited. I was a new age doctor. I soon became psychotic!
I have always said never bet against technology, but I should've known when the program that was going to understand and type my voice was in its 8th generation after being created less than 10 years prior. I have always been told that I speak too fast and mumble my words. My own wife and kids can't understand me- how could a computer program? "Oh, but you will be much more efficient and think of all the practice savings without the transcription costs!"
Eagerly, I commenced my voice recognition experience by slowly going through all these vocal coaching sessions- reading excerpts from an Abraham Lincoln speech, bits from Alice in Wonderland and Chapter 16 of 2001: A Space Odyssey. I then fine tuned my speech in the accuracy center and further reinforced my high-quality audio input using the acoustic optimizer. I was keeping up. I was doing ok. I thought I was ready.
The next night, twelve hours after trying to dictate only a half day of office work, I realized I had been brainwashed. I became convinced you couldn't "train your voice" even if you read the entire Bible out loud. I called the software manufacturer hotline who calmly explained you need more "voice training, speak naturally and create speech macros". Further, they maintained you must completely sound proof your office, have absolutely no disturbances and purchase a special microphone. You must. Ok, I must create the environment of a radio station booth... Howard Stern's radio station booth because like Stern I am sure doctors everywhere are shouting profanities at their computers. Words, of course, that won't be recognized.
Let me ask you this question. If you received a report saying, "on exam, when palpated he appeared to have a cute tiny penis," would you call the Medical Board and ask for an inquiry? Well, that was my efficient voice recognition software response when I tried to dictate "on exam, when palpated he appeared to have an occluded dorsalis pedis." Fortunately, I proofed that document. Or how about the embarrassment of describing an ascending leg infection, "being warm and erythematous and treated with 500mg Keflex" that I later discovered appeared as "being warned by hairy feminists and beaten with 500 grand catholics". The list of neologisms went on and on: residual... recent jewel; a kidney... you've given me; web site... wet site.
Yesterday, after another painfully long day I was just about to close my graffiti littered mess and hand write my dictations when I took a sip of coffee and accidentally brushed the cup across the foam microphone mouthpiece. When I looked up at the screen, a word had been added to the end of the message, after my name. The signature now said: "Lewis V. Owens, M.D. healer".
I will give it one more day.