Medical Transcriptionist Won’t Type Certain Reports

Vol. 11 •Issue 18 • Page 6
Medical Transcriptionist Won’t Type Certain Reports

Q: Sherry is the transcription supervisor at a large acute care facility. Recently, several of her medical transcriptionists (MTs) came to her complaining that their co-worker Kimberly had been “cherry picking” her reports. When confronted by Sherry, Kimberly explained that the only reports she had returned to the queue were those involving abortion procedures. Transcribing those reports, she said, would be participating in an act she considered immoral.

As her supervisor, Sherry is torn. On one hand, she’d like to be sensitive to Kimberly’s beliefs. On the other, Kimberly knew that transcribing such procedures would be required when she took this job, and Kimberly’s beliefs are interfering with her productivity.

Is it fair to the other transcriptionists to afford Kimberly special treatment? Is it fair to Kimberly to make her do something that goes against her beliefs? How should Sherry handle this situation?

A: Most health care facilities have policies regarding participation in procedures that are against religious and moral beliefs. The policy at the facility where I am employed states that if an employee is morally or religiously opposed to a procedure being performed, the person may request not to be involved in carrying out the procedure. If another qualified person is available, this person may be substituted, as long as the patient’s welfare is not placed in jeopardy.

I agree with this concept. Even though the transcriptionist is not directly involved in carrying out the procedure, but just in documentation of the procedure, I sympathize with her beliefs. However, the supervisor must consider several things. Was the transcriptionist aware at the time she was hired that this would be part of her job? Did her opposition to this procedure just recently arise? Are the physician(s) involved in carrying out and dictating these procedures more difficult to transcribe for than other physicians on the staff? Are the other transcriptionists opposed to transcribing these reports, and just have not spoken up?

The supervisor needs to be certain that the transcriptionist is not avoiding these dictations for reasons other than religious (i.e., physician(s) who are notorious for difficult dictations). If the supervisor feels that the reason is religious or morally based, then she must make sure there are other transcriptionists who do not have objections to these reports to ensure there will be someone who is willing to transcribe them. If she has enough transcriptionists willing to provide coverage for the reports and she feels the reason is justifiable, I would respect the transcriptionist’s wishes not to transcribe this type of procedure. However, the transcriptionist must realize that if no one else is available to transcribe the reports, this is part of the job and she must comply, even if only occasionally.

–Fairy B. Miller, CMT, RHIT

A: This is a difficult issue when trying to consider both sides. Sherry should remind Kimberly that all types of reports are a part of her job and within her job description. It is not appropriate to hand-pick or bypass reports based on religious or other beliefs. However, in typing these reports, is this really participating in the act? Sherry needs to be careful about honoring this kind of belief and allowing Kimberly to bypass these reports.

In allowing this, Sherry will open the door for other employees who are bothered by any information in the dictation, such as a history of or current sexual abuse, child abuse, heavy drug usage, etc. If Sherry is to honor Kimberly’s beliefs, then she would in turn have to honor any transcriptionist who states that he or she does not believe in abuse, for example, and therefore cannot type the information, allowing them to return a job half completed.

Once Kimberly is given the open door to return these reports, this encourages future complaints from Kimberly, as well as the other transcriptionists who find reports too upsetting, immoral or disturbing. If Sherry allows Kimberly to bypass these reports, others may very well give the same argument, and Sherry will find herself typing these reports instead of her staff. I would recommend Sherry very gently remind Kimberly that she is only typing what the physician is dictating, which is her job.

–Lisa Morris, RHIA, CCS