Most clients have preferences for their work.  Fair enough, it’s their practice and they can set the rules.

But what do you do when you get a preference directive from a client that is clearly wrong, or in some cases downright laughable? Do you go along with it? After all, they are the ones paying your invoice.  Or do you stand on your principles and politely but firmly explain why you cannot or will not accede to their directive?

It can be tricky.  I know someone who worked for many years as a nurse/practice manager for a surgeon.  She did all of his typing.  One of his more, shall we say, unusual directives was that he did not ‘like’ apostrophes (not for plurals, not for possessives either) and that they were not to be used in his letters.  When told of this extraordinary rule, I remarked to my friend that I would simply refuse to type in such a way, as it was not up to this surgeon to dictate the terms of the English language to suit himself.  She simply shrugged and said it was easier just to do as he asked. *

I also once transcribed for a client who would not allow commas in his typing.  None at all.  The result was very odd, almost stream-of-consciousness letters.  Horrible to look at and I presume quite hard for the recipient to read.  As this client was undertaken through a large transcription company, I had little choice but to go along with it, but I have to say that it almost physically hurt to do that doctor’s typing!

Other smaller examples include doctors who favour words that are not really words.  For example, there is no such word as ‘unkeen’, yet a surprising amount of doctors dictate this non-word! I can't bring myself to type it and therefore I always change it to something like “not very keen on [the …]”.

Then of course there are those clients who want every drug capitalised, whether it is a generic brand or not.  For those who may not know, generic drugs/ingredients are typed in lowercase, such as prednisolone, methotrexate, doxycycline, whereas brand names are given a capital letter, such as Entocort (budesonide), Imuran (azathioprine), Plendil (felodipine).  This sort of client directive I can live with.  It’s a technicality and whilst I much prefer to follow the internationally-accepted formatting rules for such things, it doesn’t take anything away from the look of a report to have all drugs capitalised or in lowercase.  Likewise, a client whose preference is always for American English (color, center, orthopedic) over British/Australian English.  I can live with that, too.

In a way, this comes back to my earlier blog post on verbatim typing.  I believe that a good transcriptionist should alter any dictated errors and inconsistencies, without changing the context.  However, going along with rules such as ‘no commas’ or ‘no apostrophes’ is something I simply cannot bring myself to do.  If that means forfeiting a client, then I have to live with that.  In the end, my goal is to produce quality work for a client, which reflects well on the physician and the practice, and of course, is a correct record for the patient, who is the primary focus.  In turn, this reflects back on me as a professional transcriptionist who knows what she’s doing.

To produce a document which contains no commas or apostrophes when they are clearly required is something I don't really want my name associated with.

* Interestingly, when I did some typing for this surgeon whilst my friend was away on leave, I included all apostrophes in their required places and he never said a word.

Verbatim typing is used when transcribing things such as police interviews, court transcripts, focus groups, etc.  It is a very specific style of typing which sets out every um and ah, every mumble, stumble and stutter.  All contractions are typed as such (doesn't, can't, I dunno, yeah, nah, etc).  It is a very useful and necessary tool in the correct circumstances.  However it has no place in medical transcription.