Margaret Retoske, CMT-R, CMA-AC passed away in November 2009 at the age of 88. She was a long-time member of the Orange County Chapter and a very knowledgeable parliamentarian. Although she did not own or use a computer, and was retired, she still rose to the request to submit letters to our legislators for the AHDI Advocacy Summit 2009. She typed, yes, from a typewriter, a heartfelt letter to the California legislators. We had the distinct honor of hand-delivering these letters during our visit to DC last June. She was so well loved by all our members. She contributed much to the association and to her fellow transcriptionists. Her dedication to the profession will always be an example to us.

Rhonda Emery, CMT of Rogue River, Oregon, died suddenly at home on October 5, 2009. She was 52. Rhonda worked at Rogue Valley Medical Center, Medford Oregon, spent a year in India as a trainer for then remotely as a team leader for Healthscribe, and QA for JLG Medical Transcription. When Rhonda wasn’t working in transcription, she showed Old English Sheepdogs and her dog, TrueSilver, was #2 in the nation for that breed. She was a superb member of our profession and will be missed by all who knew her. The picture includes Rhonda on the right, and an Indian student in their beautiful saris.

Lori Cole passed away in early September 2009. She lived in Southern California and was involved in the medical profession for 15 years before deciding to transition to medical transcription. Unfortunately, Lori never got the opportunity to meet any other MTs or secure a position in the medical transcription field before passing away.

I was a member at large for almost 4 years before becoming a local San Diego Chapter member. Even that was in a roundabout way. I’ll never forget Marie Mendez of the Orange Empire Chapter. She said to me, “well, if you’re willing to drive all the way up to Riverside to come to one of our meetings, you might as well become an OEC member.” Of course, I was sitting there asking myself, well, heck, why don’t I just join the San Diego Chapter. Many of you know bits and pieces of the rest of that history. Having served my local and state chapter in various capacities and having served national as Co-Chair of the Name Change Task Force and Legislative Issues Group chair, I now serve as a director on the AHDI board.

Medical transcription/healthcare documentation has a greater depth than just being able to type fast, and I’ve found my niche in advocating for our profession in various ways. As an AHDI director, this year I am board partner to Alaska, California, Hawaii, Nevada, Oregon, Washington and the Educational components. I am board liaison to the LIG and education alliance. I am a firm believer that we play a critical role in telling the patient’s health story. We will have to retool ourselves to stay relevant in the electronic health data environment and credentialing is a key component to that success.

In my everyday work environment, I’ve transcribed in-house at a local hospital in Paradise, California, been a transcription/QA manager, had my own business, FoxTx Enterprises, for over 10 years, and am now back to working as an IC from my San Diego office. You might say I’ve come full circle, and on the days that it happens, it feels good to be back in the “zone.” I also teach healthcare documentation at a local community college (well as soon as I get a class that has enough people to meet California’s budget requirements). I’m an advocate for career technical education and building a career path that will place the healthcare documentation specialist at the forefront of risk management and continuity of patient care.

California born and raised, I really could not imagine living anywhere else. Remember I said I followed my heart back in 1998. Well, I’ve known my spouse for over 30 years. We exchanged private vows on a rolling hill overlooking the backside of Mount Tamalpias in Marin County on February 22, 1998, and became legally married in California on July 8, 2008. My advocacy work spills over into securing equal rights for our community nationwide, and I am a member of the political action committee of the Human Rights Campaign (HRC) here in San Diego. My spouse is 3rd generation in our San Diego home, and we work hard to create an uncomplicated life. We have 3 dogs, 4 tortoises, and a cat named “kitty-kitty,” can’t get much simpler than that.

Re-print from OAMT Newsletter, Spring 2006 ~ 4 years later and still relevant.

ad•vo•ca•cy (n.) The act of pleading or arguing in favor of something, such as a cause, idea, or policy; active support.

It’s 2 a.m. and I know I’m asleep, but I hear a voice nearby…someone gently saying, “I’m going to blow your brains out.” I’m so tired, but the voice inside me is telling me to wake up…you need to wake up…I know you have been up for 72 hours, but WAKE UP!!! I hear it again…”I’m so sorry, but…” the pillow comes flying off of my head…the one I was using to shield all the lights and sounds of being in a hospital room. Then I realize the voice is the phlebotomist hovering over my sister’s arm, attempting to draw blood for her 6-hr PTT. “What did you say? What’s going on?” I asked. “I’m going to blow her veins out if I keep trying.” Oh, veins, NOT brains!!! Super patient advocate reporting for duty! “Okay, explain to me what is going on and what are the options?” He gently says we can try different approaches, including a PICC line, but someone needs to tell the doctor to order something. “Aren’t you going to speak to him?” I asked. “No, you need to tell the nurse this is what you want and they can talk to the doctor.” “How would I know to suggest this if you had not recommended it? Why is it up to me to tell the nurse to relay this information to the doctor? You’re the professional here.” “No ma’am, I’m just a phlebotomist” he responds. “You are not JUST a phlebotomist. You are the person responsible for getting enough blood out of my sister so they can run the PTT to determine if the heparin drip is dissolving the massive PEs in her lungs. Tell me what I need to do and I will do it!”

Flash back a month, my sister is having a BE to determine if there is a blockage in her colon. She has a reaction to the contrast with pain, nausea and vomiting so severe I am called into the x-ray suite to help her. Finding her hyperventilating, half-naked in a tiny restroom, I ask for some blankets, washcloths, grab a chair, and I started Lamaze breathing (hey, whatever works). After 2 hours, I ask the x-ray tech to please do something. She tells me “I’m just an x-ray tech. There’s nothing I can do.” My immediate response, “Well, I’m a medical transcriptionist and there’s a LOT I can do! Get her doctor on the phone, get me some fresh towels, and find a room for her!!” Within 30 minutes we had her in a room, appropriately medicated, and 7 hours later she is rehydrated and able to go home.

Flash back 5 months (November 2005). I went into caregiver mode while my 56-year-old sister and her husband lived with us during her recuperation following a partial colectomy with loop ileostomy bypass. I came to know everything about her I&Os, every wince, when she was in pain, if her stoma was inflamed, what is a new “normal” and what is not. Four months later she should have had her takedown procedure, be back home and working again. Instead, this viable, strong-willed, energetic production manager over dozens of workers, is back in the hospital for a revision colectomy for severe diverticulitis, fistula and stricture. This was her second surgery and 4th time under general anesthesia since November, with a couple colonoscopies in between to assess the situation. Instead, she has SOB, pelvic and back pain, fevers, and on a few occasions, pain and swelling in her knee. I relayed this info to her doctor, she spoke to him about, and even at the second preop she made them aware of it. Nonetheless, they are proceeding with another procedure. I arrive at the hospital just as she is being prepped and they rush me though as she wants to see me. As I go into the preop area, she says to me, “Oh good, there’s my advocate.” I give her a kiss and tell her I’m right here as she drifts off to sleep. They went forward with the 6-hour procedure, 3 transfusions, and one week postop she still has a heart rate of 110-120, temp of 101, and O2 saturation at 94% with oxygen and 83% on room air. They were going to discharge her when suddenly the night before her heart rate soared to 204. They figured it was equipment malfunction as it was back to 115 when checked manually. They assumed it was anxiety about being discharged and gave her a sleeping pill. This is despite her telling the nurse her heart was pounding so fast and hard it felt like it was going to pop out of her chest. This entire time I am home with a cold, unable to hover like I had for so many months. Then I get the call. Her nurse tells me, “your sister has massive pulmonary emboli in her lungs, which we found on CT chest. We are starting aggressive measures to dissolve these as quickly as possible.” PE…no two letters in the alphabet grab my attention more than these…stealth, unpredictable killers. I start asking questions again. What does this mean? What can it do? What are our options? Then she puts my sister on the phone. Her breathing is labored and she asks, “Kathleen, what does this mean? I don’t understand what they are saying. What is going to happen? I’m so confused.” How do you tell your big sister over the telephone she has a condition that has been present for weeks/months and could be fatal, but that I will do everything in my power to not let that happen? I fly into advocate mode once again. I throw some things in a bag, grab my laptop and head to the hospital, exclaiming “I’m not leaving until she leaves!” It’s her birthday and friends have stopped by to give their best wishes, but with looks of absolute fear on all their faces when I walked into the hospital. Do something, they say. Don’t let this happen to her. Giving her a gentle kiss, wishing her happy birthday, and whispering to her that her advocate is here…I go off to introduce myself to her nurses, informing them I am a medical transcriptionist, HIPAA compliancy officer for my company and President of the Oregon’s association for medical transcription, and thus, I would like to obtain the necessary release of information forms, and requested a house supervisor contact me about reviewing her records since her admission. (I had her obtain her records from all the previous visits prior to this admission, only to find the “PROCEDURE PERFORMED” section of her November operative report had a big blank where the MT could not understand the dictation…very appropriate, better to put a blank than guess, but the doctor electronically signed the report without filling in this all-important section!) Over the course of the next 3 days no one followed through on that request, IVs ran dry, meals were not delivered, pain medications were delayed sending her into a pain level of 10/10, and my heart ached…and all this happening with me right there. This should not be happening…someone should be reading the records we so carefully transcribe. Someone should be paying attention to the details. My career-long mantra has been “accurate and timely documentation for continuity of care.” Why isn’t anyone reading it? Why aren’t they seeing the red flags? Why do I have to be demanding second opinions, consultations, diagnostic tests and attention to the details? Because, if I don’t, who will?

Just in case you are wondering how it all turned out…For her colectomy and once she was properly diagnosed with the PEs, my sister received outstanding care from some very attentive physicians, nurses and CNAs. We are all human, and we make mistakes, and this could have been a fatal one, but she is doing well, on appropriate treatment, looking forward, at last, to that elusive takedown procedure, and appreciating how fragile and precious life truly is.

If we don’t educate ourselves, know what the expectations are, what the options are, and speak up, the quality of healthcare is going to continue to decline. There are so many areas within our industry that need us to speak up about: credentialing, education, funding for externships, interoperable technology to ensure secure and available information, appropriate reimbursement rates, affordable health benefits for all Americans, and most importantly, quality health care.

I have been an MT since 1980, having gone to school to be a medical secretary. Interestingly, the instructor “discouraged” us from doing the boring job of medical transcription and always promoted being the medical “secretary.” Nevertheless, even with that bias instilled, I ended up being a medical transcription as it incorporated my love for language with my love for typing. I then grew to love medicine and the medical language. Voila! A match made in heaven…

I worked in hospitals and had my own service for many years. I was introduced to AAMT around the year 1982 and went to a workshop sponsored by the Greater Boston chapter that was being done by Claudia Tessier on style and practices. I had no idea at the time that I would eventually actually work for this woman, but was in awe of this person’s knowledge and passion.

I started to get involved in chapter activities and went to my first national AAMT meeting in the mid-1980s. Soon after I applied for a position at the AAMT national office where I was hired as Certification Coordinator and later became the Director of Certification. I was employed by AAMT from 1989 to 1995 after which I was on the national board of directors.

In 2001, my husband and I became domestic missionaries in a program for troubled teens and I left the profession for about 3 years. However, once our term was over as missionaries, I returned to my first love, medical transcription. I have had a varied background in the profession, working as an MT, QA, manager, business owner, volunteer, customer care and medical editor.

I love to cook (especially baking), making bead jewelry, and my husband and I recently relocated to the warmth of Arizona from New England. I have a rescued pug named Princess who keeps me company while my husband is away as a truckdriver. He used to want me to learn to drive a truck and so we could become a team; however, he changed his mind after I spent a 2-week vacation with him on the truck (thank goodness!).