Expand at Your Own Risk – Risks of Using Word Expander

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In the transcription industry, word expanders are wonderful tools.  However, they can also be a source of dismay if we do not use them properly.

Case in point:  I used to do transcription for a colorectal surgeon who did some anal fistula or anal abscess surgeries amongst other colonic procedures.  He was quite repetitive in his dictation style in general, so I found using my word expander helped me save myself lots of keystrokes.

He had a standard phrase that he used for these anal fistulectomy surgeries where he used an unusual word – a seton (a skein of cotton or other absorbent material left inside the anus with a string protruding for later extraction).  It acts as a sort of tampon, absorbing the infection or drainage inside the cavity.  I could never remember if it was “seton” or “seaton” so I created an expansion for “as” meaning “anal seton.”  I also created an expansion for “wia” which then expanded to “was inserted into the rectum and the patient was taken to the recovery area in stable condition.”

I received a phone call one day from the office manager and she sounded a little odd, as if she was trying not to laugh and be stern with me at the same time.  She informed me that she was calling to let me know that they had received a transcription back with a huge error in it and could I please explain how this happened.  I was mortified as I took great pride in my work and had never had so much as a tiny complaint from this office in all the years I had worked for them.  I quickly clarified which report and pulled it up on my screen so that I could compare my copy with theirs.

Unfortunately, she was quite right in that there was a huge error I had not caught in my proofreading before sending the reports back.  There at the end of Mr. Joe Smith’s fistulectomy report was an obvious error that had escaped my scrutiny.  As I read, I gasped out loud – my oh my, what an extra 5 seconds of proofing could have saved me in terms of embarrassment!

At the end of the report very clearly stated was “Anna Segura, L.P.N. was inserted into the rectum and the patient was taken to the recovery area in stable condition.”  Holy cow!

I also had an expansion for Anna N. Segura, L.P.N. as an assistant for some of this particular doctor’s surgeries, but that expansion was “ans.”   Unfortunately, my brain and my fingers were not communicating that day (obviously) and I had used “ans” where I meant to use “as” and Ms. Segura took an unexpected trip into someone’s rectum.  The office accepted my humble apologies though teased me about it for years to come.

We all got a good laugh out of it and I was luckily able to remedy the situation before the report went anywhere.  However, this acutely illustrates a very important point in medical transcription/healthcare documentation.  When using expanders or templates, these are wonderful tools but….we must actually proofread what we have inserted into a report or suffer the consequences. It taught me a most valuable lesson.  Going forward, I learned to expand with extreme care and focus lest someone else end up in someone’s rectum!