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LONG BLOG

Career Interview with a Heart made of Opioids

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Hello, community blogs. How you been? Feeling a little under the weather? Unwohl, perhaps? Groovy, listen, I don't know if you have anything against doctors or hospitals, but in case you thought everyone in the medical field was soulless, you should probably know that one of our own works behind the scenes to chew bubble gum and kick ass. Kinda. Actually, it feels like part of his job is being an awesome member of Dtoid, what with the amount of work he puts in helping us co-pilot the forums.

But don't think that makes him less skilled at what he really gets paid for. Read on, and you'll see that he knows his stuff when it comes to makin' paper by pushin' it for the public health system in Deutschland. Take a look through my otoscope into the daily life of OpiumHerz, M.D.

(Medical Documentalist)

 
1. What activities, duties and work do you do every day?

Working in a hospital I signed a paper about medical and business confidentiality, so I am not allowed to go into too many details here, sorry. However, what I basically do I read every patient's file from the two clinics I take care of. My areas are Ophthalmology (Eyes) and Otorhinolaryngology (Ear, Nose, Throat). I read through everything the nurses and doctor's documented and decide what is relevant for the billing process. Another part is pretty much literally discussing/arguing with Health insurances if they think our documention/treatment was unjustified. They then don't want to pay for days or certain things we billed, so I either have to prove that it was justified or agree with them. The paperwork for this is handled by another division though. I basically only get a letter telling me what they disagree with, then I check the patient's file.

That aside I point nurses and doctor's towards problems with their documentation and I'm being consulted when it comes to questions regarding the billing system. I also work a good bit with statistics regarding my two clinics.

It's mostly bureaucracy, really. No sane person would put up with this shit by choice.



2. How were you trained for this career?

It was a three year apprenticeship that took place in what can be best described as a private university that was focused on jobs in medical. Of these three years, I spent six months in Year 2 in actual hospitals and working there, that aside we basically went to school. Due to the lack of expertise for many of the lecturer's though, I learned most of my stuff on myself. The final tests were standardized from the government, so we knew we had to be better than what we were provided. That being said, seeing this level of incompetence was a good preparation for the real world.


3. What is the salary range for people in your line of work?

In my field we're paid by union rate called TVÖD, it's for the public service. Nurses and doctors etc. are paid by it too. The wage for my job specifically varies a bit. The TVÖD has 9 classes with multiple levels each. You can advance levels up, but not classes (unless you get re-hired and are being paid in another class - for example you work at location one for Class 1 Level 4, you get hired somewhere else and get paid Class 3 Level 1).

When I started out I had around 1600€ on my bank account every month. Having no job experience back then, I found it fair enough. Every few years you automatically advance a level, so I earn a bit more nowadays too. Since public services has a very active union in Germany valled ver.di, and nurses/doctors are really on edge at the moment because they're hopelessly overworked, ver.di also strikes pretty much every year, which benefits me in the end again because the raises they negotiate hit me too.

That being said, the employer decides what Class and Level you start it. I applied for one job where the employer straight up told me I will be in Class X and Level X and that ain't negotiateable. Thus I can't really give you a reasonable range, but you can find the table of every wage (pre-taxes) class/level in the TVÖD here: http://oeffentlicher-dienst.info/c/t/rechner/tvoed/vka?id=tvoed-vka-2014&matrix=1
So the lowest monthly wage would be around 1630€ and the highest one is around 6745€.


4. What are some of the fringe benefits you enjoy?

Being part of public services I get lots of stuff cheaper. My public transit ticket for example costs me only 50€ per month instead around 90€. My employer also does a very special thing regarding retirement provisions. As I said before, being paid under the TVÖD I get a raise whenever ver.di goes on strike again for the rights of doctors or some shit, which is nice (even though I dislike ver.di A LOT).


5. What are the positive aspects of your work?

I don't have to work directly with patients. And thank god for that, because patients are fucking morons. Not as bad as retail customers, but close.


6. What are the negative aspects of your work?

I have to stare into a PC monitor pretty much all of the time, which is a strain on the eyes. My eyes got noticeably worse since I started this job and I will definitely need glasses sooner than later. Often I need to talk with doctors directly and their schedule is packed, standing in the operating room has priority over going through old files. Many doctors also think they know it all, surgeons are the worst in that regard and both my clnics are surgical ones. Telling them to shut the fuck up and listen for once because they have no idea what they're talking about is frowned upon too, because otherwise I would do that probably once a month.



7. What are some of the major trends you see in this career field? What predictions can you make about this field in the next five to ten years?

Digital will become important in the future. Digital patient files are the future and they have an incredible amounts of benefits. Honestly, if you don't work in a hospital, you have no idea how much space, money and manpower is wasted by storing patient files. My field of work also will become more important in the future, because hospitals WILL have to start watching their finances. Billing becomes more and more important, because the hospitals in Germany did a lot of mismanagement and now have huge problems. The billing system fucked them straight up the ass in 2013 on top of that, due to some changes made (it was predicted that many small to medium sized hospital will be in DEEP debt at the end of 2014 because of this - and I'm talking about "We have to close up shop"-debt).


8. Is there a lot of competition to get into this field?

When I applied, around 2010, there wasn't. There was a big demand from hosptials for my kind of people. Now, a few years later, the positions have been filled and it can be indeed problematic to get a job here, at least in Germany. If you got a decent training though (we get trained in LOTS of fields, from billing to clinical studies, we cover many different grounds and can start work in many different fields) I'm sure you can find something still. But you should be ready to move. For the job I have right now I literally moved to the other side of the country.


9. What are the strongest skills a person must have to do well in this career?

Know your way around a PC, since you work almost exclusively with it. Be a good time manager. Be able to identify bottlenecks in efficiency and remove them in a way that makes every party invovled happy. Attention to detail is important too. Anatomical knowledge for the clinic you work in is an upside too, so if you already have a history in medical that is always good.


10. What personality traits do the most successful people in this career have?

Have a good eye for detail, working fast and good, and overall just be intelligent. That might sound stupid, but that's what it all boils down to in the end. You just have to know/learn how to handle doctors, insurances, rules for billing etc. Applying that knowledge is relatively easy, but attaining that knowledge is something that takes time and experience.



11. In what other fields can a person with your training go?

Clinical Studies and everything statistics related, like controlling, are logical expansions. Archivework of different kinds too. Training regarding billing system are an option too.


12. If you had it to choose all over again, would you still enter this field? Why or why not?

This is a bit tricky. Truth is: I never WANTED to do this job. I wanted to go into journalism, but couldn't because I didn't have the degree. I wanted to go to the police, but couldn't because one of my school grades (motherfucking MATH, no less) is one score below the demanded grade. And while I want to become an author one day, with books in stores and such, that is a dream and not a career I could persue. I only learned about my job through my ex's dad and took it because I was searching for a job for three years without success and I NEEDED something. It was better than nothing, so I took it. It just turned out to be the dumbest kind of luck that I actually like this stupid job too.


I might chose the job earlier, right away. I'm happy with my job, I just like it. That's really all that is to it. I enjoy doing what I'm doing for some reason I can't explain. I would do things very differently regarding my private life.


13. What is your next career move?

Simply put: getting better. I'm not nearly as good and knowledgeable as I want to be.


14. Where can I get more information about your career?

That is a bit tough for me since Medical Documentation, controlling and billing works differently all around the world. I think I don't have to point to the huge differences in paying medical bills alone. I think my advice would be to look what kind of billig system your country uses (check for ICD and OPS systems) and follow the trace from there. Maybe ask a local hospital if they employ people for this (in some hospitals it's actually the nurses'/doctor's job, which is often pretty problematic because they are simply not trained in this field) and ask them. I could only give you advice regarding Germany, that wouldn't really help anyone.

15. What advice can you give someone who is trying to choose a career?

Take risks. Working a year in a job you dislike is shitty, but it's better than doing nothing for a year and I think it's a valuable experience nonetheless. I worked REALLY shitty jobs for years and I hated every minute of it, but I also learned a lot from it and found jobs I definitely never want to do. Maybe try to think out of the box, try looking for jobs that not everybody knows of. I didn't know of my job until I was basically one week away from signing in for that school. I believe everybody can do something good that is also fun, sometimes it just takes a few years and/or luck to find out what it is. But don't let yourself getting caught in a job you hate longterm. You will start hating yourself, your life, and everything else. I never thought I'd go into medical and here I am now.

Also get your shit straight when you apply somewhere. If you apply for a job, get your CV and letter up to speed. Writing a good application is one of the most important things while job hunting.

Eternal thanks again to Opium for his honesty and words of wisdom, and to the Destructoid community for housing such remarkable specimens. I like to think our future mechanical overlords will be more benevolent, thanks to you all.

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About Nihilone of us since 6:11 AM on 12.19.2009

Hi. I'm Dan, an admin in the forums. Come down and say things to us. You'll float, too.




"Nihil" is the pseudonym I use for writing and gaming on the internet. I came across Destructoid by searching for information on Way of the Samurai 3. Tubatic had the most comprehensive coverage on it I'd seen anywhere.

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