I would stay where you are. I never had good luck with

typing clinic/office notes versus hospital reports. I made more money doing the hospital work. Some people have the alternative situation, but 200-250 lph is pretty good. If something's not broke, don't try to fix it. I wish I'd never left the hospital job I had. I got greedy thinking I'd make more on production than with the hospital. I've been bouncing around trying to find my "good fit" ever since. At least with the hospital, I had the same pool of dictators every day. I knew the report styles and shortcuts/macros. I could crank out the lines and get bonuses. ESL was minimal. I never had connection problems. The hospital paid for my phone lines and equipment. I had a really great and flexible schedule, too. Now they won't take me back unless I start out on night shift again which is never, ever going to happen.

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