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Passage

Is Transcription Even Viable Anymore?

Published March 5, 2008 1:28 PM by Jeanne Johnston

I've been watching the various online forums with a new eye since embarking on my journey to a new career and I think it's done nothing but bolster my jaded view of the MT world.

In the Advance forums, Lisa Algeo asks for feedback on bad transcription or coding schools--which has almost entirely consisted of discussion of coding courses. I suspect if she had broken this down into two topics, the transcription discussion would have few, if any, replies at this time, aside from the usual promotion of AAMT's school approval process--a process which, in my humble opinion, started with the best of intentions and quickly deteriorated into a tainted money-making gimmick, thanks to lowered standards and apparent sweetheart deals. If nothing else, it lumps schools that barely meet the requirements on a par with schools that have set the standards for MT training (i.e. Andrews and M-TEC), both of which produce graduates who not only find jobs quickly upon graduation, but are able to pick and choose. In contrast, other graduates are either shuttled through internships because they're not ready to dive straight into the workplace or find their diploma doesn't get their foot in the door to even test for jobs. (Yes, I know they've changed their name and are no longer about "American" or "medical transcription" anymore, but the fact remains that "AAMT" is what we associate with them, no matter how many times they change their acronym.)

There is a dearth of information for potential students, as far as making an informed decision on their education and more often than not, we learn after the fact that we've chosen poorly. Not even taking into consideration the matchbook schools that are solely in it to rake in tuition bucks, and given the purported level playing field claimed by AAMT, students often choose a course based on faulty logic: Why pay $3000 for a course when I can get the "same" training for half that? Well, the sad fact is that by the time you struggle through that cheaper course that comes with no instructors, few reference materials, and often inaccurate or outdated instruction, you're going to end up paying much more to supplement with those same reference materials for the job, remedial transcription materials, and still no guarantee that you know what you're doing. There's an old adage about how a lawyer representing himself has a fool for a client and I think that applies to education even more. You can have the identical textbooks the good courses use, but without a qualified instructor, you can't teach yourself what you don't already know. Even if you could, how much longer would it take you than if you'd just gone with the right school to begin with? Even more important, how much is it worth to you to be ready to make the most money possible as quickly as possible on the job? No, even great training isn't going to make you an expert, but it is going to ensure you don't waste the first six months on the job learning stuff you should have known already. MT wages are low enough these days and if you're struggling to churn out 300 lines a day because you have to research everything, you're not going to last long as an MT.

It seems like most of the transcription questions I see posted are heart-wrenching tales of education gone wrong, people who've found they've invested precious savings and months of effort, only to find things are not as rosy as depicted in those glossy ads for cheerful mommies making $60K a year whilst their well-behaved toddlers perch on their laps. Almost worse are the tales of folks who have chosen well and love the job, but are now facing plummeting wages and speech recognition woes. Contrary to what the vendors are telling clients, SR is not that wonderful money-saver because it's so efficient. It's cheaper largely because instead of paying an MT to transcribe lousy dictations, they're calling MTs editors now and cutting their wages in half or less and requiring double the production, even though they're often finding they're still really doing basic transcription because the SR output is so bad, in essence working twice as hard for half the money. As speech recognition and EMR take over, I'm afraid we're all doomed to transitioning out of straight transcription. It does not matter that canned text and point-and-click records do not make for a cohesive medical record, it's the bottom line that's being sold.

True to form, proponents of AAMT are still claiming a rosy picture for MT, even if our jobs transform into something totally different. In The MT Parachute, we were recently told to expand our skill set, go back to school, get our CMT, and I guess learn to love speech recognition. I'm afraid I found the interpretation of a "parachute" less than logical, as it wasn't actually advocating parachuting to anything viable, just the same AAMT party line.

So yeah, I'm having a "bad MT day." I still love my job, actually, but I see these things barreling down the pike and it has me nervous. This is what prompted my foray toward CTR, after all. I think part of what appeals to me is that the organizational setup for groups like AHIMA and NCRA seems to be done in a much more professional manner than I've been accustomed to as an MT. Of course, I'm a newbie to this side of the fence and not privy to the grapevine yet, but so far, I have a much better feeling about things like school accreditation and member advocacy.

Now, if I could just fast forward to the end of my course so I see more of the picture. After whining last time about a lack of time, I spent my weekend cramming my head full of cell structure, mitosis, osmosis, and all kinds of good things--only to find that I was supposed to jump ahead 15 chapters. Good news seems to be that I can still learn. Bad news is that I apparently have issues with following directions. Gotta love mistakes--no better way to cement a concept in my head than to mortify myself with a doozy. At least learning is something you can never overdo. Now, next time someone asks me to diagram a cell, I'll be ready! In the short term, interestingly enough, I'm already finding that studying anatomy and physiology really has enhanced my understanding of my current job--something I didn't really anticipate, but a great bonus!

posted by Jeanne Johnston

11 comments

I'm a 20-year MT veteran who is going back to school.  I'm also 40, but I figure I'll still be 43 someday....with or without a degree, so best to do it now!

Over the last ten years or so, the draw to "work at home" and "be your own boss" has lured people into this field that never should have even considered it.  I believe this is also part of its demise.

VR is a joke.  How does an ESL doc use it?  Further, how could anyone even begin to edit the product?  We've been threatened with VR practically since I started into this field.  It's just not a viable option unless you have a practice where all the physicians speak clear, concise English.

W Hunter April 3, 2008 6:30 PM

I have just recently completed my MT schooling and have been preparing for a career, when I took my son in to our family doctor the other day, their entire office has been updated with a new medical program which totally eliminated ALL patient files; it's all in the Dr.'s laptops, and they can somehow "plug in patient information" (as it was explained to me by one of the office girls), and with voice recognition they are using, they do not need their transcriptionists any longer.  Talk about a let down!! I don't know if I should even pursue employment now?  What does anyone think????

Debbie April 3, 2008 9:38 AM

Your article hit very close to heart.  I have been a medical transcriptionist for over 20 years now, the last 11 or so from home.  I have a steady clientele, and manage a fair income, but I, too, have become nervous on a daily basis that it will all vanish any day now.  I live in constant fear of it actually.  If I lose one client, I'm done.  I haven't been able to find one new account in ages.  Voice recognition and all the new "do-it-yourself" technology is putting me on the unemployment line.  I keep telling my husband I better find a new occupation, but have yet to come up with a desirable alternative.  I wish I had other MT's to talk to.  It would help me out a lot.  I, too, still love what I do, I just wish it wasn't so saturated and no technologically advanced.  I have about %0d%0a5 more years to retirement and would like to stay put doing what I do best, and I am really good at it.  If anyone out there can lend a helping hand, please e-mail me.  I could use any advice you might be able to give me.%0d%0a%0d%0aThanks, fellow MT's.  %0d%0a%0d%0aAnother struggling member of a once elite profession,%0d%0a%0d%0aJoanne

Joanne Kalin, MT - home March 29, 2008 8:50 AM
FL

Dear Jeanne,

Wonderful post!

Recently a friend of my sister's asked to talk to me about becoming an MT and I did my best to discourage her from the field, for all the reasons you mention.

I find it interesting that there seem to be "medical transcription evangelists" (for lack of a better term) out there who seem so invested in preserving the notion that medical transcription *is* indeed a viable option, as if the past five to ten years just haven't happened. I have no idea what their agenda is or if they are in denial of some sort. I know these statements will get me some flak, but they must be verbalized.

Diane Fusco, medical transcriptionist March 14, 2008 7:58 PM
New York NY

From reading this article and all of the comments that follow, it is no wonder to me that the MT business has such a bad rap. The negativity just astounds me. Granted, I have worked for those same companies that watch every line you are typing and drive you to break your wrists in a day to avoid the "consequences," but on the flip side, attitude has a lot to do with everything. I could have stayed with my former company and accepted status quo and been on here griping like everyone else, but I chose to rise above, move on, and make positive changes in my life. I have now been working for a year with a wonderful company that does not drive me like a slave, values me as an employee, pays what I feel is a very decent wage for me to never have to leave my house (especially with the cost of gas the way it is), and encourages me to keep learning and building on my career. I am currently in the process of getting my CMT (which my company is paying for), and believe it has been nothing but a boon for me personally and for my career and regret that I never strived to achieve it before.  I have embraced SR and love it, and am seriously considering turning to it full time, which I have been offered to do if I so choose. With the right editing software, knowledge of medical language, and previous skills I have acquired as an MT over the past several years, I find it to be much faster, I get way more lines per hour, and my paycheck is not any less than it was before I started doing it.  It sounds to me as though you should not be examining the MT business as a whole, but stepping back and taking a look at the companies you work for and taking a leap of faith to do work for someone else or just get out of the business altogether if you hate it so much and consider it such drugery, and leave it to those of us who love it and are willing to accept the changes that come with any job or industry as time passes. If things never changed, we'd still be typing on typewriters and using liquid paper to correct our mistakes....

Ladonna, SR editor - Medical Transcriptionist March 14, 2008 7:55 AM

Talk about voice editing and recognition software has been occurring for almost all my 27 years as a transcriptionist.  However, I no longer feel that transcription will be a viable career until my retirement and am attending classes to become a coder.  I feel that coding is the future and traditional medical transcription will soon become as obsolete as the vinyl 33-rpm record.  

Deborah, Health Information - Medical Transcriptionist, Baptist Health March 11, 2008 3:05 PM
Little Rock AR

I wouldn't recommend anyone going into the M.T. profession any more.  It used to be a real "profession" to be proud of and a pleasure to do.  Now, it has descended into a "sweat-shop mentality" for those of us still in it.  We have to endure faceless "supervisors" many of whom never were M.T.'s themselves monitoring our work by actually listening in every hour to make sure we're still actively typing, constant pressure to work extra hours, make sure you're not 1 line an hour under the "quota" they have set for you otherwise you receive a warning call that you are now being watched for another pay period and if you don't increase your production to the "acceptable level", your benefits will be reduced or cut off.  Doesn't this sound like a fun way to work?  There is so much more that is objectionable about this work,  that I can't really find anything positive about it to tell any new person asking me about it or contemplating spending money to learn it.   I have served in other aspects of this business and know it very well.  

As far as being a CMT...not necessary...Your suspicion about it being a "money-tainted gimmick" is right on.  When I was learning M.T. work in the hospital and going to nursing school, my hospital M.T. supervisor told me to "just take the test and I would pass", but that the hospital didn't pay any  more for an M.T. with it or without it.  I found most places the same...I didn't take the CMT test and have never done it and during the heydays of transcription made very excellent money in three states without out it.  I was  more interested in passing nursing boards and keeping up my critical care knowledge, which in turn made me a far better transcriptionist than someone who just knew the words, not actually knowing what the doctors were doing.  

As far as coding goes, I have begun to read letters from disenchanted coders popping up every now and then in Advance, and am not surprised.  I can only see the same things happening to this job too, since most of the same M.T. company's also employ and outsource coders, too, so the same things that are reducing the amount of our paycheck will inevitably spill over to the coders.

Judie, M.T. /R.N. March 11, 2008 10:23 AM
AZ

Medical transcription as a profession is a "hard row to hoe," and those of us doing it don't really have good representation. I am disturbed that we keep hearing that we should embrace change and jump on the speech bandwagon without question or complaint. Sorry, but it sounds like we are just being asked to be good girls.

Software developers spend a lot of money selling doctors and hospitals on VR software that is supposed to eventually replace us and no one questions it. It is new technology, it is more efficient, it must be good! Having worked both speech and text in the last 2 years, I can see the shortcomings of VR for the MT all too well. It is at best a tool for use in situations where you are already on an hourly wage. If you are a production MT, you will not be able to make a great living as an MT editor. By taking away the opportunity for the individual MT to hone her skills, build her shortcuts and get to know her accounts well, and replacing   those things with pre-generated text, the MT is reduced to following along as the extension of a computer program.

In times like these I would wish for real representation, not AHDI. We are not just medical secretaries and we are not dummies, and we have a place in this industry that no software can fill.

Proud MTEC graduate, 2006

Marian Davis, Medical transcriptionist March 10, 2008 6:15 PM
Johnson City TN

Jeanne - Bravo, well written. It's so much a widespread issue, how to choose the best program to obtain a quality outcome for either transcription or coding. You describe the quandary so well. I can see you as a mentor adding value and influence to new people entering the field.

Johnna Grzywacz, CPC March 6, 2008 11:00 PM
NH

Jeanne, you are my God send.  I have been an MT for 15 years.  I have a great job, however, we are currently EMR and going to a new dictation system with SR by October.  I have been trying to decide for years what to "morph" into for my career.  I have wanted to be a nurse, a PA, but don't think I can wait three years on a waiting list to go to school - I'm 40!  I considered coding, and even took two coding classes - LOVED it, but am starting to think that coding will meet the same demise as MT - maybe just not as soon.  By the way, coding really goes hand in hand with MT - I aced my classes and had a great time, but didn't learn enough to pass the certification test, so money spent for nothing.  I have always been interested in becoming a cancer registrar, but somehow thought that my MT experience would not be helpful.  I thought I needed to be a coder first.  I am so thankful to you for your blog and the tips you have put in there, because you have given me a jump start and saved me time.  I am going to check into the classes, and probably will sign up too.  I too dread A&P, because I think some of it will be easy, some of it not.  However, my drive to change my career is strong, and that's all I need.  I agree with you about the Parachute blog - why would I want to open my parachute and continue to be an MT???  If I'm gonna open my parachute - I'm gonna fly!

Chin up with too much to do and not enough hours in the day - I'm there with you.  I work full-time, have chronically ill children, take kids all over town for activities, and can't seem to figure out how to clean my house, do my laundry, all while getting enough rest - and I'm still married!!

Anyway - I just wanted to say THANK YOU - I am going to continue to follow your blog and probably reply to you.  I wish you so much success - take it one day at a time!  

Now I'm going to go check out my new career path . . .

Sandy, Medical - Medical Transcriptionist, TCH March 6, 2008 8:10 PM
Denver CO

My compliments to Jeanne on a superb passage!  Looks like we share the same neurosis when it comes to our doomsday views of HIM.  I have this article in "My Documents" on the hard drive about the coding perspective and CAC. It mirrors what you say, to an uncanny degree.  

All these changes have also made me a little nervous about my prospectsfor the future and stability to someday retire.  This blog spoke to me in a very personal way about an extremely professional problem.  Thanks for sharing with us and know that your "Failure is not an option" attitude cuts in my direction too!  I wish you the best and keep up the will to succeed.

Kevin Shields, HIMS - CCS, CPC, CCS-P, CPC-H, CPC-P, RCC, CCP-P March 5, 2008 9:21 PM
Louisville KY

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