The XY Files in an MT World : Professional Associations

Medical Transcription: "Specialized Secretarial Work?"

Jay Vance — Tue, 12 May 2009 13:00:00 GMT

My colleague and fellow blogger Julie Weight has had a lively discussion going on at her MTExchange.com site regarding mandatory credentialing for medical transcriptionists, an issue recently reported on by ADVANCE 's Lynn Jusinski. Julie, in her latest...(read more)

Update on MedQuist/AHDI Settlement

Jay Vance — Wed, 15 Apr 2009 17:05:00 GMT

According to the updated MedQuist settlement FAQ page on the AHDI website, individuals eligible to participate in the MedQuist class settlement will be able to do so "no earlier than May 29, 2009." As I reported in an earlier post, the deadline for participation...(read more)

MedQuist Class Action Settlement Finalized

Jay Vance — Thu, 02 Apr 2009 21:37:00 GMT

According to the MedQuist website , on March 31 the U.S. District Court of New Jersey entered final judgment approving the settlement of the medical transcriptionists' class action and dismissing the case with prejudice. The website provides links to...(read more)

New Organization Formed For U.S.-Based Transcription Providers

Jay Vance — Mon, 23 Mar 2009 17:46:00 GMT

A new membership organization aimed at U.S.-based medical transcriptionists and companies has been formed. The American Transcription Association (ATA) was founded by Donna M. Littrell, who identifies herself as the Executive Director of organization....(read more)

More Details Emerge Regarding MedQuist Class Action Settlement

Jay Vance — Mon, 19 Jan 2009 18:40:00 GMT

The Association for Healthcare Documentation Integrity (AHDI) has updated its website to include answers to frequently asked questions regarding the proposed settlement to the class action lawsuit brought against MedQuist on behalf of certain current and former MedQuist transcriptionist employees. The FAQ page lists the free resources it will make available to eligible members of the class as part of the settlement. As to when these benefits will be made available, the FAQ page includes this statement:

"The settlement has not yet been approved by the court, and the free program offered by AHDI to qualifying class members as provided in the settlement will not become available until after the settlement is approved by the court and becomes final. AHDI will be notified regarding the status of the settlement after the fairness hearing scheduled for March 26, 2009 and more information will be posted."

The FAQ page also states that membership in AHDI is not a requirement in order to take advantage of the benefits granted to the settlement class members.

This FAQ web page also includes a link to http://www.transcriptionistsettlement.com/, a website that has evidently been set up by the claims administration firm tasked by the court to administrate the class action settlement. A notice at the bottom of the home page of this site states, "THIS SITE IS NOT OPERATED BY MEDQUIST. THIS CLASS ACTION SETTLEMENT IS SUPERVISED BY THE COURT AND IS ADMINISTERED BY A CLAIMS ADMINISTRATION FIRM THAT HANDLES CLAIM PROCESSING. THIS IS THE ONLY AUTHORIZED WEB SITE FOR THIS SETTLEMENT. PLEASE DO NOT RELY UPON OTHER SITES THAT SET OUT DIFFERENT AND UNAUTHORIZED INFORMATION."

This site actually includes a wealth of information relating to the settlement process, with links to PDF copies of numerous legal documents pertaining to this case. Among these are the Class Notice, Stipulation of Settlement, Preliminary Approval Order, Complaint, and Summary Notice. The Complaint gives a detailed account of the specific allegations made against MedQuist, including this from Paragraphs 37 and 38:

"MedQuist personnel knowingly inflated line counts for bills sent to customers, and deflated line count calculations for payment to its transcriptionists. These line counts were manipulated using a 2:1 line count ratio, wherein the true line count was lowered for the purposes of payroll and inflated for the purposes of billing, so that the amount of lines charged to a client for a transcribed report exceed the amount of lines paid to the transcriptionist by a 2:1 margin, and sometimes higher. The ratios and formulas employed in these manipulations were designed to create a 3:1 bill-to-pay ratio, where the dollar amount billed to a client exceeded the compensation paid to the transcriptionist by a multiplier of 3.

MedQuist's deliberate plan to overcharge customers and underpay transcriptionists to achieve the desired profit margins and revenue "results" became known among employees of MedQuist as "padding the file" or "burning the books" or "jacking up" formulas."

However, in the Stipulation of Settlement, Sections 3.4 and 3.5 state:

"Defendants have denied and continue to deny each and all of the claims and contentions alleged by the Named Plaintiffs in the Litigation. Defendants specifically deny the allegations in the complaint that they created and participated in a systematic scheme of wrongful conduct, or any wrongful conduct at all, to undercount the true number of characters and/or manipulate lines transcribed by Named Plaintiffs or the Settlement Class with purpose and effect of reducing compensation. Defendants further deny that MedQuist breached any contractual obligations owed to Named Plaintiffs and/or the Settlement Class. And Defendants deny that the Named Plaintiffs or the Settlement Class have suffered any damages or were otherwise harmed in any way as a result of the conduct alleged in the Complaint. Defendants firmly believe that the evidence developed to date supports their position that there is no liability in the case."

"Defendants have concluded nonetheless that further conduct of the Litigation could be protracted and expensive and potentially disrupt its ongoing business operations, and that it is desirable that the Litigation be fully and finally settled in the manner and upon the terms and conditions set forth in this Stipulation. Defendants also have taken into account the uncertainty and risks inherent in any litigation, especially in complex cases like the present Litigation."

And remarkably, in the Plaintiff Letter in Support of Settlement, the plaintiffs' counsel admits that

"Plaintiffs...do not believe that a better outcome is possible were this litigation-or any individual litigation-to proceed any further...Plaintiffs concluded that their prospects were adversely impacted by factual developments that diminished the likelihood of being able to carry their burden of proof at trial. Plaintiffs have not been able to develop the case that they believed to exist at the outset of the litigation."

Insight into how the parties came to agree that the settlement should go to AHDI is also found in the Plaintiff Letter in Support of Settlement:

"Initially, Plaintiffs sought to negotiate a substantial monetary settlement to be distributed directly to class members. MedQuist, however, was resistant to the magnitude of Plaintiffs' demand. Further, because MedQuist did not believe it had engaged in any inappropriate conduct and was confident it would prevail on the merits, it was unwilling to agree to any settlement including a direct distribution to class members...the best settlement that Plaintiffs were able to negotiate was a payment to benefit the class indirectly...Plaintiffs consulted with their industry expert, as did MedQuist. Our objective was to identify an organization dedicated to benefiting medical transcriptionists individually and collectively. In response to the Court's question as to why the parties elected AHDI: AHDI is the only organization that meets these requirements."

(As a side note, in reading through both the Plaintiff Letter in Support of Settlement and the Joint Letter in Support of Settlement, it appears to me that the judge in this case was particularly interested in understanding why the parties felt AHDI was the appropriate beneficiary of the settlement funds.)

Also of interest is a link to the Agreement with AHDI, which includes important details about the various free benefits AHDI will offer to eligible class members. These include limitations on the number of each free resource which will be made available. Examples include the Credentialing Prep Course/Specialty Course option which is limited to 3000 seats; Educational Presentations (Webinars) limited to 1500 seats; Educational Product Bundle limited to 2000 bundles; Knowledge Base and Information Portal (Benchmark KB) limited to 1500 subscriptions; Individual Professional Memberships limited to 2000, with all of these limitations on a first come, first served basis. These limitations are not included on the AHDI FAQ page mentioned previously, although that site does state, "Certain participation limitations apply."

MedQuist Class Action Settlement Goes to AHDI; No Money to Individual MTs

Jay Vance — Mon, 12 Jan 2009 14:16:00 GMT

I woke up this morning to find a Google Alert in my inbox regarding a most interesting post on Julie Weight's MT Exchange blog. The blog post quoted a MedQuist memorandum to its transcriptionists announcing the settlement of a lawsuit "...that was brought as a class action on behalf of current and former medical transcriptionist employees of MedQuist Inc. and MedQuist Transcription Ltd. ("MedQuist"). The suite alleges that MedQuist manipulated its company systems to underpay medical transcriptionists for transcription work that was compensated on a per-line basis. Defendants deny that they did anything wrong. The parties have agreed to settle the lawsuit."

I did a little digging and found the memo in its entirety. I must say it makes for interesting reading. The notice states that the lawsuit was settled for $1.5 million in cash, of which no less than $1 million is to be distributed to the Association for Healthcare Documentation Integrity (AHDI) "to fund programs for the general benefit of medical transcriptionists and the medical transcription industry. Qualifying class members will also be eligible to participate in certain AHDI programs free of charge. No payments will be made directly to any individuals."

A subsequent portion of the notice states that "AHDI is offering certain of its programs free of charge to qualifying class members through December 31, 2009. Program options include a choice of one of the following: free one-year individual AHDI membership, or free one-year subscription to AHDI's web-based knowledge base and information portal (i.e., Benchmark KB), or free registration for up to five (5) online AHDI educational webinars; or free registration for credentialing prep course; or free AHDI educational product bundle." The notice instructs interested parties to visit the AHDI website for more information, but I was not able to find anything concerning this settlement or how to apply for the free programs on the site.

According to the notice, individuals who would otherwise be part of the class covered by this settlement do have the option of excluding themselves from the settlement, thus preserving their right to sue MedQuist individually. The settlement covers all MTs who worked for MedQuist from November 29, 1998 through August 11, 2008 who were paid on a line-based unit of measure. Interestingly, it appears from my reading of the settlement notice that the process had not actually reached the class certification stage before the settlement was reached.

I would love to know how MTs affected by this settlement feel about the money going to AHDI rather than being distributed amongst the individuals whose paychecks may have been directly affected by MedQuist's allegedly improper line-counting methods (MedQuist admits no guilt in regards to any of the plaintiffs' allegations as part of the settlement). In any case, this certainly is a windfall for AHDI, which has struggled with declining membership revenues for a number of years. Hopefully many of the MTs who are eligible will take advantage of the free programs AHDI will be required to offer as a result of this settlement. As someone who actually worked for MedQuist during the covered period, you can bet I will!

Social Networking: The Future of Professional Associations?

Jay Vance — Mon, 08 Dec 2008 13:58:00 GMT

Recently I came across a blog posting about a new social networking group called Circle of Moms. Launched in October 2008, the group already has over 850,000 members who have created over 1000 communities dealing with everything from raising toddlers and swapping recipes to sharing money-saving tips. Members can form their own personal "circle of moms" by connecting with other mothers they trust who may be geographically nearby or who share specific interests.

In order to make the group as accessible as possible, Circle of Moms has both a dedicated website and a Facebook application, in addition to an email notification feature to alert members to new updates. Having both a website and a Facebook presence gives the group multiple touch points, and the phenomenal growth gives clear evidence that this strategy is working very well.

At a time when professional associations are struggling to attract and retain members, it seems obvious to me that moving to a social networking approach is the best-and perhaps only-hope for the future. The traditional associational paradigms are simply irrelevant to many younger people; there's too much structure, too many hoops to jump through in order to participate. The key to association revitalization will be to simplify structure and remove barriers to participation, while adopting the viral marketing strategies that are working so well for groups like Circle of Moms. Furthermore, in order to get better buy-in from members, associations need to learn from successful social networks and allow the members to drive programs, not the other way around. People will support causes they believe in. Professional associations would do well to look to their members for ideas on what initiatives to pursue, rather than simply trying to force members to support programs envisioned by leadership.

There are plenty of networking success stories to be found which can serve as models for associations looking to revitalize, but it's important to look outside the box in order to find them. We dare not allow the old "we've never done it that way before" excuse to prevent us from recognizing and adopting new paradigms in order to keep professional associations relevant to today's workforce.

A Lesson from the Presidential Campaign

Jay Vance — Fri, 22 Aug 2008 17:35:00 GMT

I recently came across an online article from the New York Times about the presidential political campaign of Sen. Barack Obama. The article quotes several Democrats voicing concerns about Obama's "hope and change" approach to the campaign thus far:

Mr. Obama has run for the last 18 months as the candidate of hope. Yet party leaders--while enthusiastic about Mr. Obama and his state-by-state campaign operations--say he must do more to convince the many undecided Democrats and independents that he would address their financial anxieties rather than run, by and large, as an agent of change--given that change, they note, is not an issue.

"I particularly hope he strengthens his economic message --even Senator Obama can speak more clearly and specifically about the kitchen-table, bread-and-butter issues like high energy costs," said Gov. Ted Strickland of Ohio. "It's fine to tell people about hope and change, but you have to have plenty of concrete, pragmatic ideas that bring hope and change to life."

Or, in the blunter words of Gov. Phil Bredesen, Democrat of Tennessee: "Instead of giving big speeches at big stadiums, he needs to give straight-up 10-word answers to people at Wal-Mart about how he would improve their lives."

This blog post isn't about presidential politics, so rest easy on that score. But it occurred to me that these observations are as germane to the issue of leadership in the area of medical transcription networking and advocacy as they are to the presidential campaign. As I've stated in a previous post, it's my belief that the vast majority of MTs fall into the "Wal-Mart crowd"--a demographic to which I'm perfectly happy to belong. It is also, in my opinion, a group whose interests need to be better represented in the realm of MT advocacy. But in order to effectively engage these folks, leaders must heed the advice offered by Governors Strickland and Bredesen.

Certainly it's worth noting that there's a big difference between giving "10-word answers" about how to improve people's lives and actually improving their lives. (These comments did come from a political campaign, after all!) Still (with apologies to Otto von Bismarck), "Leadership is the art of the possible." A key facet of leadership, in my view, is the ability to succinctly articulate what is possible in a way that motivates others to pursue that possibility with passion and hope. In my opinion, the ability to communicate clearly is the most important difference between a technically competent manager and a truly effective leader. And clear communication means getting to the point and making the point relevant to the listener.

Of course, pithy sound bites don't mean much unless we communicatees are convinced that the communicators are espousing a vision we actually believe in AND that's actually doable; we also want to know that those in leadership have our best interests at heart. I don't believe we can overemphasize the importance of these crucial factors. Talking about a big dream is important, no question, but it needs to be OUR dream. The older I get the more I come to believe that true leadership is less about telling folks what their dream ought to be and more about helping them discover their own dream, and then identify the interim practical steps that must be taken in order to make that dream come true. Not only that, but we need to believe that leadership is willing to go to the mat for us on issues that WE--not they--feel are of critical importance.

In workplace advocacy-as in politics-rhetoric only goes so far before folks want to know "Where's the beef?" We want leaders who will give us credit for enough intelligence and common sense to know what issues WE believe are the most important, and be willing to aggressively represent OUR interests. Yes, "we the people" may get it wrong sometimes, but more often than not we'll get it right.