I was reading a book yesterday and came upon a parable that made me laugh out loud, then I thought “Wait! That's like medical transcription!” Unfortunately, I couldn't find any reference to the original (and the individual quoted in the book was paraphrasing someone else, also not referenced), so I'm just going to have to paraphrase without a reference to the original source.
There's at least one technical solution to every problem, then there's a miracle solution.
For medical transcription, the technical solution would be God coming down and visiting plagues upon the medical transcriptionists' employers, making them raise pay rates, pay for down time, provide better benefits and paid time off. He'd send a thunderbolt straight into the heart of the speech recognition engines, filling them with unresolvable bugs so they put out the worst gibberish imaginable. He'd tangle the networks hopelessly so that EMRs would constantly be down and doctors would be forced to dictate again. Doctors would suddenly dictate with clarity and without a single um or ah. Medical transcriptionists would be blessed with accuracy and speed, getting twice as much done in half as much time! The work queues would never run dry, but everyone would be in turnaround! Children would be singing in their homes about the joys of a parent who has a legitimate work-at-home job!
The miracle solution would be that medical transcriptionists realize that medical transcription is rapidly changing and they need to change as well, because there's nothing they can do to turn back the clock of change.
A friend of mine on Facebook who is now a former MT noted that when she announced she took a job at a hospital, working on an EHR, she was told she was a traitor. Well okay – stronger terms were used, but you get the idea.
Ten (or so) years ago, you were a traitor if you had anything to do with overseas transcription. Unfortunately, there are still groups trying to put this genie back in the bottle, as though overseas transcription is the only cause of stagnant pay rates, increased demands and less work and if it would just go away, all US medical transcriptionists would suddenly benefit from increased pay, better working conditions, more work and fewer demands.
Then, there was speech recognition. I wish I had a dollar for every time a medical transcriptionist said it wouldn't ever be good enough to impact transcription jobs. Now, we have large facilities reducing the volume of transcription by 50% or more with speech recognition and individual doctors using speech recognition in a variety of applications to reduce or eliminate transcription.
The new traitors are anyone who works with EMRs, which have emerged as a bigger threat to medical transcription jobs worldwide than overseas outsourcing and speech recognition combined. Unfortunately for medical transcriptionists, this threat is actually more real. In spite of evidence that doctors spend precious time working on the EMR instead of seeing patients, the cost-benefit has been weighed and apparently the benefits outweigh the costs. In spite of efforts to maintain a narrative in the record, EMRs continue to roll out with slashing or eliminating transcription costs as one of the goals.
Facing the career change fear factor
If you're over the age of 40, your parents most likely stayed not only in the same career their entire life, but they also stayed with the same employer. According to career planning experts, that has changed drastically in the last 15 years, due to changes in technology and, more recently, the economy. The Department of Labor does not have statistics about career changes; however, career planners estimate that the average person will change careers three to five times in their lifetime. That's careers, not jobs.
That means if you're 40+ years old and you've doing medical transcription most of your working life, you'd be like any average American if you're considering a complete career change.
Let's face it: a career change is frightening, and the older you get, the more frightening it's going to be. If you're close to retirement, you just want to hang on for a couple more years until you CAN retire – and in the meantime, you have bills to pay. If you're younger, paying for an expensive medical transcription education probably isn't all that far in your past; not only would you like to get your money out of it, you've got bills to pay. Whatever group you're in, you're struggling more and more to find a company that pays a decent line rate, allows you to be productive so you can make a decent hourly rate, and has plenty of work so you aren't constantly struggling to get in enough lines to make logging in and working worthwhile. Changing jobs – much less careers – is an exercise in frustration and fear. Can you find a new job before you starve to death because the company you currently work for is always running out of work? Will the new company be any better?
The biggest barrier to career change is money. Any medical transcriptionist who has gone through a medical transcription education program, struggled to get that first job, struggled to get in a couple years' experience and finally come out the other side can probably expect to pay the rent or the mortgage or whatever other financial obligations the family has determined need to be paid from that paycheck. As long as the volume of work holds, an MT knows how many lines have to be produced to keep the job and pay the bills. A career change means starting all over – possibly schooling and the time and expense associated with that, training and job hunting, during which time there's uncertainty about how those bills will be paid.
Another barrier to career change is the knowledge that, like medical transcription, many careers require that dues be paid. The dues paid in medical transcription is the steep learning curve, even for those who have a good education. The thought of going through another round of dues-paying with a completely new career is daunting. And, having paid your dues in medical transcription, realizing maybe this career isn't going to help you accomplish your financial goals and you're going to have to start over with a new one carries a huge psychic cost.
Switching careers is most difficult for those in the 35 to 55 age group. For most people in this age group, there are more financial and family obligations and considerations. Any change can upset what is already a delicate balance. It's kind of like sticking your hand into a box and grabbing a handful of sand – you can't hold onto the sand, but you can't pull your hand out of the box, either.
After the miracle
Let's imagine for a moment that the miracle happens and more and more medical transcriptionists say we're fed up, we can't work like this, there has to be something better. What happens next? (Hint: a union is not the answer.)
Time to evaluate what career will meet your financial and social needs. When MTs post on the medical transcription forums that they're working more and more hours just to meet their minimum line requirements or make ends meet, I have to wonder whether they wouldn't be better off with an office job, even with travel time. I can say from experience that the biggest problem with a home office is you never leave the office.
An office job might require that children be left in someone else's care all day – but what are MTs who are at their desk 10 to 12 hours a day doing with their children, anyway? Is there any quality interaction going on there? I know there wasn't in my house. I was stressed and working too many hours. Looking back, I have no doubt I would've spent more time with my children if I'd had a job that I could leave at the office. I wouldn't have made as much money, but I would've spent more time with my children. If I was at the same point in my life today, I'm not so sure I could also say the money is better. Maybe it's time for the MT who wants to be a work-at-home-mommy to evaluate how much mommy the kids are actually getting, and whether a career change – even one working outside the home – would result in more quality time with the children.
The other reality is that there are probably as many medical transcriptionists who have to work at home as there are ones who want to work from home. Those in rural locations, those who have health issues, those who care for elderly parents… there are a lot more reasons for working at home than just staying at home with the kids. My point is that if you have options, it's probably not a bad idea to see what they are and whether or not a career change would be an improvement.
My husband has been pushing me to learn coding, so I'm going to put this one out here. Medical transcriptionists have skills that are transferable to coding. Coders are in demand and that demand is expected to continue. Coders have always made more than transcriptionists. There are telecommuting coding jobs. ICD-10 is being rolled out in the US, which means experience is going to be less of an issue for new coders – ICD-10 is radically different from ICD-9. I am told the current average coder is near retirement age and many of them are planning on retiring, rather than learn ICD-10. This will mean an increase in demand for coders. My hesitation about this career is that it is/will go in the same direction as transcription; i.e., overseas, commoditized, with shrinking pay rates. I am assured by many people that this is not a concern. I feel it's something for MTs to look at, at any rate.
It takes a lot of focus and commitment to successfully change careers. It also takes planning, developing short-term, intermediate and long-term goals, and the support of your family. And in an economic downturn, it can feel like jumping out of a burning airplane. But let me pass along some wisdom my 25-year-old son imparted to me one day. We were talking about education and he said that what convinced him he needed to finish college is someone saying to him in two years, do you want to just be two years older – or two years older with a degree?
So I'll ask the medical transcriptionists who are struggling with their fistful of sand in the box: In two years, do you want to just be two years old and still struggling as a medical transcriptionist – or do you want to be two years older with the skills to start a new career?