Not so dark, just cloudy, side of medical transcription

I was reading Lynn Jusinski's article in the latest issue of Advance on The Dark Side of Medical Transcription. The experiences related by Trudy Looney and some of her comments got me thinking about a state AHIMA meeting I attended years ago – probably 2002 or thereabouts.

Just a little bit about AHIMA. It's a great organization in many ways and I've met a lot of people I really like. Now for the big HOWEVER… as a business in the transcription industry and a member of AHIMA, I felt like the red-headed stepchild of medical records and I know I'm not the only one. It was a recurring theme among the MTSOs and MTs I talked with who were also members of AHIMA. Ms. Looney's feeling that MTs are undervalued in the medical records cycle is, in my opinion, validated by the way AHIMA – and its members – ignore transcription.

Case in point – back to that meeting I attended…

At that time, digitalization of records was advancing and there was talk of perhaps expanding the available pool of (very much in demand) coders by allowing telecommuting of jobs and how that might successfully take place. There then ensued a long discussion between particpants in the conference about the possible issues for coders telecommuting: isolation, child care, supervision, compensation. The conclusion? “We'll have to study this and proceed very carefully.”

I wanted to stand up and wave my hands in the air and say, “Hey, over here! All you have to do is look at transcription!” At that point, MTs had been telecommuting for years. And yes, experienced all the problems associated with working remotely from home. And yet – not one person acted as though they had any idea that all they had to do was talk to the transcription industry, with its many years of experience!

Moving on – same meeting – I happened to be giving a presentation on speech recognition. During the presentation, I did a live demonstration of how speech recognition works for both live dictation and recorded (back end) recognition. I used a snippet of actual physician dictation for the demo. After the meeting, more than one person came up to me and said they'd never listened to a recorded dictation before! I was absolutely floored.

Is anyone still confused as to why MT is undervalued and misunderstood?

Flash forward to 2009 and I'm at another conference on electronic medical records, personal health records, Health 2.0 and health information technology in general and not much has changed except we're more digitized. Still commoditized and marginalized, but digitally. I didn't get the sense so much from people who asked questions in the transcription-related sessions that THEY felt this way – but everyone pretty much agreed that at most facilities, the general feeling is: (1) anyone can do transcription and (2) even if they believed it takes special skills to do transcription, those skills are no longer necessary when editing speech recognition. In fact, Nick van Terheyden showed, in his presentation, that the intrinsic value of a medical transcriptionist is that s/he isn't the equivalent of a “dumb terminal,” but what we do is taken for granted because we do it so well. We make sense of the jumble, garble, frank dictation errors (well, most of us do) and turn it into a usable document which the doctor then looks at and says “Yes, that's what I dictated!”

Wouldn't they be surprised if we actually transcribed verbatim?

Part of the problem in the transcription industry is the upside-down supply/demand model. Even though demand is high, pay rates have gone down. (And yes, I do plan on getting around to commenting on the Advance salary survey one of these days.) Because demand remains high, even the worst MTs have no problem getting jobs as MTs, which doesn't do a lot for the overall impression of the value of MTs. Top that off with the fact that the better MTs are better because they have higher levels of motivation, skill, intelligence – whatever constellation of assets you want to put together – which means they are also more employable in other sectors that utilize the same or similar skill sets. If someone who has been an MT for 20 years gets offered the same rate per line as someone fresh out of school, what is her incentive to remain in the transcription industry? And yes, I know I shouldn't suppose that 20 years ipso facto makes one a better MT, but let's just pretend it does. Why did she enter MT? Because she had children at home and wanted flexibility in her work. Twenty years later, those children are grown and she no longer needs the flexibility, which gives her more options when it comes to looking to take her skills to other jobs. The MT whose skills are marginal is more likely to remain in the industry, leaving behind the reluctant and unqualified, regardless of years of experience. In what other industry can someone be completely unable to do the job well and still remain employed at that job?

No wonder medical transcription gets no respect.

I'm not pointing the finger at any one group – there are plenty of factors that led medical transcription down this dark path. I do feel Ms. Loosey pretty much hit all the nails right on the head. I just hope those nails weren't going into the lid of a coffin.

Visible black character, revisited

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