At his XY Files in an MT World blog at Advance, Jay Vance asks: Are Medical Transcription’s Days Numbered? This fairly brief blog entry includes a long quote from Nae Priest, originally at MT Chat. I’m not going to requote it or Jay’s blog – click through and read the whole thing, along with the comments.

I have to wonder where the overall job market is in the United States when the Department of Labor gives such a rosy outlook for medical transcription careers, in spite of a general negative outlook on the part of transcriptionists (and many MTSOs) themselves. And because they can point to the DOL information on medical transcription careers, the schools will continue to sell MT as a viable, vibrant work-at-home career.

Obviously, there are a lot of us with experience in the industry who disagree.

Jay brings up HITECH (see For the Record HITECH Act and HIPAA for a condensation of how this will affect medical records). After the hoo-haw surrounding HIPAA, I think a lot of MTs are thinking whatever. And, as we saw when HIPAA was passed, a few smaller MTSOs are jumping ship and selling their business before this big shoe drops. How HITECH will affect the industry overall remains to be seen, but there is a lot of discussion about whether or not it will inhibit or even eliminate overseas transcription… which, of course, leads to another discussion on how that would affect US MTs.

My opinion is that a pressing demand for more MTs in the US would not lead to higher pay rates. I think the result would be a harder push towards EMRs and point-of-care input. The way I see it, healthcare is under the gun to make records electronic and there’s a tremendous commitment of resources and money to make that happen. Short of money and already committed to spending quite a bit on EMRs, hospitals aren’t going to cough up more money to throw at manual transcription – they’re just going to find the motivation to make EMRs happen faster. Doctors who have invested in EMRs but not found the motivation to use them to their full capacity will find the motivation when faced with increased costs for manual transcription – they’re already paying for the EMR system and if it helps them eliminate or significantly reduce transcription costs, especially in the face of a rate increase, they’ll suddenly find they don’t mind using it quite as much as they did when labor was cheap.

Those of us who’ve been online for awhile will find this homily familiar: A rising tide floats all boats. The problem is, the people throwing that adage around assumed a rising tide. Guess what happens in a receding tide? You got it – all the boats are stuck in the same stinking mud. The real-world translation of that is – MTs are already seeing reduction in pay, to the point where it’s almost equivalent (and in some cases, less) than what an overseas transcription service charges. If HITECH brings all transcription back in the US, the most likely scenario (after the newfound motivation for EMRs) is that medical transcription will sink further into the pink collar ghetto, and MTs will find themselves working for rates equivalent to overseas. Possibly less – overseas companies don’t have to pay any US employment taxes or deal with the mounds of paperwork for employees that costs a company money.

And if HITECH doesn’t result in healthcare getting nervous about work going overseas (and I don’t know how it couldn’t), there’s then the cost of compliance – which includes background checks on all employees. Again, I think this is going to fuel the motivation to hasten adoption of EMRs and point-of-care documentation, simply because it eliminates the added costs and headaches.

More and more experienced MTs will bail out of the industry. Many women who entered the work force so they could be flexible and work at home while their children were young have now moved past that phase of their life and can participate in job markets outside the home. I don’t think any of this will stop the droves of young mothers and rural wives who see MT as the solution. And frankly, I sometimes wonder if companies would rather have inexperienced newbies just entering the field because they have lower expectations than those of us who remember decent pay, dictators and working conditions.

When I look at the jobs posted for MTs, it’s the same jobs, by the same companies, recycled over and over again – it’s difficult to tell if they just can’t keep MTs or if they’re signing that many new accounts, but even the #1 job site for MTs has less than half as many job listings as they did 2 years ago, and many of those are repetitive ads by the same companies.

Is there a future for MT? Sure there is – I’m just not sure it’s one many of us who’ve been around for awhile will want to continue participating in. It looks less and less like the kind of career I was looking for over 20 years ago and the changes haven’t been for the better. I have intense ennui when it comes to the concept of adapting to the changes – if I have to change, I’m going to find something that pays better for the years of experience I have. Frankly, I’d rather be paid $10 to do a mindless job like door greeter at the local supermart than bring years of skills as an MT to a job for the same pay per hour.