Whose medical records are they, anyway?

It's not often my keyboard goes all frosty twice in a 24-hour period, but by golly – the commentable comments over at the AHDI Lounge discussion about TRSi's announcement that it has launched a training program for medical scribes just keep rolling in.

Here's the gem that was posted yesterday after I got busy doing other things and forgot to go back and check to see what else was going on over there. This is by Ava Marie George, a member of the AHDI Board of Directors and the president-elect.

Here we have change in our profession offering opportunity (albeit at a low rate of pay) to document patient encounters firsthand.

Various blog posts about medical scribes (my post From Medical Transcription to Scribing?, and Kathy Nicholls' MT Tools Online) make it clear that it's very questionable at this time whether or not this is a career transition or change for medical transcriptionists.

Even more important, we've been battling perceptions about medical transcriptionists for years, ones that have resulted in deteriorating pay and work conditions. I have a fundamental disagreement with the direction AHDI has taken in an attempt to increase the value of medical transcriptionists (i.e., that MTs have a responsibility to ensure the accuracy of the record). Is she really saying that MTs should be jumping up and down to do this job all for the joy of being in the same room as the doctor and the patient? Because that, to me, seems like a giant leap in the wrong direction.

In reading that statement, I get a mental image of some scene from the 1950s (the woman, of course, is wearing a dress, high heels and an apron). Golly gee, doctor! You don't have to pay me much, I'm just so happy to be here working with you! Excuse me a minute while I drag out my virtual barf bucket.

Unfortunately, Ava Marie doesn't stop there.

Are we willing to change our point of view and take a lower rate of pay to assure that the documentation is correct?

Here's a news flash for Ms. George, and anyone else who thinks this line of thought is worth pursuing: I work for the money and no other reason. I don't care what slippery slope AHDI has committed itself to, those records belong to the physician and it is the physician's responsibility to make sure the documentation is correct.

Let me review, in case anyone missed my comments a couple years ago in Advance for HIM. The average medical transcriptionist has a high school education. The average physician has a high school education, plus 8 years of higher education. The average medical transcriptionist is trained on the job. The average physician spends three to six years in internship and residency training programs. The average medical transcriptionist makes less than $30,000/year. The average family physician makes over $130,000 a year, and that's the lowest-paid group; specialists can make up to $800,000 a year. Physicians are one of the highest-paid occupations in the U.S. The physician is trained, licensed and paid to make medical decisions; the medical transcriptionist is not. The records belong to the physician, not to the medical transcriptionist. When the physician signs the document – with a pen or electronically – he or she is verifying that it is a medical-legal document that is true and accurate to the best of his/her knowledge.

Which one of these people do YOU think should be responsible for making sure the documentation is correct?

I'm just flabbergasted that the president-elect of AHDI would think this way, much less say it in public. At least the college students who take this low-paying job are doing it because apparently it looks good on their resume and there's a motive behind the madness. Not so with MTs who would transition to this job. You'd just be trading one low-paying job for another – only now you have to get dressed and drive to work. I don't know about anyone else, but I don't love medical records documentation enough to do that. If I was going to pay the kind of money TRSi is charging for this 6-month program, it wouldn't be so I could get a job that pays $8 an hour. If you just think it's thrilling to work in a doctor's office, there are a number of jobs that require little to no education and/or training and here where I live, they start at $10/hour.

Let the train leave the station, Ms. George. Some of us would rather pick a new train than stay on one that's just headed in the same wrong direction as the one we've been on.

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3 thoughts on “Whose medical records are they, anyway?”

  1. Its a shame that this post would never make it past the censor(s) at the AHDI site because I think a lot of MTs would really love to see them give a few constructive answers to the questions you asked here and not just that warmed up pablum they are busily spouting in that thread.

    Nae

  2. I wonder if the reason AHDI is so excited about the potential of this fabulous low-paid scribe job is that they’re under the delusion that all those pre-med and med student scribes accepting $8 an hour so they can pump up their resumes are going to be enticed into paying dues to AHDI? I know, that’s a what-the-heck-are-you-smoking idea, but then I’ve wondered what was in AHDI’s hookahs since back when they were AAMT. Given their track record for misunderstanding what members and potential members actually want and are willing to pay dues for, I’m thinking it’s not outside the realm of possibility some of them think this is actually a job that will somehow preserve or even increase their (by now minuscule) membership count.

  3. An opportunity… to transition to a lower paying job? How is this an opportunity? An opportunity to get out of MT before it disppears all together and at least you have *some* job?

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