AHDI Track article by Tina Whitecotton (Advance for HIM [1], Vol. 17, No. 23 November 5, 2007)

I'm all for embracing change and I know and like Tina Whitecotton - but I'm going to disagree with the conclusions she reaches, especially those related to the Federal Reserve Bank of Dallas' 1992 Annual Report, The Churn: The Paradox of Progress and how it relates to change and the medical transcription industry. (The report can be downloaded for free from this site [2].)

The entire article intimates that if MTs would become more educated in medical transcription and create more value in medical transcription, the "churn" will work for those who are willing to accept change. Whitecotton concludes: "Those who live it, believe it and make it part of their being will continue to evolve and grow with the health care documentation industry. Those who do not will believe that MT is drying up and will leave the industry and go on to another job (and a job is what it will be, rather than a profession). Which group do you want to be part of?" The only problem with this statement is that the FRBD report is all about changing industries. Throughout this report, there are references to changing industries.

"As people shift from one job to another, transitional employment occurs. Unfortunately, there's no guarantee that everyone who loses a job will find a new job quickly or end up with a better one."

"The process frees labor in declining industries to produce more and better goods in new industries."

"Another factor that influences the impact of new technology is the ease with which labor released from the declining industry can enter the emerging one. Many of America's first autoworkers previously made horse-drawn carriages. Some actors and reporters shifted to television after it began to compete with movies and radio. On the other hand, while the fax machine opened job opportunities for programmers and software designers, it's unlikely that the mail sorters and truck drivers ultimately displaced in the overnight mail industry can easily switch to the new jobs."

"The skills needed in the past aren't likely to be the same as those valued in the future."

The FRBD report isn't even talking about creating value within the existing (declining) industry as part of the churn process, nor are they proposing that targeting a higher level of education aimed at the declining industry is the solution to bolstering it. The declining industry is just that - an industry in decline. There is no salvage for it. It's like saying the carriage whip makers should have gone to school and obtained a 2-year degree in carriage whips to save their industry, that the blacksmiths should have gone back to school and learned their trade better, and that the switchboard operators could have saved their jobs if only they'd gotten a better education in how to operate a switchboard. None of that is true and that's not what the report says the churn is about.

The churn is about emerging industries and their related jobs replacing the declining industry jobs. And although the report does very clearly state that education and re-education is the key to surviving the churn, the education and re-education is for retraining in the emerging industry, not the declining industry. The report repeatedly emphasizes that the churn provides employment opportunities for those who have the education and skills that are in demand. The churn "creates scores of jobs in growing companies that didn't exist a few years ago."

There's no doubt in my mind that medical transcription is a declining industry. Not only that, it's a declining industry in a red-water market space as described by Kim and Mauborgne in their book, Blue Ocean Strategy [3]. New transcription companies that didn't exist a few years ago aren't employing new strategies because there are no new strategies to employ, no "blue ocean" to go to. They compete on price in cutthroat competition and contribute to the downward spiral in pay rates and skills that is driving so many experienced MTs out of the industry.

Transcriptionists who embrace change in the spirit of the churn will re-educate themselves for different jobs in different industries that may or may not utilize some of the skill set they take from medical transcription. In the Letters to the Editor of the same issue, an anonymous author tells how she took her skill set to cancer registry. With the emerging technologies and jobs created by them, the options for at-home work are expanding, with better pay and benefit options. Experienced MTs who wanted to work at home are waving goodbye to their now-grown children and taking office jobs. The people who should be the most valuable in the medical transcription industry will be the first ones to find jobs in emerging industries - because their skill set is one that consists of a solid work ethic and commitment to doing the job right. These people will have no trouble finding jobs that pay better than those in the stagnating and declining medical transcription industry.

As I have discussed with Tina Whitecotton in the past - if a 2-year degree is required, people aren't going to get it to stay in or go to medical transcription. With a 2-year degree, there are much better options for employment in emerging industries. What is the point of being a "professional" with a "professional" degree when the pay rate is indicative of a "job," and not a very good one at that?