In case you aren’t up on the book publishing business and missed Borders’ bankruptcy filing and shuttering of over 200 stores, the traditional book publishing establishment is going through the pangs of change; i.e., the change from paper to digital.

Sound familiar?

The change from analog to digital forced a change in the music industry and how it does business. Likewise, the change from paper to digital is forcing a change in the publishing industry. The change from analog to digital has also forced a change in the medical transcription industry and continues to change as medical records move to fully digitized medical records.

I was reading a long (too long) discussion online about the digital revolution in the book business and this got me thinking about similarities in the medical transcription industry.

Medical transcription as a niche market

One point the authors make that resonated with me was a discussion about niche markets. Before the invention of electricity and electric lighting, candlemakers were in the lighting business. We all enjoy candles but most of us don’t use them as our primary source of lighting. Candles are now used primarily for decoration and scent. Candlemaking is no longer the major industry it was and it is no longer in the lighting business; it is in the niche market of candlemaking. Candlemaking is still a business and it still generates significant revenue, but not nearly as much as it did when it was in the lighting business. That means fewer companies making candles and fewer employees making candles and fewer people selling candles.

I could go on and on about how major industries have become niche markets, but I think you get the idea.

Likewise, medical transcription is becoming a niche market. As some industry sectors are fighting for preservation of the narrative record, larger forces are fighting for a point of care digital record and its numerous advantages over traditional documentation methods. Even if the narrative record fight is won, what will most likely to retained as traditional transcription will be a niche market. The consultant will no longer dictate a past history, medical history, medication list, allergy list, surgical history, etc., when it’s already readily available and easily accessed in the digital record. The discharge summary will no longer summarize all that, plus all the labs and studies that were done during the admission because they’re already readily available in the digital record. The narrative portion of the record will shrink significantly. I’m not sure what that niche market will look like, but I know it will be a fraction of what the medical transcription market has been in the past. Like the candlemaking business, that will mean fewer companies doing transcription and fewer employees doing transcription.

Medical transcription is not dictation/transcription

In the 1930s, automobile travel began to cut into the railroad’s passenger travel market, but freighting was really the meat and potatoes of the rail system. The development of the interstate highway system dealt a blow to the railroad industry, followed by the extra punch of air travel and freighting in the 1950s and 60s. Add onerous federal regulations and stagnant labor unions and the railroad industry was on its knees. Railroad industry leaders thought they were in the railroad business, but the railroad industry wasn’t in the railroad business – it was in the transportation business. The inability to grasp the concept nearly killed the industry. In 1939, there were 132 class I (freight) railroads. Today, because of mergers, bankruptcies and major changes in regulatory classification, there are only 7.

Except for the labor unions, that sounds pretty familiar, doesn’t it?

The railroads were ultimately saved by your tax dollars, in the form of Amtrak and ConRail. ConRail subsequently privatized and the railroads were deregulated, making it possible for railroads to operate free of government regulations that had made them unprofitable.

(You can read all this at Wikipedia – I’m just summarizing for you).

In spite of the similarities between the two, don’t look for a government bailout of the medical transcription industry. The US government, in fact, is aggressively pushing digital records. If it supports any industry, it will be the electronic records industry. (Conspiracy theorists, start your engines!)

Which brings me to the publishing business. The blog I was reading noted that, similar to the railroad industry, the publishing industry thought it was in the business of publishing. With the development of digital books, it’s becoming apparent that the publishing industry is actually in the business of distributing printed information and entertainment (thanks for the refinement, Moriah Jovan!). As self-publishing becomes easier and more acceptable, the necessity for a publishing company that distributes books (paper or digital) is further eroded. The publishing industry is trying to preserve its place by attempting to suppress self publication and digital book distribution, a move that just about everyone in that industry can see is a last-gasp effort that isn’t going to work. Amazon (and now Barnes and Noble) are staying viable by embracing digital books, as well as self publication. In 5 or 10 years, will anyone care that an author’s work has never gone through the gatekeeper of a publisher? Probably not.

If you want a blueprint for what’s happening and what will continue to happen in the medical transcription industry, just take a look at the music and publishing industries. The music industry has survived, but it’s not the same as it was before. Apple iTunes has become the #1 seller of music in the US. I’m not sure the traditional publishing industry will survive; at the very least, it will be radically transformed and the people who work in that industry will have to carve themselves a new place in the niche markets that spin off the publishing industry.

Like my transition to digital books, doctors are kicking and screaming and swearing they won’t like it, but they are adapting digital records and they are becoming accustomed to the advantages. The technology is improving and will continue to improve; at the same time, it will become less expensive. The users are becoming more adept at the technology. I think we can count on the trend to continue. Likewise, transcriptionists are kicking and screaming and swearing – speech recognition editing, overseas competition, low pay rates – can we expect any of this to change? I don’t think so. I think that as the medical transcription industry responds to changes it’s undergoing, some medical transcriptionists and transcription companies will carve out a place in developing niche markets, others will move to related healthcare fields where some or all of their skills can be applied, and a lot will leave the industry altogether. The speed at which technology moves makes it nearly impossible to see where the medical transcription industry may end up. Right now, it seems that smaller companies are losing out, as they don’t have the financing to support the technology requirements – or even rent them. I’m hearing from more and more independent transcriptionists that even their long-term accounts have stopped dictating entirely, in favor of an EMR (regardless of well it works for them). I think the larger companies have already started making the move from the business of transcribing dictation to the business of providing technology to document healthcare records. In the meantime, the Department of Labor keeps reporting that medical transcription is a good career option (I think it’s time for an update on that one), the medical transcription schools continue to do a booming business, churning out people who soon discover that they cannot get a job or, if they do, they struggle to make minimum wage – if they finish the program at all. I think more and more transcriptionists are looking at – or have already implemented – other options because they cannot tolerate the financial instability of the shrinking market and deteriorating pay rates. You have to ask yourself – in 5 or 10 years, will anyone care that doctors used to dictate and someone transcribed the dictation?

So what is the medical transcription business? Traditionally, we’ve thought of it as the business of taking recorded dictation and turning it into typewritten records. The upheaval in the market is redefining how we think of the business of medical transcription. I’m not sure what the medical transcription business is really – I’m only certain that it’s no longer taking recorded dictation and turning it into typewritten records. 

The light at the end of the tunnel may, unfortunately, be a train.

I’m soliciting comments: what do you think the business of medical transcription is, really?

In a prior post, Internet Marketers and Medical Transcription, I noted how medical transcription is an attractive target for internet marketers. What I didn't talk about was flogs.

In the medical transcription world, a flog might look like this:

Hi, my name is Jill. A couple years ago, I was desperate for work I could do at home to make some extra money for our family. A friend of mine told me about medical transcription, so I checked it out and found out it's a great work-at-home career for people like me. I went to XYZ Transcription School and got my certification. When I graduated, I found a job right away and now I'm making extra money while my children are in school. I don't have to pay for daycare, either – by the time they come home from school, my work is done and my house is clean! If you want to work at home, you should sign up today to go to XYZ Transcription School and become a medical transcriptionist, just like I did!

What makes this a flog?

What would make this a flog is if the person who owns the site and posts the entries isn't named Jill, didn't go to XYZ Transcription School (or any other transcription school) and/or isn't working as a transcriptionist – and never has. The site exists solely for the purpose of attracting people who are searching for medical transcription careers, work-at-home careers, etc., convincing these people that medical transcription is a wonderful career and that XYZ Transcription School will do a fabulous job of preparing them for this career – then referring them to XYZ.

Why would they do that?

Because XYZ Transcription School will pay them $$$. This is known as an affiliate arrangement, where you have the advertiser (the MT school) and the publisher (the web site). Depending on the program, they will get paid for a lead (an e-mail address, which is why many of these have a "free" giveaway that requires signing up for a mailing list), a phone call to the school and/or a sale. Most of them pay based on a sale and the amount can be substantial. For example, FutureMT pays $160 when an affiliate site sends them someone and a sale is generated.

Don't get me wrong – I'm all for generating revenue. And there's nothing illegal or immoral about affiliates or affiliate ads.

However, not only are flogs immoral (in my opinion) – they are also illegal. And they always have been.

Pity the poor FTC, having to police the internet.

Example of a suspected flog

I came across this site that just practically sat up and announced  "I am probably a flog" to me. Somehow, I really doubt that "Kate Delaney" is really someone who went through the program and now works as an MT. If you send her e-mail and ask her questions about FutureMT, getting a job as a new graduate, is she hiring, who does she work for, how does she like it – you aren't likely to get an answer. Even though her contact page gives an e-mail address and tells you to contact her if you have questions about a medical transcription career, an e-mail I sent 2 weeks ago from a gmail.com mail account still hasn't been answered. Maybe she's busy transcribing.

Or – maybe she's busy doing other stuff because she isn't actually Kate Delaney. Look who owns the domain name: Beth Stefani of Lariat Group. (I'm going to start the timer after I post this and see how long it takes Beth Stefani to make this registration private.)

Now, it's POSSIBLE that "Kate" hired Lariat Group to buy her domain name and manage it for her because teaching businesses how to manage blogs and be profitable is one of the services offered by Lariat Group.  I would hope that if a company like Lariat Group is advising "Kate," they would certainly make sure she complies with the FTC requirements for bloggers and endorsements. But it appears to me that Ms. Stefani gains her expertise for consulting through "hands-on experience running her own network of sites," so I suspect there is no Kate Delaney and that this is actually a site in said "network of sites."

Again let me reiterate – I have absolutely no problem with people putting up websites and trying to make money. Hell – I do that. But in my opinion, what Beth Stefani is doing at this site is immoral. And I guess the FTC agrees with me, because it's also illegal.

FTC Regulations for Bloggers

False advertising has always been illegal, anywhere. The FTC has recently updated its guidelines because flogs have been a real problem on the internet. For one thing, they're lucrative. Imagine if "Kate" can get 10 people a month to sign up with FutureMT – she made $1,600. Heck, most legitimate transcriptionists I know would be happy to create a REAL blog for that kind of money!

There's just one catch and that's the FTC's guides concerning the use of endorsements and testimonials in advertising.

When the advertisement represents that the endorser uses the endorsed product, the endorser must have been a bona fide user of it at the time the endorsement was given. Additionally, the advertiser may continue to run the advertisement only so long as it has good reason to believe that the endorser remains a bona fide user of the product.

What does "bona fide use" of an education mean? It means "Kate" not only must have actually done what her "blog" says she did (attended the FutureMT program and graduated), but she must also be working as a medical transcriptionist in order to endorse the product, which is an education that allegedly prepared her to be a medical transcriptionist. Even if "Kate" actually did attend FutureMT, she cannot endorse the product until she is working as an MT. And when she is no longer employed as an MT, she is no longer "using" the product of a medical transcription education.

One of the other requirements the FTC has clarified is that a blogger must disclose material connections with an advertiser, and that disclosure can't be hidden somewhere in the small print – it has to be easily apparent. Even if "Kate Delaney" is a real person who actually graduated from FutureMT and is working as a medical transcriptionist, there is no disclosure anywhere on the site.

When an advertisement is clearly an advertisement – such as a banner ad or Google block (who can possibly mistake those for anything but an ad??), no disclosure is required. Endorsements and testimonials are where people really seem to get into trouble. This is nothing new – the same rules apply for print ads and endorsements, infomercials, television and every other kind of media. For some reason, bloggers thought the rules didn't apply to internet advertising!

Can the advertiser be held responsible for what its affiliates do?

Let's look what the FTC says in their guide:

In order to limit its potential liability, the advertiser should ensure that the advertising service provides guidance and training to its bloggers concerning the need to ensure that statements they make are truthful and substantiated. The advertiser should also monitor bloggers who are being paid to promote its products and take steps necessary to halt the continued publication of deceptive representations when they are discovered.

That looks like a yes to me!

Last but not least – why do I care?

As noted in my last blog post, people who want to join the work-at-home workforce seem to be like cannon fodder – or lemmings. These flog sites are run primarily by people who make their living off affiliate sales and who know how to get to the top of the search engines so they'll be found. They don't care if someone scrapes and saves and spends their last dime to pay the tuition, then scrapes and lives hand-to-mouth during the entire time they complete the course, or that they are depending on the money they will make once they complete it and start their career. All they care about is getting more people to their site because it's a numbers game – more targeted traffic translates to more sales. And that's really what they care about – the sale. You won't find them promoting the best schools – you'll only find them promoting the schools that offer the highest dollar amount to their affiliates. By the time the prospective MT finds it's next to impossible to get that dream job, the affiliate has been paid – and isn't answering e-mails. They also don't care what this does to the industry and how it drags all of us down. First, it was "matchbook schools" we fought – now, it's internet marketers looking for the big-dollar affiliate payouts. I've made a good living from medical transcription all these years. No, I don't recommend it for anyone because of changes in the industry since I started – but I also acknowledge there are people who don't have as many options as I do, who really do need a job that's portable or that they can do at home, for a variety of reasons and not all of them having to do with having children. For those people, medical transcription may still be the best option. I just hate to see them given information based solely upon how much money the person disseminating the information will get if they can make the sale. Even if we believe in "let the buyer beware," the FTC has undertaken these guidelines to protect consumers. And for as long as I give even a small damn for the medical transcription industry, I will continue to try and not only call these people out when I find them, I will also try to outrank them in the search engines so that prospective medical transcriptionists come to sites where they are talking to real medical transcriptionists, not fake ones trying to make a sale.

Now for the disclaimer!

I am not 100% positive that the above-referenced site is a flog, I only suspect it is a flog. Heck, it may be legitimate. I will publicly retract my allegations if Kate Delaney will contact me with proof of her identity, a certificate of graduation from FutureMT and verification of current employment as a medical transcriptionist. As with everything else at MT Exchange, this is just my opinion based upon the facts availableto me at the time of publication.

Can anyone tell me if it makes a difference which online program you use? I’ve heard that potential employers look for someone that’s been trained by an AHDI approved program. But when I asked Future MT, a non-approved program, they said that their program was as good as the others on AHDI’s list but you have to pay to get on that list and they simply choose not to, so as to pass that savings on to the student.

I found that an interesting response from FutureMT because it’s wrong on so many levels. Well – I suppose it makes sense if you’re trying to justify to prospective students why you aren’t on that list. I wonder how many people fall for it (probably quite a few). Because if you go read that discussion at MT Chat, you’ll see that Mike DeTuri broke down the cost per student based on XX number of students and it’s pretty negligible. And aside from that, schools don’t pay to get on the list, they pay a fee to apply to be on the list – big difference. A school can pay the fee and submit the required information and if they don’t meet the requirements, they still aren’t approved – and they don’t get a refund of their application fee.

So I moseyed on over to the FutureMT web site to see what their web site says about them. And I discovered something else interesting about FutureMT:

Future MT is not an accredited medical transcription course as a university within the state of incorporation, but rather a nationally recognized online education course using similar guidelines of major Universities.

When it comes to voluntary programs designed to evaluate a school program, FutureMT doesn’t seem willing to waste its money, as it isn’t accredited by the state of Florida, where the company is based, either. Not unlike the transcription sites that all claim “best, fastest, cheapest,” making a claim of nationally recognized online education course is pretty easy. It can’t be verified, certified or accredited – but it sounds good! (Maybe I should change the MT Exchange tag line to nationally recognized online blogger.) There are a number of nationally recognized accreditations for distance learning programs, including the Distance Education & Training Council (DETC), Accrediting Council for Independent Colleges & Schools (ACICS) and Accrediting Commission of Career Schools and Colleges of Technology (ACCSCT). Accreditation by any one of these would at least give proof to the claim of nationally recognized online education.

In fact, this is one of the requirements to become an AHDI-approved school:

The school/program must be accredited or licensed through a governmental body.

So in terms of as good as, strike one for FutureMT.

What I like is the consistent theme: we’re saving money for our students!

Another benefit of Future MT’s course is that we do not have the large overhead needed to run a college, so we are able to pass those savings to our students and offer the same course at a more affordable cost.

I don’t know how prospective students read this, but it makes me wonder whether they have other cost-saving measures that might be cutting corners a tad too close – you know? Like – instructors. Like – curriculum.

Speaking of which…

Another requirement for AHDI approval is that the school must follow the Model Curriculum for Medical Transcription. And it’s really difficult to tell from the FutureMT website exactly where their coursework comes from.

The book Future MT uses is written by the staff of Health Professions Institute, which is the top name in the field, and extremely reputable. In fact, the founder of the American Association of Medical Transcription (AAMT) also founded HPI. Their materials are used widely among the most respected institutions.

As far as I can tell, the coursework (curriculum?) consists of handing you a book that can be purchased straight from Health Professions Institute (HPI) and the SUM Program practice recordings, which can also be obtained directly from HPI.

But wait – there’s more!

You get unlimited live mentoring with experienced MTs! I’m not hearing the word “instructor” or “teacher” there. For all I know, their definition of an experienced MT is someone with 2 weeks’ experience.

Students, at the appropriate time from Future MT instructors will be given access to the transcript keys and compare their work to the keys in a split-screen format, giving them immediate feedback on their errors.

Oh look – NOW we have “instructors.” Let me tell you something about giving students answer keys – they don’t learn much and it renders the rest of the exercise useless once someone has the answers.

But wait – there’s more!

I felt this part was worthy of a screen shot. Please comment if any of this makes sense to you.

Huh?

And in the FAQ titled How Long Will the Course Take to Finish?, I found this gem:

Future MT’s medical transcription training focuses on helping students find work quickly instead of spending more time training.

Yes, we certainly wouldn’t want future MTs to spend too much time training! Let’s focus instead on getting a job!

But wait – there’s more!

There’s an Employment Service!

And it’s part of the Guarantee!

So let me see if I understand… if taking a list of potential employers and bombarding them with resumes for 60 days doesn’t elicit any offers of employment – they’ll help you do it for another 12 months, hoping for a different response? (What are their affiliate transcription companies, anyway? I hope this isn’t just a list of transcription services they scrounged off Google.) Does everyone here understand the definition of insanity?

And every flippin’ page at FutureMT ends with this:

I have to wonder how much value there is to that guaranty when I’m getting bombarded with messages from graduates who can’t get a job. Money back? You can claim it within the first 30 days of enrolling. Of course, by the time you graduate and can’t get a job, the 30 days is long past.

Do I really need to keep going? Unfortunately, there seems to be no limit to the number of people willing to be the fodder for cheap programs that will take their money, turn them loose – and then fill up my mailbox with pleas for help getting that elusive job.Which is why I keep blogging about it – someday, I’d like to believe my yammering made a difference.

I think it’s pretty clear that: (a) not all transcription schools are equal and (b) FutureMT is not as good as a school that is licensed or accredited by a governmental body and approved by AHDI. Let me be clear – I don’t think AHDI approval is the be-all/end-all – but it is a distinction, a step up and frankly, all we’ve got. Given that, I think it’s essential that the medical transcription community supports that program.

But that’s not all…

OK, I have to save the very best for last. This just had my jaw dropping. I went to the LINKS page at FutureMT, expecting to find links to MT resources and information. Instead, I found this:

Is it just me – or is this about the tackiest thing ever for a professional website? The only MT site listed there is one owned by FutureMT. I mean, really – credit score reports and satellite dish links on a professional site?

(Look for my followup article next week on Medical Transcription Schools and the FTC)

Teeny tiny disclaimer: Like everything else at MT Exchange, this is only my opinion. Take it for what it’s worth.

The subject of today’s entry appears to be owned by Future MT – yes, a Crappy School with an aggressive affiliate marketing campaign. They’re all over the place. Their affiliates’ sites are all over the place. But when I stumbled on their Medical Transcription Trends site (it appears to be owned/operated by the owners of Future MT, not one of their affiliates), I didn’t know whether to laugh or cry.

But first – let me take a moment to dissect the Future MT web site. You have to love someone who will put affiliate links at their business web site! There’s nothing quite like money-making plugs for satellite dish installation and credit repair to lend credibility to a business venture. Even better, these are under “medical transcription links.” There isn’t one link there related to medical transcription – most likely because the money-making links are competitive schools. Since they appear to have an education alliance with a transcription service, why don’t they even put a link to that transcription service? And in a touch of irony, there’s an affiliate link for legitimate work-from-home jobs – apparently the owners of Future MT are covering all the possible money-making opportunities. Or are they suggesting that MT – and therefore their school – isn’t a legitimate opportunity? My other favorite on this site is that a graduate excitedly lets them know she’s landed her first job – with AM Trans Am. Apparently, they don’t bother warning their students about the various scams going on in the industry.

OK, the purpose here wasn’t to dissect yet another Crappy School – it was to comment on this site put up by Future MT. Some of the claims made are funny if you put aside for a moment that people are making decisions about their careers on the basis of what they find on the internet.

Before I begin, let me tell you that the entry is the only easy thing in the medical transcription profession.

Wha…????

Oh… this is why it’s so darn easy. You’re going to notice there’s absolutely no mention of how hard it is to get that first job:

You don’t need to possess a formal qualification to enter the field. No, this does not mean that medical transcriptionists are not qualified. They acquire the professional qualifications as they enter the industry. You don’t need any degree or certificate to make your way into the industry though. [emphasis added]

It seems they have (uncharacteristically) overlooked the opportunity to plug the need for an education – preferably the one they’re selling. I’ve bolded my favorite part. Enter the industry and BAM! You have professional qualifications! It’s that easy!

You don’t need to possess any kind of working experience. Yeah, you can make an entry even if you are a high school grad. It does not matter if you have ever worked in your life.

I like that “yeah” – kind of folksy, although I can’t help but picture Michael Cain in “Miss Congeniality,” telling Sandra Bullock – “It is always yes, never ‘yeah.’”

Notice how the issue of work experience is completely glossed over? Those of us who are actually working in medical transcription know that while the above statement is true, it’s only half true. I dare any of ya (see the folksy touch there?) to find a job listing for a medical transcriptionist that doesn’t require a minimum of 1 year of experience as an MT. If you do, send me the link. I have never, in 20 years, seen anyone care whether or not a prospective hire had work experience that wasn’t in medical transcription.

Then, they lose me with the conclusion of this article…

The easy entry into the profession has been mocked by many and the profession has been looked down upon. But just because there are no stringent prerequisites, you cannot become a medical transcriptionist. If you don’t have analytical skills or the willingness to study along with work or the commitment to meeting deadlines on a daily basis, this profession is definitely not for you. So, make sure you gauze your potential before entering this field.

Someone needs to proofread better…

Actually, the articles at this site read like many I’ve seen all over the internet that have been written by services, most of them operating overseas. It would surprise me if all these entries were actually written by someone at Future MT.

Jason Trusler, is listed as a principle at Future MT (and the contact for the various web sites I’ve found that are owned by them) and is a somewhat prolific writer of MT-related (and credit, which may explain the affiliate link at the business web site) articles. I have to say that Future MT has done its homework on internet marketing and they seem to be effectively employing the same tools as internet marketers to promote their school. Interestingly, Trusler’s bio states:

Worked in the Medical Transcription industry for over 12 years in many different fields. Currently does consulting for medical transcriptionist course training schools.

As far as I can tell, he isn’t consulting for Future MT – he’s one of the owners. And I’d be surprised if there was any consulting being done for other training schools, unless he’s counting affiliates for Future MT. I’m also wondering how many different fields there are in medical transcription.

As a fine example of what you’ll see in internet marketing articles, Trusler writes an article on How to get medical transcription training, where he states:

One of the great elements of medical transcription is that experience in the field is not a requirement to have a good chance of finding employment, although it definitely helps.

See my challenge above to find a job that doesn’t require experience in medical transcription. Don’t hold your breath waiting for anyone from Future MT to provide objective evidence to back up this claim, however.

Then there’s this statement:

It will not typically matter to a potential employer where you have taken your certification course because many of them will test you before they choose to hire you.

Uh, ok – let me clarify for anyone who is researching MT schools and hasn’t made a decision yet… Potential employers do care where you have completed your medical transcription coursework. While it is true that they will test you before they choose to hire you, whether or not you even get as far as a test will often depend on where you got your education. Testing takes time and costs money and employers are only going to test people they believe have a reasonable chance of passing the test. Trust me – if they have to choose between an application from someone who went to an AHDI-approved school and someone who went to a cheap online program – like Future MT – they’ll test the people who went to an AHDI- approved school.

The more practice you have at transcribing and the longer you study the skill through your course training, the higher the chance you will have of an employer hiring you without any on the job experience, so it is important to take the course seriously.

In my experience, this statement doesn’t have even a half grain of truth to it – it’s completely false. There are only so many hours of available practice recordings available. Repeating them over and over again isn’t going to make a prospective MT more employable. Professionally-recorded practice tapes aren’t even close to real experience. The only experience that matters is real live experience.

Unfortunately, Future MT isn’t the only school to employ internet marketing tactics and make outrageous and/or false claims. They’re just the school du jour. So… it bears repeating because I know a lot of people come to this blog, looking for information on MT schools and MT careers:

• Don’t even consider a school that isn’t approved by AHDI
• Don’t rely on the FAQs – call and ASK specific questions about placement rate (percentage of graduates hired) and the placement program.
• Check with experienced transcriptionists in the medical transcription forums and at Facebook and ask about the school.
• Make sure anyone who responds positively doesn’t have a monetary incentive for selling you on the school – many, many schools have affiliate programs and they also pay current students and graduates for referrals. Call the school and verify that the person is actually a graduate of their MT program – no school should have any problem giving this information.
• If someone tells you a school is wonderful, get specifics. Are they working as an MT? Where? How long did it take them to get a job? How long have they been working? What did they think was great about the program?

When it comes to the business side of MT, many MTs lose all sense of  perspective. Although there is a general derision for hobby MTs, the flip side is that the same (or more) level of derision is applied to the corporate aspects of the business. It sends a message that small business is okay, big business is not and that my small business is better than your small business because I run a serious business, dammit! There’s an aura of superiority put off by those who look down on the hobby MT because s/he doesn’t treat MT like the business it is and make business-like decisions. They undercut prices, they aren’t adequately trained – golly, sometimes they aren’t even real MTs! However, while the attitude is that we should be business-like, there is a fair amount of derision heaped upon being too business-like. All that business rah-rah goes down the drain when it comes to the large MT businesses and even the not-so-small MT businesses. Men are suits and women who are too business-oriented are bitches.

What got me writing is a thread at MT Chat about the sale of M-TEC and changes taking place at that school.

I am not thrilled with the corporatization of MT or the fact that what used to be an industry of primarily women has been taken over by men in suits. Men don’t think the way women do and they don’t do business the way women do. That’s not necessarily a bad thing, but sometimes it’s difficult for women to deal with, much like the toilet seat that’s left up. Unfortunately, any business dominated by women is going to look a lot like medical transcription; i.e., marginalized and commoditized and that has little to do with “the suits” and the corporations. I’ve been stiffed and mistreated just as often by the small local MTSO run by a woman as I have been by a large corporation run primarily by men. I’d rather work for a corporation run responsibly and by the book than a poorly-run small outfit and I don’t care whether a man or a woman is at the helm of either. Suits ≠ bad bad bad.

There is an attitude in the MT community that a transcription service owning/operating a transcription school is automatically A Bad Thing. Let’s apply some intelligence to this. First of all, M-TEC was originally owned and operated by owners of a transcription service. Maybe everyone has forgotten that in the intervening years. I don’t know how long Kathy and Susan ran a transcription business along with the school, but I know they ran a transcription service simultaneously with the school at some point. Second of all, the origins of this objection were based on small services with local clinic accounts that charged exorbitant sums of money to “school” people in MT. The curriculum (and I use the term loosely) was geared towards that service’s specific needs and was not even close to adequate for educating a well-rounded MT. The MTs who completed these “programs” were only employable by the service that ran the “school” they attended. This worked fine for both parties as long as the transcription service actually had work for the MTs completing the “school.” The problems arose when those people, thinking I R A MT, lost or left that job and represented themselves in the wider MT community as a trained medical transcriptionist with experience. Which – by every definition – they were! However, because their education, training and experience were so narrowly confined to that one service, they found they were simply unemployable elsewhere – and had to start all over again. That is not the case with M-TEC, whether we’re talking about past or present owners. WebMedX, in fact, would be able to provide an excellent training ground for MTs because they have contracts with a wide variety of facilities. If they intend to employ many of the MTs who attend M-TEC, then it’s a win/win situation for MTs and for WebMedX. On top of that, M-TEC gets a real boost to its placement numbers. Any MT who has completed the M-TEC program and worked for a year or two for WebMedX would most likely have no more trouble finding another job than any Andrews School graduate. So – get a grip, people! Transcription Service + Transcription School ≠ Bad bad bad, either.

The next big criticism was the shortened time allowed to complete the program before additional fees are assessed. I think what many of the participants in that discussion are not realizing is that there are many, many community colleges offering medical transcription certificate programs and that’s really the competition. I don’t have numbers, but based on my discussions with a lot of educators at those programs, the college programs are a bigger competitor than other online schools. Most of these colleges have 9-month programs and many of the requirements are regulated by the community or state education system. I was at a meeting of educators earlier this year and the college educators said that if they made the MT certificate program a 2-year program, they wouldn’t get any students. Several months ago, I did a spreadsheet of what the schools charge and some of the community colleges were the most expensive (depending on location), especially for out-of-state students. The number of credits required to complete the certificate program and the cost per credit jumped some of these well over the $5K range for tuition. While the prior owners ran a good business, the new owners have an investment (i.e., the purchase price) that the prior owners didn’t have and they need to see return on that investment. Therefore, their focus is going to be a little different and more aggressive than the prior owners’.

And while higher fees may push some people to the less expensive schools, I don’t think it’s going to make that much of a difference. Someone who price shops their education doesn’t even get as far as M-TEC or Andrews – they think Career Step is too expensive and they’re agonizing over that or one of the $900 programs.

Andrews can’t – and won’t – take everyone who applies. As I’ve said in prior posts about transcription schools, the stance that it’s “M-TEC or Andrews” (and now if you take M-TEC out of the equation, it’s just Andrews) is just unrealistic. If your dream is to see every other transcription school shut down, consider the consequences – a mass shrinkage in the labor force. We can’t even say that’s a good thing, since the MT industry has been defying the usual influences of supply and demand for years now. I’m not sure what anyone thinks would be the positive consequences of this, or what MTs who believe in “M-TEC or Andrews” think would happen to the quality of education at those schools if they started expanding to take more candidates. (Hint: There’s a reason Harvard and Yale are so expensive and have higher admission standards. They don’t take just anyone, either.)

Can an MT program be completed in 9 months? Of course it can. Just because an MT who took longer “can’t imagine” completing the program in less time doesn’t mean it isn’t possible. Someone who is truly desperate to get into the job market can complete a self-study course in much less time than that, even. It takes focus and hard work – but I know more than one MT who eschewed Andrews in favor of a self-study course they could get through quickly so they could get a job faster. Take your pick – be broke for 2 years because you’re working part time and going to school part time, be really broke for 2 years because your school won’t let you complete faster and there aren’t any local jobs available or you live in a rural area – or be really broke for 9 months or less because you’re going all out to complete a program so you can get a full-time job and stop being broke. There’s a reason community colleges can’t “sell” a 2-year program. For one thing, the pay rates don’t justify it and for another, most people wanting to enter MT need to get into the job market faster than that.

It costs money for a school to carry people who are poking along in the program. What WebMedX is doing is requiring people to make a real commitment to their education. Having to expend considerable money and a significant amount of time speaks to motivation and commitment.

I’m going to share with you one of my first experiences about learning the value of money and commitment. I joined a martial arts class at the university in the town where I lived. The instructors were volunteers and the university let the group work out in a room in the physical education building. Although the stated fee was $5 per month, it was like it was voluntary – nobody really made an effort to collect it and most students didn’t pay it. When I had gained some seniority, I told the senior instructor I was taking over the treasury – then I started aggressively collecting the fee. Oh, the whining! Even the instructor whined, telling me these were poor college students who couldn’t afford $5 a month for martial arts. I looked him in the eye and told him “they spend more than that on beer every Friday night.” Then I looked them in the eye and told them “you spend more than that on beer every Friday night.” Did we lose students? No, we didn’t. In fact, we had a resurgence of participation. Paying $5 per month was enough to motivate these students to make a real commitment to studying martial arts and working out. People who had previously come to class only when they felt like it now attended every class. For $5 a month, they didn’t try to find time for class – they made time for class. People who had worked out with a modicum of effort either dropped out altogether or started working harder. The club finally had money to buy equipment and have social events (read: parties) at the end of the quarter after belt testing.

Someone who is having financial difficulty will either decide they simply can’t complete the program in 9 months and they’ll go elsewhere – or they’ll knuckle down and work twice as hard to finish the program before having to pay more money to extend the education – 0r pay more money to extend the education. The MT benefits by getting into the job market faster. WebMedX benefits by getting more potential candidates faster. And if WebMedX considers itself the #1 employer of its graduates – do you really think they’re going to do anything that results in their getting less qualified graduates? If employers won’t hire their graduates, if they find their own graduates aren’t adequately trained to work for them – they’ll suffer the consequences of their own decision and make adjustments.

WebMedX made (presumably) a huge investment in M-TEC. From a business standpoint, it’s in their best interest to do what is most profitable and will get them the best return on their investment. Whether or not they feel preserving the reputation of the school is a necessary part of that investment remains to be seen, but they could’ve bought any of a dozen lesser schools if they didn’t care about name recognition and reputation.

I’ve said it many times over the years when a group of MTs criticizes the decisions of a business – if you don’t like the way a business is run, feel free to start your own. You can run it any way you like, including making decisions that eat into your profit so you can please the masses of faceless MTs criticizing you in the forums.

I live and breathe to enlighten you.

What follows is a cautionary tale to those who search the internet for information on how to work at home as a medical transcriptionist. The rest of us – you know, the choir – can only look on in horror.

How Google ads work

It helps to have some knowledge of how Google ads work. You see them everywhere you go; maybe you’ve wondered how they work (maybe you haven’t!). There are two sides to Google ads: advertisers, who want to place ads (Adwords) and publishers, who run the ads on their sites (Adsense). When an advertiser runs an ad campaign in Adwords, they pay Google. When a publisher places Google Adsense ads on their site, they get paid by Google when someone clicks on a link in the ad. High-volume publishers get enough people to the site to also be paid per 1000 impressions, or the number of times the ads are displayed to users. Low-volume publishers don’t get enough page impressions to make much money this way – they rely on the ad clicks to make money. Google, of course, takes a cut in the middle. The entire system is based on keywords, keyword phrases – the perceived value of the keywords (i.e., the number of people searching that keyword) and the traffic of a publishing site.  Advertisers can select keywords relevant to their product (in this case, medical transcription) and they can target specific web sites that get a lot of traffic. The more advertisers there are competing for a keyword phrase, the higher the cost goes because it’s a bidding process. Likewise, the more traffic a site gets and the more advertisers competing to be seen on it, the more it’s going to cost the advertiser.

I could spend days on this, but I’ll try and keep it simple because that’s not the focus of this topic.

Let’s say I want to place ads for my MT jobs site on a bunch of MT-related web sites that run Google ads, using the keyword phrase medical transcription. And let’s say that specifically, I want my ads to display at MT Chat. I start an ad campaign in my Google Adwords account and specify the keyword phrase medical transcription, then I select the option to target specific web sites. Google will retrieve a list of sites for me, but I don’t need them to – I know I want my ads to run at MT Chat. I then bid on how much I want to pay per click and what my daily budget is for the campaign. Now, I can bid whatever I like – I can say I’ll pay $0.25 per click. And Adwords will let me do that – but they’ll also pop up a message saying that my ad has a slim-to-none chance of ever showing up on MT Chat. Why? Because medical transcription is a high-value keyword phrase and MT Chat is a high-volume site, so there are a lot of advertisers targeting not only the keyword phrase, but the web site, as well. The more you’re willing to pay, the better chance you have of your ads showing up on the specified web site. Adwords lets me know that other advertisers are paying more for that phrase and makes a suggestion as to how much I might have to pay to have my ad show up there. The more I’m willing to pay, the better my chances are of having my ad seen. There are keywords that are paying advertisers a handsome amount (mesothelioma was a popular one for quite awhile and paid upwards of $30 per click!). If I choose not to target a specific site, it’s cheaper – my ads will show up on any page where the term medical transcription is found, which is why you see ads related to the topic in a discussion forum.

How this translates to medical transcription and matchbook schools

There is a thriving business on the internet known as internet marketing. Some people are very good at it, some are very bad at it, but what is pertinent to the readers here at MT Exchange is this: medical transcription careers is a very lucrative niche for internet marketers.

If you search the term medical transcription in Google, what you get in return is a mixed bag of sites about medical transcription services, medical transcription training and medical transcription courses. In the Google search results world, medical transcription is a very competitive term. People who want to work at home seem to be one of America’s greatest renewable resources; and as we all know, medical transcription has been an attractive work-at-home career for a very long time. There are approximately 18,000 searches a day for the term medical transcription.  That’s a lot of searches. To give you an idea of how competitive this term is, there are over 1.8 million web pages that contain the term and over 800,000 pages that contain the term in the title.

The web site that gets to the #1 spot in the Google search engine results (SER) is the big winner, capturing a huge portion of the traffic. Currently in that spot is Gatline Education Services. Gatline is not an AHDI-approved school and some of you probably haven’t even ever heard of it. So what do they get for being in the #1 spot? They will get 45% more clicks than the #2 site, which is currently the Department of Labor site. All I can say is Gatline must have some awesome people working on their search engine optimization because Google weighs government sites ahead of commercial sites in their results. The farther down the list a site is, the less likely it will be seen – the drop in clicks between the #1 and the #2 spot is bad, worse for #3 and progressively worse down the list, so that if a site isn’t in the top 5 results, it has a very small chance of being seen. While Gatline doesn’t run Google ads, being in the #1 spot means that anyone searching for medical transcription is more likely to click on their site than any other – which means they get more traffic.

In the internet marketing world, it would be foolish to try and compete for the #1 (or even #2-5) spot for this keyword phrase. The advice is – pick something that has fewer searches but also less competition. Sure, the ad revenue will be less, but your chances of getting to the #1 spot are much better – and something is better than nothing.

Here’s an example: if you were an Adsense publisher in the #1 spot for the keyword phrase medical transcription, the anticipated revenue you’d receive from having Google ads on your site would be (drumroll please) – nearly $27,000 per day. That number is based on the number of searches and the statistics for searchers not only clicking through to view that #1 site, but also clicking on the ads (and believe me – Google is all about statistics and therefore so is anyone with a serious web-based business).

On the flip side of that, medical transcription schools is searched only approximately 250 times a day and the site holding down the #1 position could expect Adsense revenue of approximately $1,000 per day. While nothing close to the $27,000 per day for medical transcription, it’s still nothing to sneeze at, and there’s less competition. There are only approximately 30,000 sites mentioning the phrase and only 16,000 sites using the phrase in the page title. That’s why, if you search the specific term “medical transcription schools,” you get a lot of crappy sites dedicated to nothing more than providing Google ads and affiliate sales for one of the schools that offers a high affiliate payout. (Google isn’t the only way to make money on the internet.) Currently sitting in the #1 spot is an affiliate site for Allied – which is also not an AHDI-approved school.

The obvious benefit to someone like Gatline Education – which doesn’t run Google ads – is capturing a huge share of the search market and selling to them directly. They’re capturing people who are already interested in what they’re selling and they are getting more of them than any of the other sites selling similar products/services.

Apparently, the more credible schools don’t feel the need to improve their search engine rankings – or they just don’t know how all this works. If there were more of them showing up in the top 5 spots for the search engines, there’d be fewer hopefuls shunting off to the questionable schools.

The site that got me started

No, I’m not going to give them the pleasure of a link. But it was an awful/funny exercise in targeted keywords by an affiliate marketer. The site is owned by someone in India. I could’ve guessed that, even without checking the domain name registry. It’s targeting medical transcription keyword phrases (the low-lying fruit ones). They’re giving away an “Easy Cash Blueprint” e-book – but you have to provide an e-mail address to get it, which means that address will be spammed from a mailing list in the hopes of selling you products. At the very least, they’re hoping visitors will click on the Google ads at the site.

There’s the really awful content (I’ve italicized the obvious keyword phrase being targeted by this marketer):

I am sure your quest for Medical Transcription Book has come to an end as you read this article. Yes, gone are those days when we have to search endlessly for Medical Transcription Book information or other such information like protein protein comparison, free voice to text software, transcription desk or even group transcription services. Even without articles such as this, with the Internet all you have to do is log on and use any of the search engines to find the Medical Transcription Book information you need.

If this article still doesn’t answer your specific Medical Transcription Book quest, then don’t forget that you can conduct more search on any of the major search engines like Search.Yahoo.com to get specific Medical Transcription Book information.

A career in medical transcription has a lot been going for it. Here we are facing an economic downturn and this field is only likely to thrive in these times. The medical transcription industry is set to steadily grow as the population ages.

All that useful information crap was packed into one article! First of all – would you read that garbage and then buy something? Better yet – would you want someone who read it and then paid for it to be working next to you?

Just as a note, medical transcription book gets a little over 100 searches a day. If this bozo captures the #1 spot in the search results for that term, there’s a good chance of making about $100/day from the Google ads. Heck, there are MTs who don’t make that much! Unfortunately for this hapless marketer, this site doesn’t even turn up in the top 10 of the results (although it is on the first page). With a little more work, it might make it there!

Here’s another one:

Title: Free Medical Transcription Helpful Information

As you devour this article, remember that the rest of it contains valuable information related to Free Medical Transcription and in some way related to home based medical transcription jobs, transcription from home, medical transcription position or global medical transcription for your reading pleasure.

(skip to the end) It might interest you to know that lots of folks searching for Free Medical Transcription also got information related to other medical billing, sirna delivery, and even transcription services bangalore here with ease.

Again, the obvious keyword stuffing that tells you nothing and frequently doesn’t even make sense. In one article at this site, the keywords were actually preceded by the word keyword. (where’s my rolling eyes icon?) I don’t even know what sirna delivery is – but I know it makes no sense in this article.

And my personal favorite wins the award for complete nonsense. This is the first paragraph:

If your major interest is information related to Learn Medical Transcription or any other such as medical transcription job opportunities, transcription systems, allegiant transcription services or dictation services, this article can prove useful.

Nonsensical use of keyword phrases is a sign of a novice who found the keyword phrases with low competition, but didn’t use half a brain cell in applying them to the article. I’d rather think that than think this person’s English is so awful this actually makes sense to them.  In addition, this bright marketer apparently researched the keyword phrases that were low competition and discovered that Allegiant transcription services fit the bill – and so it was included in this garbled paragraph!

The next time someone online asks you about a matchbook school, ask them where they learned about it. Chances are, it was through the internet version of  a matchbook.

They get a lot right in this article. To their credit, they clear up the myth that medical transcription is an easy job and they make it clear that it requires knowledge and skills – and education.

The biggest mistake made in this article is suggesting that criticism of Career Step is based on jealousy, intramural competitiveness – or even possibly paid shills.

Oh, gulp.

Career Step has an aggressive marketing campaign, including affiliates who are paid for everyone they get to sign up. Many of these affiliates run their own web sites and blogs, promoting the Career Step program with a great deal of bias. Affiliates and advertising publishers aren’t the same as “paid shills” who are “encouraged to bad mouth Career Step,” but there’s a thin line between positive shilling and negative shilling. And anyone who knows the principles at Andrews and M-TEC know that they stand on their reputation – they don’t need shills. Some of the competitive programs actually use the Career Step curriculum – hopefully with corrections and all with actual live teachers – I doubt they’re going to be bashing the Career Step program. If people actually listen to the advice of others in the industry and go to only AHDI-approved schools, they have some fairly decent choices, Career Step among them, and can avoid the really awful programs that aren’t worth the tuition, regardless of what it is.

The second biggest mistake is this comment:

Both schools [Andrews and M-TEC] —and others—offer fine training, but not necessarily better than Career Step.

I’ve said here before: Career Step serves a purpose. In my opinion, it is not, as stated in this article, on par with Andrews or M-TEC. For one thing, both Andrews and M-TEC have entry screening exams. If transcription isn’t the best career choice for you, based on your skills and knowledge, you won’t pass the test and they won’t take your money. That seems pretty honest to me, however unpopular many hopefuls wish it to be otherwise. And anyone who wants to ignore the danger signs can go to Career Step. Unfortunately, what this means is that Career Step takes a lot more people who are doomed from the beginning but don’t seem to mind plunking down nearly $2,000 to have the lesson hammered home. The second big difference is that Andrews and M-TEC have actual live instructors. It absolutely boggles my mind that a school wouldn’t have instructors, but there you have it – Career Step lets its students and graduates instruct each other in their forum. Therefore, we have the blind and the clueless instructing the blind and the clueless. Taking up the article’s comparison to a carpenter blaming the tools – what would an apprentice carpenter hope to learn from another apprentice carpenter? The third big difference is the “placement program.” Please correct me if I’m wrong, but I’ve been told by Career Step graduates that they pay extra for the “placement program,” which consists of a list of transcription services that may or may not hire new graduates and may or may not have openings for anyone, experienced or otherwise.

What I see a lot in the various MT forums are comments from Career Step about-to-be-grads who state they feel their education is adequate. Well – how do they know? Until they graduate and actually get a job and start work, they aren’t really qualified to judge, are they? And there are plenty of Career Step graduates who are critical of the difficulty they had finding a job and the inadequacies in their education that became apparent once they actually did start work. These graduates aren’t shills for someone else and the only jealousy they have is for people who picked a program they felt would have served them better in starting a new career.

For the record, I run a variety of web sites related to transcription and I accept advertising at them. If Career Step wants to advertise, I’ll let them. But I won’t softpedal my opinions about where they stand in the transcription school rankings and why they won’t ever be the best unless they make some significant changes – like real instructors.