The only person who will ever tell you that professional networking isn’t important is the person who hasn’t engaged in any of it. That same person will tell you that being an association member, getting credentialed, and coming to ACE are a complete waste of time.

I feel sorry for that person.

Get out that broad paintbrush, folks, and pass around the purple Kool-Aid. If you don’t see the benefit of AHDI membership and/or the benefit of being credentialed and/or attending the AHDI annual meeting (also known as ACE) - Lea Sims feels sorry for you.

In my opinion, it’s statements like this that tell us how AHDI views nonmembers; i.e., not as potential members, but people who are too short-sighted to understand all that membership and participation in the organization will do for them, and the great benefits to be obtained from attending the meetings. People to be pitied because we don’t have the vision (i.e., we don’t like the taste of Kool-Aid).

Really – how has the majority of MT-dom survived without AHDI membership?? At its peak, AAMT membership comprised less than 1% of the total number of MTs that AAMT itself gave as an estimate (250,000). There are still many MTs who have never even heard of the organization, much less belonged to it. Don’t choke on the Kool-Aid or anything, but the numbers support the conclusion that if association membership isn’t a complete waste of time, at the very least it’s completely unnecessary. AAMT/AHDI has always had difficulty articulating the tangible benefits of membership. Is it any wonder so many medical transcriptionists don’t see the vision? When the organization itself can’t seem to point to the benefits of membership, how are medical transcriptionists supposed to see them?

Quite frankly, the organization has been battling a misperception by MTs, almost since the day it was formed. It seems that what many MTs want is a guild or a union – or they don’t understand the difference between a guild or union and a professional organization. Probably the most tangible benefits MTs seem to want are wage protection and health insurance, which would be what guilds or unions do, not professional organizations. Clearly, the benefits most medical transcriptionists want from a professional association aren’t anything that a professional association can (or should) deliver. There’s been criticism that those of us who don’t drink the Kool-Aid see only bad in AHDI and don’t see the good, so I’ll give this one to AHDI. Too many MTs simply don’t comprehend that the purpose of a professional organization isn’t to protect their jobs and wages.

Indirectly, a professional organization supports jobs and wages by promoting the industry and the people who work in it. And therein lies the problem for AHDI. In 20+ years, it has searched for that sweet spot - and never found it beyond the first several years the organization was in existence. In spite of deteriorating pay and working conditions for MTs, AHDI continues to try and convince us that it’s doing something to elevate the industry and those who work in it – all the while blaming those of us who don’t join for not supporting it and giving the organization a bigger voice. And feeling sorry for those who fail to see the glorious vision, which is not only insulting but completely discounts the many people who thought they saw the vision, contributed to it – and for a variety of reasons, didn’t feel it was worth their time and efforts to continue their contribution.

I understand that staff members at AHDI, as well as AHDI leadership, have to be all rah-rah about the association. What worries me is my impression that they actually believe what they’re saying.  As the saying goes, the road to hell is paved with good intentions.

What I see is a big disconnect between the projects AHDI spends its time on in an effort to promote the medical transcription industry, and the reality of what’s happening in the industry. In my opinion, AHDI has been struggling for relevance, and the name change from AAMT to AHDI is one of the more visible signs of that struggle. I see the current Health Story Project as another boondoggle, similar to the ASTM standards that AAMT poured so much time and money into. (And if you’re wondering “what ASTM standards” – my point exactly.)

This is a series of tweets (Twitter) from Lynn Kosegi, of M*Modal, live from the ACE conference that highlights some of the disconnect.

The Gerry she refers to here is Gerry Lewis, speaking at the recent AHDI annual meeting. I hate to disagree with someone with his credentials – but I’m going to go out on a limb here and disagree with some of the statements reported by Lynn Kosegi.

There has been no reduction in transcription services.

Hoo boy! Really? I have personally had discussions with HIMS managers at three large university medical centers and they all report a reduction of 50% or more in dictation/transcription following implementation of an EMR. They are all thrilled. On a personal level, I have lost – completely – two large orthopaedic practices that have implemented EMRs. They do NO dictation – zip, nada. If that’s not a reduction, I don’t know what is – and that’s just a small sample of what’s going on in this industry.

Not one MT has lost a job…

I’m sure there are plenty of MTs out there who can comment on this one.

No speaker is going to go to an AHDI meeting and tell the medical transcriptionists that their jobs are going away. But is that reality? The value of attending the ACE meeting is apparently to get thoroughly indoctrinated into AHDI’s vision. Pass the Kool-Aid and take a big swig – you’ll need it for these meetings. (Please note I have an overdeveloped skepticism of authority speakers and writers, one I developed acutely after being labeled as one myself while an AAMT member. I loved speaking at the meetings, but don’t consider myself an authority and frequently had a difficult time putting the necessary rosy glow on predictions for the future of the industry.)

From the AHDI website:

AHDI works to set and uphold standards of practice in the field of medical transcription that ensure the highest level of quality, privacy, and security of health information. Complete, accurate medical records are vital to increased patient safety, improved quality of care, and the seamless functioning of the healthcare system.

Here’s where that purple Kool-Aid really comes in handy: does AHDI (leadership, staff, members – take your pick or pick them all) not see the dangers inherent in putting medical transcriptionists forward as guardians of complete, accurate medical records? For patient safety and improved quality of care?

With or without a credential, that’s asking a lot from a person who likely has a high school diploma, is working at home, and never sees or talks to the patient – much less the practitioner who does see and talk to the patient – don’t ya think? Even if MT moved towards an hourly compensation environment instead of production, as Ava Marie George (president elect) suggests in a comment on my Facebook wall – I’m sorry, I just don’t think the healthcare provider or facility is going to agree with me that if I am in any way responsible for assuring a complete, accurate medical record… for patient safety and improved quality of care – I need to be paid something comparable to what people with more than one post-secondary degree, years of training and a license to practice medicine make. I question the wisdom of making medical transcription more important by placing this kind of responsibility on the medical transcriptionist.

But wait! That’s where the value of credentialing comes in! AHDI sees mandatory credentialing for medical transcriptionists as a way to create a barrier to entry. And as you can see from the opening quote, anyone who doesn’t see the value of credentialing is to be pitied. In response to my prior post (Can you trust AHDI to represent the industry?), Laura Bryan comments:

…promoting credentialing to protect the industry from “would-be MTs”, creating barriers to entry into the field so that not just anyone has access to personal health information or the right to screw up a medical record…

This one has always been a hard sell for AAMT/AHDI. So hard, in fact, that they keep trying to make some sort of credential mandatory. So hard that they can’t get the members of MTIA, their business partner, on board. I keep hearing that MTIA members have agreed to give preference to credentialed MTs (and it’s included in the official AHDI list of accomplishments for 2009), but I’m not seeing it in the hiring practices. MTIA members give lip service to this without actually putting it into practice. (Does anyone remember the BMP? Yeah, it’s something like that.) If you want to move up to QA or some kind of management position, a CMT would probably give your ambition a boost. For the majority of MTs, however, there is little, if any, benefit to being credentialed. And frankly, if the people who hire medical transcriptionists and the people who contract for medical transcription services don’t show a great deal of interest, then there isn’t going to be a lot of incentive for the working MT to jump through those hoops.

There’s a lot of talk that the healthcare industry places great value on credentialing and that medical transcription has been somewhat invisible in that regard. This is kind of a catch-22 situation and nobody knows the answer. Would more employers require a credential if there were more credentialed MTs? Would there be more value placed on medical transcription if more MTs were credentialed?

Healthcare facilities are chronically strapped financially and looking to cut costs any way they can. To be quite blunt, the healthcare industry not only doesn’t think there’s much of value in medical transcription, but it also doesn’t really want to have to pay more to a workforce that is predominantly female, the majority of whom claim only a high school diploma and a certificate of completion from a medical transcription program. A credential that does not include the requirement for at least a 2-year college degree isn’t going to change that. (I would even argue that medical transcription is not a profession by definition. A career, yes – a profession, no.)

And what about professional networking? Here’s a newsflash: AHDI isn’t the only venue for professional networking. I haven’t seen much participation (if any) of the current AHDI staff or leadership in any of the medical transcription forums, so maybe they don’t realize that networking among MTs has been going on online for many, many years. Clear back in 1994, I voted on the charter to form the Usenet group sci.med.transcription (SMT). There was a tremendous amount of networking done there, and then subsequently on sites such as MT Chat. The regular contributors to those groups were some of the best medical transcriptionists I’ve ever known and I knew I could count on the word lists, grammar advice and medical information shared by Toni Mercandante, Barb Grow, Annie Ranieri, Ellen Drake and many others. For years, many vendors were active in the transcription forums, including SMT and MT Chat. Many MTs don’t see the benefit of joining an organization for networking purposes because they’ve been doing it online for years, and for free.

I want to address Laura Bryan’s comments about networking in the medical transcription forums online. Again, in response to my prior post (Can you trust AHDI to represent the industry?):

I have been treated far worse on the MT forums than I have ever been treated by anyone within AHDI. I find it curious that many of the people who participate in public forums and comment on the communication problems within AHDI (criticizing how they shut out comments, disregard member comments and opinions) are the very same people that have treated me and other advocates of AHDI in the very way that they find unacceptable. I don’t see AHDI’s critics setting an example that could be followed for improving the dialog. Do you really want to talk about shutting people out of the dialog? Just try posting in favor of AHDI over at MTChat!

I find this interesting on a couple of levels. I have allowed comments on my Facebook wall about this topic, without editing, deleting or censure. I accepted numerous “friend” requests from AHDI members in the last two weeks, presumably so they could read the wall and comment, should they so choose. I also don’t moderate or edit comments here at MT Exchange. The policy at MT Chat has been to lock threads when they get out of hand, but not delete or edit posts. In other words, these are all free exchanges of ideas and opinions.

Try getting that kind of free exchange in any AHDI venue.  Go ahead – ask if the comments at the official and semi official blogs are moderated. If you don’t already know, the answer is a big, fat YES. When AHDI had a forum – and they no longer do – it was heavily moderated. Apparently, even members couldn’t be trusted. Judging from Laura’s comments, there are people who prefer the moderation. It’s nicer – less honest, perhaps, but nicer. Like little sips of purple Kool-Aid.

The problem is, AHDI leadership (and staff, apparently) don’t “get” online networking. When they participated (and I use that word with reservation) at MT Chat on an official basis, they only posted to defend criticism of AAMT/AHDI. MT Chat is seen primarily as “anti-AHDI” because the majority of participants are critical of the organization. Why is that? Because supporters of AHDI, leadership in AHDI and AHDI staff don’t participate. Like the many folks who friended me on Facebook this week so they could read my wall or post a comment, they don’t introduce themselves into the community and participate in other topics. The only time we see them at MT Chat is when they jump onto the forums because they’re upset about something that’s been said about AHDI.

Have you ever had someone show up at every club party, just to sell Amway? They don’t participate in conversations, they don’t get to know anyone, they don’t contribute anything to the group – they see the gathering as a room full of potential customers, not potential friends or coworkers or people with shared interests.

This is not networking. This is more talking at people – selling Kool-Aid. The same people who say “you get out of it what you put into it” don’t seem to be able to translate that to online social networking. When your only contribution is to sell something – your services, a book, or purple Kool-Aid – you can expect the highly intelligent people who make up the majority of the online medical transcription community to call BS when they smell it. So here’s a hint for Laura: if you actually participated in the community, if you got to know people, and let people know you – then you’d be a part of the community, not just some AHDI rah-rah girl pushing purple Kool-Aid. People are much nicer and much more willing to listen to someone when they know them and have established relationships with them.

Finally, we get to the bottom of the Kool-Aid glass and see it for what it is. AHDI has problems finding relevance with MTs because it doesn’t bear any resemblance to the reality that most MTs work in on a daily basis. We’re not convinced that drinking the Kool-Aid gives anyone at AHDI any better vision of the future of the industry, or any better ability to direct its future. I don’t know about most MTs, but when I read some of the things written in a Kool-Aid induced euphoria, I am quite convinced that it doesn’t.