Medical transcriptionists file class action suit over wages and overtime

Yesterday, the Law Offices of Kevin J. Dolley and the Riggan Law Firm filed a class action lawsuit on behalf of 13 named plaintiffs against Transcend (now acquired by Nuance). For details, read all the above-referenced links, including the PDF of the original complaint – I’m not going to rehash the information.

In my opinion, this has been a long time coming and I congratulate the 13 named plaintiffs who took a stand on behalf of medical transcriptionists everywhere by exposing the abuse of employees that runs rampant in the medical transcription industry.

Knowledge workers v. production workers

Part of the problem as I see it is that medical transcription has become a commodity, paid on production, with little or no acknowledgement of the wealth of knowledge a transcriptionist must have in order to perform the work.

I was doing some research for MT Desk this week and I was struck by how much a medical transcriptionist is required to know – and how little they are compensated for the value of that knowledge. It’s been years since I took a medical terminology course and the difficult first year as a transcriptionist is happily a foggy memory, but I’m reminded as I do this research of how much knowledge the job requires and how much we have learned and must continue to learn as we do this job. And yet, pay rates continue to deteriorate, even as MTs are asked to do more and more uncompensated work activities.

One of the issues at the heart of this lawsuit is the amount of time a transcriptionist must spend off keyboard researching terms, communicating with the company, looking up demographic information, and making sure the document complies with company style guidelines – all without compensation. I’ve had MTs tell me about “style guides” for each of their accounts that are as thick as a book, with each account having its own set of guidelines that have to be followed. If this industry acknowledged the wealth of knowledge required to do this job, the amount of time spent on these activities would be compensated to acknowledge the value of the knowledge required to perform them.

Also at issue is time spent scraping for jobs that aren’t in the system. This is a practice I have always taken issue with when it comes to MTs who are employees. If an MT is assigned a work shift, he or she should be paid a base rate for those hours, regardless of the availability of work or the function of equipment. And I would hope MTs wouldn’t accept that the base rate should be minimum wage; in my opinion, medical transcriptionists making minimum wage is both an insult and a travesty. When I first became a medical transcriptionist in the late 80s, an MT working in-house at a hospital could expect to start at a wage of $18 per hour AND make production incentive pay. If there was no work, they didn’t make incentive – but they still made the base hourly wage. Most companies that overstaff a shift will send workers home, so why is it a transcription service expects MTs to sit through their shift, checking desperately to see if there’s work in the queue? And why do MTs tolerate this? As to the first question, I’ll tell you why – most companies are paying those shift workers an hourly wage and they send them home so they don’t have to continue to pay them to do nothing. Medical transcription services don’t “send home” their telecommuting employees because they aren’t paying an hourly wage for that person to sit and wait for work in the system and therefore they have nothing to lose by expecting that person to sit all day, checking the work queue. What they have to gain is awesome turnaround times, so they look good to their clients. As to the second question, I’ve never been able to answer it. I used to work as a temp and there were many times I wondered why the company needed a temp – I wasn’t allowed to answer the phone and I was given nothing to do. Many times, I sat in a cubicle and did absolutely nothing. No skin off my nose – I still got paid the same amount of money. Having hired my services, it was the company’s responsibility to see that I had something to do, not mine. And having hired my services and told me when I had to be available to deliver those services, it was also the company’s responsibility to compensate me for my time – or release me from my obligation of sitting there. In the case of permanent employees, employers know full well that telling a worker that they are off shift due to lack of work can result in employees looking elsewhere for employment. People work to make a living and their pocketbook can’t tolerate many days with no pay. Because medical transcription services don’t pay a base hourly rate, they can keep MTs hanging around with the promise of work, even if none materializes, with the added benefit that MTs will work other shifts in order to make the minimum number of lines required to remain an employee. Talk about having your cake and eating it too! Of course, this practice has a negative effect on the MTs who are working the shifts being encroached upon by MTs who are now trying to make up lines that weren’t available during their own scheduled shift, and the domino effect continues. In the meantime, MTs aren’t being compensated for making themselves available to work during their shift, nor are they being compensated for working what amounts to overtime.

If medical transcriptionists were actually compensated as the knowledge workers they are, they wouldn’t be paid strictly on a production basis. I feel that when I first started in medical transcription over 20 years ago, there was more value given to the knowledge an MT brought to the table; unfortunately, the industry has taken a big step backwards in that regard.

Trusting telecommuters

One reason companies are reluctant to pay telecommuters an hourly wage is because, quite frankly, they don’t trust them. This is an issue in all industries considering allowing their workers to telecommute. You’d think that for as many years as MTs have been telecommuting, the industry would not only have figured out how to do it right, but would serve as a shining example to other industries on how it can be done. Years ago, I gave a presentation at the AHIMA Nevada state meeting. One of the other speakers gave a presentation on coding and the issues surrounding allowing coders to work at home. I was a bit flabbergasted because all the issues being raised were issues that had been discussed in the medical transcription industry for years, but this room full of health information professionals all acted like these were unique to coding and they talked about how to resolve this issues without once considering asking the people managing another branch of the health information management department – the medical transcriptionists.

In the medical transcription industry, where transcription platforms can be used to track the actual time on the keyboard, it’s tempting to use that as a measure of actual time spent working. However, using keyboard time disregards all other activities, such as research, phone calls related to business, and computer down time. And let’s face it: if someone wants to game the system, they can game the system. Nothing is foolproof. The essential components of successful telecommuting are a clear contract and trust. At some point, companies need to trust the people who are telecommuting to report their time accurately and to be as productive as possible when they are on the clock. Does that mean an MT is going to spend 8 full hours with hands on the keyboard (assuming there are enough jobs in the system)? No, it doesn’t. But that doesn’t mean the MT isn’t giving full value to the employer. Even in an office setting, people take breaks. They go to the bathroom, they get something to eat or drink (even if they bring it back to their desk). Nobody, in any setting, is at their desk and working for 8 hours a day and it isn’t reasonable to expect to compensate anyone only for the amount of time they are; otherwise, there’d be a lot of office workers taking a big cut in pay, and they’d be as unhappy about it as MTs have been.

In addition to tracking actual keyboard time, companies use minimum line requirements to offset trust issues. The problem with minimum line requirements is it doesn’t allow for company problems the transcriptionist cannot control, such as the volume of available work, failure of equipment, telephone calls or other required meetings. Minimum line requirements have to be reasonably achievable by a full-time worker and they have to be adjusted for outside factors. If a company is going to require a transcriptionist to produce (for example) 1200 lines a day, then it’s the company’s responsibility to see that there’s a sufficient volume of work available to produce that number of lines, that the equipment is working and that supervisors aren’t constantly interrupting with messaging systems, e-mail and phone calls.

Of course, medical transcription services are reluctant to pay a base salary with minimum line requirements and production incentives because of the way the client is charged. Maybe all that needs to change, and maybe this lawsuit will be the catalyst for that change.

The WAH syndrome

What is the WAH syndrome? See if this sounds familiar:

I don’t need to be paid as much as someone in the office because I save money on gas, clothes and child care.

I’ve never interviewed for an office job where I was asked how far I had to commute because the salary I’d be offered depended on how much I might be spending on gas. Likewise, I’ve never been asked how much I pay for my business attire, or how many children I have that will require day care, or even how much I might expect to pay for day care. If it makes no difference in an office setting, why does it make a difference for telecommuters? Let me tell you something: it would cost these companies a fortune if they had to bring everyone in house, even if they could find enough people who were willing and able to work in house. Telecommuting has been as favorable for MT companies as it has been for the MTs themselves – so why is it even a factor in pay rates and the way employees are treated? Because there is an army of people out there willing to do literally almost anything to work from the comfort of their home.

OK, I’ve never heard an MT say it’s okay for the company they work for to violate labor laws because, after all, there are other benefits in being allowed to work at home – but that’s basically what’s been happening for years. I just can’t imagine that MTs think it’s okay to be expected to be at their desk and working and then not be paid because there is no work. I can’t imagine that MTs think it’s okay to work more than 40 hours a week and not be compensated extra for it. If you worked in an office where you punch a time clock and one of your co-workers encouraged you to falsify your time card information, you’d both be fired, even if that co-worker was a supervisor. So how has this gone on as long as it has in the medical transcription industry? This isn’t the first time I’ve heard of this practice, nor is it the first year I’ve heard of it. It’s been going on for about as long as there have been MTs working at home as employees. I don’t know why it’s been allowed to go on for so long; what I do know is I’m glad it’s finally been pulled out from underneath its rock and the comfort of working at home and exposed to the light of day, where it belongs.

The Stockholm syndrome

I was reading a blog post this week about how authors have something of a Stockholm syndrome when it comes to their relationship with the established publishing industry. I think there’s a Stockholm syndrome among many medical transcriptionists, as well, which might provide some explanation for why it’s taken so long for a lawsuit like this to come about when this type of abuse has been ongoing for years.

I admit, I have not been immune to MT Stockholm syndrome. I had abusive clients over the years. I put up with their abuse for a number of reasons, but the primary reason was I was making good money and I used that to justify tolerating the abusive behaviors. One day, I decided I’d had enough. I terminated a long-time client who represented a substantial amount of my income. I liken it to having a splinter you’re afraid to remove – it doesn’t seem that bad, it’s not festering too much and it’s not frankly infected so out of fear (or whatever reason), you just leave it alone. When you finally pull the splinter out, you realize how painful and annoying it’s been and wonder why you tolerated the pain for so long just because you were afraid to pull it out. That’s how I felt when I finally removed that splinter. For me, the stress relief far outweighed the loss of income. It takes a lot of courage to stand up, but at some point you have to ask yourself what do I really have to lose? Many of the MTs involved in this lawsuit are struggling to make a living – not just a decent living, but a minimum wage living. For a job that requires as much knowledge and intelligence as medical transcription, that’s just not right. And I’m sure there will be plenty of people who will say (or think) well why not just get another job? First of all – why should they have to? THEY haven’t don’t anything wrong. Second, I suspect Transcend isn’t the only company that employs these tactics or has these problems, and many MTs have gone from company to company, trying to find a fit, only to experience similar treatment.

Medical transcriptionists need to stop being afraid of what will happen to them if they speak up, and start thinking about what is happening to them because they aren’t speaking up.

It will be interesting to see how many MTs join this class action and how many additional actions are filed against other transcription service companies that employ the same abusive tactics. If you think you belong to the class action against Transcend, there’s a link to instructions in the Dolley law office blog. I encourage transcriptionists to stand up for themselves; in the end, it will benefit not only individual MTs, but the industry as a whole.

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61 thoughts on “Medical transcriptionists file class action suit over wages and overtime”

  1. Thanks for the link to my blog at MT Tools Online. You have said exactly what many of my thoughts are here. It is my hope that this calls enough attention to some of these travesties that they stop. I find myself appalled to think of anyone doing medical transcription and not even making minimum wage. And I think many times MTs have put up with it or not left simply out of fear. There’s no guarantee the next place won’t do the same thing or be even worse. No, I’m not saying all employers do these things, just that until you’re in the company you don’t know.

    Years ago I was a recruiter for a really decent MT company. Our CEO used to talk about “the abused MT syndrome.” Much like what you talk about above, that’s what we saw. Those MTs came in with a chip on their shoulder, as if they were just waiting for us to take advantage of them. He recognized that was because of what they had gone through elsewhere and was willing to a point to work with it until they realized this company was different. I miss the days of that kind of employer, who simply gets it and recognizes the value of the knowledge worker.

    1. I find it appalling that MTs do what we do, with the stress involved, for even $10, $12 or $14 an hour, let alone minimum wage. The schooling most companies require, the stress of knowing we could actually go to jail b/c a mistake a lazy doctor made (or didn’t care enough to enunciate properly) is mind boggling. I am NO fan of unions but I do hope something changes soon and our pay scale goes up again.

      1. I hear you Lori. I have been a medical transcriptionist for more than 10 years and cannot believe the abuse the industry has placed on us. As a medical transcriptionist it is expected that we know almost as much (if not as much) as the actual physician. Just ask any MT what information and knowledge is needed to complete just one report, let alone 30 or 40 per day, only to have the company you work for ding you for every cough, sneeze or hiccup that prevents you from actually hearing or even understanding what the medical professional wants you to type, let alone mumbles and accents that are indecipherable to anyone. Then of course we have the dreaded “demographics” which in my opinion is not the job of the MT to have to decipher and research. This should be the job of the office staff who actually have the information on each patient and who are being paid very well for their job. In the beginning, years ago, the job of a medical transcriptionist was to type medical terminology, not research names and addresses. Now the physicians think that it does not matter if they mumble, chew or swallow their words because the MT will fix it, or get fired trying. I have for the past 5-6 years wanted to get someone on our side and start a union for medical transcriptionists so that we could receive our fair share of a very difficult profession. Every day there are new medical words, procedures and new prescription drugs that we need to keep on top of, also the ones the doctors make up themselves. I really feel sorry for the MTs just finishing school and think they will get hired on right away. They are being lied to. The private schools are charging an enormous amount of money and the MT finishes without much chance for connecting with a real job in the transcription field. Accuracy and speed are two words that should not be in the same sentence. Especially when it comes to someones medical record. 98.5 to 99% accuracy, really? Only if they speak 98.5 to 99% accurate.

  2. Thanks for posting, Kathy. And thanks for pointing this whole story out to me. It’s been fascinating to follow.

  3. We all go to see a physician, by choice or in an emergency. Would you want your medical care be provided by a “minimum wage” physician or a physician who is paid based on the number of patients he can “shuffle” through the practice or emergency room?

    In the transcription point of view, WE provide your record so that you do get appropriate medical care. Do the large transcription companies see how important our role plays in the day-to-day running of a hospital, sole physician practice, or a tertiary care center? We are expected to produce “legal” documents and could get paid less than working at McDonalds. Do you feel that is fair?

    I think that this lawsuit may open a discussion to many things that have not been addressed for some time.

    I remember asking my COO of my hospital to sit down and type a document. He was appalled because there were no letters on the keyboard. I only had to laugh. Walk in my shoes for a day, please.

  4. I just want to say this abuse happens in most MT companies and people should call that attorney and join the suit. When I first started, I was paid 2-4 dollars at a small company as an IC. I hear stories of people who have stayed longer with them, working 7 days a week for less than minimum wage.

    Getting a job with minimum wage as an employee seemed wonderful, until I was shown that they expect us to change the clock against us and they think we should mass produce.

    They claim you can have speed and accuracy but that is simply not true. You give up accuracy with speed. You gain accuracy if you give up speed and take the time to research. These are patient’s vital documents and I am offended as a honest hard working employee who has high standards but also I am offended as a patient. I know I am not the only MT to have found medical errors in past reports.

    People should demand their medical practitioners put a stop to these unlawful and careless practices.

    If you are a MT, call and get involved.

  5. I’m sorry. I don’t see this as a good thing. I just don’t. I think the result will not be what MTs think it will be. From a business standpoint, I *do* believe services who are in violation should be held accountable. I do think companies should pay for the work they get. The problem is, many of the MTs aren’t really WORTH a whole lot. On the hiring end of things, too often I saw MTs who touted, “I’ve done this for 25 years.” Well, honey, you’ve done it badly for 25 years then. MTs who think this law suit will stop overhiring, offshoring, or raise their wages are likely in for a rude awakening. It will penalize Transcend and any company that gets added to the lawsuit. It will likely financially benefit anyone along the food chain who is not an MT.

    I know my view is not a popular one but that’s okay, it’s mine and all mine, so it doesn’t have to be popular.

    MTSOs who’ve been allowed to become large conglomerates are the ones who can absorb this kind of fight. It will be little more than a glitch on their radar. The companies who will likely suffer, are the small to medium size services who can’t absorb the costs. I work for two of such companies. I make decent money at each of them. But I can’t help but wonder where the chips will fall when this is all said and done. Will the decently paid, happy MT then be on the other side of the table? Because this will not result in better pay, better working conditions, more work, or anything close to those.

    I want to know who to thank when an MTSO tells me they will pay me $10/hr for 35 hours a week. I currently make a tad over 3 times that amount. MTs like me don’t want to see the hammer come down on the companies we work for.

    BTW, I’m not abused where I work. I’m respected and compensated fairly. That doesn’t make me better than any other MT but I have to wonder if it does mean something. I can put my keyboard where my mouth is. I give a day’s work for a day’s wages. I stay abreast of changes in the industry, programs, trends. But I do know that one of the places I work, follows the “put 40 on the time sheet” trend. (Doesn’t affect me as I’m not an employee there.) I remember when I was an MTSO, the back and forth between a payroll company and myself because trying to accurately plug production into the normal formulas was crazy-making for the payroll company.

    Do we really want to be paid by the hour? Hired only as part time with no benefits? I don’t. I want *my* applecart to stay just like it is. I’ve worked hard to pick these apples. I’ve tended my garden and watched my production grow. I make some damn fine apples. I have a feeling what we will end up with will be some sorry-tasting applesauce.

    1. I don’t think there’s anything in this suit that says it will change offshore transcription or raise wages. What it does say is that it’s time for illegal practices to stop. I really don’t understand any company having a worry about this one as long as they are following the law..If those small and medium sized companies you reference are doing things by the book, this one won’t impact them at all. If they aren’t, well, they should be. Any employer who only allows an employee to work over 40 hours in a week and does not pay overtime is negligent; if they are telling the employee to falsify time records, that’s not legal. It’s pretty plain and simple as i see it.

      Yes, there are MTs who prefer to work 10 hours and report 8. They, too, are breaking the law, not to mention how that skews their lines/hour reports, which does impact the company’s profitability if they have any kind of incentive plan. And yes, I believe that group of MTs will be unhappy about these things coming to light; we’re already seeing that online today. In the world of health care where ethics is critical, this isn’t okay either.

      What I hope from this is that any illegal activities are halted. It is, after all, the right thing to do.

      1. QA at Transcend had quotas to meet, too; 60-80 jobs PER DAY QA’d or you were “demoted” to MT status, period. And no OT was approved, so I knew many QA editors there who clocked out, then worked many more hours to get their quotas done.

        And then those who fudged the numbers got promoted to ROM or assistant ROM with a $50,000 annual check.

    2. “MTSOs who’ve been allowed to become large conglomerates are the ones who can absorb this kind of fight. It will be little more than a glitch on their radar.”

      Exactly what happened to me when I sued Transcend. Just pocket change to their very expensive attorneys.

    3. Molly, I don’t see this as an issue of whether or not MTs are worth what they’re being paid. The issue is that the employer is breaking the law when they require MTs to adjust the actual time worked so that they aren’t paid for overtime. The issue is requiring an MT to work a scheduled shift then not compensating them for their time when there’s no work available.

      There may be plenty of work during your scheduled work time where you work, but I hear from many MTs – most of them working for the big companies – that it’s simply not the case where they work. Either the company is overstaffing – or there are MTs working outside their assigned shift in order to get more lines, which takes work away from the people who are scheduled to work the next shift. These are problems that the company needs to address and fix; MTs shouldn’t be losing pay because the company is poorly run. If I show up for work, I expect to be paid.

      We’ll have to see where it all falls out, but I don’t see this necessarily resulting in MTs being paid hourly and I don’t see it punishing MTs who aren’t having issues with their employment, who are making a decent line rate, and who have plenty of work available to them when they’re scheduled to work.

      I agree with you that there are a lot of crappy MTs out there but in my opinion, that’s also a product of poorly run companies. If companies were run right, these people wouldn’t be able to get and keep their jobs. Unfortunately, it’s all about pumping out the lines with the lowest possible labor costs. But violating labor laws has nothing to do with quality of the work product.

  6. MollyCoddle,

    How many lines can you do at 0.375-0.475 to make what you currently make? That’s the going rate. Do the math.

  7. I don’t accept that rate. I just don’t. My company starts at 5 cpl and pays incentives. I earn 0.077 to 0.079 per line for SR work.

    So now I’m confused. Kathy says wages aren’t the issue. Silence is Complicity says pay is the issue.

    If the suit isn’t about pay, then that’s good (I admit to skimming), because I don’t see that changing. This suit will NOT raise wages so Silence is Complicity, I have to wonder what it is you plan to do so you aren’t working for wages where you can’t make a living?

    Oh and I do 400-500 lph so I’m still way above minimum wage.

    I’m not without appreciation of your plight. I just don’t understand how anyone thinks any of this “striking” etc will change the pay. My daughter watched her 9 cpl straight type turn into 9 cpl straight type but 3 cpl SR. She told them she couldn’t live on that and refused to do any doctor that needed more than a cursory glance. She now makes 5 cpl SR. But she works for a small company. I understand with the “Bigs” many MTs think they can’t do that, but I have to wonder, if everyone stopped ACCEPTING low wages, then and only then, would services realize they have to pay more.

    @Kathy, I wholeheartedly agree that unlawful practices should cease. Right now I guess I’m from Missouri– SHOW ME how that turns out in practice.

    1. @ MollyCoddle – I am a little late in the game, but I did the same thing your daughter did. I work for a large company that wanted to pay me 4cpl for voice recognition and I told them I simply could not do it. They raised me to 5 cpl for VR and a month later, I had to request that I be paid more which ultimately landed me at 6cpl for voice recognition.

      I would love to see 0.7 or even 0.65…but I dont know. The bottom line is, if you know you can’t make the money you need to live on, you have to tell them and if they are not willing to pay you, then you need to look elsewhere because 4cpl is not a living wage, let alone 3.

    1. Law breaking may be an issue but pay is not if you are willing to settle for minimum wage. My experience is very similar to Molly, I currently make 3 times the minimum wage. You are suggesting that we all be brought down to the same level. That is not fair to those of us who are being paid well.

      1. I don’t think anyone is suggesting that anyone be “brought down” to any level.

        The lawsuit is about making employers comply with the law. The only thing that it asks that has the potential to change how employee MTs are paid is compensation for non-keyboard time.

        If your employer has so much work that you never start your shift and find an empty queue, and the queue remains full throughout your shift, then you have nothing to worry about. But it won’t matter if you’re paid 7 cpl or 20 cpl – if there’s no work in the queue throughout the majority of your shift, and you aren’t paid for non-keyboard time, you’re not going to make any money.

  8. I am sick of their illegal practices. They violate labor laws. They violate HIPPAA when they use slave labor overseas. The pay is also a consideration but that is rolled up into the whole labor abuses they do.

  9. I think where it comes into a “pay” issue is not being paid as you should. The suit itself isn’t about the rates, it’s about not compensating according to the law. If you work 60 hours a week, you should be paid for 40 hours of regular time and 20 hours of OT. That doesn’t happen.

    Your rates for SRT are the highest I have ever heard of in the industry. That’s not most MT’s experience so I would hang onto that position. I will say kudos to anyone who stands up for themselves and commands a higher rate as i believe that’s how it should work.

    1. Just to reiterate, I think ANY company engaging in unlawful practices should be held accountable. When I’ve applied/worked with companies who wanted me to fudge a timesheet, I refused or left the company.

      I agree Julie, the companies are poorly run.

      I also believe, if this has any impact on the profession overall, it will be to move to MTs being paid hourly and that’s something I really hope does NOT happen.

      Having been an MTSO, and knowing the crazy terms so many of these companies agree to with clients, you almost have to over-staff in order to maintain TAT.

      I admit, I’m lucky (right now). I work for two great companies.

      I hope these MTs aren’t disappointed.

  10. Mollie, I sure hope if it goes hourly that we can get 20 bucks or more out of it without the whole ‘hands to the keyboard’ stipulation. Research of meds, abbreviations, terms, materials, proper patient or cc identification, and previous history are all part of the job and yet as it stands right now, we are not compensated in the way the law was set up.

    However, Mollie is right. When you quit, send the letter to the attorney general too and state your reason for leaving as ‘violation of employment laws.”

  11. I’ve been an MTSO for 24 years (and a damn good one, never a complaint). While the lawsuit is about abuse of time and compensation, I for one think it is about time “we” finally made a stand. We have been losing ground for no good reason for some time. I myself am at that “fork in the road” that Molly I hope you don’t have to come to. I am in the midst of a SR conversion and in contract “negotiations”, which is laughable, because I am essentially being told to take it or leave it. The IT being $2.00 a report. I had to terminate all of my subcontractor’s contracts and now I am going to be asked to sign a contract with a generous turnaround time, EXCEPT they still want 2 hour STATS, for FREE! Which means if I agree to this, I will be selling out and making under minimum wage.

    As the writer of this blog stated, I am insulted. To take a well oiled machine that was making them look good and replace it with a SR program that is allowed to make egregious errors is unacceptable. AND they expect me to buy 1-3 million dollars E&O insurance in case I make a mistake.

    I’m not sure if I will end up signing this contract. I can’t visualize the pen hitting the paper right now, not that anyone cares. There is a whole pool of editors waiting in the wings to absorb my workload.

    I guess this is the last stop of the “gravy train”. It sure was a swell ride while it lasted.

    1. “I guess this is the last stop of the “gravy train”. It sure was a swell ride while it lasted.”

      Exactly where I was at when I closed my doors, Cheryl. And they are now closed. After over 20 years as a transcriptionist and MTSO, I’m finished. My only involvement now in the industry is my websites.

      My rates were not considered “competitive,” and I refused to work for less. I believe medical transcription has value and I refuse to give away my knowledge and experience. I’d rather not work at all, or do a job that requires less skill and knowledge, and pays as well – and in some cases, better.

  12. Molly, I have to wonder at what you’re saying because, having been an MLS for 35+ years, if I displayed that openly “I don’t accept that rate, I just don’t” attitude, or the “I refuse to do a document for 3 cents a line that needs more than a cursory glance (and what about the fact that that would DEFINITELY put a patient at risk) declaration, I would QUICKLY and SWIFTLY have been shown the door! Now, perhaps it was done with a tad more tact than your statements would imply — that would be hard to discern. To me, I’m sorry — something just does not add up.

    1. @Cheryl, I already was met with the fork in the road and had to close my doors as an MTSO. These days I’m a happy MT, nothing more.

      @Diane Burgbacher – Of course I used tact when addressing my client/MTSOs (I’m an IC for one company, an employee with another). I told my manager that unless we could negotiate a pay rate that I could live with, I’d have to go somewhere else. I’m a pretty darn good MT and will do whatever account they need done and they knew it. They said they didn’t want to lose me and would pay me. Now, believe me, I think I’m worth even more, but comparatively speaking, I’ve got a good rate. And I personally won’t even speak to a recruiter who is offering less than 5 cpl for SR. Like Julie, I’d rather leave the profession altogether if it comes down to my only choices being so grossly underpaid, or not paid at all for my work. Both companies I work for now have made it so an MT can be very productive and I’m lucky there.

      As I stroll through cyberspace, I still see a lot of MTs who think this suit is going to raise their wages and I will be watching to see how they feel when all is said and done.

  13. Unfortunately so much of our transcription work is going to foreign companies now, that when we ask for more, we are bascially informed of the fact that these foreign companies can do the work cheaper. They hire these workers and then pay US workers to be editors and still come out the same. I don’t know what they pay these foreign workers, but it must be next to nothing if they can still pay us to edit on top of what they pay them to type. Companies are also asking for faster TAT because they tell us they will go to voice recog if we can’t do our work with a 1 hours TAT. I like getting paid production as I am good at my job and do well that way. I do, however, wish our company would paid incentive for those who can type more than a standard amount. I also think when we are on vacation our hourly pay should be more compatible with what we each individually make on average, not a set rate that averages to typing 1200 lines a day. When I take one vacation day, I have to work an extra 4 hours during the other four days to make up for the difference in my vacation pay and my production pay. I hope they win their suit and lots of people may benefit, but I feel it could cause more companies to go to VR or overseas. I think the government or whoever, should make companies pay foreign workers the same as they pay us, that would at least help that issue. Just my thoughts on it. I sincerely hope these people get what they want out of their lawsuit. I had a friend that worked for Transcent and their pay is horrible compared to all other companies in this area.

  14. What I can’t believe is that no one is mentioning another important fact of the remote transcriptionist working from home and that is that we pay for our own overhead on top of everything else. On top of the insulting pay and the companies wanting us to turn in lower numbers of hours than we actually worked, we are paying for our own electricity, high-speed internet (required for the job), computers, accessories, etc. If one of my computers goes down, I have to replace it out of my pocket for the privilege of keeping my job. I have been a transcriptionist for 30 years, am a very hard worker, never mind researching a new term (it is the only way to learn and grow in your career), but am paid like a brand-new transcriptionist on her first job. It was a good career for many years but the large companies taking over numerous accounts have made it hard to find a good job in this field anywhere. I would love to change fields but that is easier said than done at my age. Instead of being rewarded for being an employee with a wonderful employment record, longevity, experience, good references, I am going to finish out the last years of my career struggling to pay my bills as I am now. I have invested too much in my office, equipment and training to give it up at this point. I don’t know where this is headed but it is very sad.

    1. That’s why I say these companies would be in trouble if they had to bring everyone in house. It just burns me up when MTs – or managers or MTSOs – say “but you don’t have to pay for childcare or gas and you don’t have to drive to work.” So? The company doesn’t have to pay for office space, parking, electricity, A/C, heat, equipment, etc. In my opinion, the advantages are mutual and should have nothing to do with how telecommuting employees are treated.

  15. What I am concerned about is the fact that I am paid by the line, period. My actual time at the keyboard, doing the associated research and aiming for a quality document with no errors and sometimes researching doctors by name and address are not even in the mix. Also, my time “schedule” is totally at the mercy of the doctors….whenever they decide to dictate their charts, etc, since I am not “scheduled” by the small firm I am working for as a subcontractor.

    This is something that is a mixed blessing as my turnaround time is 24 to 48 hours. I appreciate having the flexibility of staying at home and working the hours that best suit my own personal schedule.

    But, all in all, it’s not just about hands on the keyboard…there is so much more that you really are not paid for in order to produce quality legal documents!

    I really don’t think a lawsuit is going to change much of this…if anything, it may backfire and hurt smaller companies who are having a hard time competing with the big ones, especially on the local level. If the docs and hospitals were worried so much about saving a few pennies, it would be different and MT’s would be given the respect and pay they deserve for all their hard work!

    1. KateinPA, this lawsuit won’t affect independent contractors at all. It only applies to MTs working as employees.

  16. It’s about time. How can I join in the suit? I have complaints against 2 MTSOs – Transcend and my current employer who is skimming lines from my counts.

  17. I am 61 years old and have done medical transcription all of my working life. I have, until now, always been able to support myself and at times made very good money at this job. Just before Christmas 2011, I lost my job as an IC because citywide the hospitals all went to Voice Transcription, including their statewide regional clinics. Out of desperation I accepted a job with Nuance in January 2012. Not quite 6 months later, I am applying for food stamps and state supported healthcare. I sit ball-and-chained to my desk for the requisite 8 hours plus/minus breaks and a 30-minute lunch, clocking in and out dutifully. I research terms, physicians and sample documents (since most of my dictation is from ESL physicians and most of whom are quite impossible to understand), open their e-mails when sent to me — all of which I am docked for by the clock since my hands are not on the keyboard. I have a very strong work ethic and the integrity of my reports means a lot to me. However, lately I sit at my desk and cry for hours while trying to work and have very strong thoughts of suicide. I am totally mentally and physically exhausted and drained at the end of 5 days. I can’t believe this has happened to a profession that once carried some respect with it.

    1. Hi Helen, I feel the same way…I have 40 years, 7 months experience. I make less money now than I did 25 years ago. I grind out the work all day, get 100% on QA, and have not had a raise in 6 years. I am so sick of this. I have started going to the food bank and pretty much, all they have, is bread, bread, bread. I used to love being an MT. sucks these days. don’t know what else I could do. Medical coding and billing are also undergoing major changes so that career changes feels very unstable to me.

    2. I am not laughing at you, but crying with you, when you say strong thoughts of suicide. I have visions I will actually fall off my exercise ball I sit on all day so my perineum will not be numb, or my toes start curling in contractures, or strangulate on my headphones, and be dead, from all the lazy sloppy dictators running around inside my head for 43 years, yes 43 years, and I have always held my standards high in QA etc and can barely make it, have no social life, and the food bank here in Arkansas has really garbage fake food. I can’t wait until I can retire from medical trans. and never put on another pair of headphones unless I am listening to music. I beat up on my exercise ball rather than punching the wall and breaking my precious fingers that are bleeding from trying to survive, make a decent living. I would rather flip burgers for $15 bucks an hour. I made more money 30 years ago than now. I feel sorry for the newbies.

  18. This is an excellent article, very well written reflecting a complete understanding of the medical transcription world today. Thank you.

  19. You all got me to thinking about the time I wait to see if I have work in the mail not to mention the humongous amount of medical terms in my brain which keeps growing. I have always said MTs are VERY VERY important and we could change a life totally if we made a huge mistake. So, yes, we are worth every penny. There were times when I made over $30/hour so I cannot complain. Never thought of bringing my waiting time into my pricing though (wow, big money LOL) Good thought but probably won’t change anything. I have been an MT since 1962 (do the math) and just happy I can still do it at home without having to go out into the cold northeast winter weather. You go girls. It’s about time we were recognized MTs a very important part of the medical field.

  20. I am MT from India and would like to share my thoughts with MT community worldwide. I am trying to represent “offshore MT community – the villains” who are held responsible for sorry plight of fellow MTs in US, and held responsible for bringing the rates down to such an extent that MT profession in US has become unviable.

    Life world over changed when the terms globalization, free trade, economic liberalism, global village, offshoring, etc.. came into existence. People who accepted the new world order and adapted well made fortune, and others who could not accept this change or adapt to this change are still struggling to make ends meet.

    With globalization, medical transcription industry hit the Indian shores and 1000s of youth in India tried to embrace it as their profession with hopes and aspirations of living an “American Dream” in India. Although 1000s tried only 100s could complete the training process, which involved learning a foreign language, understanding foreign accent which sounded like an alien speaking at that time, in addition to learning medical terminology, anatomy, physiology, drug names, foreign brands, typing, punctuation, AAMT guidelines, etc.. In my opinion, Indian MTs have to put in twice the effort, if not more, to learn the profession than his American counterpart. Determined few, who were capable of producing quality medical records and would proudly call themselves medical language specialists/medical transcriptionists and knew difference between typing and transcription got employed and started getting dollars into India, and their success story attracted 1000s of Indian youth to this profession.

    At the time when transcription industry was growing in India, the IT, software, BPO, KPO, call center industry, etc.. were also growing in India, and many of these professions were more remunerative than transcription and 1000s and 1000s of jobs were created. Growth of these industries in India and other low-cost countries of the world meant increase in unemployment in developed world, and saw emergence of anti-outsourcing/anti-offshoring sentiment.

    Anti-offshoring sentiment took its toll, and many of the transcriptionists who were at one time working as independent contractors and earning 7, 8, and more cpl were informed by their providers about the new company policy of not sending work offshore, and the best of the Indian MTs were unemployed. For them, finding a new job which pays well was impossible with almost all the jobs listed on MTjobs and MTStars reading “US MTs only” “NO OFFSHORE”. Having invested so much time and effort in learning this profession and loving what they do, many of them were not in a position to switch to any other profession and were forced to work for big American MTSOs who had an office in India like CBay, Healthscribe, Spryance, Focus, Nuance, etc.. at ridiculous rates of 3 cpl and less. The ability to get quality transcriptionists at such rates lead to phenomenal growth of these companies as they were now able to undercut the US-only companies, leading to price war in the market place and getting the rates down to the levels they are today, almost killing the smaller MTSOs and MTs working at doctor’s office.

    The decrease in income of MT professionals meant increase in profits of big corporations and hospitals and doctors. Neither US nor Indian MTs are pocketing those dollars, it is hospitals and Nuances of the world who are pocketing them.

    The way the things are progressing, I foresee extinction of US-only companies also, and ultimately US MTs will also be forced to work at lesser rates for these big corporations, which will be the only option left.

    The transcription industry which was once a profession and professionals could demand their remuneration, is now reduced to a mere job and the erstwhile professionals are today puppets with their strings in the hands of management of big corporations. We will soon reach a point where we cannot demand anything and will merely be slaves to these corporations.

    In my opinion, 75% of the work force employed in transcription industry in offshore locations like India cannot be called as transcriptionists. I would call them typists. The other 25% of the work force, who are employed as proofreaders and QAs to clean the junk produced by typists, is the backbone of these big corporations.

    If the MT community wants to salvage this profession and get back to those glorious days of the past, then in my opinion, we will have to first accept the new world order and should work towards alienating the typists thriving in this industry today, which can be achieved by accepting and acknowledging the true professionals world over and paying them what they are worth. When the backbone of these big corporations is attacked, they will have no option but to stop the price war in the market place as they no longer will be able to get or retain professionals cheaply, and only then the glory of the profession will then be resurrected.

    I hope sense prevails, and I pray to God that MT community earns a decent living. Amen..

  21. Awesome post! We really deserve an hourly wage as well as our cpl. It’s time someone did something about it! Transcription is a lot harder work than it looks…people think just because we sit on our butts all day that WE don’t deserve a good wage or that WE don’t work hard. Get real! We should all form a union! LOL

  22. We work for a company who pays us barely above MINIMUM WAGE. With the change in transcription and EMR, we would be hard put to find a job…so many of us are LOOKING IN OTHER FIELDS. If anyone were to ask about doing an MT job or court reporting, I’d tell them, find something else because it is no longer lucrative, no longer respected, and not the job they may think it is. Hurray for you if you are respected in your workplace because that is NOT the norm. We also have “guides” for every single account and every QA person has a different take. Supervisors have come and gone like water out of a faucet. We get paid less for PTO than what we make an hour. I guess they think if we don’t take PTO then, we’ll work more. Cashiers at stores make more than we do, yet I don’t see them having as much knowledge as a first year resident (which is what is said about qualified MTs!). We constantly have to stop and read idiotic emails and messages. They expect us to get so many lines (productivity like a factory peon), but want us to actually PROOFREAD EVERY SINGLE SENTENCE in the document when we are done. Obviously these people have never been MTs, they just come in from being an office manager and have NO IDEA. We are required to buy our own equipment and if it breaks down, you get reamed. So, my advice is to GET OUT and do something else. I think most MTs would be afraid in this economy to start a class action suit (esp. where I work) so good for those who are doing it. It may be the undoing of transcription companies. Maybe doctors will think twice about chewing, peeing, coughing, laughing, being near ER desks, nurses’ stations when dictating and wish they had been a little more respectful, too. I’ve heard of some places going to EMR and it’s a total car wreck. So, you never learned to enunciate doing dictation, have fun with voice recognition.

    1. I work for InScribe and have for some time and I have heard they are finally hiring again in a BIG way right now…guess I will be seeing more newbies around, which is great, makes us stronger in the long-run! Hope to see you around! 🙂

      1. Holy Cow!!! I have been thinking about taking the MT course at Career Step for some time now. I have been researching this field relentlessly for weeks. I was really very excited about a new career as an MT, that is, until I stumbled upon this site. Please, somebody tell me something good. Am I wasting my time? Should I just fill out an application at the local grocery store? Geesh….

        1. I am sorry to say that I would go to the grocery store. I have been at this for 18+ years and always advise people to stay away. It is very unfortunate, but true that wages have gone down (what other career has it gone down?). I wish I could get out, but since I have no experience doing anything else, I am going to keep doing this:(

  23. Exactly why I got out of transcription. I still use what I have learned though working in the ER as a patient access liason. I was really sad to have to change, but I work PT now making as much or more than I was working full-time/overtime doing transcription.

  24. Your article is a breath of fresh air. To hear that finally someone is taking action is awesome. I have over 25 years experience as a medical transcriptionist and have always taken an incredible amount of pride in my work; however, I could never understand why we were not compensated appropriately for what we do. For many years I have tolerated being called a “typist.” I am not just a typist. I am a skilled medical professional. I possess more knowledge of medical terminology and anatomy and physiology than most nurses I have met. I wish these brave people luck in their lawsuit. Most of us have been so beaten down by “the system” that we have reached a level of hopelessness and helplessness that we no longer even try to fight it anymore. Good Luck MTs! We are watching and praying for you!

    1. Vicki………. I appreciated hearing your comments as 1 of the 13 who filed the lawsuit. I also find it insulting that we are often referred to as “typists” with the amount of knowledge and skills that we possess to do this job. Minimum wage even is an insult, especially when at one time we (most of us anyway) made at least $20 an hour. Too bad that the MTSOs got involved as the middleman and also that they were all sold a bill of goods about how efficient VR would be. They forget to mention when they sold this VR that it depends on the amount of difficulty we encounter when it comes to deciphering the language of the ESL,

  25. Is there a link to the status of this lawsuit? When is the court date? I’d like to follow the information on it if you have that. Thank you!

    1. I’ll see what I can find out and write an update, if there is one. If nothing much has happened, I’ll just post a comment.

    2. I am one of the 13 who filed the lawsuit. We just received word last week that the judge has certified this as a class action lawsuit. I signed on last March, so it has been 1 year exactly. They now have to notify any former employees of Transcend if they want to join the lawsuit. I suspect this could take weeks or months to get the information for all of those people. This could still take months or years I fear……………..

  26. I entered the MT Field in 2001, and absolutely loved it. Fast forward about 6 years and things started deteriorating. First the advent of VR, but I’d been on my account so long I could still do okay. Then came the dreadful day we received an Email from upper management letting us know that we had been sold to a well-known, large MTSO. It took about 9 months for things to go totally down the toilet. The culmination was the day I signed on and my account had “vanished.” Later that day we received an Email saying it was going “EPIC” meaning no MTs would staff the account. Fortunately, I had started reading the writing on the wall, thanks in part to the research I did and saw the same pattern developing as I was reading about on many MT sites. I already had a job (better paying) waiting int he wings. I left a profession I’ll always have a soft spot for. I miss working from home some days, but had I stayed on much longer I fear I wouldn’t have had a home to work from for much longer. I hope this suit makes some difference for all those still struggling to earn a living at these evil MTSOs.

  27. I have been a medical transcriptionist since 1999. I am almost 60 now. I went to school in order to train to be a medical transcriptionist many years ago. It was a great paying career at one time. Now, it is simply ridiculous. I do not understand why we are not paid hourly for the important, tedious work we do! This paying by 65 character line is absurd, particularly since the transition to VR. The 4 cpl is absolutely insane. You can sit at the computer day in and day out and barely make minimal wage. It takes the same amount of time to edit the page as simply transcribing it, but your pay is half of the still low amount per line for straight transcription. Being a super fast typist does not even help, as you must slow down to dedicate your time to the accuracy of the report and other specifics, such as demographics, etc. I love medical transcription, dedicated going on 17 years to it, but the pay is intolerable, insulting, and self-defeating. I would seriously advise anyone from getting involved in it at this point in time, unless you can find some facility to pay you a good rate by the hour, a decent amount per page, or in some viable worthy form to make a good salary, rather than cpl. No way to make a living on the 4 cpl…can get a minimal wage job and make more. It appears I have just wasted my life on a dead end job/career now.

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