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RHIT and medical coding future - Anne

Posted: Oct 09, 2011

Does anyone have good input on whether medical scribes are the new medical transcriptionists only being filled my medical students, medical assistants or a part-time or piecemeal clerk at a lower rate (hourly or by piece) than medical transcriptionists -- if lower pay is even possible?

Also, what are any inputs on RHIT and the medical coding future? I already have a bachelor's degree but thought about another associate degree in RHIT in a CAHIIM accredited program. From your viewpoint, would this be a waste of time? What is the trend for RHIT and medical coding? Would it be better to spend the money and get a master's degree in business.

All input welcomed. I am not in MT management at all; just wanting some input from various individuals from hospital-based, service and IC MTs.

Thanks!

Scribes, medical coding future, and . . . an RHIA! - sm

[ In Reply To ..]
I'm not entirely sure where the "scribes" thing will go. If you think about it, you'll begin to see some awkward elements. Sure, doctors will need to adapt to EHRs, but I'm not certain that adaptation will require an entire other person to follow EACH doctor, PA, and ARNP around all day to look up stuff and type. An office that formerly had 1 MT for 4 or 5 doctors will now require 1 scribe per doctor, and half their time will be sitting around waiting for the doctor to get off the phone, get out of the bathroom, stop doing paperwork, get out of meetings, and get into the room with the patient. Whereas before you had a doctor and an assistant of some sort in the room with the patient, you'll now have 3 people in there. It's going to get a little crowded.

For physicians who practice in hospitals, they'll, what, have to take the scribe with them? They'll have to get them permission to access the hospital EHR. They'll have to drive them around, or maybe the scribe can double as a chauffeur. What will they do during surgery? Maybe they can shop and drop off the laundry?

If you are a hospital that has hospitalists, intensivists, and such, are you going to want to pay for those scribes? And give them offices and break rooms and scrub suits and whatever? This is going to escalate your overhead considerably . . . far, far above what dictation would require.

If you're a doctor in an office and paying for this scribe yourself, can you really afford it if Medicare is cutting down your payment every year? The margin is already slim and there really isn't any room for an additional $25-30K plus 25% benefits. (And who would want to work for that when coders make so much more?)

I think the scribe thing is workable for high-income specialists who can see more patients if they have a scribe, but not for just about everyone else. Doctors will just learn to do the same thing they do now . . . check the labs and everything else before they see the patient and write or dictate their note after.

The whole notion of medical students scribing is misguided. The person who thought that up has no clue about medical education. First of all, medical students can't type fast enough. Second, they have no idea of what medical writing is supposed to look like at that point. They'll require a lot of input from the physician they accompany. Lay people may think it has learning potential, but medical students already accompany physicians and spend all their time learning--their attention is taken up with THAT and scribing at the same time isn't going to be helpful for them. Even if they could do it, which they can't. Each physician will be training new scribes constantly--how annoying will that be?

On top of that, it's a lay person's idea that a medical student will welcome a part-time job. They won't. Medical students do not typically work part-time jobs. Medical school is not a 12-hours-of-classes a week affair. It is a 40-hour a week affair, with another 20 spent studying, rounding, or being on call all night at a hospital. I cannot imagine when anyone thinks a medical student will have time, or be able to predict hours, in which they can have this fabulous job learning to type for doctors. Med students won't aspire to that any more than they will aspire to work at McDonald's, nor COULD they do it. The whole idea is just profoundly stupid. Not just misguided or silly . . . it's frankly stupid.

Medical assistants have always done low-level typing for small offices, so there is no lost work from that angle. I expect they'll continue to do it.

Coding has a bright future. There are lots and lots of jobs related to coding -- they all require knowing coding and being experienced in coding -- that you can move into. The upcoming switch to ICD-10 in October of 2013 is expected to open a lot of jobs for coders, probably before that date. I don't have concerns about computers because of the potential for moving up. I don't have concerns about offshoring because of the impact of coding on reimbursement and the privacy issues surrounding offshoring. I see coders becoming more and more necessary as insurers and Medicare cut payments.

What about the RHIT? For you, it isn't such a good idea because you already have a bachelor's degree. With that, you can qualify for the RHIA exam by doing a postbaccalaureate certificate program from a CAHIM-accredited school. Some of them take 2 years, but the U of Toledo has a nice online one that you can probably do in a year with in-state tuition (even if you live in another state). That will be a total of about 1 year to get an RHIA, compared with close to 2 for the RHIT, plus another 2 for the RHIA program. With the money you save at the U of Toledo, you'll be able to fund an MBA program.

Another option for you would be to see what Western Governor's can offer you in terms of their health informatics program, which also qualifies you for the RHIA. My guess is that the U of Toledo will be less expensive and faster.

If your goal is to code to support yourself during this, you would do well to learn it before tackling either of those programs. You would then be able to complete the coding requirements of those programs without much difficulty--they are the most difficult courses in that kind of program.

RHIT, RHIA and coding program -- Great ideas! - Anne

[ In Reply To ..]
Awesome input! I didn't realize that there were postbaccalaureate programs from a CAHIIM accredited school in Health Information Management where I could take the RHIA exam instead of another associate degree for RHIT. I LOVE the idea of saving money and using that to fund an MBA. I was invited to an MBA information session just the other day. Great ideas.

Thanks for your input!

Forget the RHIT and go for the RHIA - sm

[ In Reply To ..]
Coding and health information management has a great future. These jobs will not go away like MT has over the years. I wouldn't bother with the RHIT, and like the above poster said, go for the RHIA.

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