A community of 30,000 US Transcriptionist serving Medical Transcription Industry
Does anyone know when the "outflux" of MT really began? - marge
Posted: Mar 22, 2015
I wonder what brought about the demise of the "good money" in MT. When did you first notice? When did the large companies come into place? I wonder why doctors/hospitals/etc. started jumping ship from their "local" workers and why? I can see why they wanted to outsource to India and such as the money seemed incredibly good for their savings. I'm talking about before India. Does anyone know? From whath I've seen the large companies still bill what the MT used to bill themselves so why the switch?
How much do you think they billed??? - Local MTs and MTSOs.
[ In Reply To ..]How much do you think the local MTs billed compared to what large companies charge???
I don't think anyone moved away from locals, exactly. The local companies we had here just grew into the nationals. Or they were bought up by them.
Hospitals began outsourcing overflow because they couldn't find enough MTs. Eventually, they saw how much the company MTs made and noted that it was twice what their in-house MTs produced. That and the cost of digital recording equipment, maintenance, etc., made them outsource all of it.
Now, though, hospitals are outsourcing as a prelude to going with a major company's front end SR. It is a part of their EHR conversion. The company sets it up for them.
If you are headed in the "let's go co-op and back to local MTs doing the work," I don't think it is possible. A response MTs can't handle the volume or the technology. There is also no point to it, because it is all going to front-end SR eventually.
You really can't turn back the clock on this. You would be much better off learning a new career now, before you end up completely out of work and unable to afford it.
Just wondering what happened in the industry. - marge
[ In Reply To ..]Thanks. I'm not trying to turn back the clock. I just wondered how we got to large companies, etc. I realize EMR is taking over and for some that is the answer. My experience has been that many of my docs don't want to do it. :/
Thanks for the "advice". I don't really need to train for a new career. I'm an RN who has kept my license so I can go back whenever I need to. I really enjoy the flexibility of this much better. :)
What happened - Just me
[ In Reply To ..]It certainly did not happen overnight. At least 10 years ago the facility where I work had its own version of the EMR. We used on site transcriptio but outsourced the overflow to 2 small MTSOs, one small local service and another company that offshores. We did not hire new employees, due to availability and also cost, and as people quit or retired they were not replaced and more work was outsourced. It was always money driven and offshore companies work incredibly cheap. For us, the big change came with VR and point and click, which is when the remainder of the dictation was 100% outsourced. We still employ onsite QC and anyone who says no one cares about quality anymore is full of hooey. By the way, another local hospital still has a fully staffed MT department and is actually hiring. I can retire in a couple of years so I plan to hang in there, I know my situation is unique. For anyone with more than 2-5 years left, I would definitely say to retrain for something else.
I do not swallow that excuse given - anonie
[ In Reply To ..]I do not accept the hospitals not being able to find MTs. That is just what the nationals have said all along and they are wrong. They have sabotaged our whole livelihoods and cheapened it till we don't get what we deserve. I had to take a 17 part transcription training course in the hospital while I was typing practice tapes and finally onto the real dictation. I speak English and have a good knowledge of grammar, punctuation, etc. in addition to terminology.
When VR was starting to be tried, our doctors in radiology did not want it to be used. I know other doctors who didn't want VR used. However, they will find out some day that no matter what kind of program you make for dictation, it will never be as good as an MTs pair of ears.
Where I live - It is credible
[ In Reply To ..]It's actually true where I live; small town USA with no local transcription training program and very few people showing an interest. The new hires we got were so green and inexperienced that the time we spent training was not cost effective. Some applicants had no clue what medical transcription was but applied anyway. It takes a special person to make a good MT and many do not possess the grammar and vocabulary skills required to do this job. I agree with your last statement, many are learning this the hard way.
Transcription - No one
[ In Reply To ..]I first noticed this in the early to mid 2000s. The technology companies went full speed ahead in pushing their new voice recognition programs, stating first off "that it would benefit the transcriptionists." Went with an at-home company for about seven years until 2006 when I realized the 7 cents per line deal would never improve, along with lack of "real" benefits; got a job in another city with a hospital, stayed seven years working from home, paid by the hour. Around 2012, this hot shot company out of Texas came in with a whole new transcription system, giving us transcriptionists a bunch of BS how it would be to OUR benefit (not so). We then had voice recognition, having to have a daily output of 2,000 lines per day, so after seven years, I took retirement and left with a $20,000 check from the hospital. Our new HIMS Director basically sold us out. Now she will not replace retirees or those leaving by attrition and has hired a national company who pay 7 cents a line.
See, that's what is confusing - marge
[ In Reply To ..]If the company they hired to take over is still paying 7 cents a line you know the hospital is paying FAR more than 7 cents a line so why would they do that? Those are the things that confuse me. :/ I found in looking over some of the files sent to me as "examples" that the quality was HORRIBLE. I wondered if that was one of the reasons many looked for something better?
By outsourcing transcription - xx
[ In Reply To ..]the hospital no longer has any of the expenses associated with transcription. It's not just the line rate that is involved.
If the transcriptionists are employees, there are expenses associated with whatever benefits the hospital provided. They likely also provided training in HIPAA, safety, procedures, and many other things. They don't have to do that for outsourced MTs. They had to provide a space where the in-house transcriptionists could work and equipment for them to work on. That space can now be used for some other purpose, possibly a revenue producing purpose.
With in-house transcriptionists, they had to provide and pay a transcription supervisor. They had to ensure that there were enough transcriptionists available to get the work done on each shift.
Those are just a few expense-generating issues I can think of right off the top of my head. There are likely many, many others. By outsourcing their transcription, they may pay more per line, but the total outlay for transcription is likely much lower. The MTSO assumes all the peripheral expenses and staffing issues.
When the hospital negotiates a contract with an MTSO, it knows exactly how much its transcription is going to cost for a set period of time, so budgeting that line item is likely easier. There is a lot more to transcription than the line rate an individual transcriptionist is paid.
I get it. :) - marge
[ In Reply To ..]As an IC I always forget that not everyone is self-employed. I forget about all of those things that someone ELSE would pay FOR me. :)
Thanks.
Turnaround time. - Casey
[ In Reply To ..]I think the only thing providers like about outsource is the quick turnaround. This is something that we IC's could not always provide.
In my view - anonie
[ In Reply To ..]I think that when expenses were too much for hospitals, first places they cut was transcription, laundry and other areas.
I really think when Clinton got NAFTA passed, it gave the green light to ship any of our work to other countries to get it done cheaper.
That is when I first noticed things going to India
NAFTA is the North American Free Trade - Agreement
[ In Reply To ..]Unless there has been a considerable tectonic upheaval that was never reported, India is still in South Asia, not part of North America and not a signatory to NAFTA.
Why the sarcasm. I am not stupid - anonie
[ In Reply To ..]I am not stupid. I know where India is.
That trade agreement opened the door for lots of manufacturing jobs as well as others to go overseas.
I would say it is just plain rude to constantly put insults on this site on any of the boards.
I have been in this business a long, long time so I do remember when it started changing because back then someone on MT Daily board at that time wanted all of us to try to get some notice from nationwide TV. One person wrote to 60 Minutes, but they didn't think it was so newsworthy.
It was happening in 1994 when I graduated - StillAnMT
[ In Reply To ..]When I graduated college in this field in 1994, it was happening. I think we transcriptionists started it when we started talking our doctors in letting us do this at home. While sitting at home working and not to my knowledge, some company "consultant" was scheduling appointments with my doctors telling them they could do it cheaper than me. When digital technology came in (over tapes), that undermining really took off paving the way for overseas companies and distant companies to come into existence.
When they starting hiring - CEOs in hospitals, around 2000
[ In Reply To ..]Definitely saw a change when this happened. If you had been there a long time and were making pretty good money, they were looking for ways to see you go.
CEOs - StillMTing
[ In Reply To ..]You are exactly right! I graduated in 1998 and was the last year hired with good pay at a local large hospital. I remember there was some big excitement because they hired a CEO at that hospital, and the next year the board of directors took his salary up to the 1.4 million range, and the next year we were sent home and our department was literally walled up in the hospital. By the next year, 2000, it was all outsourced as were most of the hospitals in that city. Most went to Transcend as I recall. I went with a national who was then bought up by MedQ. Ugh!
beginning of the end for MT - MT30+
[ In Reply To ..]In my opinion it was int he late 90s, early 2000's when voice recognition started and then things went overseas. I worked for the same major MT service for almost 25 years and the money up to that point was wonderful. About the time my kids were grown and out and I could really put myself into it as much as I wanted, it was pretty much over. I left MT for good in 2006 and I really miss it. I would like to have a part-time job doing MT the "old way". I have probably seen half-dozen jobs since I left in 2006 and that is it. For every job there are literally hundreds of MTs applying. I don't want to work at home EVER AGAIN and finding something on the outside is nearly impossible. Either way, my opinion is during this time frame.
Late 90s? - sm
[ In Reply To ..]In 1999, I was working in-house for a clinic, and it was later decided to outsource the MT department. So, in my opinion, I think the late 90s is roughly around the time the decline started. Please correct me if I'm wrong.
outsourcing stayed local - StillAnMT
[ In Reply To ..]I would agree with the 1990s. Now correct me if I am wrong, but that was the era of using cassette tapes and printing the work, so the outsourcing stayed close enough to a company that had a building in the local area. Sometimes I would hire a courier to pick up tapes/ drop off the printed work for me. But when digital came in, all bets were off and outsourcing went ANYWHERE.
Similar Messages:
Does Anyone Remember When Fiesa Began?
Jun 04, 2015
Does anyone remember when Fiesa began? I'm trying to figure out how they'll defend Fiesa being rolled into our rate if our rate never went up when Fiesa was added. ...
Procedure Began By Making A Small Incision,
Apr 24, 2010
approximately 1-inch, at the 4th and 5th intercostal space, dissected down through the superficial musculare layers and down into the s/l *pluera or flora* Once in the "pluera" we placed a laparoscopic port and 30 degree 5 mm camera. ...
What's Going On? My Shift Started At 12 Noon. I Just Began To Receive Work Sm
Dec 29, 2011
as of half an hour ago, but for some strange reason the work is all garbage. You know, when the doctor is dictating from across the room? Also some jobs are 1 minute away from TAT and some are 15 minutes away. Nothing seems to be making any sense. ...