A community of 30,000 US Transcriptionist serving Medical Transcription Industry


Domestic Medical Documentation Act - DMDA


Posted: Apr 23, 2014

I think any law that forbids offshoring of American medical documentation would have to be very thorough to address a number of potential problems. In keeping with this, I have a list below of some that I've thought might come up under such a law unless they are specifically addressed. These are possible loop holes that could really mess things up.

1.  It would create a sudden demand for many more MTs in this country. That's awesome, obviously, but I fear this may cause medical providers who are used to the el cheapo thing to pass the loss in revenue to the patient. I think there needs to be something in such a law to address this potential problem so that patients don't get a higher bill as a result and so that insurance companies don't get charged more and raise their premiums to compensate.
2.  There's a possibility that some powerful player in the MTSO arena would decide to really start a huge underbidding war because of the awareness that facilities have a strong desire to pay the old off-shore rates if they've gotten accustomed to it. This Domestic Medical Documentation Act would need to place a floor on how low the pay can be so that MTs and MTSOs do not get short changed, especially MTs. There should be an absolute minimum pay such that MTs get an absolute rock bottom minimum of say 8 CPL. Personally I wish it could be more, about 10 CPL as an absolute minimum for MT Pay.
3.  The Domestic Medical Documentation Act (DMDA) should forbid MTSOs from lowering MT pay while still charging the same amount of money to the clients in an attempt to pocket the difference.
4.  The MTSOs should be forbidden to take more than 25% of MT pay. If that means cutting some fat from the top, then so be it.
5.  Voice recognition editing should be completely outlawed once it can be shown by independent, nonpartisan review that the idea of it being twice as fast and therefore worth half the fee is shown to be completely false.
6.  Any MTSO that feels the need to downsize to save money absolutely must start at the top and lay off upper management, never, ever lay off MT or QA personnel until it has been shown by independent, nonpartisan review that all other attempts have been made to keep the company profitable.
7.  Every single MTSO that wants to assign MTs a shift, insist on the use of certain tools, and insist on a certain manner of doing things, i.e., using the Book of Style, must absolutely not classify such workers as independent contractors, or they are to at the very least stop telling us when we can and can't work. Obviously we need to make sure TAT is met, but okay, fine, let the MTSOs over-hire. There would be so much demand at this time that it wouldnt' matter much.
8.  Any client that feels the need to downsize to be able to afford the cost of medical documentation under the DMDA must downsize their highest paid employees first, e.g., administrative personnel and physicians, or at least lower their pay. Sorry doc, but we can't have much sympathy for you when we can barely afford our rent and you're making three figures an hour.
9.  In general, all efforts to continue making a profit in all parties concerned must cut the fat starting at the top, and I mean the top, not team leads, not lower/middle management.
10.  There must be a ceiling placed on the earnings of CEO level personnel, as that would go a long way toward saving quite a pretty penny, case in point the CEO of Nuance Communications.

That's all I've got. If anyone has anything to add, disagrees, has any other thoughts, I for one would be very interested to read it. It would be most helpful if we could try not to let anger control the progress of this thread, but of course, anyone is inherently welcome to voice any opinion in any manner consistent with MTStars posting guidelines.

Good idea.... - rose

[ In Reply To ..]
I am not in favor of more government interference in everything, so I cannot agree that we try to regulate the industry until it chokes, as is the case with so many things. If we could start by keeping all the transcription in the US (which should be a no brainer anyway) - and watch the industry didn't start to recover - it might take a year or so - we need to turn it around so that there is a need for the quality/quantity transcriptionist again and we could demand higher pay. Right now there are too many of us looking for work and not enough work - it needs to be the companies that are hurting for us - they think they are hurting now, but they really aren't because there is always someone moving from one mess of a company to another. The entrepreneurs will come out again and we won't all have to work for the big MTSO. Just my thoughts.


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