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

low wages being offered by so many MTSOs - FedUp

Posted: Jul 04, 2012

As a seasoned medical transcriptionist with over 30 years of experience, I can no longer contain my irritation with the low wages being offered by so many MTSOs. Therefore, rather than apply for the low-wage positions, I am e-mailing these companies and letting them know how insulting their wages are and what an asset I would be to their company, but refuse to accept these low wages. Some of you may not agree, but this is my form of protesting what has become of the medical transcription profession!

More power to you chickadee. Great idea. - Everyone can do the same right from their chair at

[ In Reply To ..]
I would recommend not using any words of your complaint in the subject line of the email(s) or they may not get opened and read.

What would have an impact - would be for everyone

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to send the exact same worded email. Then they would get the RESOUNDING message that MTs do commnicate with each other.

What would you consider fair and realistic? SM - Curious MTSO

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This is not a pity party on my part; I really want to get some opinions.

My expenses are up, taxes and unemployment rates are out of control, benefits cost more every year. Hospitals and clinics are going to EMRs and to offshore and to companies that undercut.

I keep reading this board and a few others and see how unhappy so many MT's are and that rates are too low.

So, based on everything, I want to know what MT's are looking for. What is a realistic rate? What do you really look for in a company? What would make you take one job over another? What is important to you?

I am an MT (or whatever we are called now) and an MTSO and I try to treat everyone well, but I want to get some honest opinions here.

As an IC - See message

[ In Reply To ..]
it really chaps my *** that you have no control what happens the minute after you sign the contract. When making a decision you consider the terms as they are stated in the contract at the time you sign, but the contract always has a clause that anything can change in the future without your approval. No need for me to give the multitude of possibilities, but that equals less production and less pay. I want them to stop taking advantage in that manner as well as pay a decent rate.

And before I go spewing out what I think is a fair CPL, well--that would depend on the contents of the contract and the ability to change it's content at the drop of a hat. I could say 10 cents a line, but what constitutes a line? And is that line description for today, tomorrow, 3 months? And if I said I wanted 12 cents a line does that mean the daily line requirement would change to some horrific amount?

There are lots of ways to get screwed. Not so much to protect your ability to make a decent living in this industry.

Why I am not surprised to only get a nasty response? sm - Curious MTSO

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I am not asking about IC's. We only have employees. The questions were to help, not to spark a war.

Well here's a response - for you

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There was nothing nasty about my response to your post, and there was no war sparked. You asked and I relayed to you what I have experienced over and over again as an IC in this industry. No need for you to take any of my comment personally.

HERE'S MY 2 CENTS WORTH - rosalind

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Here's my 2 cents worth. I was an employee with an MTSO (no longer existing). I was wonderfully happy and here's why...

I was given accounts that were best suited to my ability (MT for 10 years). The MTSO made sure the voice quality was top-notch. They didn't mind calling the doctor to report their dictations were not up to par, especially when they dictated at home, used cells phones, etc.

The platform was very simple - MSWord based.

I made 8.5 cpl with an additional 7% per line for PTO. I was not a high producer so I was not able to qualify for insurance, but I thought this fair enough.

They were very accommodating regarding my schedule when I needed off.

QA treated us like adults, giving us valuable feedback without acting like we were stupid little kiddies.

I had planned to retire from this MTSO, but alas, the company was sold as the owners were retirement age.

To me, paying an MT 7 cpl or less is a slap in the face. We are worth more than minimum wage. We have a hard job, we have educated ourselves in this profession and then to offer such a paltry wage is an insult. Fortunately, I haven't had to do VR, but I wouldn't do it unless I was paid the same as straight typing. VR is a joke.

to my 2 cents - anon

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I totally agree, 7 cpl is a slap in the face. I started in this industry 20+ years ago and was making 6 cpl. Now they want me to work for 7 cpl. This looks like "I made more than I did then," but factoring in cost of living from 1992 to 2012, I'm actually making LESS. I am single and I live alone. I told them "I can't make a living at that pay." They actually said to me "we are not here to provide you with a living, we are simply offering you a job." NO. A JOB IS MAKING FRENCH FRIES AT MCDONALDS. This was my CAREER. They want my skill, my knowledge, my experience, and my ability, and they want it for FREE. I told them "you can't possibly expect me to work for 1 cent more than I made in 1992." They said "that was then and this is now." If I'm going to make minimum wage, then it will be in a minimum wage paying establishment, such as a fast food job or whatever. I think it is a crying shame that I could actually work in a hospital and be the girl who pushes the cleaning cart and goes into patient's rooms and empties their trash can and make MORE MONEY than the people who MAKE YOUR MEDICAL RECORDS. that's what it is and that's how it's going to be and I am so out of here. I wish all of you luck who try to stay, but the end is here for me.

I appreciate this sincere inquiry - CB

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I was very happy with my company for 20+ years. Unfortunately, last year it closed and the owner retired.

What kept us happy (and willing to go above and beyond whenever asked): Headers, footers, spaces all included. As long as you got your minimum line counts per day in, schedules were flexible. You transcribed what the doctor dictated. No ever-changing BOS (seriously, who made them "boss") or account "specifics" for non-medical triviality such as date formats in the body of the note. No time-wasting/searching for ADT or demographics - all information pre-populated. We just had to scroll to pick the right visit. No nitpicky QA + never "graded" = no unnecessary stress for experienced MTs. Excellent VR (I could average 500 lph) and MTs' feedback was asked for and valued. Weekend differential and holiday pay. Incremental PTO - I had 5 weeks (what an adjustment starting at the bottom as a newbie at a new company!). Assigned doctors/department for familiarity and speed. Open communication with doctors about dictation quality. Doctors that were not good on VR were kept on straight. Our base pay was 8+ for straight (I averaged 350 lph on this platform) and 6 for VR. We had a great reputation for accuracy and skill also. When news got out my company was closing, I was contacted by three different MTSOs.

I do appreciate how discouraging it is for good MTSOs to have to deal with theses offshore companies under-cutting. It's one of the reasons my boss decided to retire when she did. Per administration, she would have had to cut our pay to 4 cpl for VR to compete and keep our major account, and thought that was terrible. Though in hindsight, after we started applying for new jobs and found out what the industry has become (the majority of us had been there for a very long time), I think we would have stayed for 4 cpl because of the reasons above.

After entering the job-search market last year, I was offered six positions and chose, and like, my current company - MxSecure - for some of these reasons: M-F schedule and no holidays (though I am willing, and have helped out on weekends and holidays when needed), 12-hour window for an 8-hour schedule, reasonable flexibility, paid holidays, sick days, PTO, benefits, production incentives, and VR is more than 4 cpl. As a bonus, they've turned out to be very nice to deal with, QA is overall helpful and constructive, I get positive feedback and feel valued (birthday gift and MT Week giftcard!), and everybody has been nice and professional to deal with. I wish the pay was commensurate with experience and the platform was more efficient, but overall am happy, especially now that I've learned about some of these companies monopolizing the industry.

I am going to assume you mean "lph" and not - "cpl" in some of this post?

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350 cpl is a little questionable.

Fairness or lack of - sm

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Sad to say but transcription has gone from nice brothels where a madam (good MTSO) looked out for us to now the Pimps (sweat shop MTSOs) getting our hard earned money while abusing us. I tell you what if the MTSOs really cared about us they would not have let the hospitals etc undercut our pay!!! I am afraid that all the MLSs that have been in this business for a long time or getting out and this industry is left with new not so experienced MLSs. Now I am not knocking the new MLSs, but I think the MTSOs lost out on how to get these new MLSs up to the quality that is warranted by MTSO's. They should pay by experience and put a new MLS under the wings of a more seasoned MLS for a good while.

Another 2 cents - Alice

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I would appreciate an employee job where the dictator is held responsible for the quality of the dictation, and where I am not required to work a set schedule unless there is plenty of work for me during that set schedule. As a matter of fact, I would appreciate a window of scheduling. For instance, a 12-hour "window" during which I would be required to complete a fair amount of lines that would equal the total hours that I work, i.e., 125 lines straight typing for each hour, 250 VR lines for each hour, etc.

Also, I have noticed that MTSOs compete with facilities for the contract and are possibly too lenient with THEIR clients, passing the "discount" down to the MTs by cutting line rates or NEVER giving a raise.

If ALL MTSOs would require more from the client, without being so willing to compromise on costs, I think our situation would be more tolerable.

I note that costs for my medical care and charges from the ER or any hospital service that I receive have gone UP, not down, so why should MTSOs be charging these facilities less or be keeping more for themselves while paying MTs less and less? Doesn't seem fair to me. It's just what "the market will bear", so I think the market should stop bearing so little.

has anyone every asked a laywer? - Snow Bunny

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BY LAW ... who is legally responsible for what written in the patient record? Is it the MT or the person who signed the document?

But, I think everybody already knows the answer to that question ...

Here's why I stay at my MTSO - Leaving MT

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I am an IC and get paid 8 cpl straight typing only on a 65-character line with spaces, but here's why I stay. My MTSO is very good about letting us determine our schedules as ICs. We have supportive QA who do their very best to make sure we do our very best, and they treat us with respect. If there is no work, we do not have to sit at the computer waiting unless we want to. We can leave and do other things. Our platform is simple, and we do not spend a lot of time on demographics. It is Word based, and we have all the functionality of Word, plus it works with just about any expander program. The audio quality is relatively good, and the dictators for the most part have good dictating habits. There are just a few exceptions. It is relatively easy to rack up lines when the work is steady, which makes up for the low cpl. Also, we get a penny more on weekends and holidays, and we are not compelled to work those except for a requirement of 4 hours each weekend. For holidays, they ask for volunteers.

I am transitioning out of MT, though, and here's why. I absolutely refuse to work on VR for 4 cpl. Because of our wintertime drop in work, it is a real struggle to get in the lines I personally set for myself each day, and we really only have enough work for me to work full time about 6 months out of the year at my current job. The other reason is that I am no longer proud to be an MT. I feel that quality is not valued in this profession anymore (or has become too expensive), and I don't want to be associated with the poor quality work that is being turned out now by big MTSOs that off-shore and underpay so much that they have huge turnover or good MTs that cannot afford to care about the nicety of quality at that cut rate. Also, I fear it is just a matter of time before some big MTSO undercuts my small MTSO and grabs the accounts from us. Every year at contract renewal time, we are holding our breaths. Fortunately, our accounts value the quality of work they get from us right now, but all it takes is a change in management at the facilities. We are very small and have only a few accounts. I do love my MTSO, though, and so appreciate this company, especially with what I read on the M*Modal and Nuance forums. Very discouraging.

Fair and realistic - On Site MT

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I have never worked for an MTSO but I've been an MT for many years. You begin by talking about how your expenses have gone up so what I am looking for is probably a moot point.

First, line rates should not be the same for everyone. Someone with years of experience and nearly perfect accuracy should not be paid the same as someone new to transcription. From what I nave read, I think that experienced MTs should be making .10 per line or more and VR and straight transcription should be paid at the same rate.

Second, I need insurance, and basing it on someone's production is not fair, it also creates a great deal of stress if a person has NJA or can't meet their quota for some other reason. People already pay a good portion of their health insurance premium. Whether or not they deserve to have insurance is not your call. When you offer overtime, it needs to be paid at time and a half, that is the law.

Please don't overhire and tell people there will be plenty of work when there is not. Ensure that people work their schedules so the workflow is consistent. Most of us have bills that need to be paid and depend on that income. When there is not enough work, people expect to be compensated for NJA or placed on another account. Pay for lines counted and spaces needs to be standardized within the industry. For example, line length varies from place to place, some pay for spaces and some only pay for VBC.

The other thing is equipment and platforms. It seems that the MTSOs have really specific requirements in terms of PCs. Sometimes it seems that each account can have different requirements. Yet, employers expect the transcriptonist to foot the bill, either for a new computer or other software. It was my understanding that employers had to provide equipment for employees. The platforms need to be standardized more than they are. Windows XP is going to be obsolete in a year or two, so the MTSOs need to get up to speed. Personally, I would be willing to pay a monthly rental/lease fee for employer provided equipment rather than having to use my personal PC for work or to have to purchase a new computer for work.

Our expenses have gone up too, please keep that in mind. Groceries, housing and health care cost more for employees too.

Those are the things that are important to me, those are my honest opinions.

What is important to you? - sm

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In my opinion, most MTs are looking to be treated where education, experience, and hard work pays off. Everyone needs a goal, incentive, and hope to carry on. If there is no reward for hard work and room for growth, then there is no hope. No one wants to know they are going to work for the same rate or less with no hope for more. No one says I'm going to study and work hard and become an MT and be paid the same rate or less forever. To combat that, MTs have tried to take control of the only thing they can for the most part and took on the mindset that any hope of higher income will come from their own hands to work harder and longer. Of course, in some cases, work is not always available leading to further stress. The basic desire to succeed and have pride in our work and be rewarded is what drives all workers.

We are purely and simply looking for hope that someone appreciates and values our work contribution and for traditional treatment with rewards and goals to work toward with fair treatment and pay.

This is one job that is still around that you cannot - FrugalFreda

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fudge your experience or education and be successful. It takes real skill and years of dedication and devotion. Many have tried in the past thinking it would be a snap and found out differently. VR has made our jobs easier but it still poses challenges. Would like to see the MTSOs pay a little higher for years of experience instead of lumping us altogether. These are very difficult times for people. The rich get bailed out with taxpayer money and the worker is left to fend for himself with lower wages and rising costs on everything. I am sure the MTSO is happy to have the seasoned MT but would like to see them live on our wages. I guess we are all supposed to be married to the rich guy or be independently wealthy. We are not alone, the whole economy is in a tailspin. It's too bad all of this had to come about when so many of us are nearing our retirement years, not to mention our kids and their kids. You can only cut so many corners. God Bless us!

"Fair" is a living (hourly) wage, so we're paid for - research, etc. that is part of this job.

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Not paying for spaces, headers, paragraph headings, etc. is really chintzy. If we type it, we should be paid for it.

Same with research. We do a LOT of it. If we do it, we should be paid for it.

I've done it! I've even gotten replies from them, too. - (Defending their dismal pay, etc.) nm

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Do tell! What did they have to say to defend themselves? - nm

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x

Yowza, Id be afraid that would get me blackballed from - ANY potential offer

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IMO, it would be easier to get an offer and negotiate a cpl, and I'd be afraid sending such an email would "flag" my name for all of the MTSOs (you know, like a "do not contact" or something).

Just me, but I kinda prefer the "honey" approach and save the chutzpah and negotiating until after the offer. I'd be afraid this approach would get me blackballed before I even got a chance to get a viable offer that could perhaps be negotiated.

Good luck, though...maybe you're onto something!

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