My 2 cents - ICManiac Posted: Oct 31st, 2016 - 1:22 pm In Reply to: Makes Sense - Bailey719
I'm not sure why all the fuss, but I did not take your post personally. I understood that you were curious about working for a service versus having accounts of your own in today's MT climate.
I think you have gotten at least one answer that personal clients are rare these days. I still have one that I have had over the last 9 years, but that is all these days. I also work for three different services.
What has really happened in the MT world has a lot to do with outside influences, not just with EMRs and VR. The IRS and Department of Education has played a part in the downward trend in employees. The IRS came up with Statutory Employee status in the 1990's specifically to accommodate the MT industry where MTs worked for a single service with a long-term commitment. Later it decided that status was being abused and greatly discouraged its use. In the meantime, the Department of Education decided services should "grow their own" MTs and offered subsidies to MTSOs to train MTs fresh out of school so the MTs would get paid at least minimum wage and the MTSO would not suffer too great a financial burden. I do not know the current status of this arrangement.
Anyway, now MTSOs want to over hire as a way of keeping clients happy and with that comes too little work for the number of people hired. Enter the earnest use of IC status so as to avoid both having to match our taxes, pay minimum wage or pay us for our "waiting" for work to be available.
When you heap on to all of that the obligation of EMRs and VR to keep rates low, we are now all swimming in the crapper of the business of medical transcription.
True ICs, the ones who work for multiple services or personal accounts, are the rarity rather than the exception and I can't help but wonder where that will lead us all next. I can't help but think it is possible that Nuance will hold a monopoly and will take it overseas with almost no one in the US transcribing for US patients anymore because the IRS might come after them, and well, we know what Nuance does when faced with paying taxes or retreating to a foreign country.
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