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

EMS Going Full Circle? - Angie

Posted: Apr 26, 2013

In the beginning doctors scribbled their chart notes so sloppily that they could not even be read by other doctors. Then the MTs were brought into the offices to put them on paper with a typewriter. Then we evolved to electric typewriters, then computers, then the digital age. Back in the early 90's when Dragon Dictate was trying to sell to individual doctors, we MTs knew it would never be something that doctors could use without editing because VR only replaces our hands - not our brains. Sure enough, doctors realized this and 80% of them returned the product. The other nearly 20% probably just put it on a shelf. A very few tech minded doctors used it and some were quite good but still needed a real MT for the consults and non-repetitive dictations. VR has improved slightly over the years, integrating with EMS but focusing only on improvement that will benefit those who buy the software, not others who use it. I used Dragon Dictate in the 90's to give my hands a break, created specialty dictionaries and could race through transcription, only to loose all the time I saved having to proof and edit at the end of the day (2 hours). I have not seen the software improve in ability to train it since then. In fact, it comes out with some outlandish transcriptions that I'm convinced must be their attempt to integrate the dictation with past records or something. Over the decades we evolved into editors but they have not been successful in completely replacing us. Those who think they have, who dare to put draft VR into the patient's permanent record without proofing and editing will be in for a rude awakening when the lawsuits start coming in resulting in skyrocketing malpractice insurance premiums, further escalating health care costs. Those who realize that doctors cannot be burdened with giving up time with their patients to do data entry, search computers for information and proof and edit VR are hiring scribes to do this for them. Have we almost come full circle? Are we still where we were in the 60's in doctor's offices creating the medical record for them because they realize we are indispensable - just have a different job title? I believe this is the case. I predict that with the frustration and cost health care has with EMS and the complications to creating the patient record without a personal MT, that the scribe community will grow and will probably be many old MTs. I think MTSOs will continue to lose accounts and dwindle in the work they can provide. There is no way editors will continue to work for minimum wage and provide all the free research they are required by their MTSOs to do to keep their jobs. I think the MTSO have excellent MTs and editors right now because we are in transition and have to make a living, but that won't last forever. If this is the case I could not be happier to get back to my old salary by working in-house as a scribe, doing what we have always done with new tools and job duties to break up the monotony. Thoughts?

They need to do something to fix this system, 'cause it is definitely broken - FBL

[ In Reply To ..]
An elderly relative was in hospital last week...scribes following docs around with portable work stations too big to get to the bedside, had to stand outside the curtain (or maybe that is where they want them). Nurses stations filled with a dozen or so people typing away...then they sent her home with discharge instructions to take alendronate up to 3 times a day as needed!

My thoughts - sm

[ In Reply To ..]
I could be wrong, but here is what I see:

The MTSOs that dont already outsource to India are in competition with India and have to out bid them, which in turn is driving wages down for MTs. Hospitals are sending more and more work overseas now that they have voice recognition, they figure it's cheaper to pay the Indian MTs to proof and edit the work rather than paying the American MTs. This is why we are seeing more and more offers of 3 cents per line for voice recognition and 5, 6 and 7 for straight typing; because we are competing with MTs overseas. Granted, this is acute care hospital work Im talking about.

Clinics on the other hand are relying more and more on EPIC, medical office assistants, Techs and now scribes to gather and input patient data into the EMR before the doctor even enters the room. They are using codes to enter diagnoses and treatments into the electronic medical record with just a few mouse clicks, alleviating the need for a narrative or dictation.

I think that there will always be some editing work for American MTs, but I think eventually the bulk of the work will be proofed and edited overseas. Some hospitals may use scribes, but I think that as technology advances, so will the EMR systems; thus, eliminating the need for MTs as technology becomes more efficient/proficient.

I do think that scribes will predominately be found more in clinics than in hospitals. As far as MTSOs, I think they will become less prominent and the big ones like M-Modal and Nuance will be more focused on technology and how to increase their revenue from that more so then delivering clinical documentation services. Eventually, my guess is that the new norm for editing pay will be 3 cents per line and straight typing will probably stagger between 5 to 7 cents per line.

It's not going to be your old salary, though. - sm

[ In Reply To ..]
It's a profession that's already depreciated below it's worth, in the approx. $8 to $12 per hour range, currently being filled by mainly medical students and the like, who are using it more as an adjunct to their training than as an actual lifelong career path. So there will be no lobby/organization trying to raise the wages commensurate to what they should be. I agree, things do look to be going more that way, I constantly have "agree with scribe's notes" statements to edit now, but scribing looks to me like a dead-end job, not a viable replacement to MT the way it used to be.

Well, I think with EMS & VR, the genie is already - out of the bottle for good, but - sm

[ In Reply To ..]
I do believe that there will be at least some kind of a second look taken at computer-generated medical records once the lawsuits start coming in. (And you better believe that, if my healthcare gets screwed up due to an EMR error, I'm going to jump on that lawsuit bandwagon, myself).

But I doubt, regardless of whether MTs are once again looked upon as useful to the medical record system, instead of just so much dead weight, as they all seem to think we are, that wages are going to go back up to where they were before. And even if they do, it won't be quickly enough to keep up with inflation and cost-of-living rates, so even if some of the work remains in the US (which right now doesn't look very likely), it'll likely be an underpaid skill for a long time to come.

However, even if it were to jump back up to pre-1990, good-ol-day pay levels, I'm still totally through with MT. If wages and need goes back up, they'll come up with more reasons to cheat the MT out of as much of it as possible.

I don't know what I'll be doing in the future, but my plan is to get out of MT ASAP, hopefully by summer, or at the very latest, by the end of the year. And I'll never go back, because I'm tired of being screwed by the MTSO I work for.

"Screw me once, shame on you. Screw me twice, shame on me."

Genie is definitly out the bottle in terms of pay - More and more offering 3 cpl.

[ In Reply To ..]

By the end of the year, most MTSOs will likely have - passed the point-of-no-return - sm

[ In Reply To ..]
with regards to ever being able to have a strong U.S. MT workforce again. We little MT rats are jumping ship faster, and in greater numbers, with every passing day.

Unless the U.S. wants to collectively lower the average take-home pay of most of its population to around $700-800/month, thus driving down the price of everything from apartments to potatoes, then an MT's 3-5 cpl pay just isn't a living wage.

Once the writing on the wall becomes more obvious to all those up-and-comers wearing their rose-colored glasses, and they stop throwing good money away on a "career" as an MT, the schools will likely stop offering MT courses, at least in this country. They may all have to move offshore or become online courses geared towards 3rd world countries.

How many MTs come back here and report how much they regret leaving MT and getting into something else? Granted, there may be one or two that miss the actual act of listening and transcribing, but even that is getting pretty unpalatable, with all the bad sound files and ESLs we have to deal with. Not to mention the watching-paint-dry titillation of VR-editing. Yuck.

And too bad for old Uncle Sam, too, because many of us are starting up our own, cash-only sidelines to fill our wage gaps. This stupid government of ours, that rewards the treachery of Big Business in America, is driving its working-class tax base underground.

As I have posted before, this is not longer a single mom - supporting the family profession but SM

[ In Reply To ..]
it is a nice second income providing profession. IMO, there will always be a place for US MTs/Editors. The same skills used 30 years ago are not the skills used more today and the MT who cannot/will not adjust to the times is not going to able to make a go of it.

Do you mean most MTSOs will be gone by the end of the year? That wont happen. Sounds like the dream of a bitter MT.

CPL doesnt matter. It is $ per hour that counts. nm - nm

[ In Reply To ..]
x

So if you are paid 2 cpl you dont think that matters? - 320 lph at 2 cpl is only $6.40 an hr.

[ In Reply To ..]
I would say cpl matters. If you were paid 3 cents a line and maintaining 320 lines per hour then you could average $9.60, which of course is a lot better but realistically speaking you would have to have a really good platform, no distractions ever, stayed glued to your seat with limited bathroom breaks if you wanted to make anymore than that $9.60 an hour.

Sure there are some speedy MTs out there and I consider myself to be pretty fast, but I doubt I can pull off anymore than 320 lines per hour on VR and maintain it. I am lucky to maintain an average of 250.

The point is, a job paying 10 cpl sux if the program, acct spec, - dictators, management etc prevents SM

[ In Reply To ..]
from making a decent paycheck. Better that 3 cpl on an acct that you can fly through and make great lines. Open your mind, ignore the trees to see the forest.

Well that would have to be one heck of platform. - but I gotcha ; )

[ In Reply To ..]

I can make $20-25 per hour on average editing at 2.5 cpl. Have worked the acct - forever, decent dictators, SM

[ In Reply To ..]
Word based platform. Sadly, it is a small acct and usually only get 1-3 hours of work a day but I can rake in the lines.

Thats great, but that situation is not the norm and one - that a person can rely on if

[ In Reply To ..]
looking for steady income. Not everyone does this for extra money, some actually need to pay bills and rent.

Correct. This is not the norm but an example of what - is out there. You just have to SM

[ In Reply To ..]
keep looking. I am the second income for my family but without my income, we would be eating beans and rice, make do with only one car, do away with cable, etc. MT is maybe not the profession for the single mom supporting a family anymore. It has changed to be different than that, different than it was 20 years ago.

This is one of 2 PT jobs that made me 27K last year. - nm

[ In Reply To ..]
x

But see, thats just it - see msg

[ In Reply To ..]
You are not the soul bread winner in your family, so maybe you can take the time to look for jobs like that, but some cant. If I lost my job today, I would be sending my resume to Nuance right now (work for MM). Why? Because they are likely to hire me right away. I just would not have the time to sit and look and search for an MT job where I was lucky enough to have 10 doctors where I can create templates and breeze through every single report.

That type of opportunity you may find at a small company or if you are doing IC work for a small physician's office. And even then, situations like that offer no guarantees. They can be here one day and gone the next - Bought out by a larger company or physicians moving to a system like EPIC.

I need something more promising, long-term. My husband is on disability so he has a fixed income. Im mid 40s with a ways to go before retirement so I need something more reliable and steady. I actually found that and now will be only doing MT part-time and I do mean *minimally part-time* as a statutory employee. I need a job that I know I can still have another 20 years from now.

I understand your position. All different situations make up SM - the world. Diffenent strokes for

[ In Reply To ..]
different people. I am sorry this is your reality and I wish I could personally change it for you. My advice would be keep looking. Try to maintain your job while trying others. I know that isnt easy but you wont find THE job without putting yourself out there and looking.

I also realize my reality could change tomorrow. I worked for one MTSO that one Monday, the work was gone. It happens and you move on.

I understand your position - See msg - sm

[ In Reply To ..]
Thanks, but at the end of my second post, I mentioned that I found another job and a good job. I am only going to be doing MT part-time. I am going to be working for a Health Network locally where I live, non-MT related. It's a clinic setting starting at $13 an hour, as they will be cross-training me to do medical office assistant. I have a strong background in medical. I have done MT for 13 yrs, but before that I worked drawing blood in a clinic and I also had a CNA certificate. I was going to become a nurse before I got started with MT. So no, I already have a good job and will be leaving MM soon.

Also, my husband was in a motorcycle accident and hurt his knee and back, but he still is able to do some work with my brother-in-law, but nothing fulltime, so we do have a little extra coming in other than his disability. My story is not as sad as it sounded. I was speaking in terms of my future though, when I said I needed something reliable and steady, a job I can retire on, but thanks for your kind words.

Btw, this is editing OS transcription. Not VR. - nm

[ In Reply To ..]
x

By the end of the year - Anonymous

[ In Reply To ..]
By the end of the year, I predict that same people will be on this board. whining about ASR, their low pay and how rotten their employers treat them. I miss MT. I had to leave it through no fault of my own due to outsourcing. I am now a QA editor (private employer) and also enjoy that, but it is not the same. I have always had great on site jobs, great pay and great benefits. I chose not to work at home. MTs are not "most of the population" and not everyone makes $700-$800 a month. How many MTs are starting up their own cash-only sidelines? You may know 1 or 2 but that does not mean everyone is doing that. And, how is that bad for Uncle Sam? And, because everyone in this forum is miserable and unhappy with MT, that does not mean that everyone is; this is only a small percentage of our workforce.

It's time to start singing a different tune. I'll come back at the end of the year and see who is still here.

This isn't directed at any one post here, but.... - (s/m)

[ In Reply To ..]
....there is an organization out there for "medical scribes." I believe it's called the American College of Clinical Information Managers (ACCIM). So, in your investigating and googling, you might want to look for the job title of "clinical information manager" as well as "medical scribe."

The scribe jobs in my area... - UsedToLoveMT

[ In Reply To ..]
pay something like 10 bucks an hour. So pretty horrible pay. They are mostly filled by med students, for some reason or another, maybe to give them experience from the documentation side of things, while observing the doctor in action. I dunno, but honestly I cannot imagine having to follow around a doctor with a laptop transcribing as he's talking. To me, that's my own personal little nightmare. A couple of the ortho docs I type for now will actually dictate while the patient is still there, sometimes asking them questions for clarification as they are dictating, and sometimes doing the exam as they are dictating. To me, this is better than having to follow him around. At least I can stop, start, rewind, and use shortcuts while I'm typing. It would be weird if you're a scribe and you need clarification on something - what would you do, interrupt him while he's examining the patient. "Oh excuse me, Doc, what was that last thing you said?" Ugh, sounds like a terrible situation to me.

UsedToLoveMT - Thats the impression I had too..see msg

[ In Reply To ..]
The way you described it in your post, but it is not that way. Below is another thread where people are talking about scribes, the person who started the thread was offered a scribe job, but you should read the post by "stressedMT" it really cleared things up for me a bit.

Also, I had a doctors appt this morning and I did not have a scribe, I had a tech. She pretty much served the role as a scribe though. She called me back, took my information, weight, vitals, asked me the usual questions all while she was entering the info into the laptop. The doctor came in after she left, by himself, empty handed, no computer and handled his part of the visit.

Scribes do not *have* to present the whole time doctor is in the room to summarize your medical visit. I suspect that at some point, he had to enter something into the EMR, documenting my visit and treatment, but whatever it is, it probably only took him less than 5 min. Advanced technology is making clinical documentation a lot more easier than we know and clinic visits dont require narrative summary.

Agree with some thoughts, but don't forget--for a decade - many insisted SR would never work.nm

[ In Reply To ..]
x

Oh SR worked alright, it just did not completely - put us out of jobs, instead it

[ In Reply To ..]
Changed the nature and the pay of our jobs. Now we are working to edit the report instead of produce the report.

Umhm. I meant, wishful thinking and self delusion by - many merely delayed their understanding. nm

[ In Reply To ..]
x

And some of us have morphed along with how the MT - industry has morphed. No SM

[ In Reply To ..]
wishful thinking here, just learning how to do MT a bit differently.

Umhm I meant - Can you please elaborate on your post? - Maybe Im slow, but I dont

[ In Reply To ..]
quite understand what you mean when you say many merely delayed their understanding and the whole "morphed" thing. Can you please post again and explain where you are coming from? Thanks!

I didnt make the "delayed understanding" post. I just think - a successful MT has to change SM

[ In Reply To ..]
with the times.

I totally agree with you, a successful MT does have - to change with times. Thanks for

[ In Reply To ..]
taking the time to clarify.

It doesnt work the way salesmen said it would and the - way management wishes SM

[ In Reply To ..]
it would. As long as they have hundreds of dictators, rotating in and out residents, different ways of dictating, different accents, etc, it wont work the way they want it to. That is why there will always be a place for US editors. And yes, this has changed MT. It is different now and takes a different skill set but still doable. Especially as the second income for a family.

Full circle - Realistic

[ In Reply To ..]
I have never thought I was indispensable, you need to get that out of your head. I wasn't replaced by technology, but by cheap labor, the offshore work force is not going anywhere. The EHR will be tied in with Medicare reimbursement and anyone who does not have it will not be able to treat Medicare patients so it is not going anywhere. Wages are what they are. I don't know what your "old" salary was, but scribes average $10-$12 an hour. I always thought doing research was part of the job and one reason why I enjoyed MT so much, I was always learning something new. I made a good salary but I never looked at anything I did in terms of dollars and cents, perhaps I should have. I transitioned very nicely to a position in health information management. I took a slight pay cut but overall it is a happy thing. As someone said in another post, what we did used to be in demand but unfortunately it no longer is. You mentioned health care costs; staffing and benefits figure into that equation big time. Someone who currently gets their work done for pennies on the dollar is not going to be in any hurry to restore you (or anyone else) to a higher wage.

Dont forget there is a place for MT in EMR. Several MM - accts are EMR, I have another SM

[ In Reply To ..]
acct that is EMR. THere are many different types of EMR and there is a place for MT.

In my city, pre-med students are the scribes - Holly

[ In Reply To ..]
A local university, famous for its engineering co-op education, was on television recently, touting its pre-med "Medical Scribe" co-op program, where dozens of their students will have thousands of hours of paid experience shadowing doctors while working as medical scribes at the hospital before graduation. So much for non-students hoping for permanent positions as medical scribes around here....

Similar Messages:

Mar 05, 2011

Hi, Has anyone heard of this company? Apparently, they are developing a web site, but that is all I know about them. I did not see anything posted on here about them in the search. .........TIA.........mt10yr ...

Oct 21, 2011

That some of the job postings are asking for 7 and 8 years experience? That seems to be a first now. Its about time they realize that 1 year experience is not enough. Anyway, with the doctors hating EMR/CPOE and India a woeful failure, maybe it will come back. I may not be around to pick up the pieces but perhaps some of you will. ...

Sep 12, 2014

I am editing an MR angiogram of brain and it says in technique, circle of 0. Is there such a thing? I know there is a Circle of Willis. ...

Jul 30, 2011

Remote s/l (circle flex) stent. ...

Oct 04, 2012

op report - percutaneous nephrolithotomy D: ...proceeded to break the residual stone further into smaller fragments and these were both extracted with the s/l Perkins circle. Never heard of this and cannot locate anything via google or reference books :( Thanks for any help!! ...

Aug 07, 2013

nm ...

Aug 28, 2014

I read the posts above where the out of work MT was advised to visit Inner Circle for company postings. So I did but that is a post for another day, what a joke. On the main page on the left side they highlight employees. Under one employee it says Podunk America AKA South Dakota USA. Is that what they really meant to say? ...

Jan 04, 2012

Describing an infant ...

Nov 07, 2009

HELP! Sounds like full CVA??? ...

Feb 26, 2012

Anybody ever type "full cor" before? as in full code. This patient is 87. ...

Dec 01, 2009

I am curious about a full-time position at a company called TTS. For those full-time, is the work steady. How many lines/week do you average there? Is there overtime available? Thanks! ...

Nov 18, 2010

Is it a capful of medication, or cap full? I can't find anything to verify either. Help appreciated! ...

Dec 18, 2011

It's a family day! I hope you all have a great day! :) ...

Jan 21, 2012

A few days ago I emailed my CCM to tell here that my brother had died and I had to take some time off. Her reply was that bereavement was only paid to full-time employees and to remind me of how many days of unpaid time off I could take each year. ...

Mar 14, 2012

Was wondering if it is realistic for me to expect to maintain full time MLS status and be a full time mom to a 3 month old? Anyone have experience with this? Thanks :) ...

Mar 28, 2012

If you work full-time for one company, doesn't that put you in the category of employee? It seems to me that a company that advertises for full-time ICs is actually inviting investigation by the IRS and Labor Board. ...

Jun 08, 2012

s ...

Jun 28, 2012

with benefits to part-time with no benefits? How does that change things for you? I've never run out of work before. Do they give less work to the part-timers? Should I anticipate any changes at all? ...

Jul 09, 2012

and yet my CCM sent out a message requesting assistance on one of my accounts for this coming weekend. What the blazes! I have had NJA on all but one of those days she is requesting help for the last couple months. What is she thinking? It is quite obvious that the account is over staffed on a couple of those days and we will not need the help this week. Its frustrating as I am barely making enough to live on as it is due to constant NJA and now she is asking for he ...

Dec 10, 2012

http://www.nuance.com/company/news-room/press-releases/2012-11-19-Nuance-Q412-Press-Release.doc ...

Apr 15, 2013

Thanks for the help. I cant work over 35 hours per week, but wanted to try for the MME position. ...

Sep 08, 2013

I am the one that got the state job and I LOVED it! During one of the training days, we ended about an hour early and the training person actually was concerned for us, because she didn't want us to have to lose an hour of pay on our checks. She told us to let our supervisor know that we lost an hour and ask if we could make that up, if we wanted to, because she didn't want anyone's paycheck to suffer due to her finishing faster than she should have. This was on ...

Dec 07, 2013

Today I've been getting probably half the ILP reports to QA with "full proof" or something similar in the QA note on reports that aren't flagged for 100%. Usually I get maybe one or two a month like that, but today I've had quite a few, all by different ILPs. Any other SHDAs enounter this? Granted, I just delete the comment and fill in their blanks and not do the full proof. If they want full proof, they will have to get put back on 100% QA so I ...

Feb 12, 2014

work 40 hours? At one time, I thought it was anywhere between 36-40 that was considered full-time. ...

Jan 26, 2015

I've never been able to do MT full time because I don't have the concentration, patience, or...whatever it takes to do an 8-hour shift where I'm constantly typing every day. It's very hard on my body. I couldn't do it even in a split shift. Anyone else like this? ...

Oct 16, 2009

code status is s/l full let and DNR ...

Dec 26, 2009

When you transcribe a doctor's name in the body of the report, do you always need to transcribe the doctor's full name and title, even if not dictated as such - for example, would you need to transcribe "Adam Adams, MD" even if just dictated as "Dr. Adams," and look up the full name and title? I'm always required to do so but can't find it in the BOS. I'm new so I don't know if this has been posted yet. Thanks. ...

Jan 19, 2010

It seems to me that full-time IC is a contradiction. I mean, in order to really be an IC, per IRS, don't they indicate that you should have more than one client? So, if one client requires full-time, that means you have to work more than full-time in order to keep everyone happy? Yeah, I know, there's no way to fight it, because there will always be hungry MTs anxious to fill the full-time IC positions. In a perfect world, in my opinion, no MT would be required ...

Feb 06, 2010

already my primary is running out of work. What kind of omen is that? My backup accounts had very little work as well. One of my coworkers told me PT and IC were told to stay off her primary the other day. I thought we'd at least get 6 months in before we started scraping for work. Is Transcend listed under the TAA? If not, it should be. That's all I'm really holding out for. If they want to pay for me to go back to school, that sui ...

Aug 12, 2010

I have a quick question. The doctor is dictating "full skin survey". How would this be transcribed? would it be full-skin survey or what? Thanks for the help. ...