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

Good Article: ST vs. SR - Edie

Posted: Jun 16, 2012

MTs Need to Get Off Inaccurate Pay Scale

http://www.fortherecordmag.com/archives/050712p29.shtml#.T7hYiI60y30.facebook

This is an excellent article - every MT and MTSO needs to read this. - mt

[ In Reply To ..]
Pay for SR/VR needs to be increased to a fair wage. Yes, we are not typing the report, BUT we have to closely edit the report which for me, takes more time.

Excellent Article! A Must Read - anon

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The woman who wrote this article hit the nail on the head and in a way that even the doctors should be able to understand it! I truly wonder how many of them do not know if they are using SR/VR or a transcriptionist. I am "sharing" this article with others!!

Even if our fingers don't type every word of VR, - every word still goes through our brains!

[ In Reply To ..]
And I think, as the article said, VR is harder because we tend to "hear" what we see printed in front of us. I've found editingto be harder than regular transcription (where one also has the added help of "muscle memory").

It also takes twice the alertness and twice the patience of straight transcription. We editors are being totally hosed when it comes to pay.

Requires exactly same knowledge to judge a line is correct as it does to - to judge that it contains errors.

[ In Reply To ..]
Frankly, it doesn't matter whether SR happens to get it right or gets it wrong - exactly the same kind and degree of knowledge is required to assess the accuracy of a line either way.

In other words, people, whether transcribed or edited, we are putting out exactly the same product - and we should not accept one cent lower line rate for SR editing than we would demand for transcribing those lines.

Last night... - ...to cite an example - sm

[ In Reply To ..]
I had a 25-minute SR dictation. Audio quality (cell phone, naturally) was about 3 on a scale of 1-10 with 1 being inaudible.

In this document, there weren't 4 consecutive words that were correct, and after laboring over the first paragraph, it was obvious that it would be faster for me to simply transcribe the document.

I wiped out the remainder of the document and transcribed it, and the whole process wound up taking nearly an hour, and at 4 cents a line I wound up earning $6.48.

This, of course, for a company that screams bloody murder if they have to "supplement" your pay to satisfy minimum wage requirements - a situation that they themselves caused when they came up with the rotten SR line rate!

There was something so deeply and manifestly unfair about this situation that I just sat at my desk for awhile, wondering what we have come to. I brought an enormous amount of knowledge and experience to that document and when it was submitted, it was letter perfect. Mistakes made by the dictator (more than one) had been corrected, and audio issues had been overcome.

I was proud of that document, as I try to be of every one that I submit, but I had an awful taste of shame toward myself that I have allowed myself to come to this.

There are two words that describe this situation, and they are words that resonate in the corporate hall of shame:

1. Slavery.
2. Sweatshop.

People, something has to change, and I think it's time for every one of you out there to finally wake up, smell the coffee, and realize that it's not going to change unless WE TAKE ACTION.

Companies rarely had to supplement line pay to satisfy min wage - before the SR line rates came along.

[ In Reply To ..]
Take it from an insider who's been a supervisor and area manager. Before the SR line rates came along (and the rotten SR software that makes editing so laborious), the company I worked for (second largest in the country at the time) RARELY had to supplement an MT's production earnings to meet minimum wage requirements.

When this did happen, we knew that we had an MT with issues that needed to be addressed, or perhaps she simply wasn't cut out for the work. Over the five years I worked for this company, supervising over 100 MTs, I probably had no more than six counseling sessions that were related to people needing supplemental pay to meet minimum wage, and in four of those cases we (the MT and I together) were able to identify the problems and craft successful solutions.

Mr and Mrs MTSO owner, you need to understand this. The MTs who work for you WANT to be productive. They WANT to achieve high quality ratings. If there are a few in your employ who feel otherwise, they're easily identified and can be encouraged to go elsewhere.

If you're supplementing folks' production pay to meet minimum wage, the chances are EXCELLENT that the problem is YOU, not them. YOUR pay rates. YOUR SR software. YOUR clients. YOUR miserably complex demographic requirements. YOUR SYSTEM.

YOU..YOU..YOU.

Wake up, Mr and Mrs MTSO. It's time for all of you to look at YOURSELVES and do some real (proper) fault analysis. This is a process in which you identify why things aren't working, and I think that you'll keep coming back to one common denominator: YOU.

Well said! (And the first time a supervisor has - ever posted something I agree with!)

[ In Reply To ..]
Up until now, MTSOs seem to be of the mind that, "If something is wrong, pin the blame on the MT." Now there are a myriad of things that are wrong, and very few of them pertain to the MT anymore. They're so overworked, overwhelmed with nightmare demographic programs and transcription software, and so under-paid, that just keeping their heads above water is a 24/7 job.

If MTSOs don't start to hold themselves accountable for the many failings of modern medical transcription, they will soon be FORCED to blame themselves, because all the MTs they were so easily able to blame in the past will be GONE, and they will be alone with their failing businesses, because another way to get the medical record produced will be found.

I feel 100% the same as you, every single day. - MTs MUST TAKE ACTION! nm

[ In Reply To ..]

Meanwhile, read about the $billionaire CEO of EPIC - Link inside

[ In Reply To ..]
See link below

Epic - Inquiring minds

[ In Reply To ..]
I'm and MT and an Epic user. Anyone who has done this job knows that change happens, I was using carbon paper, a typewriter and Liquid Paper when I started working. We accept the change, learn how to work with it, or move on. To me, she sounds like a savvy businesswoman who knew to strike when the iron was hot, i.e., the Federal Medicare guidelines for EMR use. Do you think she personally planned to do away with medical transcription? Bill Gates is also a billionaire who probably put a few people out of work in his time as well, I don't recall people getting too bent out of shape over that.

I think you missed the point completely. - sm

[ In Reply To ..]
I think the point was that there's enough money floating around in the "healthcare documentation" system to pay the folks who actually make the whole thing work - and I do mean the WHOLE thing - properly.

And this point really needs to be driven home because I'm not sure that even some of us really get it: The medical transcriptionist is quite often the ONLY HUMAN BEING who actually curates every single word in a medical document.

How many doctors actually READ every word they dictate? Maybe 1%?

How many transcribed documents pass through QA? By so-called "industry standards" (the cloth-headed folks in Modesto), about 3%.

WHEN A DOCTOR PULLS UP A MEDICAL RECORD, IF IT IS ACCURATE AND COMPLETE, AN MT IS ALMOST ALWAYS THE REASON THAT IS THE CASE - NO MATTER HOW THAT DOCUMENT WAS ORIGINALLY PROCESSED.

In other words, this whole industry of "healthcare information" stands on the shoulders of that group of people known as medical transcriptionists. Without us, one can only shudder to imagine what health documentation would come to.

I don't think all of us really, really get this because if we did a lot more of us would be unwilling to continue to quietly submit to the increasing levels of compensation abuse - among other forms of abuse - that have prevailed and become much worse over the last several years.

Isn't that nifty healthcare system great, Mr Hospital CEO? Well guess what? We're the ones who make it great because without it you'd just see a bunch of garbage - and I don't care how much you paid for it.

If MTs stopped editing for a week or two, the - CEOs would be forced to notice us.

[ In Reply To ..]
No matter how technologically advanced, an electronic medical records system is only as good as the people who use it.

Wrong. If MTs stopped editing for a week or two, the work would be sent offshore. - JustMe

[ In Reply To ..]
They are looking for reasons to get rid of us, why add fuel to the fire?

It would not be sent offshore. - Dump the boogeyman.

[ In Reply To ..]
#1. There are many clients who will not permit the work to be sent offshore. I know you might not believe this, but it is absolutely true.

#2. Offshore is not as easily doable as you might think and takes a fair amount of time to put in place.

#3. Offshore is no longer as cheap as it once was, with the same kinds of labor market forces at work now in India and elsewhere as we have seen, although not as severe.

yurquestions - sorrybutrue

[ In Reply To ..]
Your points and questions simply do not matter. MT work is gradually trickling away and, with that, MTs will only gripe more. This woman's success? It's called capitalism. Every private company has someone in charge who makes a considerable amount of money compared to those in the ranks. Why would our industry be any different?

I wonder how many people that "successful" - woman stepped on as she climbed the ladder?

[ In Reply To ..]
n/msg

You still missed the point - but even more so. - - sigh - sm and I will talk slower

[ In Reply To ..]
T h i s....i s....n o t....a b o u t....
c a p i t a l i s m....o r....C E O....
s a l a r i e s.

(Still with me? Good!)

T h i s....i s....a b o u t....t h e....
d e c l i n e....o f....M T....
c o m p e n s a t i o n....a t....a....
t i m e....w h e n....e n o r m o u s....
s u m s....o f....p r o f i t s....a r e....
p o u r i n g....i n t o....t h e....
d o c u m e n t a t i o n....s i d e....
o f....t h e....h e a l t h c a r e....
i n d u s t r y.

The trouble is, how do we communicate this - - sm

[ In Reply To ..]
message to the people who need to know it? Do we know if the Powers That Be ever even try to do this themselves? Are they MTs? Are they just administrators who look only at the bottom line? It seems so obvious to you and me, but are we just preaching to the choir?

Good point. This won't be seen by the people who need to see it. - sm

[ In Reply To ..]
If we don't think that the folks running transcription companies already know what they're doing to the MT profession, we're naive. They know perfectly well what they're doing.

And they're crossing their fingers hoping they can get away with it long enough for SR to reach the point of capability that they can do away with us entirely.

The clients might know about it or they might not, but all they care about is getting that line rate down to zero if possible - and however the MTSO wants to cut costs is perfectly fine by them.

The doctors are probably the ones who could be convinced that they should care about this, but I want you to know that the physician community has a lot of problems of their own right now and feel that they're being squeezed between diminishing returns by way of government healthcare programs and increasing costs for everything needed to run their practices. It would be very difficult to get them to pay attention to our problems.

HOWEVER, an MT work action WOULD be "heard" by everyone in the system, immediately and shockingly, and I think that some accommodation would be found VERY QUICKLY. It probably wouldn't take more than 3 to 5 days before the MTSO would be calling you with some different line rates.

Fire you? Never happen...because now they have an enormous backlog, and believe it or not, there isn't a replacement standing right behind you waiting to take your place, to say nothing of the costs that are involved in hiring an MT...who will be trained when? Up to speed when? Committing all those initial demographics errors?

What's sad is, we're really in the driver's seat but we're letting everyone else steer the bus.

If all or most MTs thought like you, we wouldn't - be in the pickle were in today. (sm)

[ In Reply To ..]
"What's sad is, we're really in the driver's seat but we're letting everyone else steer the bus."

Truer words were never spoken. Especially now that we're editing so much... both VR and India-typed transcription. As MTs, they were always holding VR and offshoring over our heads, telling us that tired old mantra, "It's where the field is headed", blah, blah, blah.

But if a work action were staged by Editors, then WHO, pray tell, would they find to clean up all their cheaply-produced VR & Indian gibberish transcription so that it was client and EMR-ready?

Answer: NO ONE.

We've got the keys to the car, and I think it's time we take it out for a little spin.

On being idealistic and realistic - Last line is key

[ In Reply To ..]
I agree with every word, but believe that things have gone too far for any course correction to occur.

The problem is the gulf between clients and MTSOs. Clients went the MTSO route years ago in order to save money on employee expenses and avoid the bother of buying and maintaining digital equipment. They pay the same now for VR that they paid for MT-transcribed work and do not see a difference between the two.

Client hospitals would be constrained by market rates for employees and local employment laws.

MTSOs are profit-oriented. They are not constrained by local labor forces because they are never visible locally. They misclassified MTs as ICs in order to decrease costs, pay on a piecework system that can result in hourly rates that would otherwise be illegal, ignore wage and hour laws, and continually seek even lower labor costs by offshoring and employing VR.

The overall scenario is a lot like migrant labor.

MTs and AHDI can clamor for justice all they please, but things will not improve any more than they have for migrant workers. It cannot improve because healthcare costs are increasing, reimbursement is decreasing, and the consumers of MT services will not pay more than they already are for a service they deem unskilled and almost unnecessary.

And when software can do the typing and a doctor's hand-written scribbles will suffice, "unskilled and unnecessary" is exactly what it is. A lot of skill may be required on the part of the MT who has to understand the dictation and write it, but it is a skill that lost its value when VR appeared.

No amount of protesting will change this. No amount of grousing on invisible MT chat boards and no quantity of letters to editors will result in improved pay or working conditions. It just cannot happen because market forces will not allow it.

Recognizing that is important. You need to recognize that and decide if you want to remain a medical migrant worker.

If you do not, you are going to need to change jobs. The skills you have WILL facilitate a move to other HIM jobs.

The author of that article, as a PA and MT, has only to learn ICD-9 coding in order to move right into clinical documentation improvement. Add CPT and she will be superbly suited for compliance and consulting. Any of you could walk into HIM jobs with little additional effort.

I did that already. It was a good step. I recommend it. I do not believe that you need or want to be a medical migrant worker any more than I did. Recognize that complaining cannot change anything, then focus your attention on getting out and into a better job.

Thanks to Cesar Chavez, things actually HAVE - improved for migrant workers.

[ In Reply To ..]
I wish we MTs had a Cesar Chavez to bring our concerns to the forefront. Migrant workers used to be "invisible" just like we are. Now, many of them likely make more per hour, and have more laws on their side, than we do.

That is because people need to eat. Nobody NEEDS - your typing.

[ In Reply To ..]
And they aren't making much more.

Is your goal to live on minimum wage? If so, why not just get a job at MacDonalds or Chik-Fil-A and get that minimum wage? It would be a heck of a lot less work.

Not posted by an MT, I'm quite sure. MTs do not refer to - what we do as typing. And besides...

[ In Reply To ..]
...no MT I've ever met would suggest that "no one needs" what we do. EVERY SINGLE PATIENT needs what we do, and without our work the healthcare system WOULD COME TO A HALT.

I'm biting my lip trying very hard not to say exactly what I think of you.

They do not need it because they now have - Faster, cheaper ways

[ In Reply To ..]
They no longer need you like they did even 10 years ago. They can get their work done using VR, point and click, Dragon, keyboard, or ink pen.

Nothing would come to a halt. You flatter yourselves with that false belief.

Where I work, fewer and fewer doctors want to dictate. They just prefer doing it themselves.

You can be as angry as you please, but that is correct. I was an MT, but got out when I realized where things were headed.

Go away little troll. - This board is for MTs.

[ In Reply To ..]
And don't tell me you were an MT because even a former MT would never refer to what we do as "typing".

Pffft! (That's the sound of troll spray.)

Re: NO ONE NEEDS - Old Pro

[ In Reply To ..]
Obviously posted by a non-MT or a very new and very clueless one. We are not typists, we transcribe.

Then you all should stop calling it typing. - Look around this board

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Amazing! You all call it typing! That is one thing I have always found astonishing about this board--the perception of yourselves as clerical workers.

You think it is fine is long as it is another MT saying it. You don't get righteous until you think you have spotted an imposter.

Not an imposter and not new. The only place I refer to it as typing is on this board, simply because the rest of you do.

AMEN - A definite "must-read" for all! - Very well written! - Meerkat - nm

[ In Reply To ..]
.

Excelllent article, I am forwarding to the owner of the company - longtimemt

[ In Reply To ..]
I have been in this business since 1980 with typewriter and belt dictation, I made more then than I do now on VR/SR. I for one am forwarding this link to the owner of the company I work for, hoping someone reads it and encourage everyone to do the same, we cannot change things without taking the first baby steps. As far as forgetting the nice things like punctuation, grammar etc, try doing that and QA will ding you for sure, we are caught between a rock and a hard place, do it the way they want and go bankrupt or make it presentable and possibly make a wage we can survive on.

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