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Medical transcription - Detailed description - of Voice Recognition for laymen

Posted: Dec 13, 2009

I am attempting to write my Hardship letter. In a rough draft, I was told I need to explain what I do more clearly and why voice recognition and outsourcing has caused a loss of income as an MT over the last 2 years. I am struggling with this and have to have it submitted, signed and dated by Friday. Can anyone who is articulate help me please? Here is what I started with. I will take out company names and leave blanks. The attorney who read it said people will read this who have no idea what medical transcription is, how I am paid and why my income has plummeted since 2008. Many think this is a fly-by-night job and that the income is not actually a reliable source. So I am told to elaborate on how I am paid by production, how being paid by spaces no longer exists, why India MTs have had an impact without sounding whiny. ::sigh::

{I have worked as a medical transcriptionist for 23 years. This job entails listening to recorded dictation by radiologists and then transcribing them into the patient's medical records ended when my account went to a format called "Voice Recognition" in which the radiologist's voice is interpreted by sound recognition software. Because of this, I had to find a new job as my company did not have a new position to place me in. I have found new work but the pay is based on 65 character line, meaning a significant decrease in pay. Training was not paid and the first 3 months on the job provided very little income comparatively speaking. However, I have now become more productive and am now able to make an income sufficient to pay my mortgage. }

This sounds so corny and I just feel like throwing my hands up in the air and saying: Just forget it!. But, I cannot. There is a mental block here so am hoping you all can come up with a paragraph that is intelligible and comprehensive.

Thank you in advance,

Hardship Letter - ClackyKeys

[ In Reply To ..]
Don't know if this will help, but here's a draft of a similar letter I had to write last year...

Iâ��ve been employed in the medical transcription (MT) industry for over 20 years, both as a transcriptionist and in management. The process of medical transcription involves listening to, interpreting, and typing medical records dictated by physicians. The transcribed document then becomes part of a patientâ��s medical record. The specialized nature of this work requires a broad knowledge of anatomy, physiology, surgery, pharmacology, etc., as well as the ability to produce concise, medically sound, and grammatically correct legal documents.

This has been a growing and very profitable industry for many years. Most MTs these days work for large national companies from their homes via the internet. I currently work for such a company as a full-time employee with benefits (medical/dental insurance, etc.). Iâ��m paid â��on production,â�� meaning that my employer pays me by the line. Depending upon work availability and other factors, therefore, my pay fluctuates from week to week.

About ten years ago, MT companies in the U.S. began to explore offshoring to third-world countries, where the work could be done at a fraction of the cost. Most MTs in the United States werenâ��t overly concerned about this development, because we know how much knowledge and training are required to interpret medical language. Nevertheless, many leaders in the industry began to slowly move work overseas about 3 years ago. In the last year, work has been leaving our country in rapidly increasing quantities, forcing many MTs to seek alternate employment. Because Iâ��m exceptionally well qualified to do this work, Iâ��ve been fortunate enough to last longer than others; however, this is no longer the case.

There are at least three reasons why my situation has become critical:
1. Offshoring of MT work is reducing the amount of work available to American MTs.
2. Voice recognition (VR) technology, as imperfect as it is, threatens to replace all MTs. In many cases, our positions have been redefined so that we no longer transcribe but instead edit what has been produced by VR software. This is a time-intensive and difficult task requiring the same knowledge but compensated at a drastically reduced rate.
3. In this economy, as people lose employment and medical benefits, they donâ��t seek medical care as often, thereby reducing hospital census as a whole. This obviously affects the volume of work available to MTs.

yadda, yadda, yadda

(Please don't flame if there are errors...I typed this in a hurry!)

Nosy.. - Aintmissbhvn

[ In Reply To ..]
May I be nosy and ask what this is for? I have no work at my job ALL the time and have wondered if I could apply for unemployment and file on the days they do not provide enough for me to do. Anyone ever thought of that?

I applied for partial unemployment (Spheris) and got it. - Had gotten PT job after laid off from Spheris

[ In Reply To ..]
I expected Spheris to appear it but they did not.

Who wants it? - MT changing

[ In Reply To ..]
Who wants unemployment? Of course they didn't show up! Your unemployment may be doable to you now but just wait until you collect for a while and have been on part-time work for a while. After you collect and you've been on part-time employment, eventually your unemployment will run out and/or it will be based on the part-time employment for that quarter or whatever. Having a "job" as an MT has become one of the most irresponsible, undependable "career" choices anyone can make.

I would not use the term "interpret" medical language, it means "translating"... - ???

[ In Reply To ..]
We are not interpreting! We are correcting, big difference. Your letter is too strong.
What was the result of your letter?

WHAT WOULD YOU CALL - HeidiHo

[ In Reply To ..]
Interpreting/translating hogwash from accounts with 99% ESLs who think they are speaking English? I would go to a U.S. Court of Law and defy a judge, or a man/woman on the street, to even understand a small percentage of what they are talking about! Do they talk to their patients the same way, who are NOT trained to listen to their ESL garbage? Did they speak this way on their interview before the hospital board on their interview for appointment to the hospital? I would think not. I'll lock horns with ANYBODY here, it amounts to translation/interpretation.

P.S. United nations interpreters/translators (6-figure salaries, bennies, free subsidized housing, shall I go on??) who have less garbage to deal with than we, as 7-8 cpl MTs have to deal with.

I presume this is for bankruptcy or as a reason - sm -

[ In Reply To ..]
why you cannot make payments on a loan/bill/mortgage? I went to a consolidator recently, they actually suggested I file bankruptcy, but that is not an option for me because of the one asset I do have, other than my car, (co-own) but cannot sell and it would I presume force the sale of it which would cause me more problems then I already have, but would pay off all my debt, but as I said it is not that simple unfortunately. The cc company offered me a 5-year plan, no interest, no fees, all my money going to the amount owed/principal, could not believe it. Had no idea such an animal existed, I knew about 12 month plans but five years? No interest? Wonderful, though it is not like they have not made thousands off of me already in interest. But in five years that cc will be off my back, yea! I have a hardship plan in place for another one as well, but that is only for 12 months no interest as well, about to start next week, so I may call them back and see if I can re-negotiate a 4 or 5-year deal with them too, or just wait until my 12 months is up, not sure. Amazing what you can do on your own though, a lot better deal than the consolidator was able to offer me (they had 9.9% interest for 57 months at a payment $140 more a month for this cc). I did not need to write them a letter, just flat out told them I did not though have the money, my income dropped about $400 a month due to an account cutting back drastically (the truth) which made my finances really go in the dumper. I am still forking out a lot every month for my past stupidity but now at least there is light at the end of the tunnel. So places will work with you, just need to make that call which is a hard thing to do, I know. --- Good luck in your endeavor.

Loan modification but I want to ask for late payments to be - placed at end of loan

[ In Reply To ..]
I have a good loan at 6.1% fixed so don't want to lose it. I just could only keep utilities on for 3 months while I was training. I have not lived large (7 year old car, tiny TV, etc.)

Many years experience MT changing careers - Not an easy change after MT

[ In Reply To ..]
I think that you are not writing enough detailed information about medical transcription, what it takes to be a medical transcriptionist, and how this job has been extremely exploited especially over the last 4 or 5 years.

I think that you should first explain that medical transcription is first a play-by-play physician account of what is going on with the patient, i.e. operative notes describe play-by-play of what exactly is going on during the procedure; consultation reports describe a consultant's viewpoint of the health issues, diagnosis, and plan of care for the patient, etc. etc. I also think that you need to describe how many medical transcriptionists (myself one of them) are extremely educated with college-level courses in biology, chemistry, anatomy, psychology, sociology, clinical assisting, laboratory, etc. and that most medical transcriptionists take the same pre-requisite courses as any other healthcare profession. I also think that you should make it a point that the transcribed medical report (accurately) is required for patient care, medical record, coding and billing, and for legal/court issues -- it is a legal document. I also think that you should mention that most all MT companies and now even hospitals upper-level management believe that a person doesn't need to know anything to be a medical transcriptionist and is basically only a typist. i.e. typing what is said and doesn't need the knowledge -- not true. I also believe that you need to think extremely hard on how to word the pay structure of medical transcription, which is a reason that people need to and should get out of it -- no other profession (especially men) would work for this kind of pay system; professions such as freelancers, plumbers, home contractors, accountants, ANYONE who has their own business or works as an "independent contractor" DOES NOT accept this type of low, piecemeal, slave wages; it is a by-the-hour job at a certain rate or a specified rate by the job. You need to explain in detail how the industry has undercut each other (which they have done for years), does not respect each other, and keeps lowering the "pay" to the point of non-livable wages. You need to explain how many managers/owners to "wash their hands" of the issue just say that the transcribers are "computer illiterate" or "don't know the information," which is entirely not true. You need to explain in detail how the systems are connected, how your low-wage, slave wages are directly related to speed of these systems and the up-date of these systems -- which it has been my experience that medical transcriptionists get the bottom of the barrel so to speak in information technology and bandwidth.

For my own editorial: The medical transcription industry has done this to themselves over the years. I was unaware of how terrible the MTs are to each other and how many MTs get their self-worth on how many lines they can do an hour -- which is just crazy. How many lines you can do an hour has NOTHING to do with knowledge or even computer skill or literacy. That mentally opened the door for exploitation and undercutting, with many of the MTs in the past feeling "superior" because they could "transcribe so many lines an hour" when all the while this very mentality was one of the many things that has brought this profession to its unlivable knees. I think that nothing will change because it is too late, that MTs have not respected each other or the profession in general like other professions, and have had a "one-up" mentality and competitive mentality with each other, no respect.

Good luck and be detailed in your writing. Think about what is and has been really going on and how difficult it is to get out of the profession. Why is it difficult, . . . because the medical profession NEEDS these reports BUT they want it for free or for nothing. I am hopefully to say a former MT, who has not been able to get a full-time job for 4-1/2 years. I will NOT work by the line and I am graduating from a major university in another field in late 2010. I have been EXTREMELY aware of how this field operated and have been somewhat shocked by how it lacks any comparison to any other line of work; however, when I got into medical transcription, I had never heard of it and was unware of how needed yet awful the job actually was.

Good luck and I say get out.

Some are cut out for this job, others not - Answers

[ In Reply To ..]
I got into this field years and years ago after having worked in the medical field for several years before that, hospital settings, doctor's offices, children's hospital and it gave me the opportunity to raise my children (did not work from home then), make as much as I wanted to live on an higher up end scale as a divorced mother and now I work by the line and have no problem making the amount of money that I now want. I did not go to college but instead had an inhouse on the job training for a year which served me well. I do not think this how many lines you do an hour has played into a downfall of this as, after all, that has been the name of the game. You type 600 lines a day and see how long you hold a job. I think what has contributed most of all is when people got into it just for the fact of it being advertised as a stay at home with the kids job. People did not love the field as much as they basically were trying to do a job they could do from the comfort of their homes. Do you not think the MTSOs know this fact, after all it is always on these boards about how a person cannot leave their home. I read that and am sure the MTSOs do as well. With that mentality, what does one expect, higher wages, better working conditions, just what?

Cut out for MT - Mt changing careers

[ In Reply To ..]
Yes, I believe you are absolutely correct in stating that a lot of trouble began with the advertising "work from home," that was an invitation to even more exploitation. However, I know many women you have children and work outside the home. They get baby-sitters and have excellent jobs. The difference I think is that a person either has to choose to sit at home with their kids for low wages or get out of the house for a better life for themselves and their children. I think that many MTs are now "stuck" at home because the industry has created a situation where many people just have no choice. I understand the reason that many people chose to stay at home and work to be with their kids, which is good; however, no matter how "nice" the company management talked about how this would work, people should have realized that there was a motive to the company's advantage for even allowing such a thing. Sometimes when people talk "nice" or how "great things will be," it requires a deeper, second look to find out the whole picture. Personally, when I worked in the office in a lead-type position, although not officially titled, and realized what was going and what I was required to do to people, i.e. cut them off, delete ports, etc., etc., I thought it was just obscene. I've worked in a couple of different type of businesses and I've never experienced such disregard and disrespect for any people as I experienced over those years. I was offered an "official" supervisor/lead position by this company two times and I turned it down twice, because I could not stomach it and instead chose to continue going to school, which obviously now I am glad that I did -- with only three classes left to graduate with a B.S.

With all that said and coming from someone (me) who could transcribe 2,000 or 2,000+ lines a day with traditional medical transcription and not 600 lines a day by any means, the MT industry HAS been exploited by the "line-count" situation, i.e. continually increasing the line-count requirements, manipulating equipment or using just plain out-dated systems which affect "line counts," and ultimately using line counts as how to base pay standards transitioning the industry into a truck-driver, pay-by-mile, work-7-days-a-week to do okay living. It has been thought in the past and only continues to get worse that MTs are "money hungry," which is a complete joke, and that MTs are not working and just "sitting around house" and can do more work.

Yes! nm - I so completely agree with you!

[ In Reply To ..]
nm

This is excellent ~ Thank you very very much! - OP

[ In Reply To ..]
Thank you. This is exactly what I need. There are many who are claiming hardship who have lived large and they are trying to weed us out. So, the more details the better I am told. It it very scary how I am so in shock that I am in this place that I am on auto pilot and can't even speak a sentence. Thank God I don't have to work in public cause I am by all appearances a half wit at the moment. Probably due to lack of sleep.

Dear OP - MT who knows

[ In Reply To ..]
You need to ask yourself an important question . . . what is hardship? The definition of "hardship" is defined differently depending on who it speaking it, i.e. where it is coming from. From what I can tell especially recently, there is absolutely NO medical transcriptionist who is "living large." And, just to mention it, no medical transcriptionist has ever "lived large." Think about what types of other careers are out there, the education required, the type of work being done, and what is being paid . . . medical transcription is a low-wage, blue-collar job plain and simple. Even though knowledge is required to do the job, it is still viewed (perceived) as a job similar to a factory job . . . people don't like to hear it but it is the truth. It is VERY difficult to get out of this field and make a change because of this fact. I think that many people are somewhat amazed after they learn of and experience my education and skill level in other areas and my knowledge, BUT . . . because of my recent experience, they are still reluctant because I have been the dreaded medical transcriptionist.

You need to know that medical transcription is a "mind game," and that the minds of many medical transcriptionists are situationally damaged from high stress levels of just trying to make it, and that if you ever try to change, it is going to take some time to clear your head of the "games" created by the industry . . . every industry has its "games," but the medical transcription industry (hospital or MTSO) is just amazing to me. Maybe what you need is to work in public on a part-time basis so that you get a sense of "reality" of what the world actually is about . . . medical transcription causes a person to forget that the world doesn't operate on that same crazy level.

REPLY TO MT WHO KNOWS - SM

[ In Reply To ..]
Your post is excellent as well. You seem to have read between the lines of all the B.S. and bill of goods this industry has tried to sell us. The MTSOs with their attitude of, "I don't care if you & yours eat or not, I've got 100 more newbie resumes on my desk & can screw you any way I can, I can disrespect you any way I can since I don't have to look you in the face - and God bless VR, as it's my latest shaft with which to do it" mentality, to the hospital and their holier-than-thou docs/dictators who can garble any line of crap and call it English and get by with it, notwithstanding their $000,000 salaries - and our less than minimum wage salaries, countless UNPAID work required to keep those insulting salaries coming in.

I have a long-time school friend, ex-MT who has worked for 3 MTSOs. She now has a position (she has a B.A. to boot) as an instructor in Medical Terminology/Vocabulary at a local metropolitan city community college. Her course is, by the way, a prerequisite of many of the allied health degrees being given by that college (R.N. nursing, respiratory therapy, etc.) Her outlook, likewise, on the MT profession, especially at-home-for-MTSOs, as of late is that, barring none, HAS TURNED OUT TO BE THE MOST EXPLOITED & THANKLESS JOBS IN THE MEDICAL PROFESSION, and makes no bones about advising her students NOT to even consider entering it.

Very true about it being difficult to leave MT'ing - either on a psychological or practical basis. They (MTSOs) have us locked in their own version of the "STOCKHOLM SYNDROME" - where, in THIS, 21st century, the whipped, beaten MT tells his/her master, "Thanks for the whipping, master, as you keep telling me, I'm lucking to have a job."

to MT who knows - mt way too long

[ In Reply To ..]
I agree and disagree with some of your comments. I don't know MTs now who are living large. There may be a few depending on what you call large, but they are few and far between. Did they ever live large, YES! Back in the day when we were respected and paid for our knowledge and skills. But this was before MT was advertised as a "work at home job" that you could do after 4-6 months in school and make top dollar. That brought the influx of the "wannabe work at home moms" to make that extra money. That is one of the things that put this profession down the tubes. That and outsourcing.

There was a time when if you had 5 yeasr experience in acute care you could pretty well get a job and name yoru salary. Believe it or not use to be that way at MQ!

MT may be viewed now by some as a factory job but it didn't use to be. There use to be respect in the field and money to go with it. MTSOs did anything and everything for a good MT to make them happy. I know I was there.

I now make less CPL but have finally found a company that has work, treats me well, has a good platform that I can produce on and it works for me. The companies are out there, but you ahve to really search. They are usually the companies you never hear anything about.

When this profession started getting advertised as a production type thing only just to make money is one of the biggest downfalls in the profession. Not only for the MTSOs and the MTs but for the patient's who are dependent upon what we do.

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