A community of 30,000 US Transcriptionist serving Medical Transcription Industry
advice on career change - Kim
Posted: Aug 24, 2011
I've been a medical transcriptionst for 25 years (most of that time working at home)...I can't believe how much money I am losing....I used to think that I would never go back into an office/hospital to work because I wouldn't be making enough money. Now, I am at my wits end. My pay has literally been cut in half, no thanks to EMR/VR. I am at a loss as to what to do...should I change careers (at age 49) or keep doing what I'm doing, while getting further and further in the hole financially. I've been looking into billing and coding, but I'm really not sure that is the way to go. I've been reading things, such as "need 2-3 years experience" etc. Does anyone have any advice?
Never too late to change careers. - sm
[ In Reply To ..]Don't look at your age as being a problem when it comes to changing careers. It's never too late! If you are not doing good financially now, imagine what it will be like in a few years?! There are so many degrees you can get on-line now, so it's a lot easier now days to work and go to school. I am currently getting my 2-year degree in health information technology. I plan to do coding and also pursue my master's degree in healthcare administration. Look into it if it is something that interests you.
Never to late - Silly Sue
[ In Reply To ..]We you able to take on line classes, or did you go on campus. I am looking at different ways to retrain. Good luck.
On-line - sm
[ In Reply To ..]CAHIIM lists accredited programs available on-line.
Change in careers - Kim
[ In Reply To ..]Thanks everyone....I'm looking into both campuses and on-line courses now. I'd really like on-line courses. Will check the CAHIIM site...
On line - Silly Sue
[ In Reply To ..]Me too. Thank you.
Change -- and NOW - MT is going away fast.
[ In Reply To ..]Just my opinion.
Maybe if we can hang in there long enough - cm
[ In Reply To ..]we will come back into style - like bellbottoms once all these other ridiculous things they are trying do not work.
New Career for MTs - Joe
[ In Reply To ..]At the recent AHDI conference in Phoenix, I presented a session on an exciting new profession, which we are calling "Medical Coordinator" (MC). MCs listen in on clinical encounters, performing all the EHR documentation in real time. The physicians concentrate on the patient, rather than on data entry or even remembering what needs to be dictated. They can now provide more productive and more effective healthcare.
For further information about this new career and on how you can get trained to become an MC, providing a critically valuable service for your physician partner, you can check out www.valadoc.com.
So, how is this any different than an MT? - stupid
[ In Reply To ..]It is the same damn thing we do now. Just get rid of the MTSOs and let us work.
It's VERY different - Joe
[ In Reply To ..]Much more challenging...and much more valuable. You listen in on the encounter from a remote location, performing all the documentation in real time, along with some other helpful workflow actions.
While the patient is communicating the HPI, you determine what is clinically significant and how it can best be documented. The physician will call out the objective findings, as well as the assessment and plan. You enter the appropriate info into the EHR, in a mix of free text and codified data.
To handle this important responsibility, you will need to go through about a month of EHR documentation training. But you would only do so once you have connected with a physician who wants this service. It's typically a salaried position, with benefits, working directly for a physician practice -- not through an MTSO.
The essential difference is that you are DETERMINING what gets documented and how it is displayed -- not just transcribing what the doctor dictates -- and you're doing it in real time. When the encounter is finished, all the documentation is done. The early adopting physicians are universally ecstatic.
So what you're saying is.... - merrymt
[ In Reply To ..]We would be a remote scribe.
Who carries the liability if we are determining what gets documented? Us? I'd rather not be in a position to get sued, thank you.
What I'm saying is... - Joe
[ In Reply To ..]...you would actually be more than a remote scribe. You would also be coordinating workflow. That means getting the nurse to the room when indicated, handling referrals, doing e-prescribing, and a number of other valuable functions.
There would be no greater liability than you currently experience...which is rather negligible. The physician still needs to authenticate the note. You are just doing a draft. If the MD signs off without reviewing, that's still her/his problem.
It seems like there are lots of positives for MTs in making this career move. You have a secure, future-oriented and EHR-compatible position, which provides immense value for your physician partners. You have a steady salary and benefits. You get to DETERMINE what gets documented and how it looks. And you are proactive about your career, before EHRs and speech rec further erode the demand for and the price of your services. The pioneering MCs are are as thrilled as their physicians, with this new initiative.
There is, however, one downside. There is little flexibility in working hours. When the physician is with the patient, you generally need to be available. For sickness, vacations, or important errands, there are backup options. We are partnering with service organizations that can cover this time. Or the physician can record the encounter or a dictation, which you could later document. So it seems like the pros way outweigh the cons.
physician records info and we type it - sounds like MT
[ In Reply To ..]I think this is a made up position!
Why do you think that? - Joe
[ In Reply To ..]There are a several active Medical Coordinators who are convinced they are for real. And they are very, VERY happy doing what they are now doing.
Well... - merrymt
[ In Reply To ..]It sounds interesting, I'll give you that. Glad to hear about the liability issue, which I know is negligible for MTs, that's why I like it ;]
A couple more questions though..
How does the system actually work---Would we be virtually present in the exam? How are we able to communicate with the Dr. in the event we can't understand what he is saying? You stated he could just "call out" objective diagnoses, and we would record them in the record, but what if he's going a mile a minute and we need a repeat? Is there a waiver the patient would have to sign if we're virtually present in the room? What is the salary range? Why would we need to tell the nurse where to go? Wouldn't they know that already and wouldn't their floor director be arranging their own workflow/patient care? Besides the fact that would be a scary proposition anyway. One does Not tell a nurse how to do her job! (I come from a long line of nurses, I know this, lol)
Lots of questions. I'll try to answer - Joe
[ In Reply To ..]You are home or in another office in the physician's building. Not in the exam room. There is a secure microphone/audio communication system. You are trained to be expert in the EHR and in this remote documentation process. The free text and codified data you enter "magically" show up on the monitor in the exam room.
There is 2-way communication, so you can ask the doctor a question or to repeat something. The HIPAA issues are handled. The patient is informed that the doctor works with a documentation specialist, so s/he can concentrate on the patient rather than entering data into a computer.
Salary is negotiable. Probably between $30K and $40K, but will probably increase as your value becomes fully understood. The physician may ask you to have the nurse come to the room, or you may anticipate the need. You are the "MC" of the clinical encounter.
Guess what? - merrymt
[ In Reply To ..]I have a lot more questions now! =] Thanks for answering the ones I had. I think concept is sensible. At the very least, it circumvents the time we waste trying to figure out what some mumbly, eating, driving in the car all at the same time Dr. is saying.
I did review your website. Frankly, it is quite vague, which is unsetteling and thus begs more questions...
Do you have live instructors or is this self-guided study? How much is tuition? What kind of job placement service do you provide? Who is the parent company? What hospitals/clinics/Drs. have you already contracted with? What kind of operating system would the MC at home need? What technical support do you provide? What happens when/if the system goes down during the patient's visit--what's the backup plan? Would the Dr. just dictate then and send an audio file for transcription? Do you accept anyone into your program or just people with a medical (language) background?
I'm probably forgetting something, but oh well, I'm sure I'll think of it.
More Answers - Joe
[ In Reply To ..]On the Training page of www.valadoc.com, you can click "Presentation at AHDI 2011". That will enable you to download the PowerPoint I used at that conference, probably answering some of the questions you'll have at your next posting. :>
I'll endeavor to answer the questions you posed during this posting. The training is mostly automated and self-guided. But there is human support if needed, and a human coordinateds the live Certification Testing. The core of the MC Training Program is a set of Interactive Tutorials, which are based upon real clinical encounters. You practice with them until you become proficient; they demonstrate "best practice" documentation.
The cost is $1,800, and it takes about a month. Typically, the physician pays that cost, along with your salary for that training period.
The company is Valadoc. Currently, there are only 5 physicians using MCs, all in private practice. No hospitals yet.
You would need to have the EHR software installed on your PC. Technical support is available.
There are two situations that require backup. If the system goes down, the physician could record the encounter or could do a dictation, for you to later convert into an EHR note. If you are unavailable due to illness, vacation, or an errand, those two options could also apply or we could provide a temporary backup MC.
We discourage physicians from training anyone other than an MT. But if they insist, we would likely require additional training at an increased price. Nobody will be able to do this better than MTs. You have unparalleled skills at understanding physician-speak. From listening to dictations, you have absorbed what data are considered clinically significant. You are comfortable working remotely. And you are facile/fast at entering text and other data into a computer.
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