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

Goodby my QC friends. It has been a pleasure all - these years but I just finished my

Posted: May 22, 2015

last shift. I refuse to take part in the grid that starts tomorrow under the false guise of "patient safety." Nothing about this grid encourages safety, it only shouts survival. While I do care about the patients, I also care about my family and their ability to have a roof over their head. I understand the MLS have put up with this for quite a while, but in the case of QC, 2 weeks notice that we are ripping $400 or more weekly from your pay BUT we expect the same amount of work is ludicrous. In QC we work across many, many different accounts, 1 report at a time. We get the worst of the worst, including those reports some MLS just can't be bothered to complete. We completed our work with pride. That is no longer the case. It's a matter of survival now and according to the grid, there is no tier for basic survival. To all my QC friends I've met over the years, as well the great MLS I've come across, I wish you the very best in your endeavors. To Nuance, all I can say is good luck. I hope you've distributed a grid to your customers letting them know where their quality will fall now and giving them the option to pay pennies for it. By the way, I'm not giving notice. I don't owe you that courtesy.

Right with you, do not blame you one bit - SoonToBeExQC

[ In Reply To ..]
We're in a nightmare scenario where once we could take pride in our work, we were happy to work that little bit extra and show that we care about our job. To be a good QC you really need to have that little bit of an edge to go the extra mile and care enough about the work to make that extra effort. But no more, so believe it when we say we understand and sympathize, and yes, they do not deserve the courtesy of any notice. Good luck to you, but you really don't want to be associated with what Nuance will shortly become known for... shortcuts, cheating and poor quality.

Good luck to you. I am also hanging up my grid - on Wednesday. (nm)

[ In Reply To ..]
1

"just can't be bothered to complete?" Really? - Will

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Sorry you got screwed but, seriously, we don't like to send blanks to QC because it costs us money to do it. The same goes for spending too much time on a file that cannot be understood. It isn't that we "can't be bothered." I hope that, in the future, you can at least try to remember that you're not the only one who is working hard and getting little $$ for your trouble. Sheesh.

Will's reply to..."just can't be bothered" - rtr

[ In Reply To ..]
Excellent points. Will hit the nail on the head. Hard to sympathize with such a condescending attitude (and one which demonstrates why some QA/QC are so disliked.)

Yes, I see a whole lot of hissy fits now that - QC are being hit by the FIESA pay cut machine

[ In Reply To ..]
Which is kind of amusing, since when it happened to us there was not a lot of sympathy from that quarter, or did I miss it?

I am happy that so many QC are able to just up and quit, for their sakes (and to screw Nuance). Us MTs are not so lucky, or at least I'm not, I have been trying for years now.

I wish there was a better job out there for me, despite the fact this one sucks, but I have looked, and I have done, other jobs, and as far as pay is concerned it is bad all around and with smaller MTSOs there are other issues plus always the threat of a buyout anyway.

She is a nasty person and has been spewing her bile sm - mmmm

[ In Reply To ..]
in emails over the past couple of weeks. Frankly, she can kick rocks.

Will, you left of "some." Believe it or not the OP is - correct. There are AnonQC

[ In Reply To ..]
MLS who do not take as much pride in their work as perhaps you do. As QC we run across this situation quite frequently. When an MLS who has spent time to do their very best on a job that may be very difficult but still must send to QC, that effort shines completely through. Not all MLS have the same dedication as you or others might have. Just as there are good and bad QA/QC folks, the same holds true for MLS. The OP said "some MLS ...," not all MLS. I really don't think the OP meant disrespect to all MLS in general, but rather the occasional ones that take advantage of the system. As QC, I have the inside advantage of knowing exactly what he/she meant by that comment.

Surely you don't think any MT has nothing better to do? - Will

[ In Reply To ..]
Regardless of variances in personal work ethic, all MTs are in it for ONE REASON--to make money. Even before Nuance's despicable pay scheme came into being, it was always unprofitable to spend a lot of time on a bad file. However, in the past, such files could be sent to QA/QC without further financial loss but with some amount of b****ing from the MTSO. Now that this b****ing has been replaced with a financial punishment, there is NO incentive to send such files to QA/QC.

Again, MTs transcribe for MONEY. PERIOD. I, for one, can think of many more enjoyable things to do with my time than transcription and I know so can everyone else--so please spare me the patronizing claptrap about my being such a better worker than any of my fellow MTs. We are all in it for the same reason and all of us have the same incentives when it comes to transcribing files--be they crystal clear or clear as mud.

Being compensated hourly and obviously - well compensated

[ In Reply To ..]
It is pretty astonishing that when faced with a production pay grid scheme all the QCs seem to be jumping ship.

I am not an MT who is careless, I am one who takes the time to do it properly.

All I can say is, the more fool I.

The only way to succeed in this racket is to get in the production, that way when your post audit gets nitpicked to death you still make a decent amount.

I only wish I had the stomach for that, but if you don't, you must accept you get close to minimum wage.

You can give us MLS who do their very best all the kudos you want, but I note when QC pay gets cut (like ours did ages ago) it becomes intolerable to you and you all just quit.

Please bear in mind how little we MTs are making. If you think it's horrible to lose $400 a week, how bad would you feel making $400 a week - if you're lucky and they don't dock you that week that is?

Transcription/QA appears to be no longer a field for those who put quality over quantity. They are considered suckers if you go by the way we get paid. And Nuance is, as per usual, leading with the worst practice policies which all the others will follow.

QC is not MT - anonymous QC

[ In Reply To ..]
I am not the OP and I've been trying not to respond to this, but I just have to and you can crucify me all you want to, but something has to be understood. I get that the MTs all had to deal with this pay grid also. There are some huge differences though between straight MT and QC. Some of us have been here for years, starting out salary when we were expected to work more than 40 a week, then we were knocked down to hourly and now this. What is not being understood here is that we are going to be paid production just like you, but we don't do what you do. We routinely get jobs with 10 or more blanks. I see at least 20 jobs a day with 25 or more. You get these jobs you can be in a job for over an hour for very little lines. I know some of you are very good MTs and don't shove through some of the stuff we see, but there are many out there who don't care. We get jobs with numerous blanks that a simple Google search can find and that's OK for a few blanks, but 25 no. QC simply cannot do their job on a production rate, not the way it should be done anyway. Some of us also are expected to know 25 different accounts; at one time I had over 50. And no we do not get paid as much as everyone seems to think. When this QC person mentioned $400, I am sure that was per pay period, not week. I can assure you no QC I know were poking at MTs when their grid came out. We were all MTs at one time, we do know what it is like believe it or not. We get audited also, we always have and we are nitpicked to death also and when putting in a reversal, none of them are reversed, we get told it was an error and it stands even if we didn't catch a "d" left off the word "and". As soon as we touch a report it becomes ours. We miss one tiny mistake that an MT missed and it is on our butt. Our jobs are very different from yours. None of us are stupid. When we seen it happening to you, we did not feel vindicated, we felt scared and sad because we knew we were next and all the QA people out there are feeling that now, they know they are next. A lot of us in QC went from getting 100% audits to completely off grid all of a sudden and no its not fair and it would be very easy to blame QA, but they will soon be right here also. We also deal with OOW situations just like you, especially since your grid came out, no one wants to send anything to use if they can avoid it. Most of us do not even understand why they are keeping us at all. It makes no sense to have an MT go through the report, and then us, and then QA, now that the biggest part of our jobs has been eliminated, that of filling in blanks and fixing other things so that MTs with less experience can learn and become better MTs. That is completely gone now, and my job makes no sense. To me I am just really an MT going through reports that were already done, seems completely redundant. Our reason for being QC is gone and that is why a lot are jumping ship. We know that we will make more on production as an MT than we will QC, or some will stay on and not even bother filling in blanks or 100% the report, just push the reports through and take your chances on audits, like one big crapshoot...that is what the job is now. One bad audit and like you we are making min wage. Our pay grid goes up to $44.33 which is not obtainable in any way because we'd have to do 2,000 lines an hour. I personally think it is an insult to even have it on the grid. None of us made even half that amount before the grid. The whole thing is criminally insane and we all have to deal with it the best we can, or we can quit.

MT is not QC - xo

[ In Reply To ..]
I do feel for you. However, there's this insinuation that QC is suffering more than MT with some of the comments made about your recent pay grid changes; that your pay grid changes are somehow worse; that QC works harder. I'm losing nearly $400 per pay period, same as what it seems the OP meant. I'm not going to go to battle with QC over who has it worse, or who works harder, or who does more without pay, or who is less deserving of pay cuts. Nuance is not fair to any of the minions. The bottom line is that unless you are in a management position of some sort with salaried pay, the great insurance, bonuses and all the perks they get, you're screwed working for this company.

You responded to my post - and I appreciate the clarification

[ In Reply To ..]
As per usual, it seems as though Nuance have not thought this thing through and I completely understand why you should not be paid on production. I think an hourly rate is appropriate, and reading this I can't for the life of me see why Nuance separated QC and QA in the first place, another thing possibly they did not think through or obviously have any input from the people who actually do the work!

I seem to recall the initial plan was to have QC earn bonuses and they shied away from that at the end?

From my viewpoint, I know I would take a very long time to proofread and figure the blanks and I could never ever do it quickly, which is why I don't think I could do your job.

What some (management, unfortunately) don't get about this work in general is that knowing an account is half the battle, all those doctors' names mumbled the breath for cc's and phrases which make absolutely no sense except for the one time it was clear and you kept it. That is the only way I have made any decent $ doing MT, by knowing an account, so this new industry-wide practice of spreading the work thin and always new accounts and so many, well, what could that be but them trying to make our pay go even lower and hoping we will quit?

One request re your post, please help my eyes and brain and separate your ideas into paragraphs. It is hard to read a long post like yours when it is all in one para and it does help the reader if the poster separates paragraphs for clarity, so we know what goes with what.

Thanks a lot for chiming in on this and helping me understand.

Thank you for this reply - In the same boat

[ In Reply To ..]
You explained it so much better than I would have in the heat of the original moment when I read the previous comment. QC is not MT, totally different jobs, which is why they were compensated differently. One job is not better or worse, just different. I too had to restrain myself. I just remembered a quote from Booker T. Washington, "you can't hold a man down without staying down with him." We should be supporting each other, not picking at each other.

I actually do NOT think QC should be paid more - there I said it

[ In Reply To ..]
Yes, they're different jobs. Yes, QC should be compensated hourly because the reason you're getting our work is because we couldn't take the time to find the blanks due to our requirement to make a certain lph. Your job requirements mean you should have the leeway to take more time.

But should you guys make double our pay? I think not. It seems like some of you are getting a lot more than us and that I don't agree with. I think a fair hourly salary should be what you get.

I have no idea what this QC production grid is, but it sounds like you are still getting more than us. If, however, it is disincentivizing QC to take the time required to get the job done properly, well, how stupid is that?

Nuance stupid, that's how stupid.

wow - anonymous QC

[ In Reply To ..]
I would have to ask if you had ever worked QC/QA. These jobs normally require at least 5 years experience, in my case I have done QC for three different companies, the first time after 10 years experience and at this point I am well over 24 years. As we are told repeatedly by the higher ups, they hire us to be the best, the most experienced, etc. Any testing I have had to take for QC jobs has been way harder than a typical MT test. The position pays higher because in general we have more experience. Anyone is free to apply for these jobs and get them if you can pass the testing and have the experience. To me it would be insulting to compare an MT with 25+ years experience with and MT with at half that or lower. It is like any other job, experience makes you better and you get more pay...normally. There is also the point that I have heard many MTs, who did use to do QC say that they made way more being an MT. We get the worst dictation because why would someone send good dictation to QC. Our grid goes up to 17, but as I said before we would have to get 2000 lines per hour or 16,000 a day to get that with a perfect audit....NOT going to happen, I'm not even sure it is physically possible. From what I've seen yours goes up to 12, not that big of difference, especially considering most of us will be lucky to make 7.

It is like any other job, experience makes you - better and you get more pay

[ In Reply To ..]
...normally.

Direct quote from your post, but in fact as far as MTs go, the newbie with zero experience they just hired gets paid the same as I do and this has been going on for years now. Plus, if you make 1 miniscule error, your years of experience, knowledge of the account, etc., count for squat, so as far as MT is concerned, they do NOT reward us for experience or expertise, not at all.

I have 20+ years experience as an MT too, I just simply would not like to do the QC job, I actually like doing MT. I am just as good as a QC, I am sure I could get the job, I just prefer MT. In fact, in my case I utilize QC very little, so you could say I am an MT/QC in one package, very economical for Nuance.

I do feel QC should get hourly pay, and considering how low us MTs are paid now you would most certainly get paid more than us anyway, but I do NOT think QC requires any greater knowledge than MT personally.

Oh, where Nuance is concerned, you also have to have a heartless streak to do QC/QA because if you find an error Nuance uses you to cut our pay whether you mean it or not, so that's another reason why I would not want to do it, I just could not stomach that.

We will have to agree to disagree - anonymous QC

[ In Reply To ..]
I think most people who have been doing this a long time knows that a QC job is more skilled. There are lots of companies who pay experienced MTs more than newbies and even pay more for certification. Until you have worked a QC job you have no basis for comparison. Also, no job I have ever done has affected someone's pay, not even here. I said QC numerous times, there are still some people who do not understand the difference. QC fills in blanks and fixes any other errors, but only for the benefit of educating the MT. What we do does not affect your pay, never has, and now we don't even get to educate. QA are the ones who affect your pay and QC pay. I started with Transcend and it was not split up and there was no docking of pay; that all came with Nuance.

interesting choice of terms... - nymt

[ In Reply To ..]
Here is an example of why certain posts are condescending and arrogant: When an MT hears for example (and this is one of many, many possible examples): "BP 173/68" but the QA/QC hears "172/68", this is counted as an MT error when actually it is strictly a matter of opinion and has absolutely NOTHING to do with "educating" or "helping MTs grow" or "guiding MTs" or whatever silly, self-important function the QC above describes. There are many MTs whose experience matches and/or exceeds QA/QC and who (like the other previous poster) may have done QA/QC in the past but simply prefer MT, so for a QA/QC to pontificate that they are "educating", "guiding", and "helping MTs grow" demonstrates remarkable arrogance, and they should not be surprised when that attitude is found objectionable and will not go unchallenged.

Amen and Amen - Will

[ In Reply To ..]
I would add to this the numerous times when those of us who have been in the business long enough have seen QA/QC correct us on an "error," only to have the client complain that they way QA/QC told us to do a thing is the WRONG way and then have QA/QC tell us to do that same thing the way we were originally doing it--back when they dinged us for the "error!" And, for the benefit of those to whom this has never happened, don't for a minute think that this has ever resulted in a change in accuracy scores!

There are bad eggs in every group - anonymous QC

[ In Reply To ..]
QC and MT alike. Just like we see horrible transcription from some MTs, I have also seen very bad QCs that you wonder how they got the job and I am sure you have all seen that also. What I am stating is about those of us in QC who do see ourselves helping. I for one never correct anything unless I am 100% sure it needs changing. I am sure there are probably QCs out there who let the "power" go to their heads, are vindictive, etc., and they enjoy lording it over MTs. However, QC has NEVER had any bearing on accuracy scores. Our job as has been spelled out for us has always been fill in blanks if we can, fix any errors we see, mentor newer MTs or MTs who have proven to need it. That type of position is always going to make people angry at those who are correcting them. No one likes to be corrected.

Another generalization... - nymt

[ In Reply To ..]
Experienced MTs, especially those lucky enough to have gotten their start in a hospital or on-site at an agency or MD office, usually remember their initial co-workers, their genuine mentors, with gratitude because these were the people who helped the new MT learn the profession, so the issue is NOT at ALL that "no one likes to be corrected". The issue is the arrogance it takes to make blanket generalizations and self-aggrandizing statements that the QC/QA position involves "more skill" than MT and that filling in blanks and splitting hairs over matters that (unless the QC has the patient's chart in her hands for reference) are often opinion-based, somehow constitutes "educating", "guiding" and "helping MTs grow". It's hard to sympathize with a pay cut when the poster is exhibiting such a condescending attitude.

NYMT: My sentiments exactly. - Will

[ In Reply To ..]
xx

I have 30+ years as MT and never above 0% to QC. - wtfe

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Please explain to me why you think you are more skilled or should be paid more, because by my calculations you are not. ??

One job is not better? I kind of think the one - that pays better is better

[ In Reply To ..]
As far as skill sets go, they are not really totally different jobs.

IMHO we MTs are the workers and you QC/QA are the enforcers. It didn't used to be that way, but Nuance made it that way. You are like the policemen of our work who get paid a lot more than we do. Understandably, we don't like that, and also I personally don't think QC should pay more than those who do the actual work.

If you think the jobs are much of a muchness, then compensation should be relatively the same, right?

I find all this mincing of words and crocodile tears on the part of QC a little disingenuous.

Come on, you OBVIOUSLY all think you are better than MTs and that you deserve more. Now that Nuance is popping your $ balloon you are starting to squeal, hoping we won't remember how no one from QC had any objections when it happened to us, and hoping we won't notice when you pretty much are saying "But, but, but...how can they do that to US!!!".

Believe me, Nuance don't care how much anyone or any job is worth, their objective is to pay us all as little as possible, and they will keep going down down down until either you squeal too much for them to keep a lid on it or some government agency puts the screws on them for the massive wage theft they are attempting to perpetrate.

It's very easy for them to remain unexposed because they know we're a bunch of mostly women at home all over the country and can never organize at any level, so their abuse continues and the feeble attempts to draw media attention usually fizzle out, which they are extremely happy with. It also serves them well to divide us.

Despite all your lip service about "supporting each other" they have obviously convinced you all that you are cream of the crop and selected based on so, and deserve your role as our enforcer and your higher salaries.

Maybe there should be a QA/QC board, because if you want us to get on board with you you will have to admit we are just as good as you, which apparently is something that you all really just do not believe. Your paycheck and the drivel you have heard from those hiring you makes you really, really want to believe you are better, so fine, but if you think we are going to accept you deserve a better deal than us, you are dead wrong about that.

Commiseration between badly treated employees is probably the best you can expect under these circumstances.

Notice - xo

[ In Reply To ..]
My heart goes out to everyone feeling the pain of these pay cuts. It's unconscionable. As an MLS on Futurenet/Bayscribe accounts, I would like to point out that we too only had a 2-week notice when the second (third? fourth?) set of changes were made to our pay grid. That's when the bottom fell out for many of us financially. They made making more than 8 cpl nearly impossible and 7 cpl very easy with the latest changes. Again, it's unconscionable all the way around.

They don't deserve the courtesy of a notice and I applaud you for taking a stand. It is their loss and I also wish you the very best in your future endeavors.

Verbiage looks familiar to me, I am sure I know who sm - mmmm

[ In Reply To ..]
are and don't let the door...you know the rest. You have been very nasty to people who have done nothing to you.

Losing $400 a week? - toobroketochoke

[ In Reply To ..]
I am amazed at losing $400 a week, when I think the vast majority of MLS barely make $400 a week since the first grid appeared. Not to mention OOW. Just saying . . .

Yeah, that's a good point - with a pay cut that big

[ In Reply To ..]
How much do they actually make anyway?

I knew it was more than us, but did not realize it was so much more.

And it seems easy for QCs to quit, so I assume there are plenty of better jobs out there? Interesting.

Not enough money in the world to do that job. I - very shortly moved to a QA position

[ In Reply To ..]
back when they were QA specialists. I quickly realized it was not for me. I ran back to my MLS spot so fast it wasn't funny. It's a frustrating, stressful, thankless job and you have to really enjoy it to last.

goodbye - hadenuf

[ In Reply To ..]
Wow, the OP sounds just like me. I was in QC until a few days ago, started an IC transcribing position the next day. I cant stop worrying about how to pay the bills now because the new job is not much money either and I had almost forgotten how typing all day kills your body. BUT, i dont have the stress of the crap at Nuisance anymore. (oh and i didnt give notice either).

I'm trying to make this decision! I just don't think I can do another SM - old QC

[ In Reply To ..]
do even one more day there, I really can't.

I don't even want to give notice. I just want to be done. I support myself, do you do too? I'm scared.

trying to make this decision - hadenuf

[ In Reply To ..]
Hey old QC -- I know how you feel. And, no i dont support myself. My husband works also but he was making a few dollars less than me when we were making hourly, so we cannot live on either of our paychecks alone. I got another job doing transcription and my wrists are already sore and I am so far making about $10 an hour at 7 cents a like (VBC). I also have to take out my own taxes now and have no PTO. So think long and hard and have something really good ready before you quit. I am still looking around some. I am going down almost half of my former pay and back to transcription because I wasnt able to find any QA jobs. But, if i had stayed at Nu i would have been making about the same -- close to minimum wage in my state. Nuance has screwed us all over BIG. I have done this for nearly 30 years and I make less now than I did 20 years ago. Best of luck to you. I know its a hard decision.

They just want to pay India and America the same is all. - nm

[ In Reply To ..]
xx

It is so sad that we are baited to battle each other rather than support one another. - sm

[ In Reply To ..]
It is so sad that we are baited to battle each other rather than support one another. When I first got into this field over 20 years ago, it was a very supportive environment. QC/QA was there to guide and help the MLS grow. It is sad that we get pounced on by the corporation and fellow members of our field. It is sad.

It is so sad - QC2015

[ In Reply To ..]
I have been thinking the same thing when reading these posts. We all should be kind to each other at this point, because it will not get better but worse.

Having said that, I will be moving on as well. Plans are in the works and the count down has started.

Good Luck to ALL!

"baited"? - arn

[ In Reply To ..]
Yes, if I posted remarks claiming that both testing for and performing my job required "way" more skill than your job and that by doing my job I was "educating" you, helping you grow" and "guiding" you, I definitely would be baiting you and I would not expect too many "kind" responses in return.

Goodbye - tmtqc

[ In Reply To ..]
I agree with everything you have written except the part where MTs don't bother to finish a report. I've never come across such a thing. If I have it was probably because of poor audio. When I was an MT I probably did the same thing. I still consider myself as an MT. I've been "in the trenches" and I know what it's like. I plan on saying goodbye this week. QC is being screwed big time. I'm going back to my first love....medical transcription. I have an excellent opportunity waiting for me and I know I am going to be treated with the respect I deserve from my new employer. They seem genuinely happy to have me come on board. It feels like a breath of fresh air to the tune of a decent wage! I wish all my fellow QCs the best of luck.

Goodbye - QC2015

[ In Reply To ..]
I am so happy for you!

I too have plans to leave, just need a little more time.

Good luck to you, and to all others, MTs and QAs alike.

QC 2015 - tmtqc

[ In Reply To ..]
Thank you so much. I wish you well!

goodbye - hadenuf

[ In Reply To ..]
Can you say where you are going and if they have any more openings, TMTQC?

Goodbye - tmtqc

[ In Reply To ..]
I'm going to work inhouse at a major hospital near where I live in Texas. I applied several months ago and got a call back the day after the conference call about the grid. Talk about timing! There are jobs out there. I just got incredibly lucky. If it can happen to me it can happen to anyone. This old MT has still got it.

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Doing a consultation in which the doctor is trying to figure out if the patient's has sleep apnea. He says a list of reasons: "...history of elevated body mass index, snoring, large Mexican friends and hypertension." I'm sure he can't actually be saying large Mexican friends, but I can't hear anything else! ...

Aug 12, 2012

When asking for help, please give us a "running start" and as much info about the patient and their diagnosis as possible. Thanks. ...

Dec 05, 2012

Their way of figuring it is so convoluted. I wonder if they keep us all low like that. ...

Dec 15, 2009

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