Medical Transcription: The Training Paradox

Vol. 14 •Issue 20 • Page 16
AAMT Track

Medical Transcription: The Training Paradox

A medical transcriptionist’s (MT) job is to listen. This is what we hear:

“I can’t get a job without experience, and I can’t get experience without a job.” (new graduates)

“The work is being sent overseas because it is cheaper. I’m afraid I’m going to lose my job.” (experienced MTs)

“We can’t find enough qualified MTs in the United States!” (medical transcription services, hospitals and clinics)

Here’s the rock. Here’s the hard place. And the medical transcription industry is firmly caught between the two.

So What Are the Real Problems?

There is a lack of qualified MTs to handle the ever-increasing amount of documentation. Skip Conover, president of CBay Systems Ltd. wrote a guest editorial for ADVANCE (March 1, 2004) and stated, “Our company, among others, has stated that it will hire any qualified American candidate who applies. Last year we tried to hire five MTs in Charlotte, NC. After a five week search, we could only find two who were qualified.”

The value of the MT to the health care documentation cycle is unappreciated. The doctor dictates a rough draft. The MT listens, organizes and improves that rough draft, producing finished documentation that is relied upon by health care providers for patient care; insurance companies for billing purposes; and attorneys and juries in a court of law.

To produce that finished documentation, the MT must be highly skilled and knowledgeable in medical terminology; English grammar; anatomy and physiology; disease and pathology; surgical instruments and techniques; pharmacology; all areas of medical specialization; the medicolegal aspects of patient documentation; and research techniques.

This training takes a minimum of one year of intense study. Developing proficiency in the art of translating dictation into a finished medical record requires at least another year of actual hands-on practice. Then, to remain proficient and up-to-date, the MT needs continuing education as much as any other health care professional.

And compensation for MTs is going down instead of up. In testimony before the California State Senate Medical Privacy Hearing on March 9, 2004, Amy Buckmaster, immediate past president of AAMT stated, “Low entry-level wages and lack of adequate compensation for skilled, experienced MTs have discouraged many individuals from selecting medical transcription as a viable career option, unfortunately at a time when our MT workforce is aging.”

The medical transcription industry is unregulated. Without licensure or required certification to practice, anyone can claim to be an MT. Furthermore, there are hundreds of transcription education programs across the country operating without any kind of accreditation program in place. There is no standardization to ensure that a particular program will provide the education necessary for the student to be employable. This often leaves employers with the expensive task of having to provide additional on-the-job training.

What Are the Solutions?

The American Association for Medical Transcription (AAMT) believes that solving the real problems will require addressing both sides of the equation—MT education programs AND employers. AAMT is developing an Education Approval Program that brings together educators and employers to set an industry standard for training programs that will produce employable graduates. Transcription training programs will apply for approval by AAMT and, in turn, AAMT will be able to provide potential students with a list of programs that meet the standards set by the association.

There is discussion underway about developing an entry-level exam that would help to evaluate the newly trained MT’s readiness for the marketplace and provide employers with an assessment score for the purpose of hiring.

In addition, AAMT would like to see employers support internships to help transition the trained MT to becoming a productive MT. From a legislative standpoint, AAMT is asking law makers to consider tax incentives for U.S. businesses willing to hire entry-level U.S. MTs to help defray the additional training expenses.

AAMT also urges employers to take a good hard look at what an MT does and how long it takes to do it well and then reconsider basing compensation on production. Stuffing envelopes or putting the widget inside the wadget is production work. Interpreting health care providers’ often garbled spoken word, editing for clarity, identifying discrepancies, and assuring the accuracy and timeliness of health care documentation is NOT production work.

This summer, AAMT released its new level 2 certification exam worldwide. The exam is completely computerized and will provide instant results to the candidate. Additionally, AAMT is looking at the validity of licensure to secure the integrity of the practitioners in the field.

As the only professional association for MTs, it is AAMT’s job to listen. We are hearing graduates complain that they can’t find jobs and also hearing employers say that they can’t find qualified employees. AAMT believes that the Education Approval Program and certification will help bridge the gap that exists in the profession today. For more information about certification or the Education Approval Program, please visit

Kim Buchanan is the 2004 AAMT president-elect and works as a mentor for Healthscribe Inc. Pat Stettler is a member of the AAMT Board of Directors and Lead Faculty for a nationwide medical transcription program at Everett (WA) Community College.

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