Medical Transcription?Is It an Industry That’s Just Hanging On?


Vol. 11 •Issue 23 • Page 22
Medical TranscriptionÉIs It an Industry That’s Just Hanging On?

MT Training Programs

By Lori Boone

Seems ironic doesn’t it? While patient census is on the rise, the U.S. workforce in the field of medical transcription is simultaneously on the decline. Studies have shown this industry loses approximately 10 percent of its U.S. labor pool each year. This would explain at least part of our shortage crisis. But with patient census climbing as high as 15 percent to 20 percent annually in some regions, who is doing all of the work and why aren’t more people entering this profession?

The Catch-22

It wasn’t until approximately 10 years ago that the experience level requirement to obtain a position as a medical transcriptionist (MT), particularly at the hospital level, was a minimum of five years in certain regions. At that point, the minimum requirement changed to around two to three years of experience, in hopes to attract a larger workforce. However, even at this level, the question still remains: How does one break into the industry without the experience, and where does one obtain the experience to get into the in-dustry? It’s a catch-22, particularly because many transcription service providers or hospitals do not offer on-the-job training due to lack of resources.

And while there are several independent, home-based medical transcription training courses available online and off, many of these courses are self-motivated and self-driven, without the structured support of mentoring and, more importantly, job placement. There are also many trade schools that offer courses in medical transcription, although usually combined with various other subjects that typically do not apply to this profession specifically. A community college is another avenue and many offer an associate’s degree in medical transcription but, again, there is very little successful job placement due to the lack of experience required by the vast majority of hospitals and transcription vendors.

Moving Transcription Overseas

As a direct result of our decreased labor market, the industry movement at large for the last several years has been to send transcription work abroad to cut costs and access larger workforces. This, however, raises additional concerns in terms of which direction the medical transcription profession might be headed as a whole; how it will affect the U.S. MT workforce; our economy; the overall impact on patient care/confidentiality; and our health care partners’ true bottom line. Presumably, at least as advertised, the cost savings are passed on to the client. But even if that were true, what does the quality look like and what is the back-end cost to our health care partners?

On the front-end, the advertised low rates may be enticing and look attractive at the onset. But what about the cost of the labor-intensive requirements of health care providers and administrative staff to correct the poor quality of the grave errors made in grammar, medical terminology and patient demographics from MTs whose second language is English?

And how about the cost of labor to take the phone calls from unhappy providers? And what about the cost of printing and reprinting the corrected version of those reports in need of repair, and the cost for labor to deliver the corrected document to the health care provider for a second look/signature and then finally off to the chart, again? Moreover, what about the errors and omissions factor? The continuity of patient care? The impact high error ratios can have on increased liability and the risk of malpractice as a result of inaccurate reporting? What’s more, how does all of this impact the critical reimbursement process for each health care organization and the message being sent out to referring physicians who may receive poor quality reports? With all things considered, that low rate may have just doubled, if not tripled.

Can We Cut Corners?

While some may view this as an inappropriate analogy of this situation, the old clichŽ “you get what you pay for” comes to mind when we think about sending U.S. work offshore, particularly at “low rates.” Clearly we cannot afford to cut corners in our health care systems and our economy, and continue to turn our heads from the underprivileged constituents in our own backyard. By sending our work offshore, we are damaging our own economy, increasing our tax payments and significantly impacting the quality of life of our fellow citizens, family members and loved ones across the nation.

“Employment fell and the unemployment rate rose sharply to 4.9 percent in August,” the Bureau of Labor Statistics of the U.S. Department of Labor reported on Oct. 2, 2001. “The number of unemployed persons increased by more than half a million.” And although this percentage may not seem that high, this equates to “nearly 7 million” people. “The unemployment rate rose by 0.4 percentage point to 4.9 percent, seasonally adjusted, the highest level since September 1997.”

The Bureau of Labor Statistics also reports, “Total employment dropped by about 1 million in August to 134.4 million, seasonally adjusted. This decline followed an increase of about 450,000 in July. About 1.4 million persons (not seasonally adjusted) were marginally attached to the labor force in August, up from 1.1 million a year earlier. These were people who wanted and were available for work and had looked for a job sometime in the prior 12 months, but were not counted as unemployed because they had not searched for work in the four weeks preceding the survey. In August, the number of discouraged workers was 335,000, up from 205,000 a year earlier. Discouraged workers, a subset of the marginally attached, were not currently looking for work specifically because they believed no jobs were available for them.”

These figures are astonishing and invariably will rise drastically as a direct result of the devastating terrorist attacks in the United States on September 11.

It’s Time to Rebuild

This, now more than ever, is the time that we need to focus on rebuilding our economy and strengthening our integrity by taking responsibility to our nation and providing education and job placement opportunities state side wherever possible. With English as a first language in the United States, this task should be relatively easily accomplished, especially coupled with advanced technology and learning tools readily available to us. A number of very competent U.S. citizens today cannot afford cost of living, let alone health care for their families, yet rely so heavily on government assistance in order to survive, which we all ultimately end up paying for through tax dollars year after year.

All of these very critical issues have caused us to take a stronger look at our mission. It’s time someone stood up and took responsibility for keeping our work onshore, thereby supporting and promoting our economy through education and job placement. By keeping the work in this country, we are making a very important contribution to our society by promoting the circulation of transcription dollars back into local communities, promoting our economies and ultimately reducing the amount of tax dollars spent on welfare through local, state and federal government assistance programs. This also enables our underprivileged fellow citizens to regain lost integrity by giving them the opportunity to learn a skill and earn a decent living, while having the cost-effective flexibility of working at home and raising their children in a healthy, stable environment.

Companies Making a Difference

Medical transcription service providers can make a difference by partnering with job training and educational programs. The accompanying list includes a number of medical transcription educational programs that can provide training and job placement assistance to those wishing to enter the field of medical transcription.

I encourage our health care partners to take a look at true transcription costs, including the contribution to the economic challenges in sending abroad, and to support our economy. Make certain your transcription work is being done in the United States and support education by ensuring that your transcription vendor provides at least some sort of on-the-job training to newcomers to this industry. Together as health care partners, we can make a significant impact on our economy and overall quality of life through economic development and excellent patient care. n

Lori Boone is president and chief executive officer (CEO) of TRX Inc., with offices in Portland, OR, and New York City. You may contact her at [email protected].

The Andrews School

Web site: www.andrewsschool.com E-mail: [email protected]

The Andrews School was founded in 1989 to offer a comprehensive educational program in medical transcription (MT). It began as an onsite program in Oklahoma City, OK, but later evolved into a distance-learning program that currently enrolls students throughout the United States.

The Andrews School MT program is based on an educationally sound curriculum that emphasizes textbook learning, transcription of authentic physician dictation, research using an Andrews School-supplied reference library and feedback from experienced instructors. The program is self-paced, but usually takes students 15 to 24 months to complete. The Andrews School specializes in providing extensive, detailed feedback to students and individualized attention via phone, e-mail and private message boards.

The Andrews School is licensed by the Oklahoma Board of Private Vocational Schools and also offers a comprehensive long-distance program in medical coding.

Career Step

Web sites: www.careerstep.com E-mail: [email protected]

Phone: (800) 246-STEP (toll free) or (801) 489-9393 (local)

Career Step LLC is a private school founded in 1992 by Andrea L. Anaya, CMT. Career Step is a registered school under the Utah Post Secondary Proprietary School Act.

Offered on an open enrollment basis, the program is a comprehensive independent home study course that provides the students the opportunity to learn at their own pace. The course is a complete program available in a text-based format using textbooks and cassette tapes. It is also available in a fully interactive online format.

Using the Internet, the course integrates the curriculum into an interactive learning experience that includes electronic tracking, automatic grading, on-demand pronunciation of terminology, WAV sound files for practice transcription of up-to-date doctor dictated reports, and innovative on-screen text comparison.

Health Professions Institute (HPI)

Web site: www.hpisum.com E-mail: [email protected]

Phone: 209-551-2112

SUM Program for Medical Transcription Training is used in more than 500 accredited community colleges, public and private vocational schools, and in on-the-job training programs in hospitals, clinics and transcription services. The SUM (Systems Unit Method) Pro-gram uses carefully selected authentic physician dictation, se-quenced by medical specialty on CD-ROM or standard-size cassette tapes, coordinated with textbook reading assignments and exercises. HPI makes The SUM Program available to individuals who wish to pursue self-directed study and provides free consultation services to schools and employers implementing The SUM Program.

M-TEC Inc.

Web site: www.mtecinc.com E-mail: [email protected]

Phone: (330) 670-9333 (local) or (877) 733-4346 (toll free)

The Medical Transcription Education Center (M-TEC) Inc. trains qualified medical language specialists through its Tier I Premier program for individuals with no prior experience in the medical field, and its Tier II level for the health care professional wanting to make a career change to MT. The program is approved by the State of Ohio Board of Proprietary School Registration.

This program follows the AAMT Model Curriculum II training guidelines, covering coursework as outlined; uses the Beginning and Advanced SUM program, selected AAMT medicine/surgery and Foreign Accent modules; and pairs each student with an instructor.

M-TEC offers a weekly interactive/online grammar class, MS Word class and audioconference class on word expanders.