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Serving Over 20,000 US Medical Transcriptionists

There is an article in Radiology Today that MQ just got all of Christus Health, more than 40 sm

Posted By: MT Pockets on 2005-09-24
In Reply to:

hospitals.  I suppose that means that more work will be available very soon, which might be why they are recruiting and keeping so many transcriptionists hanging on.  Has anyone heard a start date?  Are they losing accounts too or just adding?  Trying to make a decision and this just made it more confusing for me.


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Just read article about health crisis sm
for the MT workers in India. Study says workers are getting stressed working long hours and developing health issues. Check out the amount of lines they put out and with 99% accuracy compared to AAMT's accuracy of 98% Oh please!
MT Salary woes article in Advance for Health Information Prof. 8/2008







Vol. 18 •Issue 17 • Page 20
Reactions to the MT Study

A group of professors is taking a hard look at the medical transcription industry.


His knowledge of the industry a few years ago? Admittedly, zero. Coming from, as he described it, a position of ignorance about the medical transcription industry, Gary David, PhD, associate professor of sociology at Bentley College, Waltham, MA, hit the road and headed to Reno, NV, last year, where he took in the Association for Healthcare Documentation Integrity (AHDI) Conference. After realizing no formal academic research had ever been done on the medical transcription industry, Dr. David and two Bentley colleagues, Donald Chand, PhD, professor of information and process management, and Angela Garcia, PhD, associate professor of sociology, set out to do an in-depth study of the industry.

The first part of the study was an online survey taken by 3,800 MTs, and the results of the survey were compiled, analyzed and presented as the study's preliminary findings. The full study is still in its infancy; the preliminary results from the survey represent only one part of the teams multifaceted approach. Dr. David has become embedded in the industry, serving on task forces and committees with AHDI and the Medical Transcription Industry Association (MTIA), and he's now a staple at the annual conferences.

ADVANCE spoke to Dr. David, as well as to experts in the industry. We aimed to look at specific aspects of the study's preliminary results and gauge its reception. The opinions are mixed when it comes to three major issues in the medical transcription industry: quality, the work force shortage and the ever-present salary issue.


Questions on Quality

The survey posed several questions related to the quality of documentation done by MTs. Nearly half of MTs reported that they see how flagged errors are resolved only rarely or never. Also, the survey showed that 59 percent of MTs transcribe for multiple physicians at multiple hospitals and/or clinics. Dr. David's view is that if an MT isn't told how a flagging issue was resolved, he or she may not know how to resolve a similar issue in the future, which can affect quality. Likewise, Dr. David noted, if an MT is transcribing for many accounts, he or she might not be able to develop an ear for physicians.

According to David Plummer, founder and CEO, Probity Medical Transcription, Harrisburg, PA, quality review is useless unless that information is shared quickly with the MTs. He also agreed that transcriptionists should have primary accounts to work on, and then when that runs out, have pre-determined secondary and tertiary accounts. Today, many MTs are transcribing the dictations of multiple physicians from multiple hospitals and/or clinics, Plummer said, and that's just the way the business model works for most medical transcription service organizations (MTSOs), he explained. Quality, turnaround times (TATs) and productivity suffer in this design; however, when you have a transcription system where the pools do not contain sophisticated logic and has transcriptionists flit from one account to another, these are expected outcomes, in Plummer's opinion. What has happened is that the architecture of some of the newer platforms has not been built with [MT familiarity] in mind, and it creates these massive pools with multiple hospitals and tens of thousands of physicians, and that's just not good for quality or the MT, Plummer explained.

Chris Hopkins, chief operating officer, Landmark Transcription, St. Davids, PA, looked at the survey results from another angle. He noted that approximately 50 percent of his work force consists of independent contractors, which may indicate that those MTs are working for multiple companies, which would explain why they are transcribing for many different accounts. Hopkins also said that just because an MT is transcribing for multiple accounts doesn't mean that quality work isn't being produced. Landmark maintains a system where MTs are assigned certain accounts, and MTs do transcribe for multiple physicians. By working on certain accounts, however, MTs can keep track of the different client specifications, something that Hopkins said may be difficult in a pooling system as mentioned above. [MTs] can't build up any kind of speed or fluency on an account when they're doing 10 different accounts, Hopkins said.

Bonnie Crow, director of U.S. operations at MxSecure, Scottsdale, AZ, agreed that in an MTSO setting, MTs are most likely transcribing for multiple accounts. These MTs are often experienced and highly skilled, Crow said, and therefore they produce high quality documents. With the flagging issue, Crow said that software used at MxSecure provides feedback to MTs, and she believes most platforms will allow this (Probity and Landmark have software that lets MTs see how a flagging was resolved, as well). Crow also noted that MTs should go through a quality auditing process on a consistent basis. I strongly feel the Quality Assurance monitoring process today is the best it has ever been, Crow said.

That's due in part to the technology that can allow MTs to follow documents through the quality assurance (QA) process. Kathy Eberle, who works in QA and is the operations supervisor for Landmark Transcription, explained that as soon as a document leaves QA's hands, MTs can immediately see the changes that were made. Some platforms make this difficult, however, and MTs and QA personnel may have to work harder to ensure that errors are explained. It is extra work to give them the feedback that they need, but in the end, it always pays off for QA because the MTs always become better for it, Eberle said.


Shortage or No Shortage?

Besides quality issues, another point brought to light by the MT study's preliminary results is the aging work force and, potentially, a looming work force shortage. There's no denying that the work force is on the older side—77 percent of respondents are older than 40. There is, however, room to debate whether or not there's an immediate crisis when it comes to a work force shortage. Dr. David commented that because there are no solid numbers on the actual number of MTs working, there's no way to determine if there is definitely a shortage.

Plummer disagreed with the conclusion that there's a work force shortage right now. He pointed out that Probity uses all domestic labor, and noted that all of the accounts he'd like to secure are either being transcribed in-house or by other MTSOs. When an account is landed, the MTs on that account typically join Probity, and the need for more workers is quickly met. Plummer called the work force shortage overplayed.

Eberle referred to the shortage as simply a shortage of qualified MTs, rather than of all MTs. She's noticing that many good MTs are leaving not just their positions, but the industry, and they're going back to school to start different careers. With quality MTs, we're truly lacking at the moment, Eberle added.

Hopkins echoed that, to a certain degree. He admitted it was hard to say whether or not the industry was facing a work force shortage, and said he doesn't see that happening at his MTSO, where his needs differ from some of the bigger transcription companies. At my level, where we are, we don't see a tremendous shortage of transcriptionists, Hopkins said.

He added that if he has an opening, he advertises it and that day, he'll wind up with 40 résumés in his inbox. I can usually fill a very specific position within a day, Hopkins said.

Crow, however, is worried about finding qualified MTs to support the growth of the industry. There aren't enough younger MTs to replace the retiring MTs within the next 10 years, she pointed out, and she strongly believes that there is a work force shortage. She added that new education programs are being put in place to produce good MTs, and many MTSOs are offering mentoring programs. Her company started a mentoring program 2 months ago for new MTs to help them garner experience in the field. This seems to be easing the labor shortage, according to Crow. We are very excited with the decrease in attrition numbers we are seeing already!


Salary Woes

While there may be debate over whether there's a work force shortage right now, one certainty in the MT industry is that wages aren't heading upward. In the survey, MTs reported varied personal incomes, with the majority, 72 percent, bringing home $10,000 to $50,000 annually. Another survey question asked about the number of wage earners in MTs' households, and 33 percent said that there is only one wage earner in the household--the MT.

Dr. David called the industry one of the only places where the laws of supply and demand don't work. There may be fewer transcriptionists and there's a greater demand for transcription services. [That] should mean that [MTs] get paid more, but their pay doesn't increase—if anything it goes down or stagnates—and so part of it is linked to how there's just no perceived value in what it is they do, he explained.

The industry as a whole needs to recognize that MTs spend a lot of time and money learning their craft, and if wages continue to drop or stagnate, potential MTs are going to look elsewhere—to other industries—for jobs, Hopkins pointed out. We want to see a viable pool of labor here in the United States, he said. If people can get better benefits and better wages at McDonald's, why wouldn't they go there? It's too hard to learn this business. It takes years of work to be fluent and professional.

Dr. David observed that there was a sense of unrest in the industry about salary issues. There's a number of things impacting [MTs], causing their wages to go down or be less robust in terms of going up, so it's definitely an issue that we've heard about, Dr. David said.


What's Next?

Overall, despite differing opinions on the results of the survey, everyone agreed that it could be a valuable tool in the industry. Crow said she hopes the study can lead to medical transcription being recognized as a degreed profession with mandated certification. I think once this is in place, the profession will be viewed by the younger people as a desirable health care position, Crow said.

Hopkins hopes the study highlights the fact that offshoring labor is doing what he called a disservice to the industry. I think if people focus on providing a livable wage to the transcriptionists with a reasonable package of benefits and a decent schedule, the labor pool will become deeper and broader because more people will start to come into the industry, he explained.

Plummer hopes to see more transcription programs set up at colleges to help school more domestic MTs. He also hopes the study helps companies adhere to better quality, because that could help the entire industry. Overall, he found the preliminary results to be valuable, and he noted that the industry is ever-changing. It's a dynamic study, too, because it's like painting the Golden Gate Bridge—by the time you get done, it's time to do it again, Plummer said.

Lynn Jusinski is an associate Editor with ADVANCE.



Christus Helath/MQ
Where is this hopsital located??? Are they doing MR's and Radiology??? MQ is pushing a lot of VR with radiology
Keystrokes has the best radiology accounts IMO. I have plenty of work and radiology only. nm
I make a good living and rarely run out of work. When I do, it is for a few minutes at a time and usually because the rads have not started early enough. No other complaints!
Keystrokes for radiology. They are the biggest for radiology out of all of the companies out there.
I have been there 2 years and have been very happy. I make a lot more money than when I worked for Edix/Spheris.
Keystrokes has a radiology division. They used to be radiology only but their sm
customers started referring other departments to them.

I know that they just got a bunch of new accounts!
For radiology, Keystrokes is the way to go. They seem to have the most radiology accounts. sm
I have been very, very busy since starting with them 19 months ago. No complaints at all other than one or two of the radiologists who speak at the speed of light and expect us to be able to transcribe what sounds to be a mouse on a treadmill!
article
Rochester Business Journal - August or Sept 2005.   And it wasn't all 15 years ago.... charges still pending in 1999 -- but read the article for accurate information on the convictions and judge for yourself. 
I saw that article too
They pay their MTs the equivalent of about $135/month US, which for the year is more than 3 times their national average of about $500/year US.  My electric bill is over $135/month.
Here is the article

http://www.ajc.com/search/content/business/stories/2008/05/25/ga100transcend.html


If they delete this link, email me; I have the article saved.


Very interesting article.
Sadly, the wave of the future, I suppose. I'm glad to see some of the transcriptionists spoke up, but unfortunately, people who don't understand transcription are always the ones making the decisions! Thanks again for sharing.
This was a great article.

Thanks. 


did any other HISers see this article? sm
http://www.toledoblade.com/apps/pbcs.dll/article?AID=/20060408/BUSINESS03/604080390
I saw the article...AND the CEO's pay. Yowza. nm
x
Interesting article

 In 2003, Indian employees, who were working on medical records for Ohio’s Heartland Information Services, threatened to release confidential records unless they received a cash payoff from the company.


http://blj.ucdavis.edu/article/604/#_ftn60


 


It's a slightly old article -
.
Right. That's what the article said, basically.
That all correct English is the same, wherever the country:

English in India may have a British hangover but by no means is it vastly different from American English or any other correct English for that matter.

She expects Indians working for American countries to have excellent English ... like hers. If only our visitor could write like that, we wouldn't be appalled.

what article?.....and why would I be disappointed?
nm
i looked at the article...
and it still does not clear up the line count issue for me at all. : (
Can you link this article?
I am interested in reading this and how they came up with their figures. I QA Indian reports, and maybe 5% of the MTs could pass a quality audit at 98%. I wonder what kind of guidelines they are using to get this 99% figure.
It is definitely going to India....big article
xx
Do you have Link to article? nm
nm
Here is the article - they do offshore

and seem mighty proud about it.  LG states that about 15% of the work is outsourced to India (that was in May, 2008 - number more likely 35% by now), but that the clients are in the U.S.  That was a strange quote, IMO.


http://www.ajc.com/search/content/business/stories/2008/05/25/ga100transcend.html


If this link disappears, email me.  I saved the article.


Good article.
That's right — the Franchise Tax Board and IRS come after you and, at the very least,
disallow your related business deductions.

Yikes, only one more reason not to work for the companies that treat their ICs like employees.
Link to article

http://www.presstelegram.com/news/ci_12022094


Can't bring up the article - could you cut and paste - sm
it so that we could read it??
Thanks
What is the storyline title to the article?
p
Toledo Blade article....let us know on here
if it gets published..I'm down in Lima and can pick up a copy..would love to see it..I know I can read it online but I would rather see it in the paper down here.  Good Luck!
According to the article posted, one of the proposed

Am I googling correctly, that Nuance is affiliated with both Dragon (speech recognition) and Focus Infomatics (Indian??). 


So, if Philips sells to Nuance, what are the implications?  Does Focus have American MT's?


I know these are scary questions and purely speculative at this point. 


If I understand the article correctly,

the records were stolen FROM a Transcriptionist who was subcontracting, not BY a transcriptionist, probably as a result of a computer being stolen or a home break-in, although the article did not say.  It seems the only way to prevent this type of records breach would be to keep all transcriptionists in-house.  Or am I missing something? 


Tried to get article about outsourcing from Transcend
today from the newspaper. I have to call back tomorrow, the department closed today. That might be true what you are saying but what do you think about the statement that not enough MTs in the US to do the work. I find that kind of odd because I see people on here saying they are out of work.
I just read the article. Man, those answers sure don't
Like how little MT's are paid. Like how much they expect them to know, how fast the work is expected to be turned around, and how most MTs don't even have health insurance, and have to work 2-3 jobs just to live. They also didnt mention how much editing is involved with SR and offshore work. And I think their US-vs-India ratio is bogus as well. Most MTSOs these days have more work don in India than in the US.
Deception seems to be everywhere. There was an article about a trucking cm

company that set up a dummy office in another state to license its hundreds of vehicles there to avoid paying taxes here where apparently it is higher.  I know it is not MT, just seems like Corporate America (or Corporate India) is packed with liars everywhere. 


As far as the MT part goes, I would be tempted to contact the clients and ask if they knew their work was going to India, but then I suppose that could set you up for a bunch of lawsuits.  Still, it would not hurt my feelings if they somehow ended up losing their accounts because of all of this deceit.


Ab article below that says Proscript lost a lot of their accounts. Can someone tell me about this as
I am interested in this company or at least I was.
how can i find mary K article that everyone is talkign about?
s
Do not believe that article about Spheris. You'll be disappointed.
nm
Is this an article somewhere? I thought MD-IT merged with SOAP in
s
article in For the Record - iPhone dictation
get current with the industry or it will run you down - MModal is pitching doctors to dictate and edit their own reports on iPhones...Obama's plan is to get electronic medical records rolling - and all those technology saavy students, residents, interns etc may just pick up their iPhone to dictate - they probably already have one....lol. As far as dictaphone/Nuance - the extext system is very short on being anywhere near self-sustainable as a VR - they ought to worry about their competition and quit the prediction games.
Article- could Indian Outsourcing Be in Trouble?

I wish I had kept the article out of the paper on Transcend outsourcing
The home office located (as you might know) close to Atlanta and it was listed as a top company for Georgia but was I surprised when the person speaking made no bones about their outsourcing and the reason they STATED for it, lack of American MTs. Well, ladies, who do you feel about that? I am sure someone posting on MTstars has this article because they did last time. Hopefully they can quote word for word.
They did say that, with the added "foreseeable future." Right in their own article about the
acquisition it says something about moving some of those jobs onto their VR platform, as well as stating that they plan to offshore more and more work.  So they are concerned about making lots of moola, not the MTs having jobs.  Somewhere in there it even stated something to the effect of they can make more $ by using FEWER MTs with their VR platform.  See the thread above about how the current people have no work on the NIGHT SHIFT, watch it disappear at 10 p.m. every night, even tho they said they only offshore BECAUSE nobody will work the night shift.  And yet the poor night shift worker sits there with no work and watches it go to India.  That's a travesty, especially in our current economy with astronomical unemployment rates.
Article is from 12/04/05 edition of Nashville Medical News

I found an article stating they have already spent over 6 months
already in place to take over immediately. I found it on their website if I'm not mistaken.
CBAY is Indian owned - article in Baltimore
Business Journal went on and on about how successful the Indian owner was and how he flies to India every other week to go to the office in India. I was really appalled and disgusted by the article because our American writers made it seem like Americans could not handle the work and therefore, had to be offshored and therefore, made this Indian owners a huge success in the US.
Thank you. That is a great, factual article. I hope the others read it.
nm
I read the article, it states exactly what the company always tells us...
that they offshore a small percentage of their work, and that it will never take the place of their domestic MLS. I love working at Transcend.

For someone that doesn't work at Transcend, you sure have gone to a lot of trouble to find the article and continue posting about it. Any other issues?
The Transcend article has to be accurate as it is part of their SEC filing. sm
Unless of course they are pulling a Medquist!
Article in local paper about Spheris and outsourcing to India
Franklin-based Spheris Near Top of Medical Transcription Business
BY SHARON H. FITZGERALD

In today’s world of Palm Pilots and voice-recognition software, you might think the need for medical transcriptionists is waning. You would be wrong. Franklin-based Spheris employs more than 5,000 medical transcriptionists worldwide and is looking to hire more as its service to more than 200,000 physicians at health systems, hospitals and doctor groups continues to grow.

The world is changing because the demand for electronic medical records … is very high. Certainly there are some technologies being tried and adopted, such as speech-recognition technology or systems where the physician is required to key in his or her own information. Those are still in their infancy and hold some promise in the distant future. But for right now the work-flow habits of physicians and hospitals and the need to see many more patients and process them more efficiently is driving the demand for what we do to its highest levels, explains Harry Shaw, Spheris investor relations.

In July, Spheris was named No. 7 among the nation’s fastest-growing healthcare information technology companies. The designation was by the publication Healthcare Informatics, which also ranked Spheris 28th for total revenue. The company is the second largest in the medical transcription industry.

Spheris’ growth is in no small measure due to its December 2004 acquisition of HealthScribe (also known briefly as Avicis), which was No. 3 in the field. While terms of the deal were not disclosed, Spheris gained a workforce of more than 1,800 transcriptionists. About 1,500 of those employees work at a centralized facility in Bangalore, India. Thus, says Shaw, the transaction gave Spheris a much-needed global perspective.

To service this increased demand that’s out there, having enough medical transcriptionists to do the work is a real challenge to the industry in general. One way to tackle that increased demand is to tap the resources that are available globally, he says. One of the neat things about having an operation based in India is that a lot of dictation is done at the end of the day after hours. So we get a lot of volume that comes in late in the evening, and if you follow the sun, that’s the morning time for India. They’re just starting their business day, so we can route a lot of volume that we get late in the day to India when transcriptionists are just coming to work.

Shaw says the fact that Spheris owns its international facility and employs its workers rather than subcontracting differentiates the company from similar businesses. In addition, all Spheris’ medical transcriptionists in the United States are either full-time or part-time employees of the company.

With more than 3,500 employees and additional sites in St. Petersburg, Fla., and Sterling, Va., Spheris depends on high-tech global systems to quickly turnaround client transcription. Here’s how the technology works: Spheris provides clients with a server and whatever voice-capture system the client prefers. That might be a hand-held device or it might be a phone number the client calls. Shaw says fulfillment shops ensure that the client — as well as transcriptionists — have the hardware and software necessary to do the job. Following a patient encounter, physicians and other healthcare providers dictate details such as patient history, diagnosis and medications prescribed. The voice files are sent to a data center in either Franklin, St. Petersburg or Sterling, then passed out to transcriptionists.

The technology play is critical for a company of our size, and it’s one of the advantages that we offer in terms of cost savings, he says. He acknowledges, however, the continued existence of sneaker net, with some physicians continuing to speak into a tape recorder; then tapes are picked up at the office for delivery to Spheris.

Most of Spheris’ U.S. transcriptionists work out of their homes, where they usually receive digitized voice files over the Internet. Spheris offers the client a variety of templates, or the client may have its own format. Turnaround time is 12 to 24 hours, Shaw says, although stat service is available.

As it is known today, Spheris is the result of a small Franklin company called Total eMed, which purchased the much larger EDiX from IDX Systems in June 2003. The resulting company was branded as Spheris. In November 2004, the company completed a recapitalization in which two private equity investors, Warburg Pincus and Soros Private Equity (now known as TowerBrook Capital Partners), acquired ownership. The management team, led by President and CEO Steven E. Simpson, also invested and continues to lead company operations.

Asked if an IPO is in Spheris’ future, Shaw says the company will take a cautious approach to that. We want to make sure that we stay disciplined around the acquisition of HealthScribe, making sure that we’re fully integrating all aspects of that. … We do have a growth strategy in mind, and that certainly is an option down the road.
Should Dennis Paulik and Kathy Clemmons read the article?
Should they know we will not be silent? Our voices need to be heard.
Good luck with that since the article posted from the Toledo blade
The firm had announced it would be getting out of that five-year-old business and took a $7 million accounting charge in the first quarter.
http://www.irs.gov/businesses/small/article/0,,id=99921,00.html
nm