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Serving Over 20,000 US Medical Transcriptionists

There would never be a valid reason to go to her clients - ever. sm

Posted By: Blu on 2006-02-06
In Reply to: Thanks again, I appreciate your input... - Experienced MT

Remember - those clients are her bread and butter. HER business is to protect HER BUSINESS. Late TAT one time would not be enough reason to stop using your services. Late TAT enough times that SHE is getting uncomfortable with the client is ample reason.


You have no business relationship with the clients. Your business relationship was with the MTSO.




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Another very valid reason
First let me say, I am so sorry for what you have been through.  I hope and pray you find your child.  This is just one of multiple reasons credit reports should be personal.  The next thing you know, they will want sexual histories before hiring someone.  It is just PERSONAL and PRIVATE and should be respected as that.  I wonder how many companies that do credit reports for potential employees would like to have credit reports pulled on their business practices.  Really, again, it is private and very personal.  I believe every one has good intentions until proven otherwise. 
unfortunately, you have a very valid point sm
and unfortunately, there is nothing we are going to be able to do about it. Of course, we can choose to shop at American owned stores-I do-we can choose to speak to Americans only-never tried asking for an American, but in the end, this is all a futile effort on our part! It's the wave of the future, and the bottom line is all that matters to corporate America! That's why we have to bring up our children with good values, excellent work ethic, and high moral standards, so that when they get out into the "real" world, they can out perform the, um, what do I call them, foreigners!
Is this a valid thing? sm
All of a sudden one day this box appears at the bottom of my computer stating....Repair Registry Pro has found 466 errors, click here for more information...I clicked it and it wanted to charge me a lot of money for this...I think maybe it is something not like a virus but not anything good either.  I clicked on Microsoft website to see if I could find anything about this, and while there ran some tools to see if I had any errors which it did not report any.  Has anyone ever came across this and is it legitamite (sp?)?
Your concerns are valid, unfortunately : (

EMR and voice recognition has put me out of a job.  On my former job, there was one other Transcriptionist besides me.  Because she had been there longer, she got what was left over after most of the docs jumped on the voice recognition bandwagon.  They use Dragon Naturally Speaking.  I have seen it at work myself and it is quite accurate.  There is no editing being done on their work.  Now, I'm doing a job that is just that, a JOB.  I enjoy transcribing and am looking for another job, but MT jobs seem to be few and far between where I am.  I can't get high speed internet where I live, so most services are out.  I may move onto a different career if something doesn't come around soon.  I thought about legal transcription.  Anyone have experience with that?


 


valid point
This is a valid point and I am not happy with the cut in pay either. On the other hand, I do love what I am doing and accept that it will take some time for me to reach my full earning potential, although I am not too sure it will come to the 41,000 I made in the past. The point I am making is that although it is a cut in pay, I am still paying the same household bills I was contributing to with my other employment, although it is not as easy and I have never been the type of wife to rely on her husband for pocket money---I have always had my own and this has not changed.
It's a really valid question.

I've seen a lot of posts on this board from MTs who said their accounts went to EMR and they were out of a job.  I haven't experienced that, though.  I worked in house for an oncology practice that had a software program that was designed for EMR but everyone still dictated.  The account I'm on now has EMR and they'll put things in the dictation for the meds, and review of systems that say "detailed review of systems in electronic medical record" or that the meds have been updated and a full list is in the EMR. Other times they dictate the med list and dictate a review of systems.


Personally, I don't think it's ever going to completely get rid of us.   There are still too many variables in some reports.   We may end up not typing things like cataract reports, or some surgical procedures which are pretty routine, but things like H&Ps, consults, discharges, and office/progress notes are still going to need something more than point and click.


That's my experience, anyway.


Definitely not...how do you know if it's a valid complaint?...(SM)
This happens very often with abuse claims. A case is started, the claim is false, someone's reputation is wrecked, and it costs them a fortune in legal fees to restore it. If you are worried she is not getting help or advice, the only discrete way to find out is fake a spontaneous meeting and get into conversation with him/her and go from there. You could never let it be known that you read her/his records...records that she thinks are confidential. (Boy, are a lot of people in for a shock.)
My license is valid again. Yay! I called the

numbers on the suspended license notice this morning and was told to go to the courthouse, which I did. I told them I was contesting the ticket because it was not me who got it but I know who did get it. I explained what my sister did and the lady told me to go to DMV and file identity fraud charges where I fill out a form saying someone is using my name and give their name if I know who. That's done! She also cleared my name in the computer and gave me a copy of the ticket which says issued in error. The ticket was issued at 3 in the morning so she's lucky she didn't get a DUI on my name. The ticket shows her car and her license plate number. Gee, wonder how that happened? I now have a court hearing middle of September where I explain my case and the officer who wrote the ticket will be there. You can bet I'll be bringing life size photos of her to show that it wasn't me. Now I can breathe again, at least until September.


Tried to e-mail and said addy was not valid.
Most likely you would need a USB pedal or an adapter to convert any other type of foot pedal.  There are numerous options available as far as internet - cell phone, dial-up, WiFi, satellite, air cards.  It depends on how you will be traveling and where you will be staying.  You need to have a primary plan and a backup. 
You make some valid points; HOWEVER,
telling an MT to use the BOS is not really helpful. Many of us transcribe "verbatim" accounts where we are told to reference the BOS. Scuze me, what's the line between verbatim and the BOS? And if the BOS says one thing but the client specifics say another thing, then what? Pretty much NOTHING in this business is standardized. Not pay, not line count methods, verbatuum vs nonverbatim...

As far as looking things up, I will look for a name or address (if I'm given enough information to do so) for 2 minutes. I'll relisten to a potential blank 3 times on its own and then in a final run-through of the entire report to see if I can get it by context. But this is a PRODUCTION job and I do not get paid to spend all that time looking things up.

And there are a lot of words that really are not words that doctors use. What do we do with those?

I've been doing this 12 years and still occasionally run across things that are wrong that I was told to "do it this way" by one client or another along the way and the "wrong" way just stuck. I'm always happy to have those pointed out so that I can correct any old bad habits...

But here's another thing. If we, as so many of us are, are required to work on 3-5 accounts to get the equivalent of full-time work, and those 3-5 account all have different specs, then it should be expected that screwups are going to happen.

Again proving my point that NOTHING is standardized and the BOS is, at its best, a fundraising tool for the former AAMT and, at its least, a very general sort of guideline.
Know is old post - but valid concerns

I don't kow what they could do to help you RE: Katrina but companies need to verify the NEED to cut back or do it across the board, at least in the department / job level. I worked for this company for 6 yr & had several cuts in my take home. The platforms used became slower & slower because of the amazing amt of data in the programs. I had 3 gig memory & STILL took forever & you aren't making a dime for that several minute while a report is sending & the next coming in & then doing the demographic page.


I've been trying to find out if there was anything of that investigation - I never did get that paper that so many other employees got. And I had a definite beef.


you raise such a valid point...
"If money is your goal"...

I too thought about the nursing program... It's really the only other thing I could see myself doing long-term... but I don't want to give up MT because of all the freedom I have. Granted, I get no benefits, it's hard to scrape by sometimes, but I basically get to do whatever I want as long as I meet my TAT...

Money, however, is my goal for the things I want to continue doing. Plus all the money I'd go in debt for for schooling... will it ever equal out. I just feel like I'm too old to start a career, by the time i want school over with i would hope im married with a baby. HAHA

Oh I Hate being indecisive!!!
this was maybe 20 years ago valid, but not nowadays
with such a low line rate and VR, when transcribing's speed has to be tripled to get the same pay.

Newbies can still learn and profit from the answers given on the word help board.

CHANGE is inevitable in every field.
FYI - Internet petitions are not valid in most
x
Plenty of room here! Your thoughts are as valid as all the others.
.
Her points are valid, true, and very appropriate to discuss here.
The only thing I would add to that is that in addition to discussing this age-old medical "dirty secret" here, it should also be discussed with anyone and everyone, until the issue can be brought to the forefront in the medical industry. A lot of terrible medical mistakes are being averted because of skilled MTs catching them.
We are an important line of defense in the medicolegal risks every doctor & medical institution faces every day. Yet because very few people know this profession even exists, we're continually being kept in the medical industry's darkest closet, and many of them get their hides saved from financial ruin every day -- literally at our expense.
Bitter? I think the recruiter/owner had some valid points. nm
x
To get own clients or not....
I have thought about getting my own clients, but working for a company, if I want time off, I can easily arrange that and know there will be co-workers to cover the accts.  If I get sick, the company will find someone to cover the accts.  I don't have to worry about the billing, tech support, trouble-shooting, complaints.  Maybe someday I will chose to give up what life I have and get my own clients, but for now I like being an IC for a company.  This way, I am a great employee and an even better boss. 
My clients...
Consist of clinics.  They all get 48-hour turnaround time guaranteed, and anything STAT (a TRUE emergent STAT) they need, it's done at no extra charge.  Radiology gets four to eight-hour turnaround for obvious reasons.  The rest of the clinics don't need a 24-hour turnaround time because let's face it, their staff basically sit on it, and I'm not going to break my neck so they can just sit on it....
Clients
Hello!  I'm new to the board but not to MT.  I've been working from home for my own clients for 10 years.  I wondered if others who do the same have ever experienced a situation I just encountered and wondered what your thoughts were.  I had a client whom I transcribed for for two years, then he moved and started back up in his practice and called me and I've worked for him for an additional year in that new practice.  When I noticed recently that I hadn't received his dictation as usual, I questioned it, i.e. was he on vacation, did they lose a tape or what?  The receptionist said he must not have dictated yet.  I found this off as he usually dictates each day he's in the office.  A week had gone by w/o work so I called and asked and the same girl said she'd have his wife (who works in the office) call me because she didn't know why there wasn't work, etc.  At this point I got suspicious and had asked the recep. if there was something going on I should know about. She said they're working on this new software and maybe they just got behind.  New software? I talked to his wife and "I" mentioned this software.  She didn't.  I asked if this affected my workload and she said 'yeah, probably quite a bit.'  I asked if she would please let me know AHEAD of time if they were going to make this transition so I could prepare and plan (she had just made it sound like they were just looking into it and kind of testing it out, NOT that they'd by any means started using it full-time).  She said oh certainly they would let me know ahead of time.  Then I pressed a little more and finally she told me he'd already been using it for his patients and when I asked if I should replace his work, she said yeah, probably because he really seems to like it and will probably use it.  I don't know what the software is but I hate it just because it took a big client from me.  But I"m also wondering if this is common practice for a physician just to outright not tell an MT that they weren't going to use their services any more.  I mean, not only did they not give me notice beforehand, but they hedged on admitting it when I came right out and asked.  I find this incredibly rude and inconsiderate, especially when I've been a faithful MT for them for three years.  I"m just dumbfounded at this behavior.  Has anyone experienced this?  So now that leaves me in the lurch with bills to pay with an already tight budget (hubby in college, two kids, high heat bills, blah, blah, etc.) and me looking for work to fill in the gap.  Sorry I ranted and rambled.  I'm just really upset by this and wondered if anybody experienced being treated this way and/or knows what this software might be and if it poses a threat to any of us.  Thanks so much!
Own clients
This has been discussed many times with many different opinions/ideas.  You might do a search as there was quite a heated debate on this about two months ago.  I have a brochure that I send out with my card.  For those I am very interested in I do stop by in person or if anyone calls inquiring I stop by in person.  You have to be prepared with equipment to do tapes or digital and some may inquire about a call in system.   You may have to pick up and deliver, provide your own paper.  Be prepared to do any type accounts.  Your rate will depend on the area you are in and can be anywhere from 11 to 16 cpl from what people say on this board.  You have to be prepared to have some back up if you get very sick or have an accident and for vacations.   You will not get any benefits, will not getpaid when the doctor takes a month off to go to Spain.  It will be a tough go at first until you esablish a rapport with the office staff.  But I like it and have been doing it for 18 years.  Just did a report and have made 4K more this year than I did last year so things are looking up for me.  Good luck.   Patti 
One of my clients for whom I have done only
tapes for has given me a CD to load onto my computer.  I haven't put it on yet but I'm wondering if you all can help.  It's an Olympus CD and looks like it's for .wav files which is what he intends.  He says I should be able to load this onto my computer and then after that, he can email me voice files.  Now, is this correct and what will I need to have in order to play and transcribe his voice files?  I have a Bytescribe pedal. Please tell me I won't have to buy a different pedal for this! Thanks in advance for any help!
want to get own clients

Hi Everyone,


 


I have over 2 years’ experience in medical transcription and really want to get my own client(s).  I feel that I am finally ready to take that leap.  The question I have is – how do you go about talking to potential clients?  What is the best way?  Mailings, calling, just going in?  Should I make business cards?  Unfortunately all of my doctors offices (family, ob/gyn) husband's GI doc and daughter's pediatrician are all EMR.  Ugh.  So that's no help. 


 


I’m not really afraid of what to charge or contracts, the rest is what has me stressed the most.  Should I buy a program like DocShuttle or will they basically tell me what they want?  I have been with nationals and small  MTSOs alike and just am not sure how to go about everything myself. 


 


You can feel free to e-mail me with any advice also.


 


I really appreciate the suggestions/help!!!


Getting own clients
I am currently transcribing for GI docs who are using the EMR system, I love it. There is barely any paper for me to handle, I fax everything right from their system to the referring physicians, once in a while I will get a physician who doesn't have a fax and so I need to mail. The final copy goes right into their system. I am currently working from home through my business. They had the equipment installed at my house, fortunately for me, I was with them for four years before I went on maternity leave and have been doing it from home for the past two years.

I also transcribe for ENT docs in my area, before I went on maternity leave I asked them to use my digital phone in system (really didn't expect them to since they were 'set in their ways' but they agreed).

As far as getting new clients, I would get some business cards printed out, and some fliers stating what equipment you will use, i.e. tapes, digital; will you be dropping the finished work off, and also turn-around-time. Then if it were me, I would take these to local doctors, speak with the office manager and offer your services, may be you can start off by offering to cover vacations (I know how hard it is to get coverage for yourself on vacation. You might have to start small and work your way up, but at least it is a start.

Well that is all I can think of, I hope this is helpful to you. Good luck!!
Best way to get clients? sm
I want to market my service in my area. I have gone to offices before in the past, but they sometimes get annoyed. I have also done mailings and get no response. Is there another way to get the OM's attention that maybe I overlooked? Any suggestions would be appreciated.
Some clients won't go there
Some doctors have such rotten dictating habits they know running their reports through ASR will result in utter garbage; they have TAT to meet and they know if they take the time to have those reports extensively edited post ASR its just an extra step.  Some clients know for them it will be a time and money waster; it is the MTSOs that are pushing for all ASR, not the clients.  Many hospitals have tried ASR inhouse and end up scrapping it and going back to MTs.  Its a lot like outsourcing in that many people are on the bandwagon, but there'll always be some that refuse to ride it.
Clients have the right to not have an
MT transcribing that reports if that MT continually makes mistakes. Not talking about the ones QA catches, but the reports that are sent straight through without QA and they catch the mistakes on their end and have to send it back. The client I am assigned at my MTSO has said that certain mistakes will not be tolerated and those that make those will not work on their account. They have the right to pull the account from the MTSO if their wishes are not followed by the MTSO.
getting own clients

Does anyone have a sample letter that I can look at to try to get my own accounts?  I would really appreciate the help if there is anyone willing.  I just need something to get an idea of what to cover in a letter just to get my foot in the door.


Thanks in advance.


I don't have any of my own clients...sm
so I have never had this problem. They said you were no longer transcribing his letters. Does that mean you are still transcribing other types of reports for him or is that the only type of report you did for him?
If the secretary called you before and asked questions about "How often ARE you coming to get work" or something to that effect, then it leads me to believe he was not happy with you for some reason. Sounds like he found someone else to do his work. He could have found someone to do it cheaper, who knows? I hate to hear you lost this client. I know money is tight.
Why not just get your own clients?
Just curious why you would rather subcontract when you could just get your own clients and make more money instead of paying a middle man.
I just heard clients are now
very interesting, indeed.
Finding Clients
I had gotten my previous clients when I worked in a hospital Medical Records Department as an MT. The docs just came to me and asked me to do their work at home. I am going to have a professional letter and business cards made up now to send to local doctors, just anyone in the phone book who looks good, but mostly cardiology, neurology, neurosurgery and orthopedic docs. They seem to have the most consultation letters.
Contracting own clients
It's actually two units attached and working together: A Sony BM-890 microcassette dictator/transcriber and a DTI-800 phone interface. I bought the unit (years ago) for about $1,300.00. The top unit (BM-890) is where you put the tapes in and is like a regular Sony transcriber. (I transcribed the tapes on a separate transcriber, though). The unit gives the doctors the option of pausing and backing up to listen to their dictation and make changes if needed.
Contracting own clients
I agree - to make good money, you need to get your own accounts. My long-time cardiology group account just got EMR with VR, however, so I need to find a new account now. This one was really nice in that the doctors dictated over their phones to my Sony answering system, and then I would just e-mail the completed work back at the end of the day for the office to print it all out there; I never had to do any pickups of tapes or delivery of hard copies. Just wondering now, is this very unusual, or do others here have similar arrangements? Thanks.
None of my clients have no idea what a CMT is...
Seems like they should spend more time/money educating doctors about the mere existence of CMTs instead of rolling out another level of certification.
Ditto! What do clients think when they -
It appears as though the majority of this company's managers don't even know how to type! Must look awful if they use emails to communicate with clients!
I would just tell your clients that you have expanded, now
having 2 branch offices and that all invoices are being generated out of your new office and that is where payments should be made.
One of my clients uses Chartscript
It is a little confusing at first, but once used to it, it is a breeze. You just have to be careful because the system is picky about what it will accept, such as no % signs, but rather spelled out, etc. Not hard. If I can do it, anybody can. :^)
It COULD be a lot worse. And clients and QA are much more likely
to comment on obvious padding than grammar errors, so I'd keep my head down if I were you. Just do it the right way. You say there is no QA, but if you get yearly reviews or anything, do mention you would appreciate any feedback on quality that they were able to provide. But I'd rather work with somebody who is padding their reports a bit than somebody whose work is full of grammar errors or real medical errors like I've seen so much of in the hospitals where I have worked.
For people who have their own clients....

Do you bill monthly, twice monthly, or bi-weekly?  I have work from a hospital coming soon and wondered how most people bill.  Also, while I'm in the process of making up a contract, what would you say is the norm in terms of the percentage you would charge if they were late in paying you?  About how long after you send the bill do you expect to be paid?  I know all of these things are negotiable, I would just like some feedback on what others are doing as this will be my first contract.


Thanks a lot! 


 


"stealing" clients
Actually I DO believe what you did here was unethical. And it is the exact reason that noncompete clauses get created. Any MT who is contracting with a service has no business going straight to a client UNLESS they have been asked to do so by the service they work with. To do so and then make an attempt, successful or not, to take that client away from the service does smack of ethics that I wouldn't want to be associated with personally.
These are not local clients.
They are nationwide clients. I provide digital dictation access.

I also have QA contractors that are included in my overhead costs as much as the MTs.


It's always been my experience, with your own clients...sm
you can produce many more lines per hour (as you become so accustomed to them, you know what they'll see before they even do). On the other hand, when I have worked for nationals, my production is way lower because I have always been tossed around to different specialties. Those account specifics for each specialty (worked for hospitals through nationals, combined with the templates, looking up referring physicians, etc. will your eat your productivity up. You have to weigh the pros and cons of having your own clients or working for a company. My wrists, hands, and neck are starting to wear down after over 20 years of this. I certainly don't miss the overhead costs of having my own clients, estimated taxes, etc. I used to be able to whip out 2,000 lines a day easily with my own clients, now I do 1,000 per day with a company, and I am quite content with that because I can no longer stand being strapped to a computer for hours and hours. I think my kids (now grown), thought the desk and computer were a permanent body part of mine!
ah, but just because your clients don't follow BOS,
nm
Questions about getting clients. sm
I want to get a client and was hoping to get some suggestions on what has worked best for others.

I was wondering how I should dress when going to an office to give out flyers. I was wondering if flyers were a waste of time. Any suggestions to help get my services noticed would be appreciated.
private clients
It is refreshing to see normal expected amounts given to other MT. So often I see "I would not expect less than 10.00 per page and such high line counts" I believe the misconception by many is that you can make a bundle with little effort given some of the "I won't do this" attitudes. When looking for your own private accounts, think about who they are, where they are coming form and who did them before and assess accordingly. And keep in mind you may have to negotiate and get a bit less but your first client and everyone after is your own - which is a good thing
You get your own clients, then you hire them...sm
MTSOs are paid on production, too, so most simply cannot take on the task of training a newbie. If you think that's a good business plan, get some clients and give it a whirl. It's just not realistic to expect MTSOs to train inexperienced MTs and still have enough hours in the day to handle other aspects of the business, as well - and still make a small profit of some sort.

When I see suggestions like this, I have to assume they come from someone who has never even run a business before. It's easy to sit on the sidelines and make suggestions when you have no idea what is involved. The MTSO doesn't just sit on his/her tush and eat bon-bons while the MTs type their fingers to the bone. There is a LOT that goes into running a successful service (key word successful). The lucky MTSOs find enough help to where they don't have to transcribe and can handle just the business aspect, but many aren't that fortunate and still do a good deal of transcribing along with that.

Besides training those inexperienced MTs - and that's a full-time job in itself, believe me - you will have to proof their work very thoroughly (which will mean a full listen on all sound files to ensure accuracy or risk losing your clients altogether). You will also be responsible for tracking and assigning work to the MTs, scurrying to find help when someone decides they'd rather go shopping than work that day (happens more often than you might think), handle payroll and tax documentation for each individual client and each individual MT, invoicing and billing your clients and tracking payments, maintenance of equipment and supplies, handling client phone calls and concerns including next-to-impossible "tech support" questions from clients that really just don't understand the equipment, etc., etc. The list goes on.

Keep in mind, while you are training the inexperienced MTs, you will also need to do a LOT of transcription yourself. Most inexperienced MTs will take all day to finish one 25-minute file, so you will have to transcribe many lines yourself to meet the client's TAT if you want to keep the clients. Since it takes most people at least a year to finish MT school, you can count on keeping up this pace for about that long. And it would probably be more like indefinitely since everyone learns at a different pace.

You will be putting in at least 12-hour days, assuming you are fast and efficient, and you will rarely get time off. If you do take time off, it will be without pay and when you return, you will have so much work piled up that you'll spend the next 2 weeks working around the clock to get caught up.

I'm all for keeping it in the USA, but you cannot seriously expect companies that are also paid on production to train newbies. Would you expect to be trained from the bottom up to be a plumber? Doctor? Dentist? Lawyer? Why do so many MTs think they deserve to be hired without any skills?

If you are up to training inexperienced MTs on top of all that, knowing full well that you will make next to nothing in pay yourself after you pay said MTs at least 7-8 cpl, then knock yourself out and be sure to let us know how it goes!

If I wanted to train inexperienced MTs, I'd start an MT school. Yes, we were all new and inexperienced at some point, but since MT has gone to production pay and offsite, most are not trained OTJ anymore. It's just not feasible, no matter how good your intentions. Even the "experienced" MTs require some training on account specs, so most MTSOs lose money in the first month or so of hiring, but there's no way any smart businessperson would agree to that indefinitely.

If you want to keep jobs in the USA, get adequate training and act professional. Don't accept rotten line rates, even if it's just "for now," and don't turn in work with careless mistakes. Don't say you'll work but then call off because you'd rather take Little Mary and Johnny swimming because it's a nice day. Don't expect special treatment just because you're a mom - many MTSOs are moms, too, and are working long hours and sacrificing time with their own families in order to make sure the clients are happy!! There is no option for MTSOs to just blow work off for the day, because if they do, they probably won't have clients come the next day. Clients won't put up with it since they can just get online and find another service willing to do the work (and more often than not, they don't even have to do that becuase services are marketing to them regularly).

It's not even about offshore competition. It's about changing the way MTs are viewed on the whole. Act professional and you will be treated as a professional. It really is that simple the majority of the time.
And I might add, wondering where all those clients would go
and if the MQ has a heads up to those clients. What about patient care? We all are thinking of ourselves that that platform is down. What about the patients who are not getting their H&Ps and STATS into the chart? Man, if I owned an MTSO, I'd be calling all over the place to see if anyone needs a new supplier for good transcription. Just IMHO.
That's way too low for IC with direct clients. sm
I live in a small midwestern town, so believe me, line rates aren't splendid here but as an IC, you should charge at least 10 cents per line. However, you should add up your expenses, i.e., supplies you'll need, gas if deliveries, etc., and figure out what you need in order to turn a profit on top of that. If a practice won't pay 10 cents per line, you don't want it because they're just looking for a bargain and the first person that walks in quoting a cheaper rate will have your job. JMHO as someone who has dealt with direct clients for almost 10 years now.
It seems like a lot, but I have demanding clients
who don't telecommute, so I have to drive 44 MI each day to pick up and drop off.  I have to print the original note and any copies, print envelopes.  If they call and need something ASAP, I am expected to drop everything and type and fax it to them.  If I am out sick or on vacation, I am not permitted to subcontract it out to another MT.  It sits until I get back and then I am expected to work extra hours to make up the work.  There are only a couple of MT's, who work from home, and we are supposd to complete dictation for 9 Drs/NP's in 24 hr turnaround.  Also, I am supposed to abbreviate as much as possible to cut down costs. 
I'm not giving my clients away, plus
up tapes twice a week; neither one of them will go digital.  You would like the pay on one though; they pay me for blank lines, which is great.  I do wish you luck on your search.  I didn't say they were "pain in the butts," but just simply stating that 8 cpl not to have to deal with the administrative end can be worth it sometimes.  I'm on the East Coast.