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State of the Profession – Medical Transcription
In This Issue: The State of the Profession – Medical Transcription
For years, AHDI and other sister organizations have sought reliable information on the state of the profession of medical transcription. A report was commissioned that surveyed existing transcriptionists who provided some interesting input.
Interesting that no one really knows how many transcriptions are engaged in healthcare in the US or worldwide. However, the survey did obtain results from 3800 MTs and the results are considered representative of the industry.
In the importance of and the actual production of medical information and documentation, medical transcriptionists are often overlooked. Quality healthcare delivery often depends on the quality of the medical record. This covers not only the treatment factors of patient care, but is an absolute necessity to providers recovering the costs of treatment. Any deficiency in record-keeping may have obvious impact on not only patient care but in its reimbursement.
The Office of Medicare and Medicaid initiated a Recovery Audit Contractor in 2007 to discover discrepancies that could have impacted reimbursement to providers. As a result, in just one state, Florida, healthcare providers had to return $125 million dollars to the federal government with half the cases relating to incorrect billing-coding and revealing that one-third of the records reviewed showed the treatments provided were medically unnecessary.
As everyone in the coding and billing business is aware, doctors do not generate revenue, documentation does. Medical transcriptionists provide a majority of that documentation. Healthcare providers need to understand fully the importance of transcriptionists in their economic model.
Transcriptionists are committed to ongoing education since the learning process is perpetual consistent with the new terms constantly being added to research, laboratory analysis, pharmaceutical products and techniques for treatment and rehabilitation.
Cost pressures have forced MTs into a lower earning position which definitely hurts recruitment and retention.
Data Summary
1. Who does medical transcription by gender?
95.7% are female. However, due to the workforce replacement issues (see Number 2, more men are expected to enter the field.
2. What is the age of the current workforce?
Percentage Age range
5.6 18-29
17.5 30-39
30.8 40-49
34 50-59
10.8 60-69
1.3 70+
The results are not that surprising. The majority of the work is done by MTs that are 40 or more years of age, and 45% are older than 50! What does that mean? It means that there are grave concerns for the creation of the replacement workforce.
3. Where do MTs perform their work?
71% work at home. The remainder work at a healthcare facility.
4. Who do they work for?
MTs are employed across a range of environments, home and doctor offices, hospitals and clinics. The increasing trend toward utilizing medical transcription service organizations (MTSOs) (approximately 54%) is observable and is probably related to economics,. Of the MTSO segment, more than half are small 1-3 person companies.
5. How are MTs compensated?
* 53% are paid by how much work they produce
* 31% are paid hourly or by annual salary
* 13% are paid by a combination of hourly and production
A preponderance of respondents noted that their MT income was a crucial component to family earnings. Based on the sheer economics of a downward trend for MT income, a decided negative impact on family economic stability is becoming a reality. In point of fact, MT income has not kept up with inflation and has made it more difficult to attract and retain new MTs. However, the general stagnation of MT income has been felt across numerous industries and workforces as well.
The majority of MTs are paid using a production methodology.. Most generally, this is calculated “per line”. For several years, efforts were made to standardize what numbers constitute a line, or how many lines are typically on a page.
Other factors new to the MT traditional job include the use of speech recognition technology. That advent resulted in a decline of the traditional line rate payment averages. VRT requires the MT to read rather than type resulting in a decrease in the line rate. In fact, it takes far less time to proofread and edit a patient record, so some adjustment would be reasonable. There is also some hesitancy among older MTs to learn new technologies associated with editing.
6. Where did MTs learn their skill?
* 53% received formal training
* 47% received no formal training (self taught and on the job)
Based on the statistical nature of the age group, it is not surprising that only 53% had formal training. Of the younger group (30 and under), it is probable that a much higher percentage received formal training.
7. Other significant factors.
* Number of dictators
The other significant aspect of the MT job is the number of doctors for whom they are transcribing and editing. The study group reported by 59% that they transcribe for multiple doctors (and multiple specialties).
MTs must become accustomed to a variety of healthcare dictators and their proclivities. This is all too true for those who have rather poor dictation habits. Over time, MTs develop an “ear” for dictators that enables them to complete the jobs more quickly and accurately. However, it takes time to develop that proficiency.
* Variables in report formats
The other complicating factor involved in the training-learning curve is the lack of standardized reporting formats so that an MT must learn a wide range of styles and protocols to suit individual clients.
FUTURE MT
Medical transcription is estimated to be in the $15-20 billion range annually with a double-digit growth rate. It is estimated there are as many as 400,000 transcriptionists working.
* Need
The Department of Labor estimates the current need for immediate workers is in the 6,000 person range.
* Standardization of dictation and formatting
Common document formats would be a major improvement in learning and the retention of staff. Though a more difficult project would be to have doctors conform to more standardized ways to talk, adoption of a relatively standardized format would be a step in the right direction.
* Voice recognition technology
Speech-recognition technology is merely a transcription tool, not a transcription replacement. The “editing” process involves a need for experienced professional intelligence and logic that essentially will prevent that technology to replace traditional medical transcription.
Summary Points
* Quality healthcare often is dependent on quality medical records.
* Doctors do not generate revenue; documents do. Accurate and complete healthcare documents are essential to a doctor’s and institution’s revenue cycle.
* MTs as a group are committed to education and training.
* Economic factors have resulted in MTs earning less which affects recruitment and retention. Efforts should be made to stabilize and facilitate the professional nature of the work performed and pay accordingly.
* Common document formats are a high priority as well as some effort to improve manner of dictation.
* Speech recognition is a tool, not a replacement for a key person with the required knowledge to effect an acceptable medical record.
Medical transcriptionists represent the future workforce with its challenges and technological advances. It should be approached as a worthwhile challenge.
The survey itself was conducted by Bentley College under the leadership of Gary David, PhD.
