Let's Talk About...Credentialing Our Industry Leaders
AHDI President-Elect Sherry Doggett and Kristin Hagen, CPHIT, CPEHR, CPHIE, AHDI-F, have written the latest in a series of open letters to healthcare documentation professionals. The letter is entitled, "Let's Talk About...Credentialing Our Industry Leaders." In their article, Sherry and Kristin address what has become the topic of some, shall we say, "spirited" conversation on some online MT-related venues, and that is whether or not AHDI board members should all be required to hold a CMT credential. This conversation is particularly relevant in light of the resolution passed in August 2010 by the AHDI House of Delegates advocating for mandatory credentialing of all healthcare documentation practitioners, with the obvious implication that the AHDI Board of Directors should lead by example.
In their letter, Kristin and Sherry make the case for the need for directors holding credentials other than the CMT. They point to the decision by the membership in 2007 to change the name of the association while broadening the membership base to welcome practitioners from other healthcare documentation-related fields. Sherry and Kristin also point out the value of having directors with a variety of professional backgrounds and skill sets as a means of moving the organization forward in a rapidly changing healthcare environment.
The discussion surrounding professional credentialing in the healthcare documentation field will continue with an AHDI Town Hall meeting on Tuesday, May 17 at 4 p.m. Pacific/7 p.m. Eastern. The online webinar will be hosted by Brett McCutcheon, CMT, AHDI-F, and Lisa Williams, CMT, AHDI-F, and will give attendees the opportunity to weigh in on this important and timely issue.
Jay Vance, CMT
AHDI Lounge Administrator/Moderator
In their letter, Kristin and Sherry make the case for the need for directors holding credentials other than the CMT. They point to the decision by the membership in 2007 to change the name of the association while broadening the membership base to welcome practitioners from other healthcare documentation-related fields. Sherry and Kristin also point out the value of having directors with a variety of professional backgrounds and skill sets as a means of moving the organization forward in a rapidly changing healthcare environment.
The discussion surrounding professional credentialing in the healthcare documentation field will continue with an AHDI Town Hall meeting on Tuesday, May 17 at 4 p.m. Pacific/7 p.m. Eastern. The online webinar will be hosted by Brett McCutcheon, CMT, AHDI-F, and Lisa Williams, CMT, AHDI-F, and will give attendees the opportunity to weigh in on this important and timely issue.
Jay Vance, CMT
AHDI Lounge Administrator/Moderator
Credentialing will never have credibility when given to people with little or no experience. Experience is what makes a true transcriptionist. Ask any service owner. You may have a CMT but if you are new to the field that means nothing. If you give the test to someone with less than 5 to 10 years of experience -- it is not worth anything. I asked this of someone I used to work for and she said she had more trouble (per her experience) with workers who had CMT than those who did not. They were, by history, less qualified and had less experience. You need to have some "meat" behind this for true credibility -- and that will always equal experience == not testing.
Y'all are missing the point again. Board members should hold some sort of credential that gives them credibility, and maybe now that we have "evolved," LOL, they don't need a CMT. But then you can't go telling MTs they need a CMT or an RMT and you certainly don't make a case for credentialing. And why is it that AHDI doesn't post information like this until they are outed by other "online MT-related venues"?
One of these ladies is an educator and, regardless of all the great credentials she has, should be required to hold a CMT. Instead of writing rebuttals, maybe they could spend their time studying and just go get their CMT designation so they can continue to tell us how valuable it is--because if it truly isn't valuable enough for our leaders to have, I'll let mine drop and stop spending the $$ every year for CEs.
I just cannot take it seriously when you're telling me to get the CMT yet board members do not have it. I am well educated and hold multiple certifications in the healthcare career I had prior to being an MT. What this looks like to me is that the CMT should be required unless it is inconvenient and right now requiring the CMT of board members is inconvenient. I just cannot take any further cries from AHDI about mandatory credentialing seriously. As a professional organization, this should be plainly embarrassing. In all the posts and articles Lea has made about mandatory credentialing I have never once read her write that a certification in something related to MT would suffice. I could take this article a little more seriously if it was written by a CMT as well. How do the board members who hold the CMT feel about this? Of course two members who do not hold the CMT don't feel they should have to. We need an organization that is for the MT because this one no longer is.
I've been a proponent of mandatory CMT/RMT credentialing, have encouraged my staff to do so, have led study groups for the same, and have always been proud of my CMT--even feeling like it has led me to opportunities I may not have had without it. I'm done. If the board feels it is unnecessary for leaders, then it is unnecessary for MTs. It's really too bad the board decided to let the non-CMTs write the article as well--doesn't really lend itself to validity, you know?
The part I find most interesting in this letter is this:
"Given the fact that our association opened its membership doors (and access to leadership
roles) to anyone with a vested interest in healthcare documentation, it only stands to reason that we will see an influx of members and leaders who work in related domains and hold credentials in those areas. Requiring all leaders to hold a CMT would be restrictive and
unreasonable. We’re not suggesting coders, for example, hold a CMT credential in order to
participate in our organization. We would ask those coders to support our goals for
credentialing and demonstrate that by holding the credentials relevant to their scope of
practice and contributory role in health care."
I am sitting here looking at membership data from March 2010 through Feb of 2011 ... where exactly is this influx of members and leaders from related domains? It is sure not reflected in these membership stats. I don't see any big influx of coders or HIM/IT folks joining at all. Don't they have their own (much larger groups than AHDI) organizations to join, groups that work exclusively for their benefit, groups that are not attempting to scatter their efforts over the entire spectrum of documentation folks, sort of hoping to catch someone in the cast net as it were?
If AHDI is going to continue along these lines then I think it needs to spend a little more effort at letting the working MTs (the ones they keep insisting should join AHDI) that they are not really an MT organization anymore. As such, it kind of sounds like they don't have any right at all to even try to make the "you must have the RMT/CMT" in order to work requirement mandatory for anyone right now, and for sure they really don't have a right to be making standards for any of those other professions they think are going to flood the membership at some hypothetical point in time. So who are they working on behalf of, exactly, and why do they seem to expect working MTs to be willing to pay the cost of working for those other professions instead of their own?
Most MTs I know wish to belong to a group that is actually working for them ... not coders, not scribes, not IT or HIMS people. I think maybe AHDI needs to straighten out this identity crisis before it starts setting standards for anybody or worrying about who is credentialed in what.
I'll let our board members respond to the statements made here about the necessity of all AHDI board members holding a CMT and what the board and nominating committee position on that subject is.
Someone mentioned my articles above, and I will personally clarify my own position and that is that if you spend the majority of your day (1) doing medical transcription, (2) editing transcription or SRT drafts, (3)doing QA on the work of other medical transcriptionists, or (4) educating medical transcriptionists, you should be credentialed (RMT for level 1 work, CMT for level 2 work). If you aren't working as an MT but work in some other HIM role, it makes little sense to have MT credentials or for us to require them - no matter who you are or what position of leadership you hold in the association. Again, that's my personal position and one I advocate for from my executive position on staff every day.
I am hopeful to see our education approval process include a requirement for CMT educators, but that takes consensus among the employers and educators who shape our model curriculum and our approval policies. I know they are mindful of making that requirement so onerous that no one can qualify for approval, but I believe a transitional strategy to move schools toward that goal is critical.
Finally, I did want to address the comment above that this letter was put out because we were "outed" by another blog. If you will go to the Let's Talk About page on the AHDI website, you will see that this later was slated to go out from the beginning of our series. All of those letters and Town Hall meetings have been on the schedule since February. It just happens that the election of our new President-Elect generated dialogue around her credentials the same week we were scheduled to release this letter.
The fact that we have a couple of board members without a CMT has been "out" for awhile now. I also think it's worthy of some mention here that those board members were duly elected by our members. If members felt strongly that their lack of a CMT credential (despite their divergent work or credentials in other areas) was a deal-breaker for leadership, I would have to assume they wouldn't have been elected. As always, a stronger, more robust field of credentialed board candidates would render some of these discussions moot.
Lea M. Sims, CMT, AHDI-F
Director of Professional Programs, AHDI
Nae, I believe you hit the nail on the head. AHDI needs to address the existing identity crisis.
Either we accept we are the American Association of Medical Transcriptionists and consider its opportunities and limitations:
Opportunities:
• Strengthens our desire to support the RMT/CMT credential
Limitations:
• Is this too narrow a focus and really viable long-term?
IF we desire this course of action then it would make sense to require our membership/leadership to have their RMT/CMT credential.
OR we accept the need to broaden our reach to focus on the roles needed to protect the integrity of healthcare documentation and consider its opportunities and limitations:
Opportunities:
• Larger membership base – i.e. MTs, billers, coders, etc.
• Louder voice
Limitations:
• Welcoming and equally representing others and in some sense…moving away from our current membership base
IF we desire this course of action then it would still make sense to require our leadership/membership to be credentialed, but view a variety of credentials in the same light.
"I also think it's worthy of some mention here that those board members were duly elected by our members. If members felt strongly that their lack of a CMT credential (despite their divergent work or credentials in other areas) was a deal-breaker for leadership, I would have to assume they wouldn't have been elected. As always, a stronger, more robust field of credentialed board candidates would render some of these discussions moot."
When I read this membership data, the group actually has MORE members who are not allowed to vote than it does members who are allowed to vote. I am not real sure that having only a select few as the voting body accurately reflects anything about how the group et. al. feels about anything, but that is just me :)
Not to mention that obviously this is a very big sticking point with a significant number of nonmembers or it would not keep coming up, and since those are the ones AHDI tell us it is actively trying to recruit as members common sense would tell me that maybe the organization needed to do some rethinking on that one.
I agree. We need to broaden our base to be inclusive of others...to continue doing the same thing and expect different results is insane.
Its time to accept reality!
For the board to appoint a director as president who is not credentialed cannot be explained away. We also have another director without a CMT being appointed. We cannot forget we have director with other non-MT credentials being on the board especially when they are heavily involved in MT education. The message we are sending speaks much louder than any blog article meant to explain it away.
Despite the ability of the individuals, the message was clear..Mandatory credentialing is lip service. We are not going to push it (not require our MTS to get it) , MTIA is certainly not (they have said so and yet we still partner with them), but we want all you members to do it because it is the most important thing for this profession.
The RMT and CMT is the core knowledge a director needs. Any other credentials add to that value, but cannot replace them. HIT credentials (which pale in quality to the CMT.RMT) are good but only if you have that RMT or CMT. Every director should understand the MT profession.
We need leaders to step up. Kristen, Sherry, Linda. Will you commit to getting your CMT before the end of this year?
Our membership has spoken...they have elected these Board Members to represent them. If you feel differently cast your vote differently next time.
In the meantime, its obvious the individuals pushing this issue are in the minority and do not represent the views of the membership and thus the industry.
Its time for AHDI to wake up, stop talking out both sides of their mouths and recognize the need to move on to something which brings value to the membership before its too late and there is no longer a membership base to advocate for.
With dwindling membership, high unemployment, lower wages and turmoil throughout our industry we should be looking for ways to be inclusive; not look for ways to drive people out of the industry...God knows there is enough of that going on already!
The RMT and CMT is the core knowledge a director needs...I don't agree with this at all!
That's like saying the President of a hospital needs to be a doctor or the Executive Director of AHDI has to be an MT.
The core competencies I look for in a Board of Directors are vision, strategic thinking, culture and communication.
Kristin, Sherry and Linda meet or exceed my expectations in each of these areas. And equally as important to possessing these competencies they consciously decided to volunteer for their positions.
Which leads me to ask...do those "anonymous" individuals pushing this issue have their CMT and/or have they ever considered running for the Board. If "yes" to either of these...I wonder why they were not elected?
"When I read this membership data, the group actually has MORE members who are not allowed to vote than it does members who are allowed to vote. I am not real sure that having only a select few as the voting body accurately reflects anything about how the group et. al. feels about anything, but that is just me."
With the exception of a one or two people who've voiced a concern over it, Nae, the majority of people who fall into our associate member category have told us they are perfectly happy getting the lower-cost membership with their KB and aren't interested in the other "benefits" they would receive if they upgraded to professional membership. The first one they typically tell us they don't care about is voting and holding office. Those who care about those two things (in any category of membership) tend to be a small group no matter what. By the very nature that they won't upgrade from the free membership they get with their KB to any other paid level of membership tells us loud and clear that they aren't interested in those professional level benefits - including voting and holding an office at the national level.
By your argument, we should just extend those rights to those members merely because you think they should have them, even though their investment in membership has been minimal and they have willingly opted out of more benefits and greater engagement.
The associate category, by design, is the category for that mailbox member who has historically told us they just want to stay connected to industry information and they want products at a discount. They are not interested in the full scope of professional benefits nor are they interested in association life as an engaged member. Those that step into the association through that category and find they do want more and wish to engage can upgrade to the same category all of our other voting members are paying for - individual professional membership.
That has nothing to do with credentialed board members, so throwing associate members into this discussion is a bit of a red herring. No matter how many people can vote or how many actually show up to vote for board elections (never a very high number, regardless), these directors were not appointed. They were elected.
And if you are posting here about those board members, I have to presume that you voted for somone else, because it would seem unfair to cast stones if you (a) voted for these board members or (b) didn't vote in the election at all.
I agree with anonymous above that we should be looking for ways to be inclusive and focused on solutions. Not one mention has been made here about the willingness of these directors (credentialed or otherwise) to step up and serve when so few are ever willing or able to do so. Few are willing to make the effort, sacrifice their jobs and family time, and truly commit to the level of work and public scrutiny required of those positions. And they do so without compensation and often without gratitude from our members. I realize that doesn't negate the real concern about their credentials, but it should be factored in.
-Lea
Things like this always bring out the passion in our industry, don't they?
Not too long ago, I wrote a post about this as well on the MT Inner Circle. I won't repeat the entire thing here, but I do want to make a point. If you want to read the entire thing, I'm sure you can find it.
One thing that I think is worth noting is that the resolution to support mandatory credentialing was only done less than a year ago. That said, it wasn't a clear "push" until after any of the current board was elected. Going forward, if the membership thinks that's critical, that's how they should vote.
As someone who has sat on the board, I really don't think the credential is what we need. I think what we need is a skill set. The board of directors is responsible for running a business. Not everyone can do that. I'd love to see that criteria changed so that we identify certain skill sets and recruit candidates based on that. For example, we need marketing expertise, we need finance expertise, we need expertise in advocacy, etc. I'm not pointing this out to say we don't have any of that now, just that "1 year of membership" simply should be beefed up as the main criteria.
Yes, we DO need people on the board who "get it" about our profession. At the same time, frankly, we have staff who could serve that education role for a board. In the last position I had, we had a board who knew nothing about medical transcription (for a transcription service). The value they brought to that business because of their understanding of the world of business was invaluable. I'd much rather see our board focused that way. What great value that would bring to us in trying to operate a business.
Our association hasn't been "only" for MTs since the House of Delegates changed the mission and opened up the association membership. It's time we recognize that and acknowledge it for what it is. When we do that, I think these kind of discussions will become irrelevant in the AHDI world.
It has nothing to do with "who" is or is not elected Lea ... to me, this is about the organization's lack of ability to follow it's own dictums. As long as it continues the "do as we say, not as we do" mind set I doubt the discontent with AHDI policies and goals as pronounced from "on high" are going to be any more well received that this one has been.
If the leaders of the group refuse to follow their own standards then it has no business telling members or nonmembers what they must or must not have in order to do the job. That's a pretty darn simple concept that even the least informed of healthcare document workers can understand.
Actually our board choose the officers to lead us and chose a replacement, both without credentials. Both will do good work, but this may be the final nail in the coffin for mandatory credentialing. When a board and staff come together to explain away something this noteworthy especially when it affects them, it does not leave us with much hope for the future. We are in desperate need of true leaders.
I believe it would be a worthwhile discussion to review the purpose of a board of directors and the responsibilities of the directors (http://www.ahdionline.org/GetConnected/Leadership/AHDIBoardofDirectors/tabid/192/Default.aspx) --not just AHDI's but any BOD for a nonprofit or even a for-profit.
A fully competent board requires a variety of skill sets and a variety of perspectives in order to make well-informed decisions. Absolutely! There should be practicing and certified MTs on the board, but we also need the perspective and experience of educators, business owners, accountants, managers, HIM directors, and others with experience in healthcare documentation. We cannot make decisions in silos, apart from the industries that are tightly connected to us. It is single-mindedness, limited experience, and limited knowledge that leads to poor decisions--regardless of the industry, association, or circumstance. Our industry is faced with very serious problems and we need a variety of input to help make good decisions.
Look at the profiles of boards that govern businesses...these boards are not "stocked" exclusively with experts in the given profession--they are populated by a variety of people with a variety of experience. For example, the board of Apple is not exclusively IT people or programmers (http://www.apple.com/pr/bios/bod.html). Or GM—it’s not stacked with engineers (http://www.gm.com/company/board-of-directors). What does Coke and Genentech have to do with cars and computers?
MTs certainly have a broad range of knowledge related to clinical terminology, grammar and style, but that does not mean that the most excellent and qualified MTs among us have experience reading financials and profit-loss statements, understand issues surrounding the EHR and evolving roles in documenting care, industry trends and drivers, legislative issues, government regulation and healthcare reform, education, and all the other issues that have a bearing on the decisions made by the BOD.
In fact, I believe it is a lack of experience outside of medical transcription that leads to the majority of the negative discussions and criticisms of AHDI. Many (but not all) of the criticisms hurled at AHDI are based on misinformation or a misunderstanding of purpose.
A summary of the previous posts:
Experience is what makes a truly (competent) transcriptionist; this I agree with.
You may have a CMT but if you are new to the field that means nothing; this I agree with.
The RMT and CMT is the core knowledge a director needs; this I don't agree with.
I am hopeful to see our education approval process include a requirement for CMT educators; this I don't agree with.
You may have a CMT but if you are new to the field that means nothing; this I agree with.
In these difficult times we need to be "inclusive" not fabricate ways to be "exclusive.
The entire board comes from the MT background, so they should have their CMT. One is even heading education at an approved program without a CMT.
Anonymous, she is not teaching the course. She did not develop the course. She is the HEAD of the program. Just like the other board members without CMTs. They are not typing, editing, proofreading. Although they have in the past, which is better because they do understand the challenges of the working MT. Their expertise and strengths that they bring are on the business manager, supervisor, CEO levels, not the practicing RMT/CMT level. All of these elements perfectly blended together with the board members that are CMTs, which is what is needed to face what we are facing right now. We should all focus on trying to be a part of A solution, and not try to cause A problem. Look at your own goals and missions, and make sure you are working hard to achieve those. If you do not see the example that you would like in a leader, then YOU step up to be that example. There are enough forces outside of the industry working against us, we do not need to continue to work against ourselves inside the industry/Association.
Mandatory credentialing is a misnomer. The MTSO owners and those purchasing our services do not value the RMT/CMT. Without their participation this dog just doesn't hunt! After spending more than a year on this let's move on to something that brings us some value.
"Anonymous, she is not teaching the course. She did not develop the course. She is the HEAD of the program."
So now we don't think that someone with a title of "Director of Curriculum Development" actually develops courses? I doubt that in a small company.
With all of the others having quit, she is the program director and as such needs her CMT. As an ACCP-approved program, there should be a CMT leading the program. ACCP-approved programs should strive for higher standards or the approval will lose its meaning
I was very much amused by the message that said a CMT with less than 5-10 years of experience, paraphrasing here, was worthless. I suspect that was written by someone who doesn't yet have their CMT. I believe that because over the years I've seen a very consistent trait among CMTs. We encourage others to become CMTs. There is absolutely no advantage to waiting for 10 years so you can be a 'real' CMT with experience. That's just not how it works.
NOTE REGARDING MISSING COMMENTS
Yesterday blogspot.com experienced an extended outage, and today after coming back online, it appears that several of the comments on this thread are missing. WE DID NOT DELETE ANY COMMENTS. Oddly, there were several comments that had previously been approved that this morning were back in the queue of comments to be moderated. Even so, there are four or five of the latest comments that have simply disappeared. I can only assume the deletions are related to whatever problems blogspot was having yesterday. I would encourage anyone who posted a comment that is missing to re-post. I am glad that we have been able to have a pointed but productive conversation about this issue, and to reiterate, we have not deleted any comments.
Hate that the comments were eaten by the system as they were spot on. We need transcriptionists on the board to be CMTs. We need individuals heading educational programs for ACCP-approved schools to be CMTs or the school should ask to have their approval removed. Everyone on the board right now is a medical transcriptionist first, then maybe a supervisor/manager and possibly a business owner. There is no reason why any are not CMTs other than some excuse. We are not accepting excuses from the practitioners, so we must stop accepting it from the leaders.
Appointing non-CMTs to the board and to the presidency showed a lack of commitment and foresight (even though they are strong individuals who will do well) as it has permanently tarnished the message that we must be credentialed. Leaders lead by example, not by words.
Fox (part 1)
How do I comment when I agree with both sides of the argument? We (actually at many levels of the association) have put ourselves in a “do as we say, not necessarily as we do” predicament with those members and nonmembers who are paying attention to the credentialing debacle. One could argue that the national board members on the board who do not have the RMT/CMT credential do represent a large portion of our membership and our profession, both in their decisions to pursue different avenues of credentialing and/or education and in their pursuit of leadership roles within the association. Does it present a pickle when we advocate for those with direct documentation or instruction to become credentialed, absolutely. Will it change someone’s mind about whether to get credentialed or not, I wish it were that “easy.” What will definitely move the needle on credentialing is for those who hire us to require something more than they have so far, hopefully on that we all can agree.
For myself, I went to school intending to get credentialed; in 1998, I did and have dedicated myself to the lifelong learning process through my CMT recertification and looking at what my next education experience may be. My colleagues on the board have also set a path of lifelong learning, though perhaps on a different pathway than my own. I will let my board colleagues speak for themselves on the decisions they have made and on how this current thread has impacted them.
As far as what do I look for in a leader of the association, if I stopped at only RMT/CMT credentials throughout the organization I would have missed out on some extraordinary leaders. I was not around during the time when you had to be certified to be an officer. As is pointed out in this tread, we are facing a lack of leadership already. How do you think that would work now? As well, we have diversity of workforce. There is certainly merit to what Kathy describes with respect to the subject-matter expert diversity in the makeup of our board or future boards, and I would add that is at all levels of the association.
I do think our AHDI board represents the diversity of our workforce. I also have every confidence that our board-elected (publication correction: not appointed) president elect, president of 2011/2012, is the best fit for the job coming on. Her ability to work with vendors, CDIA members, her understanding of our finances, her connection with staff as an executive member of the board for at least 2 years, her ability to hit the ground running and her connection with many of our members catapults her to positive exposure internally and externally, particularly as we bring on a new CEO. I also have every confidence that the skill sets Kristin has and the credentials that represent those studies in HIT, EHR and PHR certification bring a wealth of expertise to our board diversity and our association as a whole in the many leadership and committee roles she has taken on both within the association and externally through her collaboration on HIEs and advocacy, particularly in the state of Idaho, and as a very successful business owner. Linda brings strong skills and alliances with her onto the board as an MTSO and a DC advocate.
(con't)
Fox (part 2)
Nothing in our association is simple. Many of the decisions the board makes have complex thought and impact in a variety of arenas. Add to that, very little in our industry is black or white. Take the CDIA response to our “ask” of moving to a fully credentialed workforce. Sure, I am disappointed that we did not get a resounding, “yes, we’re on board!” However, I firmly believe that by having the partnership we have more credibility than we ever have had to continue working toward the goal. If we gave up and just threw in the towel every time someone (anyone) said no to us or disagreed with our position, well, we would not get very far. Will the board continue to press on with our initiative to see MTSOs and facilities incorporate credentialing as “mandatory” to hire, absolutely. Will we have to find different opportunities to get there, maybe. Can we do it by ourselves, not likely. Action comes in many forms and if there is one thing I have learned being on the board and involved in AHDI leadership for a bit it is patience.
Take the example of having to have a CMT to teach transcription. I remember when that question came up at our Educator’s Summit back in Tennessee 4 or 5 years (maybe longer) ago. This was before we had an approved program or the progressive model curriculum and 28 approved schools like we have now. The room was in an uproar as you heard program directors and instructors plead their case on how that requirement would shut down their programs. Personally, I agree that a CMT should be required somewhere in the staffing process of a healthcare documentation program, preferably at the direct instructor/student contact point. I also believe our programs should reside in business technology as well as allied health. I also promote moving toward an AS degree at the community college level as a compliment to students taking an RMT as an exit exam. Had we held firm on the CMT requirement that day, we would have lost the attention span of the hundreds of educators in that Tennessee ballroom, and I imagine our program approval process, the evolution of our model curriculum and even the House voting to support mandatory credentialing would have been impacted in some way. Having been an educator with a CMT, I can also say my CMT was not enough. There is a balance that needs to be struck between transcription background and teaching experience.
How about the question of how relevant our RMT/CMT credentials are with respect to the current industry trends. We have some very active volunteers working on our next version of the model curriculum to include Kristin. How do we step up the technology side, the speech recognition, natural language processing, understanding of SNOMED & ICD-10 language, and EHR exposure within our curriculum when many of the healthcare documentation programs are already at maximum unit load as well as the squeeze from the political side on reducing funding for education? Do I believe that our RMT, CMT and CQE exams are the best we have to date, you betcha. Will we have to evolve, yep.
(con't)
Fox (part 3)
I actually think we face a bigger issue. We learned in DC that the DOL is revamping its listing of the workforce for 2018 publication. Deadline for submission of “titles” of workforce is 2012/2013. Is our profession (particularly the professional) ready to find a single title? As we progress into future roles, does a single title even exist? Did you know that AHIMA/HIM introduced themselves on the Hill in March as having 40 different employer types and over 120 different job functions? How do we (and will we) define ourselves? Honestly, does the RMT/CMT “title” even fit anymore? This broader topic goes to the core of our membership and to a great extent our credibility, as leadership and an association. I have many colleagues, whether credentialed or not, who consider themselves first and foremost a medical transcriptionist no matter where they have landed in their career today. What about the myriad roles we are already serving in as well as the ones that will emerge as we move into the EHR domain? Are we ready to consider a title change and what would that look like? Are we able to stake claim in the workflow process of healthcare delivery? Does our workforce even want to “do” whatever “it” is?
What can the board do about it? What can the membership do about it? Where is the educator’s alliance on the subject? The goals are great, the routes to get there complex. What’s my stand? We cannot make any of these decisions in a vacuum. I think it’s time for another educator’s summit to discuss these and many pressing issues of how our programs must evolve. We need to actively address how we are going to re-train and prepare the workforce we have now into the roles of the future as well as bring new professionals into the career path. Our workforce development voice needs to be louder and more integrated at our next Advocacy Summit.
Before all that, we need to get a new CEO in place, work through the leadership changes at the board and workgroup levels, followup from the Advocacy Summit, continue to build alliances, provide strong partnerships to get our strategic initiatives connected to all levels of leadership, get the NLB up and running, connect associate, current and future members to the association, continue our external outreach, build leadership succession and a whole host of things on an accelerating time line.
So my commitment to you, our members and our future members, is this: I will continue to support credentialing at every level of this association. I will continue to encourage my colleagues to obtain credentials and advanced levels of education. I will continue to promote inclusion of members from a variety of fields. I will strive to find the best answers and action items as I work through my service on this national board. I look forward to working with a diverse, engaged leadership contingency at all levels of this association in service to our members and the public, and I do not do so alone but with all my colleagues on the national board, AHDI staff, members and leaders throughout our organization and through outreach with our allies to include those of you who took the time to read and respond to this thread.
Karen L. Fox-Acosta, CMT, AHDI-F
AHDI Director 2009-2012
It seems that everyone is talking about this but those who are not credentialed. Can we get a direct response from the directors who do not have their CMT (Kristin, Sherry, and Linda), why they do not think they need it, and how that affects the message of the association?
Lea made a comment a couple of days ago that just hit me right in the gut. She was right on target when she said, "As always, a stronger, more robust field of credentialed board candidates would render some of these discussions moot." Often when I'm asked to contribute, I have to decline because of the responsibilities of running my school. As a CMT who isn't willing or able to serve, I really can't complain then, can I?!
But, you are a CMT running your school with a credential. That is part of the side discussion. A non-CMT running an ACCP-approved school.
That said, our board is not a robust field of specialties. It is medical transcriptionists, some QA, and managers. They are transcriptionists who need the CMT to be credentialed in their specialty. There are no MBAs, IT, coders, PhDs, etc. If there were these other individuals, then the discussion about some not needing the CMT would actually make sense.
Is this AAMT or AHDI? I thought we made the decision to expand our reach to be inclusive of other roles and specialties. Why do we continue to rehash this...we are NOT AAMT anymore. Those days are long gone. Accept reality.
All the board are MTs not other specialities. If they were and were credentialed in their field your point would be valid. We said we wanted more specialities and each should be credentialed in their field. All we are asking is that our board adhere to those standards.
Hey, where's my post...the one asking "Anonymous" to contact Kristin, Sherry or Linda directly?
If we are going to allow anonymous individuals to "call-out" individual members of our BOD for comment, I think it fair that everyone understand that Anonymous has the opportunity to contact them directly via the telephone for comment yet chooses not to. Which begs the question: Why?
In a passive aggressive way their response could be because they want it to be available to everyone, which would be valid, but which truly doesn't explain why the request has to be made "anonymously".
The only valid explanation to call them out anonymously AND ask them to respond here publicly is because of a single persons desire to continue to smear the reputations of these elected individuals, the companies they work for and AHDI.
It would be unfair to allow the previous post by Anonymous and not allow this one. However, if the powers to be do choose to censor this it would be further reason why Kristin, Sherry and Linda should NOT respond to the previous request for comment.
Your previous post resorted to name-calling and that will not be permitted on the Lounge. Please keep the discussion focused on issues and not on personalities or possible motivations.
I speak plainly and bluntly when others are being treated unfairly.
You are welcome to express your opinions within the guidelines we have established here, as is everyone else.
There is a lot to be said about silence. This discussion was initiated by two of the three board members in question, but they have not been responding to legitimate questions. This is the biggest weakness of these "Let's Talk About" series. A valid area is briefly mentioned in a non-committal draft by a director but there is no follow through on the tough questions except by staff and members. The scribes issue was the same. Strong questions, word speak answers. C'mon. Let's talk about this stuff.
As a member of multiple organizations representing the HIM field, and a member of the AHDI, all I can say is that after reading through these comments and dialogue I can see what is really wrong with this industry.
Us. Most transcription related sites I go to that have discussions that are the most argumentative, and sometimes just plain rude, sites I visit out of all the organizations.
No wonder nobody treats us like professionals.
Go somewhere like MTStars. If you were an outsider looking in what would you think of medical transcriptionists?
Same goes here. While most of the comments are intelligent, mature arguments there are still some (as there always is) where it is just plain childish bickering.
The problem with this industry is the MTs. Not the AHDI, not the MTSO...us. If we want to sit home and act like this everywhere we go on the internet then we really should not expect a lot of respect.
I agree with the above post. Why should we feel obligated to post when what we see are mostly anonymous opinions so far? I would love to "talk about this stuff", but I would also love to know who I'm talking to. I also agree that anyone can call us freely to discuss our position on anything. For a discussion to be public however, we should identify the participants, should we not?
Karen, I applaud you for at least coming here and trying to respond. I wish more people on the board would do this.
I think asking that is valid, for anyone. I won't reiterate my post above.
When this lounge was started, I seem to recall something about it being a place for dialogue. Dialogue, means people participate, we don't always all agree, and yet it's done respectfully. It disappoints me when I don't see many directors coming here to participate. It's a place the association set up for dialogue, but without the board members coming here, dialogue just doesn't happen. Maybe it's just that we are trying to learn how things like blogs work, I don't know.
To the poster who said MTs are the problem, I'm really sorry you feel that way. Disagreement doesn't equate to being negative or being a "problem" and I've sure seen nothing here like we have seen at MT Stars so I think that's an unfair comparison. You did ask, however, what you would think if you were an outsider looking in, so I'm going to answer that from my own perspective.
I would see a very hot topic, a post by the association representative that created lots of questions and dialogue, a response by staff (one that even says she will "let the board members respond") and yet with one exception, I don't see the leaders here commenting. Engagement is a hot topic these days and when half of the equation is missing, there really isn't any engagement. And that, folks, is what I think part of our problem is.
Dear Colleagues from Sherry.Doggett@UCHealth.com Having trouble posting so posting as anonymous LOL but it's me. :)
Thanks for all the comments/feedback regarding the letter written by Kristin Hagan and me. I have decided to post snippets of my presentation to the board when I decided to run for president-elect. I feel it is important that members know who I am and what I bring to the table. This decision to run was not made lightly. I spoke extensively with my boss, the CIO of UC Health, a multi-hospital system in Cincinnati, Ohio. Most importantly, I also spoke to my husband, sons and spoke to each of the board members prior to our meeting/election. I have been in the healthcare field for over 30 plus years. I am passionate about patients, families and the roles that I have played during that time. I spent several years working in private practices as a medical secretary, medical transcriptionist and assistant practice manager. I transitioned to a hospital based medical transcriptionist role and then eventually worked as a transcription supervisor for a 40 physician internal medicine practice. I learned about AAMT when I became a hospital based manager. For the past 20 years, I have worked as a hospital transcription manager and 16 years ago assumed the role of Director of Corporate Transcription Services for UC Health. As our system expanded our department grew from 10 people to well over 130 plus staff serving 7 hospitals, Level 1 trauma center, 700 residents, responsible for all medical documentation in HIM/ED/clinical results. Our site has served as a pioneer in back-end speech recognition and served as beta site for multiple vendor technologies. I have seen the department through multiple changes, growth and now reduction to four facilities. We are now implementing Epic and I have been asked to guide our department through that change. I serve on the IT leadership group, work with HIM Directors, serve on various key committees, MR committees, etc. Over the years I have been involved with enterprise wide process improvement initiatives even outside of HIM arena. I have extensive budgeting and financial experience in running a large department.
I am seen by my workplace peers and exec VPs as someone who gets things done that move our group forward and align with organizational goals. I am analytical and thoughtful in my thinking processes. Can see big picture and see impact upstream and downstream. Can make quick decisions based on key facts, asking well thought out questions and utilizing historical decision making processes. I attended college, have completed a healthcare management program through a local university in partnership with my employer, Six Sigma greenbelt training and TQM training. I have established relationships with key transcription vendors, EHR groups, and CDIA current and past board members. These key relationships can help AHDI reach out to other organizations and vendors. I also have other voluntary board experience serving on our 21 million dollar credit union board for 20 years and served as chair during a difficult transition.
Part Two coming
From Sherry.Doggett@UCHealth.com. Had trouble posting so posted as anonymous but it's me LOL.
Now let's talk about credentialing. Do I believe in credentialing. You bet!!! As I have served on the board I have spoken with MTs across the country, members and non-members who have sought information about credentialing. I have referred them to study groups, sent them links to our website for material. I have spoken to students who ask about our organization, credentialing, and the ultimate question "should I get into this field with all the EHR changes coming." I am a huge proponent of the RMT/CMT as the foundation for any MT who wants to continue in the medical documentation field. But I also remind people that we can longer be complacent about our overall education and skill sets. There are many unknowns out there and we need to continue to prepare for the future through continuing education. What we as an organization must realize is that no longer one size fits all. Many of us will retire in the near future (such as myself), others will continue as MTs and others will move to roles within the realm of the EHR. Technology is important to our jobs no matter what role we play in the medical documentation field. I always tell folks to expand their technology education.
Our organization cannot stand alone. Changing the name was a huge step to open our membership and our board to create a more diverse membership base. If we stand alone we fail. These are scary times as we navigate the water. None of us have all the answers, but by focusing outward, become more inclusive, not exclusive we can move forward.
I would ask any member and anyone posting to this blog to feel free to contact me directly at sherry.doggett@uchealth.com I would be happy to call you if you like.
Respectfully,
Sherry Doggett
Thank you everyone for this robust discussion. It is great that AHDI provides a place where members and nonmembers alike can share their thoughts and feelings.
While we are on this hot topic however, I do want to advise everyone of an issue that is currently on the Association's agenda. We are currently in need of Board of Director candidates for District 6. That would include, FL, TN, GA, MS, SC, NC, and AL. Nominations are being accepted through Monday, May 16th. Interested candidates can request a packet from Wendy Carriegan at wcarriegan@ahdionline.org. This would be a great opportunity for someone who qualify in that district to step into that leadership position to serve our Association. Please do not let this opportunity pass you by.
With that said, I would like to share with you an answer to one of the questions on the board of directors candidate packet in regards to implementation of the Association's goals as specified in the current strategic plan. My thoughts were:
When I read over the strategic plan for 2011, I found that I am already doing a lot of these things in the daily running of my business. I frequently talk to new hires as well as applicants about the Association and credentialing. I recently paid for one of my MTs to attend a CMT study group when she expressed interest. I have also rewarded another MT with purchasing her RMT plaque for her to display.
This is just to touch on my thoughts and views about credentialing, and how I continue to encourage others. I would also like to share my thoughts as a business owners and how I look at applications when they come across my desk. The first thing on the resume is the MTs name, so I look to see if the MT has their CMTs first. That is the first thing I see, so it is the first thing I notice in viewing resumes. I also look at their experience and what transcription school they may have attended. So I am looking at the credential, the education, and the experience of that MT. Not once in my mind do I think "well I don't have my CMT, so why am I looking for CMTs". I am not looking for CMTs because I feel that they will have a stronger core knowledge and a keener ear or eye, but these are the things that stick out to me first. I do go further to test them to make sure they are qualified in that aspect, but the CMT resumes get noticed. I will also be perfectly honest in saying that I also test non-CMTs because of the lack of CMTs, so that I can have a greater pool to choose from. I will also add that I have hired CMTs and non-CMTs who have had more than 10, 20 years experience, and the work they put out was garbage. I have also hired CMTs and non-CMTs however, that demonstrated outstanding work ethics and competency. That the reality of the workforce, and is present in any industry. My rationale when looking at the CMT however, is that I feel it shows a commitment to ones career and industry. I feel that it stands out from the rest of the MTs. I also know that by holding the CMT credential, the MT is required to continue to learn from the required CECs to maintain the CMT. So in my mind, the CMT allows you to (one) to get your foot in the door, (two) to show you are serious about your career and industry, and (three) tells me that you are committed to continuing education in this industry. So a credentialed workforce would scream these things to the industry.
Part 2 to come
Now I'm also not going to regurgitate my career path, my MT experiences, etc. and make excuses about not having my CMT. I will tell you however, that if I needed it to get into the doors that the practicing MTs need to get into, I would definitely have it. I have other core knowledge and skill sets that demonstrate that I am serious about my career and my industry. And (as in number three) if I had my CMT, I would have extra credits to give away based on all the credit-worthy seminar, webinars, etc. that I have participated in. My career path and obligations have not dictated my earning my CMT. The juggling of my family, business, and volunteer work did not allow for it as well. Therefore, I do not have it. I do however, make sure that I have it on my staff level so that when my clients ask about the credentials of our team, I can speak to that issue. Many of you may not agree with the above, but I'm just putting my honest opinion and situation out there, and it is purely my own and not that of the board.
Now in reference to leadership, and how one might feel that they can lead in an area that advocate for mandatory credentialing, without having the credential; I will be happy to speak to that. First off, that is not the only thing that AHDI advocates for. So if my not having my CMT is not the example of leadership to the members who wish to become a CMT, then please use one of my fellow board members for that example. Karen Fox-Acosta, CMT, Lisa Day Johnson CMT, Susan Lucci CMT, Brett McCutcheon CMT, Barb Marques CMT, or Harriet Stewart CMT. Use me as an example of the leadership that I exemplify if that is what you need to do. Do not punish yourself or the whole for what you feel is my shortfall. As was stated before, this board represents a diverse and robust group of individuals who have various strengths, ideas and passions. We cannot all be alike. The healthcare industry is not comprised of CMTs alone. All of the Association's goals and missions are not rooted in the core knowledge of the CMT. When I sat in a meeting with Peter Preziosi and Maria Cardona (Dewy Square Group) to meet with Ana Ma, the Chief of Staff at the Small Business Administration, we talked about developing the workforce and technology funding so that small business who employ MTs across the country could remain in their jobs. The CMT factor was not a part of that discussion. However, representing an Association as a Woman-Owned Small Business Owner was very relevant to that discussion. Also that I work with independent contractors who are also considered small business owners. In addition, when I spoke to one of my clients about being a "physician champion" for AHDI since he has similar views on the EMR and the preserving the patient's narrative, CMT and credentialing was not a part of that conversation. Me being able to tell him about the Association, our position, and our advocacy efforts were, however. So I bring you back to the diversity needed as the industry moves forward to tackle the challenges that we are faced with. I bring you back to recognizing me for my strengths and contributions that you feel I am qualified to lead in, and looking to our other board members for the strengths and contributions that I do not posses. I bring you back to looking at the AHDI Board of Directors as a whole component of leadership and not trying to hold one individual up to that standard because we do not function on the board as one individual.
Part three to come
I shared this with others, and would like to share this with you also. I read in John Maxwell’s book Success 101, the following: Lead Yourself First. If you want to influence others, you must always lead yourself first. If you can’t, you have no credibility. That applies whether the influence you desire to exert is on the people above you, beside you or below you. The better you are at making sure you’re doing what you should be doing, the better chance you have for making an impact on others and being successful.
So notice he says whether the influence is above, beside or below you. That tells me that some people are not where I am just yet, and some people are just where I am right now, and some people are past where I am (CMT for the sake of this discussion), but that does not disqualify me as being a leader for those individuals. If I continue to work with the passion that I have worked with, continue to learn and grow as we move into the future of the EMR, and continue to do what I can to advocate and push the Association's goals and strategic plans forward (weather I meet those same criteria's or not), then I can live with that.
Now the main question here, I think, is why AHDI feels that credentialing the leaders is not important. Well, no one on the board can answer this question because it was a membership decision. AHDI is comprised of members who vote. The members who vote, vote for board members and members understand that board members will be making key decisions for the Association. So for instance, when I was asked to join the board, there were 6 CMT board members and 2 non-CMT board members. Remember that all of these things are done by votes. So at least 5 board members would have to have elected me for me to be asked. With only 2 non-CMT board members, that would have meant that at least 3 CMT members felt that my qualifications and experiences where adequate enough to ask me to join them, without a CMT. Kristin and Sherry was ELECTED to the board. It should be noted that previously Sherry was asked to join the board, like myself, and then decided, "you know what, I'm going to RUN for the board so that I can give the members a chance to ELECT me to the board. Sherry was then ELECTED to the board by the voting members. Kristin was also ELECTED to the board by voting members. An AHDI professional membership cost less than $12 per month. So this is not a huge chuck on change we are talking about, so the members who wish to vote, I would assume, ARE voting members. So the question of why AHDI feels that leaders do not need to be credentialed, ask the voting members.
Now how does AHDI expect members to take them seriously about the messages of credentialing when the leaders are not credentialed, read all of the above. I would also add however, that I personally feel that I can speak to members about becoming credentialed because I am an employer in the industry who look for credentialed workers. I can speak to members about becoming credentialed because I have clients that ask me about the credentials of my team members. I can speak to members about being credentialed because I advise practice managers and HIM directors that ask me should they look for credentialed MTs when they are seeking in-house transcriptionists. I can speak to members about becoming credentialed because if you look across most of the hospital systems (and this is what I noticed from participating in the managers/supervisors listserv) the supervisor and manager positions are credentialed employees.
Part 4 to come
So why is it that I do not have MY credentials? I feel is my own personal decision and business, but as a board member, since anonymous wants to know, I will share it with you. When I first started transcribing, I was typing my own doctors. I did not even know about AAMT or the importance of a credential until about 5 years after I came into the industry. By then, my current doctors started referring me to other doctors and thus started my business. When I got involved in the industry, I got involved as a business owner, not a practicing MT. At any rate, as my volunteerism grew more visible, I did start seeking to become credentialed. Then I was asked to chair the EMR Alliance, which brought forth the EHR Toolkit. I was also asked to participate in the QA Best Practice Guide development, which brought forth that manual. After that was completed, I again completed a study course with M-Tec (Vallie can attest to this), but was then asked to Chair the Legal Issues Group (LIG) to "keep advocacy alive" for the members and help with Advocacy Summit preparations. With that said, I ask you, should I have said no, and focused on studying for my CMT to get that before I sat as chair or volunteered in any group? Yes, I would have to study for it because I have not transcribed or done QA in my business for the last 3 to 4 years. If I would have said no, would someone else had done it? Were there other people who held CMTs, who the board members or leaders felt were qualified, available? Did I serve a greater good for the Association by working in those leadership roles than by obtaining my CMT? My answer to this would be a resounding yes, but everyone has their own opinion.
I will also add that volunteering on this level does speak to my willingness and ability to volunteer for the Association. These are my intimate contributions to the Association. I say intimate, because volunteering on the levels that I have in the past, takes a commitment and focus, as well as giving up of my personal time to help serve the Association and its members. This is personal time taken away from my business as well as my family. This is the very reason that a lot of people are unable or unwilling to volunteer on such levels. I will also add however, that what I have received from my participation and volunteering for this Association is far more than what I have given.
So in closing, I will say that we are not talking about don't swear, but I swear, don't smoke, but I smoke, don't drink, but I drink; this is not that type of situation. We are talking about coming together as an industry, supporting credentialing, supporting the Health Story project, supporting future roles, and moving together as an industry for the best possible outcome for each individual as well as the whole. We are talking about supporting the industry's mission and working TOGETHER, not apart. A credentialed workforce would send a strong message to the healthcare industry that this sector is qualified and serious about what we do. Without a credentialed board, a credentialed workforce could still send that message. Without a credentialed workforce, a credentialed board means nothing.
Part five to come
I will remind you again that the ballot will soon be released for voting to begin for At Large Directors as well as District Directors. Also do not forget that we need some nominees for District 6. If this topic is as important as these lounge posts would suggest, I expect the voting members to be ready to vote to support their position, and I expect that the non-voting members, who wish to vote, will pay for a voting membership so that they can vote. I would also expect that we will have great attendance at the candidate debate webinar so that you can hear your candidate's positions. Again, thank you all for a great discussion. This is too much to put on these lounge post, so why don't we hold a press conference. Also forgive me for any comma misplacements or grammar errors for remember, I am not a CMT. :)
Thank you everyone!
One more thing....
I will also add as Sherry did that anyone can feel free to contact me directly at lpgiles@aol.com and I would be happy to call you if you like.
What we are hearing here is the same thing an uncredentialed MT would say regarding mandatory credentialing. People are getting defensive at hearing others suggest they may not be qualified to lead because they do not have a CMT. Think about how a practicing MT feels to hear they are not qualified to work in their profession because they do not have the CMT. The leadership role is not an income generator like working a job and yet we are getting heated replies. How much more so for those being told they should not be allowed to earn an income if they do not get the CMT.
The 'mandatory' terminology is cold and final. If it is mandatory then you simply are not qualified to practice or lead without it regardless of your other abilities because it is required to have in order to be accepted. Period. End of story.
This is something our current and new leaders need to seriously discuss. Maybe this profession is not ready and never will be ready for mandatory credentialing.
Much of the original discussion supports itself through the collaborative open letter to MTs. As a professional, I have a diverse background in education, clinical medicine, high-technology, medical transcription, business ownership and success of sale, in addition to my leadership roles served.
AHDI was founded on the Association for Healthcare Documentation Integrity, one built on a principle mission, vision, and goal. I became an active volunteer leader under the theme “Change is Everything,” attending Reno, NV. Idaho did not have a representative chapter and I wanted to bring this to my state. Shortly following the conference, Utah-Idaho was established and elections were held. I served as delegate, lead team delegate, chaired the sustainable structure task force, participated in advocacy days with an invitation to join a HIT committee. As a volunteer leader, I have never stopped day by day working for a collaborative healthcare system made up of diverse HIM roles. We all fall within the professional arena when it comes to advancing the healthcare system.
I was elected to the board in 2009 and have made significant contributions to live out the mission of the association for the working membership. I serve in multiple board liaison roles, including manager/supervisor workgroup, new professionals alliance, model curriculum committee, and participate beyond the auspices of AHDI. A connected healthcare system cannot be derived within the doors of AHDI alone. I traveled and participated at HIMSS, AHIMA, MTIA, and AHDI, in addition to local components. This is about understanding the industry as a whole and working as a team and will knowledgeable skill set to pull large project management tasks together. Each member has different traits that accompany themselves to volunteer and serve.
My work with health data exchanges, health information technology committees, regional extension centers, and other personal commitment of my time, balanced with family and work, are a measure to working hard, understanding the needs, research, education, and seeking credentialing. I AM A CREDENTIALED INDIVIDUAL, make no mistake about that. Prior to the decision in 2010, I had already self-initiated credentialing of health information management and informatics programs. Owning my business in 2005, standards based, I knew where I was headed with clientele – to the data exchange. The relevance of participations for physicians, hospitals, facilities, allied healthcare worker to include ourselves and my MTs, was paramount to delivering on the nation’s goals.
I am skilled at a variety of levels and know the markings of a good board and leader include the diversity of education, willingness to learn, and reach common ground and develop solutions are the answers to walking forward. Is there a staff both in my past and present that work alongside me and around me? Absolutely! A successful team leverages experience and expertise off its team, true in any domain. I supported the letter not to say I do not fit in credentialed, rather the opposite. I am a credentialed, recognized individual who is part of the AHDI vision, mission, and goals and understand large scale to minutia opportunities to show the knowledge, career path, and professional we at AHDI should be known for.
Please contact me at khagen@trsinstitute.com or phone me. My solid commitment and focus have been clear from the day of the delegate to the current workings on the board. Without all of our skills and talents, the AHDI board would not allow for the growth and innovation needed to succeed when “Change is Everything.”
Posting by Sherry.Doggett@uchealth.com
In response to anonymous posting 5/14 2:04 pm. I certainly empathize with your concerns. Linda and I have posted to demonstrate our qualifications to serve on the board. Membership has been opened to include others related to the medical documentation industry and thus our current board reflects that diversity. Linda and I would never want anyone to think we are defensive; we are providing an open honest dialogue.
We serve as elected board members chosen by our membership. We choose to run because we are passionate about healthcare documentation. We have found our passion in our day to day jobs or other volunteer activities.
Recently I have learned more about the journey taken by coders to become a credentialed workforce. It did not happen overnight, nor a year but over multiple years. Perhaps we are begining to take that same journey.
I would happy to speak with you to better understand your concerns. There is so much unspoken when not voice to voice or face to face.
Respectfully, Sherry
Thank you for your replies. I think this settles it once and for all. The push for mandatory credentialing is over. You do not need a CMT to educate, practice, or lead.
Anonymous,
I'm heading home from a week of advocating for our profession with AHIMA members, putting our best foot forward, and speaking to the membership on "EHR Technology Primers." We are being recognized in the HIM professioa and all of us are visible.
Credentialing in any domain is a standard of practice to ensure as the US Healthcare education requirements elevate, our profession will continue to be eligible for working directly with patient's medical records, in any new role that may take on. Will other credentials be recognized as well to perform different functions within the EHR, administratively? Yes. The goal nationwide is to protect the integrity of interoperable electronic records through a multitude of roles emerging and available today. The government offers incentives for credential uptake as well as AHDI of www.healthitcertification.com through the Vendor Affiliate Program for discounts on EHR, HIT, HIE, and security and privacy credentials. Job descriptions may also specify, or at least include, "x years of experience preferred."
Education is a gift and will guide you through new doors as we all grow and the system matures. In addition to my credentials, like others on our board and in our membership, continued college education is also occuring.
Hope that helps!
Kristin
Agreed, credentialing will never have credibility when given to people with little or no experience. Experience is what makes a true transcriptionist.
Moving forward we need to represent our entire membership and look for ways to be inclusive not divisive or exclusive.
I too, agree this should bring to closure any further discussion of requiring a CMT to educate, practice, or lead. As a result I am hopeful the Educators Alliance will take note of this discussion and respect the vast majority of our members who have chosen to make this field their own, some for 10, 15 and 20+ years and for a variety of reasons (like our board) have chosen not to pursue their CMT.
Like all of us, they deserve the same services and support from their Association; not to be made to feel like second class members; especially when many of them are vastly more qualified than some of those who are CMTs.
I remember several years ago there was a discussion on the BOD about having an all-credentialed board. We wanted to attract a variety of skill sets to the board, so we knew we couldn’t make it “CMT only.” We talked about setting a minimum number of CMTs for the board, but that also was going to be difficult to control because members of the board rotate 3-year terms and some have to step down early and others serve 5 years (if they serve as president). Since the board doesn’t have “seats” or “places” (like city councils for example), there is not currently a method in place to control the number of any given “type” of individual or background on the board. I remember we talked about devising a system so we would have so many MTs, so many business-type backgrounds, so many HIM directors, etc. But at the end of the discussion, it seemed very convoluted and counterproductive to put “quotas” on the “types” of individuals and backgrounds that made up the BOD. Just as employers can “prefer” a credentialed MT over a non-credentialed MT, we could (and do) prefer that the BOD candidate be credentialed (in something).
But given the fact that the HOD just voted last August to advocate for mandatory credentialing for the workforce, I don’t think it would have been in the association’s best interest at the time to immediately discharge all those on the board who were not currently credentialed and to run a whole new set of elections. We were already in the midst of restructuring the governance and extended the terms of the BOD members to give the changeover more continuity. There hasn’t been an election for the BOD since the HOD resolution was passed. We are just now accepting candidates for the newly formed National Leadership Board and, quite frankly, having a hard time fielding the ballot. As the number of credentialed MTs increases, the ability to fully stock the board with credentialed individuals will be easier, and I would hope, mandatory. Mandatory credentialing is going to be a process, not an overnight switch, and I suspect it will be that way for the board as well. Policies and procedures will need to be written, which will not be as straightforward as it first appears.
I’m treading in deep waters here and will probably get lambasted for this, but honestly, I think this argument about the BOD is somewhat of a red herring. I say that because several (or maybe the same person posting several times as anonymous) have used this issue to dismiss the validity of mandatory credentialing altogether. Don’t get me wrong, I think the discussion of a credentialed board is very worthwhile and necessary, but to say that credentialing is a crock because the BOD is not all CMTs is not a valid argument IMHO. I think people are looking for any reason to invalidate credentialing or maybe even an excuse for not getting credentialed themselves. As I write this, I’m hearing my mother’s voice in my head saying “if your friends jumped off a bridge, would you do it too?” As parents,do you allow your kids to say, "Johnny didn't do his homework, so I'm not either"? You have to make your own decision based on what is right. Whether or not the board is fully populated with CMTs, it is up to each one of us to do the right thing. I personally believe that if you work as a transcriptionist, striving for and obtaining a credential is the right thing to do.
I have been doing my job without errors for many years. Why should I get credentialed? It does not seem like I need it.
Unfortunately, there are MTs that have been doing a very poor job of transcribing for 15-20 years. Experience is no indication of excellence. Twenty years of poor experience, with the MT being lucky enough to find an employer who accepts poor work, is not what a professional organization should be promoting. Certification should not be based on amount of time worked, good or bad. Certification should be based on the ability to pass a skills test, the ability to transcribe at a marketable level or above.
I am disappointed that we are unable to find qualified CMTs, with or without additional credentials or work experience, to serve on our BOD. Those who have not experienced being a medical transcriptionist, working to prepare for certification, and then receiving the certification itself, don't represent me in the way I would like to be represented. If a CMT has additional qualifications, that's fine, but the bare minimum I would require, if I were making the rules, would be a CMT.
Now if we are going to say that those representing leadership in AHDI don't need to be CMTs, then it really does speak volumes. The rest of us don't need ours either if our leaders don't.
I'm disappointed that we are going that direction, but I will probably consider dropping my CMT if it is no longer respected by AHDI and its leadership. If it isn't required of our leadership, it shouldn't be required for any other purposes either, which makes it pretty much worthless.
I became credentialed a year ago. The company that I worked for at the time scoffed at credentialing, and I honestly believe that I was "pushed out" of the company through "mandatory scheduling changes." I had been with that company for 4 years.
However, when I went looking for a job, it was because of my credentials that I found an awesome job almost immediately. I had only had 2 years of acute care experience but I applied anyways even though they were looking for someone with a minimum of 5 years acute care experience. Because of my credential, the minimum years of experience was waived and I am now happily transcribing for a huge hospital system.
I didn't "need" a credential where I was at, I chose to get credentialed, and believe I lost my job because of it. But, did I really want to work for a company that did not value my ongoing education in this ever-advancing field?
I hope those suggesting they should not be credentialed because of the board's lack of dedication to getting credentialed themselves look deeper into the issue. We can all make excuses but professionals do not make excuses for why they should not adhere to standards they profess to be important. Let's face it. We should be credentialed and these directors should be credentialed. Maybe the members will have to lead by example since our board will not.
I am an MT student who will be getting credentialed.
It is my decision to do so, the value in it is something that I feel is important to me.
However, I think this controversy over RMT/CMTs is about a decade too late. What we should be looking at now is the future bearing down on us all.
Karen Fox-Acosta made two really good points that have gotten bypassed in all the sniping and derisivenss. Perhaps they need their own "Let's Talk About...?"
1) The DoL is asking which professions need name changes. Medical transcriptionists badly need to update their job image, title, and description to be viable in the HIM arena. We are in danger of becoming the industry's dinosaurs.
2) If we were smart, and this discussion makes me fear we are not, we would be looking to the not-so-distant future and beginning now to figure out how to credential Speech Recognition Editors. The RMT/CMT is verging on becoming obsolete.
Look ahead, my friends. There is work to be done.
Congratulations Gayle!
That is one thing I would LOVE to see more of...the stories of how credentialing has benefited those with it. I always hear the arguments for and against mandatory credentialing and both sides make great points.
Yet, what I am looking for is how has credentialing benefited your MT career?
-Billy Jean
Mary Lands wrote: "how to credential Speech Recognition Editors. The RMT/CMT is verging on becoming obsolete."
The most recent edition of the CMT exam (released earlier this year) DOES include speech recognition technology :-)
See page 30 of the Candidate Guide listing the following objectives related to SRT:
2.3 Given an SRT term or concept, identify the correct definition, or given a definition, identify the correct SRT term or concept.
2.4 Given a list, identify success factors for SRT adoption/integration as de-fined by the Book of Style.
2.5 Given scenarios, identify the correct application of Book of Style standards for resolving style conflicts in an SRT editing environment.
2.6 Given audio and SRT draft text, identify area(s) that require editing or modification for accuracy.
http://www.ahdionline.org/portals/0/downloads/CredentialingCandidateGuide.pdf
Awesome Laura!
Steps in the right direction: Forward!
Much has been written here about 3 directors out of 9 not having earned a CMT or RMT credential. These individuals have their roots in transcription and their hearts and heads now in leadership of this association for the benefit of the profession and the membership. The concerns about the credentialed status of our board members have been heard and will be directed to our nominating committee so that consideration around these concerns can be given when shaping criteria for further board elections.
I have one more thing to say/share and then I hope this matter is closed:
I belong to an veteran's organization and have been the local president for the last 10 years. My executive boards are made up of mothers of veterans (me), wives of veterans, daughters of veterans, sisters of veterans, grandmothers of veterans, and aunts of veterans. Very few of us (less than 1%) are veterans and yet we are the largest female advocacy group in the world and have quite a say on Capital Hill.
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This is our mission statement and goal:
Mission:
To support programs for veterans, young people, and community
To provide for today's needs while being advocates for a brighter future
To advance the understanding of patriotism and responsibility of citizenship
To promote individual integrity and family values
To ensure as volunteers, that the members continue to be the leaders in all that is good in this nation today, tomorrow and for generations to come through serving others first and not self
Goals:
Attract and retain professional, well-trained staff and leadership at a sufficient level to support our mission.
Have a knowledgeable, vibrant and engaged membership.
Have a diverse income stream to support our mission.
Effect a positive image of the the organization and its members.
Continually foster a positive relationship within our veteran's organization family.
Attract and retain a membership base of women from a variety of communities and eligible groups.
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Now the AHDI Vision & Mission Statement
AHDI Vision: To direct the evolution and ensure the integrity of healthcare documentation and data capture
AHDI Mission: To promote the integrity of healthcare documentation through development of an educated, prepared workforce in clinical documentation
AHDI Purpose: To set and uphold standards for education and practice in the field of clinical documentation that ensure the highest level of accuracy, privacy, and security for the U.S. healthcare system in order to protect public health, increase patient safety, and improve quality of care for healthcare consumers.
AHDI Goals and Objectives: To provide healthcare documentation professionals the tools to ensure accuracy, privacy, and security that promotes patient safety and quality of care through the following objectives:
Participating in the development of healthcare documentation standards to protect consumer privacy and security of medical information.
Advocating for legislation and regulations that protect the public’s healthcare information.
Setting standards of education and practice for healthcare documentation.
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I SEE NO REAL DIFFERENCE BETWEEN THE TWO!
I see a gigantic difference. You are not presenting the case that people should work toward becoming a Veteran, that it is important to be a Veteran. AHDI, on the other hand, has in the past promoted certification, although I'm really confused now. I don't know what AHDI is saying. It is no longer important? We are no longer medical transcriptionists so it doesn't matter?
Barb,
Can you assure us that uncredentialed applicants will be weeded out in the nomination committee? With so many new directors coming on board and the current ill state of credentialed MTs on the board, this could become a situation where we continue to head in the wrong direction.
@confused, how has technology affected your work as an MT?
@Confused. You ask a great question. Credentialing is more important than ever to quantify the intensity of our medical language knowledge and the diversity of our scope of practice. We also must continue to stake our claim in the healthcare documentation process during a time of critical evolution of how the patient’s encounter is recorded and kept in the electronic health information world, and how there could be unintended consequences unless we preserve the patients full narrative story.
The point that I was making is that you don't have to be credentialled in all aspects of (health information technology) to advocate for an organization or group.
We are no longer an association for transcriptionists alone but an organization that advocates for the integrety of the entire medical record, a patient's story (a patient's life).
From the Open Letter Series letter:
AHDI supports the mission and vision of credentialed individuals and leaders in ANY health information domain.
I do not believe that someone with a degree in HIM cannot advocate correctly and successfully for me. We are all a part of each patient's story.
Ok: Part I:
I understand what Gayle is saying: their group and their board directors don’t all need to be veterans in order to speak well on behalf of our veterans. I see the parallel and hope others do, too. As noted, hospital CEOs are not expected to have M.D. after their names but to hold other valuable expertise in order to direct that hospital. And, yes they are responsible for holding up licensing standards for their hospital. But what does our RMT/CTM credential mean?
Credentials in our society are respected and deemed to signify knowledge, experience, expertise and certainly commitment. We looked for certain credentials in the makeup of our next CEO in that search because they speak to knowledge, experience and expertise. We did NOT require that the next CEO have a CMT; there are other, more relevant credentials and experience we need in that role.
I think you’ll find that AHDI all along has advocated that the quality of the medical record and those who are qualified to bring that quality are what counts. We know that MTs are skilled and educated in the tasks required to produce that quality, and can prove it, and feel they are the most likely to get the jobs when and if it comes down to credentialed vs non-credentialed applicants. Does not having a CMT or RMT make one a “bad” MT? No. Does having a CMT automatically make one an excellent CMT? No, again. And we all know MTs on both sides of this picture. But that credential does give future and current employers a base on which to assess an MT’s skills. If nothing else, it is a commitment to continuing education in medicine, medicolegal issues, security and privacy, and technology.
More and more employers are requiring their workforce to be credentialed, as we recently confirmed with employers at the CDIA conference, with most if not all RFPs (requests for proposals) asking what percentage of a company’s workforce is credentialed. The case is building for employers to seek out credentialed employees for a variety of reasons that include cost effectiveness, quality, security training and dependability.
Part II, please:
The CMT or RMT is the badge you wear on your journey as an MT and beyond. AHDI is saying that you will more than likely need that badge, if not now surely in the future, to potentially keep your current positions as well as to open other doors as technology, medicine and legal requirements for documentation evolve.
I believe it is reasonable to consider that on this journey some of us have identified a path into management of departmental workforces and standards, business owners and/or experts in the EHR, which doesn’t diminish the importance of a CMT, but perhaps makes it less of a priority in those circumstances for them personally. Does that mean these pathfinders understand any less the issues MTs face or have less value? I don’t think so. Does it mean a non-CMT AHDI director skilled and credentialed in associated avenues is any less capable of understanding the issues surrounding our sector or less able to guide our association and profession? Again, I don’t think so.
No, I will not assure you that all future directors will hold a CMT; why would we put that limitation on our association? We truly do need skills on the board of directors that include education, workforce development, management, finance, and familiarity with the issues that face the MT whether service-based or hospital-based and the business of our association. We have that now. We have opened up membership in the association to anyone interested in healthcare documentation, because by including others we can more effectively guide and speak to the standards of quality and skills of those who work in documentation, as opposed to closing our doors to those connections. We can more realistically expect to work side by side with others credentialed in the HIM field as a credentialed workforce. I wish that admission clerks would join our ranks and we were able to encourage them to have learned medical terminology, but maybe that’s just me!
Finally, I value the process by which this issue of credentials and other requirements for running as a candidate for a position on the BOD can be evaluated by a broader representation of our association. If you sincerely continue to feel that this needs further investigation, I invite you to join the Nominations Committee as they work this fall on this issue. I know that the chair of that committee and I would be happy to see more members of this committee.
I disagree Barb. If we are saying that we advocate for MANDATORY credentialing then you are saying that anyone without it is not qualified to be a transcriptionist, ie not good enough. We are really playing both sides of the fence here. Either we say that we want mandatory credentialing and those without it are not qualified to practice or lead or we are saying credentialing is just a nice thing to have. The HOD and BOD, including you, all voted for mandatory which does say that without one is not qualified. Are we going to rescind that vote?
@anonymouse 9:26
I don't think "qualified" in this sense is equal to "not good enough." Any person with a certification has demonstrated through an objective, third-party process that they possess knowledge to perform a given job. The CMT and RMT gives objective evidence that the person has learned a specified body of knowledge that includes medical language, privacy, security and medicolegal considerations, and transcription technology. These are skills used everyday in the execution of medical transcription and speech recognition editing. The association believes that if you perform these tasks on the job, you should be able to demonstrate knowledge of these tasks through an objective testing process.
The CMT and the RMT exams do not test for leadership, business management, the ability to read financials, communication skills, organizational skills, and other tasks performed by members of the BOD. These are important skills needed by members of the BOD.
We're not playing both sides of the fence. There is a huge difference between "being a practicing MT" and "being a leader." I understand that being a leader means setting a good example, and those members of the board that are "practicing MTs" HAVE set that example and ARE CMTs. Those who are not currently practicing MTs are the only ones that do not have the CMT. They have set examples of leadership in other ways, like Kristin has done by pursuing additional education and certification in the EHR (very important to our future), or Sherry, who has shown amazing leadership and business management skills and is a terrific role model for anyone pursuing a management role. Linda has set a tremendous example of legislative advocacy.
A good board of directors (for any organization) is diverse, not homogeneous.
It is certainly your prerogative to disagree; I respect that. I’m sorry that I don’t see it as purely black or white as some do. The HOD resolution stated, “1: Support the restriction of access to protected health information to properly credentialed individuals and actively advocate for mandatory credentialing.”
I also support this explanation: “…if you spend the majority of your day (1)doing medical transcription, (2)editing transcription or SRT drafts, (3)doing QA on the work of other medical transcriptionists, or (4)educating medical transcriptionists, you should be credentialed (RMT for level 1 work, CMT for level 2 work). If you aren't working as an MT but work in some other HIM role, it makes little sense to have MT credentials or for us to require them - no matter who you are or what position of leadership you hold in the association.”
Again, does AHDI think it’s important to the future of MTs as transcriptionists, as SRT editors and as QA managers that they be credentialed? Yes, because it is a valuable commodity for MTs to have. It's not just whether or not those practicing are qualified or not to hold this position; it's also a question of whether or not you can prove it. Is it important to the visibility of our sector and our credibility in urging the preservation of the healthcare story in every patient’s medical record that those directly involved in that documentation be credentialed? We think so. Should everyone who speaks on behalf of our profession or helps guide the business of the association be required to hold the CMT credential? I can’t quite get there.
I'm also not buying this argument. I don't feel that we have been well represented. If it continues down this path, there won't be an AHDI because there will be no need for it. It won't be representing anyone, but it will promote and represent quality of the generic medical record, not just that but the global medical record. We work very hard for our money. Why should I want to invest in that? Who among us is going to invest time and money in an organization that represents a thing, but seems to have less regard for us, as members, every year. I see that we, as members, are told we must stay educated. We must be credentialed. We must stay informed and be ready to call ourselves something else, learn new skills, etc. At the same time, we are told that AHDI doesn't represent us. Why should we bother to continue to be members? That's a real question. I'm not being snarky or sarcastic. I'm really beginning to wonder if membership has any value. Yes, I hear that we should be members so we can promote quality of the medical record. I can do that without a membership. I can write to my Congressman, who never listens anyway, and I can otherwise do my work without representation, and without paying money to an organization that is proud to say that it doesn't represent us.
Finally, I wonder how many CMTs AHIMA has on its board. I haven't looked, but I'm pretty sure they wouldn't consider anyone who didn't have their own credentials in addition to the CMT.
I think most of us discussing these issues want AHDI to be relevant, not only to the record, but to us, the people who do the work. We want and need AHDI to succeed, but we'll be willing to be part of it only if we see that it benefits us in some way, and is not some esoteric group. We want practical solutions to our own problems. Much is being asked of us, but we're not getting much in return. Recently we had an AHDI leader who told us we're pretty much worthless unless we have a degree and credentials. It was almost like the last straw for some of us. That is what started all of this close examination of our 'status' and whether we, as MTs even want to be what AHDI wants us to be. It is confusing. We need to keep talking until we again have an identity and a belief that what we have considered to be our own professional organization indeed believes that we are worth something.
I have to agree with another anonymous. I pay over $100 a year for what? A journal that keeps repeating itself in articles, and the last issue had a kudos to teachers (focused on school rather than professional)???
And yes, if you look to AHIMA board members you are going to find them with the same credentials...CCS, CPC, RHIA....that AHIMA encourages for all to streghthen their professions.
I am a member of AHIMA and AHDI and I get sooo much more from AHIMA and truly feel they are there for their members.
I'm sorry you feel that AHDI doesn't work on behalf of members, that the association "has less regard for members" every year. From where I work and what I see done, and the time I invest in this organization, it is ALL about our member MTs. Again, I will pass this issue on to the Nominations Committee for consideration as an inclusion in the qualifications going forward with candidacy for the National Leadership Board. We do have a process to address this going forward. Any member, at any level of membership, is welcome of be a part of that committee. Just let me know.
Dear Longtime Member and CMT, I agree: I dearly want MTs to feel that AHDI has relevance. How do we do that? I would like to continue this conversation under another topic that perhaps we can title as "relevance." I'll see about posting such a topic in the next few days for a continued conversation. Will you join me there?
"whether we, as MTs even want to be what AHDI wants us to be. It is confusing."
This statement seems to presume that AHDI is the one initiating the change in roles for MTs. Outside forces (HITECH, ARRA, HIPAA) are changing our roles and AHDI is trying to keep our skill set in the forefront of the decision makers and show that we have skills that can be utilized in whatever scenario emerges from the EHR. IT IS CONFUSING! I think everybody in healthcare is nervous, unsure, and unsettled. The entire system is being turned on its head and every sector is scrambling for a place. AHDI believes that a credentialed workforce will be our best "bet" for finding a place in the future of the EHR and emerging documentation roles.
I don't think "AHDI" is asking people to do these things just for the sake of asking. AHDI is trying very hard to secure a place for MTs and their skills and is trying to inform MTs of what is coming down the pike--or more accurately, what is ALREADY hitting us.
@longtime member and CMT @ 11 a.m.
Thank you for your candor. As this thread has become rather lengthy, I'd like to propose we take your very pertinent observation, we "want AHDI to be relevant" onto it's own string. While we are moving it over to it's own title, think about it for a bit and help us with what would make AHDI relevant and particularly your excellent comment "until we have an identity and a belief that what we have considered to be our professional organization indeed believes that we are worth something." This is a very powerful statement and one that bears exploration to ensure that somewhere what we all see as relevant (leaders and members at every level of the Association) intersects and not just on a few occasions.
I would love to see the testimonial of Sherry, Kristin, and Linda as they commit and prepare to take the credentialing exam this year. I think this would make a phenomenal blog series where each shares their thoughts and fears about credentialing later in their careers. How they are studying, how they are balancing their time, how they overcame their excuses. They could be a real example for every practitioner who is making an excuse as to why they should not credential. The final impact of these three obtaining their CMT or RMT would be a tremendously powerful message to every member. Be bold! Be an example!
Longtime Member and CMT, your post above cut me to the heart. As someone who has spent 8 years on staff working diligently to make sure every word, initiative, concept, program, and service is always shaped by the question "How will this benefit and/or impact the working MT?" I can tell you that it is truly disheartening to hear that you feel such a complete disconnect from those objectives. I can't speak for what prompted that AHDI leader to suggest MTs are worthless without a degree (which few around here would ever agree with) or that they are worthless without credentials, which we are trying to rally MTs around recognizing is good for them but would never suggest that you are a bad MT without them. It is your (our) "worth" as knowledge workers that we are laboring so hard to convey to healthcare, members of Congress, to our employers, and to each other.
No MT should ever measure themselves against what they perceive "AHDI wants" them to be. This isn't a dictate or mandate from on high. We're not a regulatory body. We are a hard-working group of MTs, just like you, who are trying to rally our profession across the finish line - where we all have a relevant, contributory role in the EHR, where we have positioned our skills and core competencies in a measurable way, and where we are valued by the healthcare team as a qualified allied health member.
You mentioned that much is being asked of you. Aside from the invitation to consider membership in AHDI, we are asking nothing of you. That's probably the most empowering thing I can say to you and others who feel as you do. We are not asking you to do anything for us. Nothing for AHDI. We are pouring our energies (as best we can) into creating opportunities for you to do something for YOURSELF - to be an advocate for yourself, your value, and your skills. We believe there is a chance credentialing can help us do that for ourselves and each other, but there are no guarantees and we recognize that some may not agree. But that doesn't change our plans to continue to push the MT skill set as far as it can go.
I would love to talk with you one-on-one to heart your concerns and get your feedback on how we can convey that message better. Please feel free to email me at lsims@ahdionline.org
Lea M. Sims, CMT, AHDI-F
Director of Professional Programs, AHDI
Thanks to all of you for hearing what I had to say and responding to it. I appreciate the fact that all of you are here and available for discussion. I'm like everyone else, struggling through a tough economy and wondering what life will be like 10 years from now, and knowing that nobody knows. I know that AHDI is having to map out the future when there isn't enough yet to go by.
Lea, maybe I will contact you, although you've probably heard enough of me by now.
Lea wrote: but would never suggest that you are a bad MT without them...
I disagree! This was exactly what AHDI was promoting a while back. Look back at your promotions!
You'd have to be more specific, Anonymous, and point me to a specific instance of us ever equating a lack of credentials with "bad" MT skills because I've been pretty zealous in our messaging to make sure we are conveying that credentialing is about registering your skill set through an accountable exam process.
What is interesting here is the assumption that AHDI thinks you're a bad MT if you don't have credentials. The reality is that without your credential, we have no idea what kind of MT you are. That's the point. If you repeatedly bombed the credentialing exam and couldn't transcribe even the easiest of audio excerpts on the exam, I might be led to question your skills as an MT. But if you've never been through the exam, we couldn't possibly assert that you're a bad MT (or a good MT). Your skills are, quite simply, undocumented through any formal verification process.
Credentialing is not about stamping "good" or "bad" on the foreheads of all MTs. It is simply an objective measurement that attests to a defined scope of practice and skills. Having a driver's license doesn't make you a good driver anymore than having an MD after your name makes you a good doctor. It just means you've met some minimum benchmarks that allow you to do those things in a way that doesn't put the public at risk. And that's exactly what we're talking about with credentialing MTs - we want to make sure that MTs are required to meet some minimum benchmarks before having their hands in a US health record.
-Lea
Lea,
If credentialing ever becomes mandatory which is the Association's push doesn't that mean an MT without them would not be qualified to transcribe?
"...doesn't that mean an MT without them would not be qualified to transcribe."
I'm sure Lea will reply, but I thought it would be useful to point out there are two meanings for "qualified."
qualified
1 a : fitted (as by training or experience) for a given purpose : competent
b : having complied with the specific requirements or precedent conditions (as for an office or employment) : eligible
The credential would make you qualified under definition b. Actual work experience and performance on the job would qualify a person under definition a.
None of us would allow a physician to practice on our children without a medical license or a lawyer represent us in a legal case with the bar license. Each are mandatory. Coders cannot code without their credential. They are viewed as unqualified. I think we are saying that one can be knowledgeable enough to do the job but unqualified due to like of a proper license, credential, or certification. If mandatory credentialing happens, then those without it will be out of work. There is no way to sugar coat that point.
Point of correction: coders are not required to have a credential. In fact, there is no REQUIRED credential for any health information management position.
They may be preferred. You may not be able to get a job without one. But they are not REQUIRED.
And you simply cannot compare the education, license and credential requirements for individuals who see patients, make medical decisions and/or provide hands-on treatment with positions that require no education, make no medical decisions and don't even see patients, much less touch them.
None of which has anything whatsoever to do with the discussion.
If you cannot get a job without the credential, how is it not required?
Julianne, just because there is no regulatory body that mandates it does not mean coders are not required to have a credential to code or that HIM managers are not required to have an RHIA to hold the position of HIM director in a hospital. Each of those people will darn sure tell you that their credential is "required" in order for them to have a job. It is more appropriate to say that they are not mandated by a regulatory body to hold those credentials, but that's not the same thing as saying they are required. We would like to see MTs held (preferrably by the marketplace) to that same requirement to have access to patient health records.
-Lea
We will not get to this place of requirement so long as CDIA refuses to require it. This really should be a focus of our partnership. If you cannot convince CDIA, then we might as well give up.
We definitely cannot get there when our own board cannot agree to become credentialed.
Anyonymous, CDIA as an organization is as powerless to make its members comply with its position on credentialing as AHDI is to force MTs to earn a credential. Members (in both organizations) are feeling their way around the subject of credentialing right now. Everyone, including CDIA board members, think credentialing MTs is the ideal. If one could wave a wand over our workforce and "make it so," the leadership of both organizations would be happy to see it happen. In the absence of a magic wand, however, the practicalities and logistics of making that happen are more complex. In many ways, MTSOs are guilty of the same problem MTs are guilty of - they're waiting for someone or something to exert regulatory or contractual pressure on our sector that forces the hand of everyone in it to get credentialed. If we had the Joint Commission or CMS, for example, scrutinizing the qualifications of those who have their hands in the record, we'd see external pressure from those agencies on our healthcare facilities, who would then require credentialing of their own MTs or those they outsource work to. MTSOs would have to respond by seeking only credentialed MTs.
In other words, everyone has their arms crossed and is basically saying, "Make me." The MTs are doing it, and most employers are doing it. They prefer CMTs but until someone makes them hire only CMTs, they'll continue to hire the qualified, whether credentialed or not.
Where CDIA has specifically expressed an interest in our credentialing program is in the area of privacy and security training and evaluation. Given the fact that our new RMT blue print contains a considerable number of HIPAA and regulatory compliance objectives, CDIA board members felt that better positioning our exam as one that certifies MTs in those domains would be something they could leverage with purchasers. So I'm going to be exploring how to make that happen. It's been suggested that we're long overdue not only for a change in role/title for this sector but also a change in title for our credentials so they communicate something that healthcare cares about and is willing to pay for (such as HIPAA certification). We intend to push that envelope moving forward.
Meanwhile, we continue to work with our colleagues at CDIA to figure out how to address the dilemma of getting our workforce credentialed in a way that makes sense. And breaking our relationship with them - ie, pulling our toys out of the sandbox and going to play elsewhere just because they don't do what we tell them to - is not going to get us any closer to our goals. We're not letting up on our messaging to them, but we're also not issuing them any empty ultimatums.
-Lea
Mandatory credentialing will happen, over time. I'm confident of that.
I’ve always been protective of the CMT, A big promoter of it, and I probably always will be. I’ve been almost militant about the fact that our BOD should be made up of CMTs, until yesterday evening. I have changed my mind.
I sat here and mentally went through the various boards I’ve served on and the two that I serve on now. It was an eye-opener for me, one of those thumping your head kinds of ‘What was I THINKING?’ moments. I had let my CMT ego get in the way of common sense.
Our BOD for the Big Brothers and Big Sisters included people who had never been a Big Brother or Big Sister. They were accountants, business people, and attorneys. Depending on the topic we were discussing, they went from just listening, when we talked about things out of their realm, to being our main resource when we were making decisions in their area of expertise, legal matters, accounting, etc.
Our BOD for the Better Business Bureau includes all business owners other than spots held by newspapers and television stations, valuable resources to us even though they are not business owners.
Our BOD for the Oklahoma Board of Private Vocational Schools includes, by state regulation, a certain number of board members who are executives with the Department of Education, a certain number of board members who are executives with the state career schools, several slots for business people, and then a required number of slots for private school owners like me.
Using the same ‘rule’ I had in my mind and stubbornly held to about the AHDI BOD on these other boards, things look dramatically different to me. Many times during the Private Vocational School meetings, members turn to me to ask questions that only a private school owner could address, but I often turn to the attorney at the end of the table to ask for his recommendations, and wouldn’t dream of attacking the duties the CPA at the other end of the table handles with ease. Then there are the business people who have certain contacts that we need, and those state executives who have access to information and facilities that make our board more effective. They also make our board life easier for us.
After thinking about it and fighting my natural tendency to make all things about the CMT, ready to fight if anyone challenges that CMT in any way, I now see the great benefit in having others on the board who are not CMTs, when they bring needed resources to the board.
Linda,
Thank you! Thank you! Thank you! You said this so much better than I did. This is what I was trying to get at when I made the comparison to the veteran's organization I am involved in.
To me, this is just common sense! Thanks for clarifying and detailing further. AWESOME!
Lea wrote: You'd have to be more specific, Anonymous, and point me to a specific instance of us ever equating a lack of credentials with "bad" MT skills...
It may have been an MT week promotion several years ago. It said something like only CMTs produce accurate and quality medical records, thereby, in my opinion, implying that non-CMTs produced inaccurate, poor quality medical records.
I believe that the end result of this rather long string of comments (over 90! Wow! That just might be a record here!), one of the things that should be evident to all is that, once again, there is no consensus on this issue. As strongly as some might feel about the lack of CMT of a few of our board members, others do not see it as a flaw or a conflicting message. This is the nature of associations, folks. Despite how passionately we may feel about an issue, positioning our feelings on a table where conflicting positions are also given equal consideration can be humbling (and admittedly frustrating). All of this, I believe, is good feedback for our nominating committee as they consider the qualifications of those running for office on our new NLB.
I personally would like to thank all of those, anonymous and otherwise, who have hung in there with us here through a tough week of back and forth. These issues are not as easy or as black-and-white as they appear.
We have our work cut out for us!
-Lea
Lea will the nominating committee require a CMT from all board candidates for the district directors who come from an MT background?
@Lea and @anonymous (whichever one it is)...
There is no legal requirement for coders and other HIM practitioners. Just because the employers prefer it doesn't make it required. I am certain there are positions that don't require it, and that there are positions that prefer it but will hire an uncredentialized person under the right circumstances.
There's a difference between preferred and required, credentialed and licensed.
@Linda - I don't think a credential will ever be mandatory for medical transcriptionists, much less required. At best, I think it MIGHT be possible to make the case for it to be mandatory for supervisory or quality assurance staff.
@Julianne- I believe you are right about it never being mandatory especially with the inability of our board or CDIA's board to get serious about it.
CDIA's actions or inaction as well as some comments on For the Record make it clear they have no desire to require it, most likely because they fear having to pay more and clients just do not care about the credential.
Even our Association is unwilling to require all instructors of ACCP-approved schools to be credentialed or requiring it of the board who come from the MT side. These two areas should be no brainers.
I do feel that we have tarnished our reputation with the bold statement of making it mandatory and then lackadaisical approach since that time.
I just want to add a point of information here. I am chairing the Model Curriculum Revision Taskforce this year. We are indeed looking at whether it should be mandatory for instructors to have their CMT. So at least in that arena, this is being addressed.
@Julieanne, I would disagree with your assertion above that just because a regulatory or legal authority is not mandating it, that a credential is not "required." I'm not talking about employers who put "preferred" on their job ads. I'm talking about the jobs in HIM for which the credential absolutely is "required." I looked in my local newspaper on Sunday and happened to see 5 job openings for HIM directors or medical records managers for which a minimum of RHIA was required (not preferred). I think you would be hard-pressed to show me very many ads for coders or HIM managers/directors where those credentials are not required to even apply for a position.
The hair you are splitting here is not about whether a credential is required but, rather, WHO or WHAT is requiring it. Certainly regulatory requirements have more irrevocable teeth to them, but that doesn't mean that a strong marketplace requirement doesn't yield the same impact on a workforce when it comes to whether they get that credential or not.
-Lea
I had a personal struggle with this issue. I strongly considered running for the board this year but even with an Associate’s degree, two bachelors, two masters, one being an MBA, and currently working on my doctoral degree in business administration, I do not think I am qualified solely because I do not have the CMT. Could I do the work, sure. Would me not having a CMT send the wrong message, absolutely. I can make the excuse that I only work on the business side, do not transcribe, do not teach MT, do not QA, and do not head a school, but the truth is that is just an excuse. I come from the MT side and for me to be a director of an Association that has a goal of mandatory credentialing, I should be credentialed. If I was coming from the coding side, I should have that credential. It is a goal I am working on for this year and until such time there are more qualified CMTs who should be heading the association.
@Lea - the anonymous poster stated:
"None of us would allow a physician to practice on our children without a medical license or a lawyer represent us in a legal case with the bar license. Each are mandatory. Coders cannot code without their credential."
This implies by comparison that there is no difference between the requirement that physicians and lawyers be licensed and a coder needing a credential. There is, in fact, a big difference.
A doctor cannot practice medicine without a license. A lawyer cannot practice without a license. Neither has the option of seeking employment in those fields without the requisite license. A coder may seek employment without a credential and an employer may choose to hire a coder who isn't credentialed.
In my opinion, that fact that it isn't legally required is not the same as most employers requiring it. It is still a choice for both parties. It is not a choice for doctors and lawyers, physical therapists, etc.
Julianne, you are right but it is very much splitting hairs. From the practitioner side as a coder my only concern is if I can get a job without the credential, not who is keeping me from getting a job without it (government vs. essentially all employers). Either way I would be unemployable, not qualified, and forced to get the credential in order to perform my job.
@Julianne Thanks for clarifying that. I agree with you 100% but also think we need a different mindset in our sector about what "mandatory" would ever look like - more likely to be successfull (if at all) through a marketplace requirement than a regulatory one - unless we can make a solid argument to someone like CMS or HHS or the Joint Commission that there is at least SOME risk to the patient in having unqualified hands in a health record, considering how inconsistently physicians actually read the records they put their signatures to.
@Chad Your assertions are probably correct. But if there are "more qualified CMTS who should be running the association," it would help GREATLY if any of those people would actually step up to the plate and run for a board position. We would not be having this discussion if that were the case, and you are well aware that we had our hands full trying to fill the ballot for every open position. Something has got to give here. There needs to be some transitional "grace" extended over this board while we get more people to (a) get their CMT and/or (b) be willing to run for the board, because right now, we're spending a lot of time here hounding the handful of people who are actually willing to serve at that level. :(
-Lea
Chad, I think your reasoning is backwards. As Speaker-Elect of the House, you most directly represent the membership and are definitely in a position of leadership. Why is it not important to have that CMT as SOTH, but it is imperative that you have it has a candidate for the BOD? Given the roles and responsibilities of the House and the BOD, your reasoning doesn't make sense to me.
Your current qualifications and academic credentials are very appropriate to the role of the BOD.
Linda Andrews put forth a very clear description of a diversified and functional board. A variety of expertise is required, and insisting that everyone on the board be a CMT is NOT in the best interest of the association. YES, there SHOULD be CMTs on the board--ABSOLUTELY--but making that the first and foremost requirement would prevent us from attracting the kind of diversified skill set that is needed to make decisions at the BOD level of the organization.
If this discussion was about requiring CMT for the House of Delegates, I'd be for it 100%. Of course, we'll never have that discussion since the HOD is on its way out. That's where the criticism should have come--that the HOD did not expunge itself of noncredentialed members when it voted to support mandatory credentialing.
The BOD serves an entirely different function and is best populated by a group of DIVERSE talents.
The argument is not addressing the roles and responsibilities of the BOD and how a CMT credential contributes to a person’s ability to perform in THAT CAPACITY. For those who argue that the CMT should be required for all directors, please outline how the attainment of the CMT would make a person a better director and how a board fully populated with CMTs would best serve the interests of the association.
@laura: "If this discussion was about requiring CMT for the House of Delegates, I'd be for it 100%. Of course, we'll never have that discussion since the HOD is on its way out. That's where the criticism should have come--that the HOD did not expunge itself of noncredentialed members when it voted to support mandatory credentialing."
You're right, this one really isn't relevant either. In the very same HOD where the House voted to support mandatory credentialing, they voted to dissolve themselves. There just isn't anyway to expunge from something that will cease to exist. Frankly I'm not sure either one makes sense.
In the end, as long as we make excuses for anyone, and that does include leaders, I think we lose our audience. That would seem to bear itself out by looking at the current list of board candidates and seeing that only two or three of the elections are even contested. For everyone else, they are in by default. Perhaps the better question in all of this is why people aren't interested in stepping up to those roles. Some of it no doubt is because there are fewer members in those categories where they could serve in the first place. For the first time in over 20 some years, I see no reason to vote; everyone on my list to vote for is running unopposed and that means it really is a case of the vote not counting.
You also have to wonder to what extent the "politically unpopular" state of AHDI has to do with people deciding to not run. There are too many people online that find pleasure in bashing the association just for the sake of bashing it. How many want to volunteer 20 hours a week, give up time at their desk to make money, spend their own money to travel to unreimbursed venues, give their all to something they are passionate about only to be publically ridiculed and derided for "not caring about the MT anymore." Those who say that simply have never met the people that run for the BOD.
I would also add that the same thing applies to staff. This group of CMT staff members give way behind their paycheck and far beyond 40 hours a week and are treated with such disrespect, it literally breaks my heart.
I'm all for public discourse and public comment. Constructive criticism is good and should be welcome. But just as journalism has long served as a check on public/government excesses and abuse, it has now turned into a circus that neither informs the public or contributes positively to necessary public discourse. The same thing has happened on the MT blogs and forums. Many of those who criticize are not interested in improving the association; they are not interested in facts; they are most interested in destroying it. The new American pastime is to destroy, not build. For that, we should all hang our heads.
@Laura- This was a realization I made after I stopped making excuses for why I did not have it, primarily after we passed the mandatory resolution. I would now say that a delegate/SOH should be credentialed but it is irrelevant since the House is going away.
I will be perfectly honest here. I do not believe we are serious about mandatory credentialing. This is what I told Peter last year when he mentioned the resolution would be coming out. I felt we were at the point that if we said it again and failed to deliver, mandatory credentialing would be lost. A year later and I see no real progress. I see the same as before. Uncredentialed board, uncredentialed instructors, CDIA seems to reject it.
Regarding the board being credentialed (RMT/CMT), it is simple. If you come from the MT side as a practitioner, program director, etc, there is no reason not to have the CMT or at the very least the RMT. I will also agree with others that credentials other than the RMT/CMT are good add ons, but MTs need the RMT or CMT as their primary credential. I would question why we push to get out non-MT credentials or school degrees but refuse the RMT/CMT (and I am speaking to myself here too). Our resolution made it clear, everyone would have the RMT or CMT. I also agree with others that we cannot say mandatory as in you cannot get a job without it if we are successful, but you can lead the Association that is trying to make it so that you need it to get a job. You cannot advocate for something you yourself refuse to do even if you can make a logical reasoning why it is not necessary for you. Well, you can, but people will see you as a hypocrite and your message would be hurt. Let's be honest, this current issue has caused some undesired ripples.
I do understand that it can be hard to get candidates, but a lack of people wanting to run is a whole other issue. Still, I was extremely pleased to see that the overwhelming majority of board candidates are credentialed (CMT/RMT).
Lastly, I cannot think of anything more powerful and meaningful than the directors without the CMT committing to taking the test before this year is out. The impact that could have on people making the same excuses could be significant. Now that would be a great Lounge thread.
@Laura- I completely agree. I have zero issues with members or those volunteering who shout their issues from the roof top. I think they should do so. We need to shed light on real issues or we will keep our head in the sand. We do have some very legitimate issues we need to fix and our declining (non-KB) membership shows that to be the case (even though some will argue that the huge losses are a sign of other things). Still there are a great many others that simply look for "gotcha" comments to put on their blogs, forums, etc. I think that serves no purpose other than to drive traffic and form clicks that ultimately do more harm than good. Still, there have been some who have made very insightful comments. If someone does not feel, for whatever reason, that they can get an issue addressed through AHDI or feel it should be discussed openly, I think they do well to post it on blogs, forums, etc. For me, I think when it is done right and with the right reasoning, it is ultimately good for the Association.
One criticism though that has been legitimate in the past is that people need to be able to freely comment that something is wrong without feeling like their is a concerted effort to shut down their opinion. I think this has gotten much better but it is interesting to see what appears to be a behind the scenes planning of what to say followed by a group posting back to back with extremely similar comments.
I would say that I think we need more directors replying in these threads. The initial topics are interesting as are the initial drafts, but the replies are largely dominated by staff. In a director-led series, I think it should be the other way around. I think the majority of the opinions of the Association should come from those making these decisions. Members need to know where their directors are coming from so they can see them as meaningful.
Chad: I see lots of buzz everywhere on folks really looking at credentialing as their next step, particularly on FB with people looking for study groups. Even in my working environment, we have more people interested than ever in considering RMT/CMT as one of their goals for this year. It may be too soon to tell if we're making headway on a grander scale, but I do think are gaining momentum.
@Karen, I think you are right about the "buzz." I hear more and more MTs talking about getting their RMT or CMT. I've even seen a local hospital start to change directions--they were longtime critics of credentialing and now many of their staff members are getting credentialed.
@Chad, Just for the sake of playing devil's advocate, how would you define an "MT coming from the MT side as a practitioner"? The three current directors that are not credentialed are not currently transcribing or doing QA. All three have done that job in the past—some recently and some remotely. How long should that interval be between practicing as an MT and working in a different role? Should we write the rules to say that if you EVER made a living as a practicing MT, editor or QA, you must have either the RMT or CMT to run for the board? You could argue that Sherry is management, not an MT. One could argue that Kristin represents the EHR and vendor community in her current position and Linda is an MTSO owner. I know it sounds like I'm hedging on the mandatory requirement, but seriously, there are questions that would have to be answered and put down in black and white policies and procedures. We would further need to define how many CMTs are required on the board. That would rabbit trail into how many other kinds of representative roles should be on the board. If we determined that there are a requisite number of each type of role, how would we maintain those numbers given the rotating nature of the board positions? These are all questions that would need to be addressed.
I'm not saying this is an impossible task or an unreasonable task, but it certainly needs to be addressed in order to require the RMT/CMT credential on the board.
@Chad, I agree with you in regard to public comments and criticism of the association. Absolutely, people should be able to come forward with their comments without concern for being ridiculed. Comments made on public forums serve a tremendous purpose and should not be squelched, even if they are negative of the association. Honestly, I don’t think censorship has ever been on AHDI’s agenda. Jay, you have been the moderator for many of AHDI’s official public forums, I think you can address this issue most directly.
I think that people have mistaken the "right to openly criticize" as the right to call names, slander, and sling mud. There is a big difference between making legitimate criticisms based on facts (not gossip and hearsay) and name-calling, gossiping, and ignoring facts. I believe that those who have screamed most loudly about AHDI's "censorship" have been those that believe name calling and mudslinging is a legitimate and productive form of public discourse. Unfortunately, our nation’s elected officials are not setting an example of leadership in this regard. It is that form of "conversation" that drives many people away. When I attend FTF meetings, it is not unusual for MTs to tell me they will not participate in online forums because of the hateful nature of the conversation. Unfortunately, their voices are not heard, and that is the real shame. Those who believe they are doing their “civic duty” by voicing their concerns in a hateful and destructive manner are actually intimidating and squelching the voices of others. There’s a serious irony inherent to that behavior.
@laura. I completely understand and agree with your question/comment about how we draw the line or should draw the line. Just to be sure this is not lost, I think all three have a lot to bring to the table. I know each and value their contribution which makes this a tender topic. I did voice my concern with several directors during Advocacy and shared some of the many comments members had voiced to me regarding this issue and the hopes that each would commit to test this year.
One heads/develops an MT training program making her an educator so that changes that dynamic especially if the new ACCP approval requires credentialing, two others supervise MTs and have access to PHI. I would be curious if any ever tested or will test and why not. It would be ironic if none ever tested since they could have the necessary experience for at least the RMT. I really felt like I was seeing reasons any practicing MT would give. “I can do my job without it” or “I am working in other areas” or “here is what I am doing for the Association.” I see it more like a nurse or physician who decides to move into management. They still maintain their primary professional credential. I would say that someone who has only ever handled the business side (as seen in some of the big MTSOs), never the MT side would require an MBA as that is their roots. I would expect someone who designs software to have their appropriate credentials/certifications.
@laura for the post above. agree completely. We should be able to completely disagree even in a heated way but never devolve to it being personal. Once it hits that point, any point the person(s) have is lost.
With regard to the approach to openness here on the Lounge, I can tell you that one of the conditions for my participation in the Lounge was that we allow people to express their opinions in a civil manner regardless of whether or not their views adhered to the organization's stated positions. I've never gotten any pressure from anyone at AHDI to censor someone or some point of view. I have taken some flak from a few folks over the fact that the Lounge is a moderated blog, the idea being that in order to truly give people freedom to express themselves, there shouldn't be any moderation whatsoever. I believe we've struck a balance between freedom of expression on the one hand and preserving a climate of civility on the other. I've deleted very, very few comments, and it's always been because of personal attacks, name-calling, etc., not because of the point of view being expressed.