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The AHDI Lounge is an exchange blog for dialogue and discussion around trends, drivers, and challenges facing the healthcare documentation profession and a place for AHDI members to address these issues. It's just a spot for busy MTs, editors, educators, students, managers, and service owners to chat about the profession. So grab a latte and join us!

About AHDI

AHDI (Association for Healthcare Documentation Integrity) is the world's largest professional society representing the healthcare documentation sector. Our purpose is to set standards for education and practice in the field of health data capture that ensure the highest level of accuracy, privacy, and security for the US healthcare system.

Medical Transcription's Uncertain Future

A recent article in For The Record magazine highlights the challenges facing the medical transcription profession as the U.S. moves slowly but inexorably toward an electronic medical record environment. The article, by freelance journalist Selena Chavis, doesn't cover much new ground in terms of what MT professionals already know: technologies such as speech recognition and EMRs are having a negative impact on transcription volume, but nobody knows for sure what the future holds for the profession.

From my perspective, there are a number of trends in motion which will impact the medical transcription industry in the coming years, some positively and some negatively. On the downside, more and more hospitals with in-house transcription departments will look at outsourcing as a cost-cutting measure. There's no doubt in my mind that in-house MT positions will become much scarcer in the next few years due to outsourcing. At the same time, some of those MTs may decide to pursue other career opportunities within their institutions, perhaps in coding, abstracting, quality improvement, or EHR support roles. Speech recognition technology will continue to negatively impact the volume of traditional transcription, but again, the increased use of SRT will create an accompanying demand for more MT editors. Finally, I think it's safe to say that EMRs will generally decrease the demand for transcription, some more than others. For instance, our local hospital is implementing the Epic EMR, and their plan is to eliminate transcription altogether (we'll see how that works out). But not all EMR implementations are created equal in that respect; some customers include a dictation/transcription option in their workflow because the doctors demand it.

Overshadowing everything in this discussion is the fact that the demand for healthcare documentation is going to explode over the next 20 years as we Baby Boomers reach retirement age. I strongly believe that over the next couple of decades, even with EMRs, speech recognition, natural language processing and who knows what else, our healthcare delivery system is going to need plenty of skilled healthcare documentation professionals in a variety of roles. Yes, we will have to adapt to new technologies and new ways of doing things, but what else is new? Adapt is what MTs do, and I have no doubt we will continue to do so for the foreseeable future.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator
Director, District 1
AHDI National Leadership Board


  1. Anonymous said...

    Then MT "schools" should STOP recruiting students and lying about future employment!

  2. Anonymous said...

    The approval process should stop approving programs that take under a year to complete. We need acute care MTs, not clinic work.

  3. Anonymous said...

    At the very least, MT schools should start including a solid editing component, which few of them do.

  4. Jay Vance, CMT said...

    There will continue to be a demand for transcription and SR editing over the next few years, and even now there are not enough new practitioners coming into the field to make up for the attrition that's taking place in our industry. Additionally, MT schools are starting to look at what additional training elements they need to include in their curriculum to keep their graduates relevant in the work place.

  5. Anonymous said...

    The demand will continue to drop as jobs are sent overseas also. Why do we not have lobbyists to prevent that from happening, hint hint. The pay has dropped significantly, benefits are horrible. Maybe if the overseas outsourcing would stop then maybe we might have a chance to make some money instead of always seeing NJA. I agree that schools should stop recruiting as there is no future in being an MT anymore, which is unfortunate as this was a great profession. If there was ever a job that should be "Made in the USA" this is it. No foreign country should have access to medical records and personal information. I know, I know no one ever listens to me.

  6. Chad Sines said...

    I am going to be blunt on this first point. You are not going to stop overseas transcription any more than PhD computer engineers could not stop programming jobs from going overseas. Face it, we leave in a global economy. You either compete or perish.

    It is disturbing to see so many "we are done" comments at a time when many services of all sizes are spending a lot of resources trying to recruit qualified acute care MTs. Read into that..not clinic work MTs. Maybe you are talking to different services and facilities than I am, but we keep placing our graduates easily. What many of us have been saying for so long is that clinic work training leaves the MTs unqualified for the jobs that are in high demand. We have to up our game. CMT instructors, CMT program directors, acute care training, program lengths greater than 12 months.

    We also have to branch our training to include HIM and other related areas so that we control our future and not someone else. MTs are positioned with a knowledge set that other allied health do not possess yet we have been unwilling to demand our seat at the table.

  7. Betsy Ertel, CEO said...

    In response to Chad's post, I would like to confirm that during the AHIMA conference this year in Salt Lake City, I walked the vendor hall speaking with the 20 MTSOs on the floor. They were All looking for MTs to serve in the capacity needed for their workflow and some were even looking for smaller MTSOs to partner with. We are not dead yet folks. Evolving maybe, but not deceased. Maybe we as an industry could better match up the needs of the MTs with the needs of the MTSOs?? We have AHDI and we have CDIA with active websites. I see a golden thread here.


  8. Jay Vance, CMT said...

    Part of the problem MTSOs are having finding enough workers has to do with the level of compensation the average company is offering. The cutthroat competition on pricing is rapidly approaching the point--if it hasn't already reached it--where experienced, highly skilled MTs simply will not work for what is being offered. Until that dilemma is solved there will continue to be a shortage of skilled labor. I understand the pressures MTSOs are under to compete in this cost-conscious marketplace, but I also appreciate the fact that at some point MTs will--and should--say "No!" to both a level and a method of compensation that treats knowledge workers like widget makers.

  9. Anonymous said...

    The average company is often offering the best it can. It is having to compete with the big companies who are bidding at rates under 6-7 cpl even for domestic-only work. These companies cannot pay more than they bring in.

    One message AHDI has failed at is getting MTs to realize that MTSOs are not raking in the money and shafting them in the process. Many are struggling just as much as the MTs they employ.

  10. Anonymous said...

    Regardless of whether or not MTSOs are raking in the money, some of the line rates being offered are flat out insulting.

  11. Anonymous said...

    What do you suggest? If those rates are what MTSOs need to secure the account, how can they pay more?

  12. Anonymous said...

    Maybe the rate being paid to and by MTSOs has bottomed out. Isn't that one of the features of a market economy? Now that compensation is too low, maybe rates should stabilize. Even the big companies won't make it if there is no margin for profit.

  13. J. Hohman said...

    I have been working with voice-recognition software now for a little over 2 years. Overall, I am not very encouraged by what I have seen.

    Since hospitals are now outsourcing their transcription (and, unfortunately, I am one of the many displaced MTs who have lost their in-house MT position because of outsourcing), I have noticed some very alarming trends, the most important of which is document integrity.

    The going rate when working for one of these outsourcing companies is 4 cpl for edited lines. The trend I now see is because of such low wages, MTs are now more apt to leave blanks in reports instead of trying to research information, even looking back at old reports. And, dare I say, most of the doctors DO NOT fill in the blanks in their reports, or even read their reports before signing them. This leaves the burden of maintaining the integrity of the document to the MTS, who unfortunately is more interested in making money instead of document integrity.

    I myself have been a victim of this; I had an ER visit at my local hospital, and there were blanks left in my report by the cardiologist. I complained and complained, but nothing ever became of it, and hence I have an incomplete, inaccurate medical record. This is very, very frightening to me.

    Unfortunately, I think it's going to take patient deaths (if there hasn't been already) for change to occur. In my opinion, I think this is by far the worst outcome so far with VR software. If medical facilities, large and small, want their documentation correct, they are going to have to start paying their MTs more. I think the old saying applies here: You get what you pay for.

  14. Anonymous said...

    Future of medical transcriptionist? Galley slave. As a 30 year MT, I feel the downgrading of transcriptionists is appalling, and I'm frightened for the medical record/patient. Post outsourcing, I'm now working for a transcription vendor who is voraciously gobbling up smaller companies. We now make near minimum wage despite our formal training, experience and skills, and our having invested a lot of time and money in continuing education. The skills and education good transcriptionists strived for and were proud of are not an asset in today's transcription industry, in fact, are a hindrance, as we transcriptionists are instructed by our employer to "produce as much as you can, type what is dictated regardless of discrepancies/errors/omissions; it's the MD's job to sign the report and fix errors," (and not being permitted to bring a discrepancy to a provider's attention, instructed to disregard JCAHO mandates, etc.) It's very difficult to type a garbage report when for decades the focus was on quality. I no longer say "I'm a medical transcriptionist" with pride, but with shame.

  15. Anonymous said...

    I was an MT for 10 years. I loved it and made a decent living for the first 6 years or so. Then SR (aka speech "wreck") came about, and so began a downhill slide. If that wasn't bad enough the company I worked for was sold to another larger, well-known company. After two pay cuts, loss of bonuses and bennies, and the final slap in the face, my account of 10-plus years going away one morning without warning, I was forced to seek opportunity elsewhere. Until things get bad enough, and enough medical mistakes are made to put the pay back up where it belongs the field will continue to lose good, qualified people. Who can afford to have pay CUT to minimum wage for a skilled profession? It got to the point I could have gone and flipped burgers and gotten more $$$ and respect! Yes, MTSOs are recruiting, the one I used to work for has left a couple messages asking me to consider coming back. I'd love to, but I don't trust them anymore and never could again. Very sad.

  16. Anonymous said...

    I am an hourly MT, mainly because my job is so diverse and full of interruptions, and I work in a doctor's office setting. Since there is potential that my job may have to change directions, I was wondering what the average number of lines per minute for MTs is out there, and the average pay per line. Can anyone shed some light? Thanks bunches.

  17. Anonymous said...

    I am a small MTSO who still does pay my MTs well (10 cpl), but I don't know how long I can afford to do that, because my clients no longer want to pay 14 or 15 cpl. I already can't afford to hire any office personnel or QA; I have to do all that myself. And I am a working MTSO, because I have to transcribe myself to have enough income for myself. Contrary to what some MTs believe, MTSOs don't get rich off of the work done by their MTs. Maybe some of the bigger ones do, but the smaller ones don't. Now I am looking at needing to spend 2 cpl (or more) for a "technology partner" for a platform, EMR integration, electronic signature, etc. to be able to compete with larger services. I don't know that it's worth it. I'm honestly considering getting a job in an HIM department doing other work, while I pursue an RHIA, and run my transcription business on the side. I have already lost two clinics to EMR. They literally switched to VR overnight. It's scary that it can happen that fast. I have surgery center accounts that are looking for ways to cut costs and I'm sure if they find an EMR that allows them to eliminate transcription, they will do it. And I have a hospital account that has just chosen Epic as their EMR, so I'm afraid that will impact the volume of work as well.

    I don't blame transcriptionists for not wanting to work for 8 cpl. I wouldn't do it. The work we do as transcriptionists is nose-to-the-grindstone work. It is tedious and mentally exhausting. There is a lot of knowledge required. The pay should be much more than it is for the work we do, but that is never going to happen now. And yet, you go into a clinic and see the clerical staff with no special skills or knowledge making what - $15 an hour plus benefits? - and their jobs are so easy compared to ours. They can chat, do one thing for a while and then do something else, do nothing at all when there are no patients checking in, etc. etc. Transcription is very different because you have to be concentrating intensely on what you are doing for every second that you are being paid. When your hands are off the keyboard, you're not being paid.

    The truly skilled transcriptionists are going to pursue other options, because it's just not worth it anymore.

  18. Technician 101 said...

    Private practicing physicians may need medical transcriptionists to keep their files organized and coordinated. They have proved to be invaluable as office staff and can ensure efficiency in a physician’s office. They pay a mean wage of $16 per hour, or $33,320 annually on average. Average Wage of Medical Transcriptionist

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