Part - IV

(To read Part III, click on the �Previous Article� link, on the left)

The possible long-term effects of price competition on the entire industry could be enormous. The shortage of qualified transcriptionists in the U.S. stems largely from aggressive outsourcing by hospitals in the late 1980s and early 1990s (a move designed to cut costs), which deprived the industry of a comprehensive training base. Not only do services typically not have the resources to train new transcriptionists, price competition in the acute care segment of the market drove down pay rates, making it difficult to attract new people. Transcriptionists chose instead to work in the clinic segment of the market or as independent contractors servicing a few small physician accounts and the number of MTs trained in acute care transcription continued to dwindle. The drain has continued as the U.S. economy began to improve and technology opened up more jobs that could be done electronically. Many experienced transcriptionists, their children grown and gone, have evaluated pay rates and stress factors and made the decision to return to the work force outside their homes, where they can work set hours and receive benefits not typically available to workers in the industry. In a healthy economy, the earning power of a medical transcriptionist in the U.S. doesn�t compensate for the amount of time spent learning terminology and the skill level required. Individuals whose education and level of competence would make them an ideal candidate find other opportunities available that provide higher pay and better benefits. While these conditions are in favor of overseas companies entering the market, timing could be a problem � the availability of US transcriptionists to train and edit, the skill level of overseas transcriptionists, and the technology advances in speech recognition (SR) and electronic medical records (EMR) will collide. With the US work force becoming increasingly disenchanted with compensation and benefits offered and with an aging skill base in the U.S., overseas companies will have to quickly improve skill levels and productivity to move into the gap before technology has a significant impact on the volume of dictation.

John (Jack) Welch, former CEO of General Electric, feels the power of globalization is intellectual capital, bringing together the world�s greatest talent and ideas. Intellectual capital, not price, is the power of globalization. Unfortunately, the many years of aggressive marketing techniques, coupled with selling transcription services as �cheap,� and indeed delivering poor quality, has resulted in a trust issues and a negative reputation that will be difficult to overcome. Transcription services of the subcontinent have a lot of repairing to do before they can successfully transition to a perception of contributing intellectual capital to the transcription industry.

Trust issues will have the most far-reaching impact on overseas companies in the medical transcription industry. From the beginning, promises have been made of 99% accuracy, even if the accuracy delivered was closer to 50%. I have seen company profiles that delineate in painstaking detail a tortuous course of quality assurance measures, and yet my consulting services are being called upon to resolve quality issues. If you have a plan and you have not trained it, you don�t have a plan, you have a document. A variety of excuses have been offered to explain the discrepancy, the favored one being that the US client has a different set of standards or purposefully applies more stringent requirements in order to avoid payment under a contractual structure that allows it. Experienced transcription service providers understand that accuracy depends not only on the skill level and experience of the transcriptionist, but also on the quality of the recording and the dictator. Quality measurements should be clearly defined by all parties. In the past, I have rejected contractual verbiage that held the transcription service provider accountable for blanks if they could be filled in by �someone at the contracting facility� as, by definition, this would include the dictating physician. It would be my expectation that the dictating physician would know what he or she meant to say, even if it was not intelligible on the recording and thus the blank would be an error subject to penalty.

Continued�

(To read Part V, click on the �Next� link below)


Julianne Weight
CEO
AlphaBest LLC