We’ve spent this week looking at the historical changes in medical transcription salaries, and then really looking into why they really haven’t increased relative to other professions in the health information management section of health care. What a week of great discussions! I appreciate each and every one of you, whether you commented and joined the conversations, shared the discussions with others, or simply stopped by to read.
Who is the Advocate for the Medical Transcriptionist?
So, today let’s talk about advocacy. The online dictionary I use defines this word as “the act of pleading for, supporting, or recommending.” Who does advocacy for the medical transcriptionist? In years gone by, that was one of the purposes of AHDI. I don’t see that as their purpose now. Their purpose, as clearly stated on their website, is defined as “to set and uphold standards for education and practice in the field of health data capture and 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 works to advocate for workforce development and credentialing in allied health and the critical role of the technology-enabled documentation knowledge worker in the electronic health record (EHR).”
In 1997, which is one of the years I was on the AAMT (now AHDI) Board, we published the MT Bill of Rights. I know some of you weren’t around then, so let me show you what that says:
Whereas, the medical transcriptionist contributes significantly to the delivery and quality of patient care, while also helping to assure appropriate reimbursement, promote research integrity, and fulfill providers’ legal obligations through documentation of health services.
Be it therefore declared that each medical transcriptionist has the following rights:
- The right to an appropriate job classification and pay level appropriate to one’s abilities, limitations, and responsibilities.
- The right to full disclosure of the basis on which pay is determined.
- The right to fair pay, including overtime pay, and to benefits, including sick pay, holiday pay, vacation pay, and health insurance.
- The right to nondiscrimination on any basis, including gender, age, disability, race, religion, sexual orientation, and ethnicity.
- The right to a safe work environment that promotes prevention, identification, and treatment of work-related injuries and disabilities.
- The right to communicate with others in order to assist or be assisted, including feedback on performance and inquiries made regarding dictation or transcription.
- The right to edit dictation as necessary and appropriate to produce a clear, concise, and accurate document, correcting grammar, punctuation, and spelling, drawing attention to inaccuracies, inconsistencies, incomprehensible dictation, and potential risk management concerns.
- The right to professional resources (print, video, audio, electronic) that facilitate the preparation of accurate and complete documents.
- The right to environmental resources (space, equipment, furniture, lighting, and supplies) that promote the efficient and effective accomplishment of responsibilities.
- The right to professional development and continuing education opportunities.
- The right to professional association membership and participation.
- The right to participate in the development of, to be informed of, and to adopt professional guidelines and standards for medical transcription.
- The right to respect and recognition as a professional, as a medical language specialist, and, for those who have earned the designation, as a certified medical transcriptionist (CMT).
- The right to participate fully as a healthcare professional in the preparation of patient care documentation in order to enhance the quality of that documentation and thereby the quality of patient care.
I vividly recall those days. Imagine a room full of MTs at a meeting and this being read out loud and as each point was reached, an MT from across the room standing up to read that point. It would give you goose bumps! I believe it was a time when many MTs felt someone was indeed advocating for them, as individuals, as professionals, and as a group who brought value to the table.
What has changed is that we now advocate for the quality of the healthcare record and, in that, the protection of the patient. There’s nothing wrong with that, it’s important too. What I think we have lost is that now no one advocates for the individual medical transcriptionist.
Let me be really clear. AHDI is not a union. They never have been. It is a professional organization. What that means is that it’s not AHDI’s job to negotiate higher wages for me as an MT. That’s my job. What I DO think a professional association can do is advocate for those things listed above with employers, with government agencies, and anywhere else we can take that message. In the end, however, that is not the job of the professional association we have today. The mission statement is clear that the job is to be the advocate to accomplish this: “To promote the integrity of healthcare documentation through development of an educated, prepared workforce in clinical documentation.”
Partnerships
In May 2007, AHDI entered into a partnership with MTIA (now CDIA), which is the trade association for medical transcription businesses. That was met with a lot of mixed reactions throughout the industry. How would the two organizations work together? On what issues? With this, the staff would now work on behalf of both organizations. I’ve always believed that employers and employees should work together in partnership. It is what makes business run better, and that lets everyone benefit. Is the same true when it comes to a professional organization?
MTIA released their paper related to MT credentialing (I think in 2009) where they stated they were in support of developing a credentialed workforce, as well as acknowledging it would be good for the industry. What is also telling in the last paragraph of that statement is a very clear statement that they were NOT saying the cost of that credentialing should be born by the employer. They believed, simply, that MTs should approach credentialing “with the same commitment to professional development and credentialing that characterizes all other allied health professions.” They do recognize that some employers may choose to bear some costs related to credentialing and while they aren’t discouraging that, they are making it very clear that it is not their recommendation that employers should have to do that.
So now we have the challenge. One of the things I remember saying in 2007 is “no man can serve two masters.” So what happens when the “best interests” of each group isn’t the same thing? It may be in the best interest of the MTs to see wages that recognize credentialing, expertise, and years of experience. From the business owner’s perspective, adding those costs decreases profit. And so, we simply move our focus to say we advocate for the quality of the record, not the individuals. I really believe this is a big part of why some MTs don’t feel like the professional association represents them, or at least doesn’t represent them well. Perhaps understanding that it is not the association’s mission to do that clarifies that a bit.
What’s the Solution?
Okay, here’s where you come in. What IS the solution? How do MTs find the advocacy they are seeking? Would, dare I say it, (some have suggested it in the past) an organization that is totally focused on MTs and not two diverse groups make a difference? If it existed, would MTs even rally behind it, invest in it with time and money, and get involved? I’ve seen some try that before without a lot of success. I don’t know why. Perhaps it was that MTs weren’t behind the “cause” of the organization, perhaps we don’t like to organize. Perhaps it was the structure. There is a type of organization called a “business league,” defined by its activities as follows: “an organization’s activities must be devoted to improving business conditions of one or more lines of business (as distinguished from performing particular services for individual persons). It must be shown that the conditions of a particular trade or the interests of the community will be advanced.”
In the end, MTs have to figure out the best way to stand up for themselves and not let someone else do it. It’s critical, our time is now, and we simply must step up and do it. Remember we DO write our own life story. What say you?
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