Last time we talked about the “percent gain” and how that metric is over-used and misused.
Today let’s talk about compensation.
Devising an MT editing compensation plan based on one across-the-board expected increase in productivity (often a 100% expected increase with 50% reduction in line rates) does not benefit the MT and does not make sense for the MTSO. MTs when typing have an incredibly wide range of productivities..how do we expect to pick ONE number upon which to base our comp plans when transitioning to speech recognition?
Here is the worst part…
Cutting line rates according to one expected percent gain in productivity will reward your lowest producing MTs, and will hurt your high producers! And your company will suffer in the long run.
MTs who are low producers when typing will see a higher percent gain when editing. They have much more room to improve. They will see a pay increase because they are very likely to hit that magical “% percent gain” number.
MTs who are high producers when typing will see a lower percent gain when editing. They are already fast – and there is only so much that you can speed up an audio file and still produce quality work. We expect them to listen to the entire audio file, don’t we? If they don’t meet that expected percent increase, they will lose money.
Reality Check –
There is a number we should all use as a reality check point when determining if an MT can really achieve the productivity she’ll need for her pay to stay whole as she transitions to speech recognition.
At M*Modal we call it the Edit RT.
How many minutes does it take an MT to type one minute of dictated audio? An RT of 1 means the MT is typing or editing as fast as the doctor is speaking. She is editing in “real time.”
Average for traditional transcription tends to be around 4 to 4.5 for U.S. based MTs. That’s approximately 135 to 150 lph.
An MT who can transcribe from scratch at a rate of 300 lph (and they are out there) is already typing at approximately an RT of 2. For her to double her productivity, she has to get to an RT of 1. This means that you expect her to edit AS FAST AS THE DOCTOR SPEAKS for every job if you cut her line rate in half.
Do you want your MTs to listen to the entire audio?
You will hear talk about MTs averaging 600-700 lph when editing. Sure it’s possible…we see it every day. But this kind of speed usually means one of a couple things:
1. A good percentage of the text in these documents is introduced through Normals/Standards or template text. This means there are lines in the document for which there IS NO AUDIO. (think about this when you hear productivity claims from speech rec vendors)
2. The doctors are repetitive enough that the MT has created a good number of her own macros.
3. The MT is NOT playing back the whole audio and your quality is at risk.
HOWEVER, the MTs who are high producers with LOWER percent gain when editing are going to produce more lines, faster. Taking care of THESE MTs will allow your company to significantly increase its OUTPUT without increasing MT head count – and all of the subsequent support personnel and expenses.
Please remember this – your company is paid for its OUTPUT, not for that high percent gain!
This industry has seen an alarming increase in MTs who are not interested in transcription as a full-time career. What is happening to the career MT? How will the profession attract the quality-minded, dedicated professional if MTs can’t make any money?
It won’t – it will attract the person interested in making a bit of extra money working from home – the “hobby MT” as opposed to the “career” MT.
An MTSO who pays MTs for what they are – skilled professionals – will attract the career-oriented, professional MT. The MTSO who pays its MTs based on some arbitrary metric useful primarily for marketing for speech rec vendors will lose its professionals and will be forced to hire higher numbers of lesser skilled, less productive “hobby” MTs.
What does this mean to an MTSO’s finances?
What expenses do you have that are the same for every MT, regardless of her productivity?
How much does your company pay for:
o Training per every new hire?
o QA for every new hire?
o Support for every new hire?
• Supervisors and managers for every x number of MTs?
• Technical support people for every x number of MTs?
• Technology costs, foot pedals, software licenses, workstations, internet connectivity for every x number of MTs?
• Paid time off and health and welfare benefits for every x number of MTs?
• Administrative, HR, payroll personnel for every x number of MTs?
• Managers, directors, and senior managers for every x number of MTs and the requisite QA personnel, trainers, administrative personnel, technical support staff…..
Which MT is more expensive? Your low producer or your high producer?
• Which group has the highest turnover and subsequent costs?
• Who sends more work to QA?
• Who consistently delivers high quality work to your customers?
• Who requires more training, software support, and assistance?
• Who can you most rely on to work scheduled hours, to work extra when needed, and to help you meet your turn-around time requirements?
Your high producing MT is your biggest cost efficiency. Be creative – think beyond that MT line rate when you consider cost reductions.
Cut the line rates by a reasonable number – but use incentives or bonuses to keep your high producers whole! Use the transition to speech recognition to get rid of your dead wood – NOT YOUR MOST HIGHLY SKILLED EMPLOYEES!
Think about where that high-producing MT can save you money elsewhere in your organization.
Let me leave you here with one thought about what you’ll need to do as a company if you intend to stay in business as the dust from meaningful use settles and everyone finally comes to terms with the fact that there is no value in a paper document.
I once heard an MTSO executive say that his company would reduce costs by cutting line rates, allowing the high-producing MTs to leave, and then hiring a bunch of lesser skilled MTs at lower line rates.
Great idea – if you want to support three times the number of MTs you need to produce your volume, significantly increase your turnover and the cost of turnover, and if you have no plans to stay in business into the future.
We have all been talking about Meaningful Use and the EMR and the role transcription plays in that discussion.
The MTSO of the future will need to transition from a company that produces typed documents to a company that produces and VALIDATES meaningful clinical content.
I have heard a number of comments that MTs do not have the skill necessary to validate content in a meaningful way. I just heard that yesterday!
All I have to say is that a professional career MT certainly has an excellent knowledge of medical terminology, anatomy and physiology, and understands the subtleties of the meanings of words based on the prefix or suffix used, and the context in which they are used.
Come on folks – how many of us used to test applicants for MT positions who were nurses and coders and turned them DOWN because they did not have the wealth and breadth of medical language knowledge that a good MT has? But is an $8 an hour job going to attract a person with that level of skill?
Cutting your compensation rates such that you lose your highly skilled MTs may save you a few dollars now. But you will not be able to provide the level of service required of you into the future.
Thoughts? Would love to hear from you…
Filed under: Clinical documentation, medical transcription, medical transcription editor, Medical transcriptionist, speech recognition, Speech Understanding Tagged: | clinical documentation, medical transcription, medical transcriptionist, MT, MTE, speech recognition, voice recognition, VR