The conversations here and online in this past week have fascinated me as we explored medical transcription salaries. When we looked at whether employers really are supporting the notion of mandatory credentialing, it was pretty telling to not hear one single person say they were at a place where there was a pay differential for their credential.

Exploring the relationship of the professional association with the trade association in our industry also brought some interesting insight from everyone. Can the two truly co-exist when there are clearly different values? One group wants better pay and working conditions. One group wants to increase their profits. Certainly both can rally around the notion of quality healthcare documentation. In the end, does that mean individual needs go unmet?

What is our Driving Force?

Not too long ago, I attended a meeting where someone asked about the resistance to mandatory credentialing. When the topic came up of it often not equating to an increase in pay, one of the leaders in the meeting asked how many really were in that meeting who didn’t want to make more money. Really, she said, if you think you make enough, I’d like to talk to you so I can do what you’re doing. I think this is not a fair representation of what MTs are saying. MTs aren’t “money grubbing” people just wanting to make a boatload of money. They are simply trying to get by and support their families. In the end, her suggestion was that perhaps what gains mandatory credentialing is peer pressure. She went on to tell a story of how she was in a role as a coder, the only one in her department without a credential, and although she produced an equal amount of quality work, her coworkers shunned her. She finally got the credential. Is that the answer? I certainly hope not. I was rather glad that meeting was via webinar and not in person or everyone would have seen my jaw on my keyboard, shocked to hear such a suggestion.

I believe our driving force is just what we have talked about: First the ability to adequately support ourselves and our families. It is about taking care of those we love. It may then become about proving something to the world, showing we’re “good enough” or that we “have pride.” For me personally, it’s not about acceptance, it never has been. I also believe in the end, if we don’t have that first step of our physiological needs being met, nothing else matters.

I got my CMT in 1989. At the time, I was self-employed running my own business. I did it simply because I wanted to put those initials on business cards because I thought it would “look cool.” Back then, if you passed the test, you could have the association send a letter to your employer acknowledging your accomplishment and telling them a bit of what it was all about. I did that, for every single client. Of my 10 or so clients at the time, I heard from one of them. He wanted to know if that meant I was going to increase my prices. :) I’d love to tell you that I said of course, that’s what that means, but I didn’t. I was making great money at the time and I had annual increases built into my contracts. I didn’t see a need to increase it because of the credential. Today I maintain my CMT because in the things I do, it brings credibility. If I consult with a school, they want and need the CMT. In the courses I offer both here and on the HIPAA website, having the CMT shows anyone who registers that I know what I’m talking about because I’ve done it. Interestingly, in all of this discussion this week, I have realized that the cover of my new book to be out next month does not have CMT after my name. And you know what? I’m not even sure why. It just is.

Does It Matter that we Work from Home?

I thought the comments about MT being a lower paid profession this week were interesting. On the one hand, we hate it. On the other, we do attempt to justify it by talking about how much we save if we work from home. And then someone said but wait, if I take any other job, nobody cares that I have childcare, have to buy clothes, etc., it’s simply not a calculation into my wages. For those of you who work in an office setting, I’m pretty sure that’s accurate. I don’t imagine you get an increase in your salary because you have to drive to work every day. And yet, we are all quick to point out those things as a rationale for lower pay.

In the End, It’s Up to Me

In my last position, I recall vividly being in a meeting where the managers were discussing that an MT had resigned. The company president looked around the room and said “Whose fault is it?” I was new to the company, only been there about two weeks. We all looked around the table, like deer caught in headlights. He then pointed to each person and said “It’s your fault, and yours, and yours, and yours…..and mine.” My very first reaction was to bristle and think “I’ve been here two weeks, I can’t be responsible for what’s happened before I came!” And then I got the lesson. It is about personal accountability. It’s about each of us taking responsibility for ourselves. It’s about the MT who refuses to work for less than she’s worth. It’s about deciding, if credentialing is a value we have, that we only work for companies who truly value that, and who are willing to put their money where their mouth is. It’s about standing up when we’re told speech recognition technology means your pay rate is cut in half because “you’ll make it up in volume.”

Many years ago, one of my clients approached me and asked about a “discount” on his rate after a certain volume. He was a very high volume account and one I sure didn’t want to lose. He said he figured he should pay his regular rate for xxx number of lines, and then everything after that was discounted. The benefit was that he brought so much volume to me, he felt it would be worth it to me as well. I thought for a minute, and then asked him this: “At what point in the month have you seen enough patients so that every patient after that gets a discount on their eye exams?” Of course, he had no such formula. At the end of our discussion, he had a clear understanding that I was in business just like he was and he wouldn’t be getting that discount. We had a relationship of mutual respect and I always appreciated that. I’m not sure that would have been the case if I had given in.

We are a critical time in our profession. In our professional association, we are at a critical time as well. We’re voting on major changes to the association that will eliminate our representative body and replace it with a larger board of directors. The mission is, as we know, to advocate for quality documentation. It’s up to each of you to choose what works for you. If that mission and the representation you have will work for you, then jump in and support it. If it doesn’t, find something that does. If that means working on your own or with a group of MTs, do it. I don’t believe for one minute that MTs don’t want to be involved in change and speaking for themselves. I DO think there are times when we just haven’t found the things we’re passionate about in the opportunities that are presented.

Now it’s up to you. Let’s hear your thoughts.