PROTECTIONISM MAY KILL MY JOB
by Pamela Maltzman, guest contributor.
[January 18, 2005]
I've been a practicing medical transcriptionist (MT) for over 15 years. I've been self-employed and have mostly worked for the same medical transcription
service for nearly eight years. I got trained on the job at Long
Beach Memorial Medical Center, a major teaching hospital in
Southern California. They had an experimental MT teaching program
for one year only. I'd gotten bits of experience at other businesses
(one of which was truly shoddy), but I managed to test for, compete, and
win a position as a trainee. Most MTs I've known over the years were
also trained on the job.
Association for Medical Transcription (AAMT), started a couple
of decades ago by Claudia Tessier, has offered a certification
test (Certified Medical Transcriptionist, or CMT) for some time now
as a voluntary program. They've been trying to persuade MTs that
this credential is either necessary or a good thing, and that employers
should offer more money for having obtained it. I've not bothered
to get any credentialing because it has not seemed necessary. Most
MTs I know are not credentialed.
many MTs feel threatened by overseas outsourcing (in particular to India),
they're now attempting to restrict entry into this field. In August
2004, the AAMT passed a resolution seeking to:
* Make certification mandatory before any person could work at any level of medical transcription;
* Institute occupational
the education process (now that on-the-job training is nearly impossible
to find) by "approving" educational organizations (private or public) that
offer MT training;
tax monies to "help" employers hire new MT program graduates in "internships." Tax monies will also be required to establish credentialing & licensing
bureaucracies in all 50 states.
looked at the Bureau of Labor Statistics
website and called the AAMT. As of 2002, there were approximately
101,000 MTs employed in the U.S. The AAMT told me they've about 8,500
members (of all types; i.e., "students," practicing MTs, and corporate
and educational members), which includes about 2,000 CMTs. So their
membership is less than 10% of the actual number of MTs.
the AAMT has discovered the joy and excitement of feeding at the public
trough. It would be a lot of money and a power coup if they gained
the legal right to be the gatekeeper for this occupation. Their certification
exam costs about $275 or $195, depending upon whether one is an AAMT
member. The certification must be renewed every three years. Membership costs anywhere from $55 to $400 every year, depending on what
you are. An individual MT like me would pay $135 a year.
a lot of money, any way you look at it, if the AAMT succeeds in forcing
every MT in the U.S. to get certified. More money yet if we have
to be licensed.
I am utterly
dismayed at this turn of events, although many non-free-market MTs are
of course overjoyed. In the name of "protecting" themselves from
the overseas competition, they have no qualms telling people such as me
that I am no longer welcome in this occupation, and that I will not be
able to earn a living unless I jump through their hoops.
claims they will not be a union -- but I believe that if they become the
sole port of entry/gatekeeper to this occupation, they will be de facto a union.
they want "Standards. We must have standards!" But every
place I've ever worked at has had standards. They also test every
prospective MT for transcription competence.
written letters to the editor of Advance
for Health Information Management Magazine about this situation,
with copies to the AAMT.
is stating that just anybody with a computer can "pose" to be an MT. But the fact is that anybody with a computer, who doesn't also know what
they are doing, doesn't last long. The market does work. I know of at least one person who tried it but didn't stay with it, because
it turned out that she is not a good speller.
ridicules the notion that all one needs is a "fundamental ability to
get the job done to the satisfaction of industry employers." That is very nearly a direct quote from the editor of the AAMT Journal.
ask, what more is necessary? What more is needed? Satisfying
my client (my "boss") who thereby satisfies his clients. My boss
gets paid and then pays us. What a concept. Such a deal. It'll never make me rich, but it has given me a decent living.
ago, having been a member of the AAMT for about a year, I saw the letters
and debates in the AAMT Journal on the issue
of the AAMTbecoming a union. Most letters to the editor were in favor
is happening at a time when many MTs complain that their compensation is
going down, and at a time when many people are feeling extremely burdened
by the ever-increasing load of taxes we all pay.
this will give impetus to the adoption of voice-recognition
software because it'll be cheaper in the long run, even if such software
doesn't capture all the nuances and perform the editing which a trained
course, there's no way to track all the people who might have gone for
on-the-job training but aren't going to jump through all the hoops the
AAMT is putting in the way.
of QA at my boss's office -- herself a CMT -- thinks that the mandatory
credentialing / licensing process won't happen within our lifetimes. I am not so sure.
I am contemplating
eventually finding another line of work; but in the meantime, I am sticking
with medical transcription. It's my best-paying job skill, and I
have to say that I have gotten very good at it -- that is, so long as I
can hear the dictation!
Copyright © 2005
by Pamela Maltzman.
Pamela Maltzman wants YOUR advice!
1. Assuming the AAMT is successful in lobbying politicians, does
anyone know how long such a process might take to implement in California? Months? Years?
2. Is there anything I can do to either stop this process, or at
least stave it off while I prepare myself for another line of work?
3. I'm thinking of writing to Tom
McClintock, the most high-profile politician I know of in California
who is at least sympathetic to libertarian/freemarket values. Is
this something worthwhile, or would I just be spitting into the wind?
4. Is this something the Libertarian
Party, or any other libertarian organization, might look into? I've long been uneasy with political action and/or lobbying, but this is
one issue where it might be necessary as an act of self-defense.
5. Any advice or ideas that anyone has, please email me at: email@example.com.
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