#7 - Your Own Business (Part 2)

Still considering going it alone? I don't want to intentionally dissuade anyone, but here are a few more things to think about.

What happens when you want/need time off? What about an unexpected surge of work, and you've promised the client to have the reports back within a specified time period? Do you have a backup plan to have someone cover for you? Even if you're not planning to hire MTs to work for you, it's a good idea to have temporary help available for the unexpected (and be prepared to work the occasional all-nighter).

Business owners must also think about the opposite - not enough work. Perhaps you're a year or two into your business and lose a large client, regardless of the reason. A lot of your expenses are fixed and don't increase/decrease in relation to your revenue stream. Are you financially prepared? This is especially critical if you have employees expecting paychecks. Nothing sends an MT running in the opposite direction faster than not getting paid.

Until next time ...

#7 - Your Own Business (Part 1)

Having your own transcription business can be quite exciting. There's undoubtedly a sense of pride and accomplishment that comes with this achievement, but MTs considering this venture should weigh out all pros and cons.

The MTSO (Medical Transcription Service Owner) must wear many hats! Before the company can generate revenue, it needs clients. You must be ready and willing to knock on doors to solicit transcription business. It only takes one to get started, and if you do a great job, referrals from that one client are always a possibility. An advertising campaign can't hurt either, but this comes with a cost.

Before you solicit customers, you must know what you're going to charge them. This entails not just determining a per-line cost but the definition of your "line." Will you charge on a gross line or a character-counted line? If the latter, what methodology are you using to calculate that line? Is that method easily verifiable? Should a client challenge the line count you bill on, can your method support your invoice? Believe me - it must, or your business will probably be short lived.

Insurance is another must-have. Your clients are entrusting you with very, very confidential information, allowing you to take it to your office (be it commercial property or within your home). You must ensure the utmost in safeguards to protect that sensitive information, just as you must protect yourself in the event of a breach. Talk with your insurance representative and be sure you're covered. Don't make a policy decision based solely on price. Know the liability policy well and understand your protection.

#6 - Transcription Service (Part 4)

A final word on services ... for now.

One of the big advantages of working for a service is a pretty consistent flow of work. (Remember - you're probably getting paid on production, which means if there's nothing to type, you're earning nothing.) Depending on the size of the company and the number of customers they service, you may work simultaneously on 3 or more accounts. Then you should never run out of work, right? Well, not necessarily. There is a "seasonal" component in this industry, and although they're few and far between, there are times when incoming dictation will be slow. The week between Christmas and New Year's is definitely one of those times.

The key is to plan ahead. If you're working with a well-managed service, they should be tracking their volumes and be willing and able to share volume peaks and valleys with you (and even if they're not, track them yourself!). While work might be slow the week after Christmas or the weekend after Thanksgiving, it'll be coming in like crazy in the preceding weeks, and bonuses and overtime may be plenty. Some services will offer up to an additional $0.02/line as a bonus when accounts are behind. Take advantage of these opportunities and put away some of that extra cash to supplement the smaller paychecks.

Again - periods of low work are few and pretty short-lived, and the work certainly doesn't stop completely. There are peak times when MTs like to work, however, and if you're competing for jobs to transcribe during those peak times, well ...... be willing to work some evenings, and you'll never be without work. I recognize that many individuals work at home to be with their kids, and evening time is prime time with the family, but sometimes some sacrifices have to be made. Giving up a few evenings here and there is a small price to pay for having all the others free. You'll also earn the reputation within your service of being a team player, which can go a long way.

Enjoy the weekend!

#6 - Transcription Service (Part 3)

Payment methods of transcription services vary widely and are deserving of their own discussion. Almost always based on production, the typical method is a set amount for each line of transcription (i.e., $0.07 for each 65-character line). Brand new MTs can start at rates as low as $0.05, and seasoned MTs working shifts can command up to $0.12. Where the situation can get a little tricky is in defining the "line."

A "gross" line refers to each line on a page, regardless of how many words or characters it contains. If dictation happens to end after you've started a new line which has only one word, that still counts as a line. Not too many services pay on gross lines anymore ... for reasons I'm sure are obvious. Larger fonts and wider side margins have huge impacts.

The more common method in current times is a count of characters then divided by the number which defines a line, typically 65. In other words, all characters typed on a page are counted and divided by 65; the result is the number of "lines" the MT is paid for. This is a fair method, but when comparing service to service, be sure to know if blank spaces are included in the character count. Being paid on a 65-character line that doesn't include spaces is very different than one which does. It may not be visible, but your thumb still has to hit that space bar. Some services may pay on actual keystrokes, but that too can be unfair to the MT who has built up a library of macros or shortcuts, designed to display full words, sentences or even paragraphs with just a few keys.

Whether line counts include headers and footers is another consideration. A footer may consist of the patient's name, medical record number and a page number. The name and MR# are probably pulled in from a field that the MT did type - but only once. If the document is 5 pages long, that footer is going to appear 5 times. Some services will count footers in the total character count, but don't be surprised if they're not. Again - you've only typed them once, so to be paid once really is fair. If you're paid for every time they appear, say a quiet "thank you," even if only to yourself.

This same rule applies to headers, both those at the top of each page (similar to footers) and those used within the body of a report to designate a new paragraph (i.e., "History of Present Illness" or "Physical Examination"). Depending on the software being used, some companies may present you with a template that already includes these headings in the document. They may or may not be included in your character count because - you really didn't type them. If you are paid for them, whisper that "thank you" again. It's pointless, not to mention unprofessional, to argue that the service bills the client for those characters. You're not paid based on what the service charges ... that's between the service and their clients.

Until next time!

#6 - Transcription Service (Part 2)

Most medical transcription services require at least one year of transcription experience before they'll even consider testing a candidate. While some are willing to hire new graduates, those openings are often limited in number and can require the MT to work various shifts. Be prepared to take at least a transcription test consisting of a variety of medical documents, but written tests to determine a candidate's skills in grammar, punctuation, etc. are also common.

After successful completion of testing and acceptance of an offer comes equipment. Some services will provide equipment, others may require that MTs provide their own, and some will lease equipment to MTs for a monthly rental fee. The handling of equipment is often tied to the type of openings the service has - statutory (basically independent contractor) or employee. In addition to equipment, MTs who are actually employees of a service also receive employee benefits ranging from health insurance to paid time off (PTO) and 401(k) plans. They may also be reimbursed for internet expenses should internet connection be required to access voice files and transmit documents.

Methods of payment by services can run the gamut and will be touched on in a separate discussion.

Enjoy your day!

#6 - Transcription Service (Part 1)

In the late 1980s and early 1990s, transcription services were few, and of those, even fewer provided an opportunity to work from home. Telephone costs were still quite high, so those MTs who could work at home were limited geographically, being required to live close to the office (or at least within toll-free calling distance). Reduced phone rates and VoIP have certainly changed all that! The number of transcription services continues to grow, and experience MTs with a good work ethic have multiple options to choose from.

Working for a service means this: The service goes out and solicits business from hospitals, physician practices, etc. (all those business types previously discussed). The service then makes the work available to transcriptionists for processing. The MT transcribes the documents and returns them back to the service, not directly to the client, for processing. It's up to the service to properly format and deliver the documents according to their contract with the customer. All the MT needs to do is perform the work according to any guidelines provided by the service and do so in a timely manner. Sound easy enough?

Now what?

Fast forward 2-3 years when you finally have a few years of transcription experience - now what? If you have a great job, the choice is obvious; however, if you're working on site and still yearn to be at home, you have two options.

#5 - Teaching University Hospital

Teaching hospitals affiliated with universities differ from the previously discussed acute care hospitals in that they also serve as teaching facilities for new healthcare practitioners. Medical students and residents are assigned to attending physicians in rotations, and they quite frequently will be assigned the responsibility of dictating necessary documents. Dictating is a skill that must be learned and honed over time ... this is where they start!

Like hospitals, university facilities don't frequently allow their employees to work from home, so MT applicants should be prepared to work on site.