This article, "MT.Con: The Cockroach Problem In Medical Transcription", is intended for medical transcriptionists, MTSOs, physicians, medical records administrators, and student MTs.

By Elizabeth Dearborn

cockroach problem - noun. A problem that is bigger than it initially appears.


Andy Serwer, Editor-at-Large, FORTUNE: "Well, Terry, Procter & Gamble has a cockroach problem, and, you know, we know what that means; in other words, you've got one little piece of bad news, and there is always more, just like those little bugs."  "In the Money," CNN, June 8, 2000


What happened? Have we all somehow been conned? At the very least, we've let a good thing slip through our fingers. Medical transcription, once a lucrative, respected career, has become a pink-collar sweatshop industry.

It didn't happen all at once. There is no one person, institution, or corporation we can point to as the enemy. No matter what state the economy is in, hospitals must control their costs; MTSOs must make a profit in order to stay in business. MTs must make sure that they have decent working conditions, wages, and benefits. Most of all, they need to regain their ability to respect themselves. It's a recurring theme at the IRC chat room #mt~freespeech. Listen to the conversation:

A transcriptionist I will call Esmeralda^ says: "Ten or twelve years ago, I made twice what I'm making now. I got more cents per line and the lines were 10 characters shorter. I knew a lot less then, but back then, there wasn't as much to know. I can't hardly keep up!"

"Tell me about it," _LowRain_ responds. "I used to type along happily all day minding my own business. Now I've got the company looking over my shoulder, even though I work at home and get paid by the line, making sure I'm cranking out a certain amount of lines per hour."

Sylvia_39 says, "Yeah, I'm always trying to think up more macros and expanders. I try to figure out how to shave off a microsecond here and there, because how the hell else am I going to get a decent line count?"

This past week, I was sitting at my computer waiting for work -- a frequent occurrence in the summertime when things are "a little slow" -- and jotted down a list of six good things about the MT way of life, and more than twice as many things that are bad and ugly.


1. The work is intellectually stimulating 2. Can make a meaningful contribution to society 3. Can be done at home 4. Can sometimes make a lot of $ 5. Autonomy & accountability 6. With the internet, can find more info faster
1. Declining line rates 2. Competition from underqualified individuals and corporations 3. Competition from offshore 4. Information overload 5. Poor dictation 6. No QA, or overly picky or arbitrary QA (continued)

© 2001 - 2018 MeDiCaLeSe.org