Thursday, September 20, 2007

Hiring Cheap: You Get What You Pay For

Attention smart shoppers! Are you interested in quality? Do you want reliable products that have a proven shelf life? Or are you just looking for a bargain?

If the object you wish to purchase is a backpack, wristwatch or pantyhose, shopping is fairly simple. When it comes to finding qualified workers who possess a unique set of core competencies, the search becomes more complicated.

Today’s labor market has changed so dramatically that qualified job candidates are hard to find. If you want to hire good people, you have to offer them the right package of incentives. If you want to keep them on your team, you’d damn well better keep them happy.

Why does a chef at a four-star restaurant earn more than a fry cook atMcDonalds? That person has gone through extensive training at a culinaryacademy and developed a repertoire aimed at satisfying the palate of a gourmet. Why should a professional medical transcriptionist earn more than your run-of-the-mill office temp? Because the knowledge that a professional MT has acquired over years of practicing a highly-skilled craft has value. And if you take the experienced transcriptionist out of the dictation/transcriptionprocess, it will cost you dearly.

As managed care has taken more and more decisions out of the hands of doctors, many decisions about how to purchase transcription services have been made with little understanding of what goes into the dictation/transcription process. All too often, the people who purchase transcription services lack experience transcribing. To them, it’s all about numbers.

For people who take pride in the quality of their work, it’s not just about numbers. It’s about professionalism, meeting expectations, and going the extra distance to deliver a quality product. I frequently caution clients that when they start working with my firm, a very important role reversal takes place: The MTSO becomes the doctor and the doctor becomes the patient. But whether a professional medical transcriptionist works for a hospital, a service, or is self-employed, one of the inescapable costs of doing business is paying for the downtime spent trying to decipher a physician’s incoherent mumbling.

Thanks to the dumbing down of the American educational system, we live in an age where more and more people have become functionally illiterate. Therefore, it is important to recognize the value of people who possess strong language skills. One of the best investments you can ever make is in real talent. I’m not talking about medical transcriptionist wannabes who lack sufficient skills or experience. I’m talking about the tried and true transcriptionists who continue to pump out dictated reports day after day, week after week -- the veterans who meet their deadlines while turning in work that is not only accurate, but measures up to appropriate standards of quality assurance.

When my company was threatened with the loss of its largest account to one of the transcription industry’s 900-pound gorillas, a friend who once chaired the hospital’s Medical Records Committee told me that unless I met the competition’s price I could not hold onto the contract. Faced with a situation in which a chain of hospitals was trying to consolidate services with one national vendor, I knew it would be futile to compete against a publicly-held corporation that had the financing to come into town and underbid local vendors. I also had no intention of devaluing my service by slashing my rates as much as 25%.

As you can guess, my firm lost the contract and the promises made by the national vendor took nearly a year to implement. Doctors who were used to extremely attentive service were often shocked to discover that reports they had dictated had still not been transcribed after 10 days. People who remained on board to handle quality control shook their heads in disbelief when they come across transcribed reports containing sentences like “The patient is walking in the Emergency Room with a taxi.”

Purchasing transcription on the basis of price and price alone has its risks. Knowing the costs involved, how quickly would you write a check if you saw an ad for:

“CT Scans and MRI Exams -- only $29.95!”

“Free face lift with every hysterectomy.”

“Implants ‘R Us -- no waiting in line!”

That message is totally lost on folks like Dr. M. who, like many employers, believes in hiring cheap. Not only does he hire people with minimal education and/or computer skills, he works his staff so hard that there is a substantial employee churn at the end of each year. His paranoia, combined with a desperate need to micromanage, has given Dr. M a bit of an attitude. One day, while complaining that he had discovered $250,000 in uncollected receivables after an employee quit, he told me that two more of his employees planned to leave after Christmas. I politely pointed out that his constant turnover in office staff said something very serious about the kind of employer he was.

“Oh yeah?” snarled Dr. M. “Well, tell those heifers you’ve got typing for you that the competition’s offering to do a month’s worth of work for my office for free! Do you hear me? For free!”

Boy, was I ever impressed. And when Dr. M. didn’t give us any of his dictation for two months, it didn’t bother me in the least. Why not? Because, when it comes to service, quality, experience and trust, you get you pay for.

In case you wondered, Dr. M is back dictating reports into our system again.

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