Hourly Wages Versus Productivity Incentives

Back in the 1970s and 1980s, many medical transcriptionists worked in hospitals and clinics where they were paid an hourly wage for their labor. Once they established a comfortable pace, they pretty much kept to that level of productivity.

• If the work load began to back up, they didn't type faster. Nor did they necessarily volunteer to work overtime. They knew what they had to do in order to collect a weekly paycheck and did not aim much higher.

• The fact that these transcriptionists could be assured of a weekly paycheck (and anticipate the approximate amount of that check) meant that they could take the luxury of devoting some extra time to looking up words, rewriting the dictation of a doctor who could not speak coherently, and reworking certain documents until they were satisfied that their work matched some personal aesthetic standard.

• Knowing that they were union or tenured personnel allowed them to enjoy a certain degree of job security, rely on a comfortable benefits package, and be sure that they would be paid for the hours punched on their time cards -- no matter how hard they did or did not work.

• They could also spend as much time as they desired socializing on the job.

As hospitals started farming out more dictation to transcription agencies, the really good transcriptionists learned that, by transcribing a hefty volume of dictation on a production basis, they could make substantially more money than they did working for an hourly wage. With that incentive in mind, some medical transcriptionists were stimulated to work harder and set new goals for themselves.

As computers became more affordable, a noticeable trend began to emerge. Transcriptionists with stronger skills, more discipline, and a greater desire to determine their own work style began investing in home offices. Many of these "new-age entrepreneurs" realized that by adapting the latest technology to their needs and developing a client base, they could stop working for another transcription agency.

The brave ones started their own businesses, nurtured them, and watched them grow. Their belief in the strength of their skills allowed them to take dramatic risks and earn sizable rewards. They quickly learned the truth behind the old adage that "You have to spend money in order to make money."

What did they spend their money on?

• Faster computers

• Faster modems

• More memory

• Laser printers

• Better software

• Ergonomic office furniture

Because their success depended on staying on top of the latest technology, these people did not stint when it came to upgrading software, buying reference books, and acquiring any tools of the trade that could help their businesses to grow.

The people who were being paid on an hourly basis, however, were dependent on waiting for their department heads to purchase new reference books. Because many of these people were not computer literate, and had no incentive to learn newer word-processing programs, they continued to work on software that was quickly becoming obsolete.

Because many hospital administrators lacked insight into the tools needed by medical transcriptionists to improve their productivity, those tools were never purchased for the people working in the hospital's transcription unit.

Next: Facing Up To The Bottom Line

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