It Takes A Virtual Village

Every now and then a message appears on one of the Internet MT boards in which some newbie complains about “those old fart MTs who think they know everything but won’t give anyone else a chance.” Age and life experience are remarkable benchmarks for measuring one’s professional standing. Maturity and craft are not measured in years so much as by accumulated wisdom.

Many newbies haven’t a clue about what it was like to perform corrections on seven carbon copies of a report with only chalk and razor blades at your disposal. As a teenager, I remember the thrill of visiting the IBM pavilion at the 1963-1964 World’s Fair and testing those newfangled Selectric typewriters where the carriage did not move. I even remember what medical transcription was like before digital dictation systems, medical and pharmaceutical spellcheckers, drug databases and e-mail. It wasn’t so very long ago that certain electronic tools (which we now take for granted) didn’t exist.

Because we live in an age dominated by rapidly-accelerating advances in electronic technology, new inventions bombard us so quickly that last year’s breakthroughs are easily forgotten. “The further and faster the human race goes, the more difficult it becomes to remember its receding and ever-expanding past,” claimed William Clay Ford. “To neglect that heritage is to risk a future in which young people find themselves without a means of building on the firm and reassuring foundation of the past.”

Had it not been for the zeal with which Ford’s grandfather, Henry Ford, collected traces of America’s Industrial Revolution, there might be little left to remind us of our not too distant history. Their pattern of display at the Henry Ford Museum in Dearborn, Michigan is vastly different from that seen in most other science museums. In Dearborn, visitors can observe minute changes in technology and design. The evolution of dictating equipment proves fascinating when compared to the technology of today’s electronic office.

An indicator of the breadth of Henry Ford’s collection is to note that during the first few years of the museum’s life perhaps 80% of its visitors could recognize and identify most of the objects on display from their personal experience. At best, no more than 5% of today’s visitors can readily identify the same objects.

The society in which we live is a far cry from the society that existed when the senior physicians on staff at most hospitals entered medical school. Sweeping changes due to technology, politics and healthcare reform have altered the way we think and work. Just as new technology has brought about some dramatic changes in the surgical suite, technology is forcing changes in how we dictate and transcribe medical reports. In order to understand where we are headed in the era of Internet access, we need to stop, take some time to reflect on recent changes in our culture, and try to understand how our work has been affected by changes in the society in which we live.

Now celebrating its 21st anniversary, the American Association for Medical Transcription (AAMT) has over 130 local AAMT chapters and state/regional associations. AAMT established the Medical Transcription Certification Program (MTCP), publishes the bi-monthly Journal of the American Association for MedicalTranscription (JAAMT), and boasts a strong calendar of lectures and programs which allow MTs to earn continuing education credits. But the long, hard years of building AAMT’s membership toward the 10,000 mark were based on a power structure rooted in a local/state/national hierarchy.

Legend has it that when King Arthur was a youngster, Merlin transformed him into a bird so that he could soar over the land and learn that national and political boundaries are meaningless. Today, anyone with Internet access has the ability to research information pertinent to medical transcription on the World Wide Web. There is no need to drive 60 miles to a meeting. One need not wait another month for the next opportunity to network with MTs. The only secret handshake is made by modems screeching at each other to establish an on-line connection.

How did it become so easy? The quantum leap occurred about five years ago, when Compuserve and Prodigy were major players in the on-line services industry and America OnLine was a rude little upstart with a tiny portion of market share. Back then, the forums maintained by major on-line services were only accessible to those who paid for the service which maintained a specific forum. Thus, someone with a full-service Internet account who did not belong to a major on-line service like Compuserve or America OnLine could not access the forums for medical transcriptionists maintained by those on-line services.

Because staying on-line to read and post messages on such forums once produced an exorbitant bill, I decided to reverse the process through the use of an electronic mailing list or listserv device. Instead of users having to find their way to each forum and access messages that had been posted on that forum, I set things up so that messages posted by subscribers to the KAMT-LIST mailing list would automatically be distributed to all subscribers. Whenever a subscriber logged on to gather e-mail, any messages which had been posted to the list were waiting in the subscriber’s mailbox.

Because my sister is very active on the LM-NET mailing list for professional librarians, Alice and I often compare what is happening with subscribers on both of these lists. What continues to amaze us is the newfound ability of MTs and librarians to reach out and share their knowledge, wisdom and opinions with newbies, oldies, and those who are just curious.

I can certainly tell you that my investment in creating the KAMT-list has paid off in spades. Thanks to the KAMT-list I have been able to find some wonderful local subcontractors through word of mouth without ever paying a cent for advertising. I have been able to start writing a column again (I was an opera critic for 15 years) and have my professional voice heard through this magazine. I have been delighted to get feedback from readers after each article comes out.

The brave new world of electronic mentoring is an incredibly exciting phenomenon. I'm particularly gratified that subscribers to the KAMT-list (and a variety of other MT message boards) have been able to give sound business advice to MTs who were not sure whether they should:

• Enter a new job situation.

• Take on a new contract.

• Confront an abusive physician/supervisor/client.

• Go to work for a particular service bureau.

• Tell someone to take a flying leap.

Previously, free professional advice from people in every state was not only unavailable, it was highly restricted by association guidelines and old- fashioned employer/employee taboos. When I started the KAMT-list back in October of 1995, the use of the Internet by professional groups was a relatively new phenomenon. The sci.med.transcriptionnews group was still in its infancy. My own company (Alert & Oriented) was the first medical transcription service to have a web site on the Internet.

As millions more have acquired Internet access -- and as new software keeps evolving -- we have witnessed a formidable growth in on-line networking. There are now MT chat rooms, message boards, and web sites filled with information on pharmaceuticals, employment opportunities, you name it! If the Internet has helped to break down some of the old communication barriers, then all hail the Internet and the people who make use of this exciting technology.

While e-mail has had a tremendous effect on our lives (uploading transcribed reports, communicating with colleagues all over the world, and contacting people about employment opportunities) the World Wide Web has had a profound impact on the world of medical transcription. The freedom of expression available on the Internet gave rise to a wealth of websites, message boards, and mailing lists devoted to serving medical transcriptionists and, most importantly, offering them valuable information for free.

Perhaps we should all stop for a minute and think about how being able to communicate with each other electronically -- at almost no cost -- has helped us to:

• Gain strength and confidence as professionals.

• Take a break from struggling to understand muckmouth dictators.

• Enjoy a few raunchy laughs around the electronic water cooler.

• Ask and answer reference questions at all hours.

• Ease the loneliness many of us feel while working at home.

• Stay in touch with our professional peers without having to pay annual dues to an association or travel to a meeting.

Ironically, it was the freedom of speech available on the Internet that broke AAMT’s stranglehold on the microphone in this profession. For whatever reasons, AAMT’s leadership had refused to participate in any of the on-line forums. When the AAMT Track column decried the Internet as a “passing fad equivalent to the pet rock,” it became obvious that certain people had their heads buried in the sand. Had AAMTused the Internet shrewdly, the organization could have been a potent force in the online community. But alas, one of AAMT’s most tragic blunders was the trepidation and downright timidity with which it approached the new world of interactivity and electronic communication.

Franco Zeffirelli’s film Tea With Mussolini depicts the poignant situation of a bastard child whose father can’t find the time or desire to raise him as his own son. The boy, Lucca, is saved from an orphanage and taken under the wing of the father’s very prim and proper English secretary, who doesn’t hesitate to tell Lucca’s father that “There are no illegitimate children, only illegitimate parents.”

What does this have to do with medical transcription? There are strong parallels between a small town’s condescension toward a bastard child and AAMT’s reluctance to establish a viable presence in the world of on-line networking. The rapidly growing on-line community of medical transcriptionists deserves special credit and an extra special vote of thanks for its generosity in encouraging newbies, sharing information about job opportunities and employers, offering technical tips, coming to the rescue with word help at all hours of the night, and building a priceless sense of professional camaraderie. That sense of community has never been defined by payment of one’s dues to a professional organization. Indeed, the only fees these people pay are to their ISPs or to on-line providers such as America OnLine.

If you ask the average medical transcriptionist to choose between spending $100 on a year’s individual membership in AAMT or $100 for five months of Internet access, the choice will pretty much be a no-brainer. It’s far too easy for most MTs to identify which item is a luxury and which has become a professional necessity.