Wednesday, September 26, 2007

Stupid Is As Stupid Does

Many years ago, while working swing shift at a hospital in Michigan, a medical transcriptionist noticed a sign on the employee bulletin board advertising a new janitorial position. Long before the term “informavore”(someone who devours all kinds of data) had been accepted by the mainstream, Janet was reading between the lines. It didn’t take her more than a few seconds to understand that the new janitorial position being advertised paid 50 cents more per hour than what she earned as a medical transcriptionist.

Janet wasted no time in submitting her application for the janitorial position. When she was interviewed, the department head could not imagine why my friend would want a lowly janitorial job when she was comfortably working behind a desk as a medical transcriptionist. As a single mother of three children, Janet explained that the pay differential could make a big difference in the amount of food she could feed her family. At that point, she was politely informed that the janitorial position had, in fact, been created as part of an affirmative action program aimed at creating jobs for minorities.

“Fine. Then, I qualify for the job. You can go ahead and hire me. After all, I belong to a minority” stated my friend, who looked very Caucasian.

“And just what minority might that be?” sneered the interviewer.

I’m INTELLIGENT!!!!”answered Janet. Needless to say, she did not get the job.

Ironically, the kind of global intelligence possessed by many medical transcriptionists is the exact weave of critical thinking skills that is highly in demand in today’s information age. The trouble is that nobody wants to pay these people what they deserve. MBAs fresh out of business school smell money to be made in medical transcription, but keep stumbling over critical faults in their logic and their lack of real-time experience in the workplace. Entrepreneurs whose venture capital is heavily invested in (and whose programmers are often totally infatuated with) new technology can’t understand why some things don’t work the way they expect them to. Physicians who expect to make a killing in the medical transcription industry are often surprised that their return on investment isn’t happening quite as fast as they expected.

Meanwhile, veteran transcriptionists – whose opinions have often been dismissed or trivialized – sit on the sidelines thinking: If only they’d listen to what we’ve been telling them for years, they could save themselves a lot of money and grief.

Strangely enough, it reminds me of a scene from my adolescence. Try to imagine a man who is one third Alfred Hitchcock, one third Jackie Mason and one third Barney Rubble. The result would be my high school chemistry teacher. A short, rotund character who struggled against impossible odds to pound the Chart of Scientific Elements into the heads of horny teenagers, Mr. Fialkoff was famous for his nuclear meltdowns. On a bad afternoon, he would pound his pudgy little fist into the desk and roar “You know what my problem is? I’m surrounded by mental pygmies. That’s what my problem is!”

Years have flashed by and, like Mr. Fialkoff, I often feel as if I’m surrounded by mental pygmies.

  • Several months ago, when a picture I had taken with my new webcam began to appear with this column, I received an e-mail asking “Why is your head bald? Do you suffer natural hair loss or are you using that as a marketing technique?”

  • One of our clients is a teaching facility where a resident physician has developed a nasty habit of dictating “For the rest of the report, you can just put blah, blah, blah. That’s all.”

  • The other day I took a phone call from an orthopedic surgeon on the brink of an anxiety attack because he couldn’t figure out how to order a book from

A recent study on incompetence in the workplace revealed that people who are incompetent often have vastly inflated ideas about their true levels of competence whereas others (who are indeed quite competent at what they do) are often more reluctant to brag about their skills. Those who demonstrate mind-boggling levels of incompetence usually don’t know how much they don’t know, but are sufficiently narcissistic to be damned proud of it! You don’t believe me? Read this man’s claim:

“I am a retired Executive with 27 years experience in Life insurance, well conversant with medical terms, good in English and very intelligent. I am a Masters in psychology also. I can counsel also. I am widely read. I was as programmer in computers for 4 years in main frame. I am conversant with Internet, Java, Foxpro, Visual basic and PC usage. I am suitable for many jobs and although I do not have experience as Transcriptionist, it will take not more than a week to excel in it. I am sincere and honest to the core and would be glad to serve to anyone's satisfaction. I have Internet in my house. I would like to be given a trial job without payment to assess me.”

Forrest Gump’s mother was right when she warned her son “Stupid is as stupid does.”

Several years ago, Corel unveiled its “Medical Edition” of WordPerfect 7.0 at an underattended, underpublicized product launch which showed what an appalling job Corel’smarketing force had done in trying to understand the medical transcription marketplace. Corel’s marketing team trotted out an elderly Canadian physician who was on their advisory board (no doubt expecting that MTs would swoon in ecstasy at the mere sight of a doctor) and swore their undying support for their “Medical Edition” in future releases of WordPerfect.

I don’t know what happened to the “Construction Industry” version of WordPerfect 7.0 that was released at about the same time as the Medical Edition. What I do know is that only the Legal Edition of WordPerfect made it to Corel’s version 8.0.

Last Christmas, my partner and I were approached by the marketing team for a new business venture which was hoping to gain a portion of the medical market. Their concept sounded intriguing — and has since been seen in similar software ventures coming to market. The basic idea is to design a suite of products to be used by physicians in such away that entrepreneurs capture control of the physician’s desktop and build allegiance to their web portal. By doing so, businessmen can underwrite the costs of their venture by targeting advertising from drug companies toward the physicians (whose attention will be captured as they look at their desktops). Sounds cool, right? In a relatively short time, the entrepreneurs can then go for an IPO and make a killing.

Just one problem. The physicians say they want to have transcription available to them as part of the overall package. So entrepreneurs need to findpartners” who can handle the transcription for them while they take over the MTSO’s revenues.

Who cares if these people know nothing about transcription? If that’s the service they’re going to be providing to clients, why should that even matter?

I still cherish the memory of a phone call from another Silicon Valley startup firm that said they needed a transcription company to partner with them right away because they were going to have a tremendous amount of dictation to be transcribed. “How much volume?” I asked. “Oh, lots,” replied the caller. “How many doctors do you have dictating at the current time?” I asked. “Oh, none at the moment, but there will be lots,” replied the caller.

Do these people think medical transcriptionists and MTSOs are so stupid that we don’t know how to run a business? Or that the multi-million dollar medical transcription industry has evolved over the years because nobody asked to see any numbers?

Since we now find ourselves in a new phase of industry growth -- in which technology truly drives change– I’m happy to report that some of the more outspoken medical transcriptionists who frequent MT discussion boards on the Internet have been invited to sit on the advisory boards of several new ASP (application service provider) software programs that are currently in development. Hopefully, these people can provide today’s entrepreneurs and software developers with some stiff reality checks about the market that is really out there.

Let me tell you why.

  • For each vendor pushing a new software program who boasts that he’s spoken to doctors and knows what doctors want, I can point to the lovely technophobic physician who stated “I’ve always been afraid to dictate. Would it help if I tried doing this with my eyes closed?” (I politely asked the good doctor (a) if that was how she learned how to drive, and (b) how she expected to be able to read the patient’s chart with her eyes closed.)

  • For each aspiring entrepreneur or marketing consultant who “wants to get a handle on what’s really out there in terms of the future of the medical transcription industry, projected revenues and market share, etc.,” I no longer feel the charitable urge to give away such information for free.

  • For each piece of e-mail which states “I am a lady doctor (non practicing). I am interested to work as a medical transcriptions. Kindly advice me how your esteemed organization can help me in becoming one?” I strengthen my resolve to create jobs within my own community and use people who are truly qualified to work as medical transcriptionists.

I’m not suggesting that medical transcriptionists, as a rule, are intellectual snobs. There just seem to be an awful lot of money-crazed morons trying to muscle in on our profession.

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