Tuesday, September 25, 2007

Taking Pride In Your Work

Medical transcription is a strange craft that requires intelligence, curiosity, strong reference skills and a genuine love of language. In surveying the professional landscape, one often wonders why people keep transcribing. Surrounded by a work ethic in which most employees do the absolute minimum to collect a paycheck, why should MTs knock themselves out trying to transcribe for hours on end? It’s not for love of money. Nor is it for prestige. With the medical transcription industry becoming more and more like an electronic sweatshop, it certainly can’t be for the sheer glory of typing another report.

Doctors, nurses, and other members of the hospital staff have little or no understanding of what a medical transcriptionist’s work involves. As MTs continue to cope with the dumbing down of the American education system, they must struggle to find ways to feel appreciated for their work and the contributions they make to the patient care team.

It ain’t easy.

Medical transcription is not the kind of work that can be trumpeted to the public with advertisements screaming “We’re #1!” or “Best Transcription in the USA!” Instead, it depends on an old-fashioned set of values which claims that if your work is good, it will speak for itself. And if your work is bad, nothing you can say will make it better.

In the 1980s, John Houseman taped a series of commercials in which the crusty old actor grumbled “Here at Smith Barney, we make our money the old fashioned way: We earn it.” Many medical transcriptionists lack the funds and/or opportunity to enter medical school. Some lack a college degree. Yet, as a class of information workers, these people have done a remarkable job of learning about medicine through sheer guts and tenacity. In their own way, they have earned their stripes.

As a result, recognizing medical transcriptionists for their peculiar yet vital contributions to maintaining high standards of patient care becomes increasingly difficult as MTs are distanced from the workplace (where they can interact with other members of the patient care team) by working in the isolation of their office cubicles and homes. In some ways, the work of a professional MT resembles an anti-virus program -- it functions silently in the background. Because MTs are so frequently out of sight, they remain out of mind.

Many physicians regard dictation as a necessary evil -- a costly part of the insurance racket that forces them to waste valuable time performing an activity which they despise. Those hospital administrators and transcription service owners who look upon medical transcriptionists as a pool of semi-skilled laborers are often frustrated by MTs whose wounded egos and underrated
intellects have placed them into the category of prima donnas and other wild beasts.

Like Rodney Dangerfield, MTs can’t get no respect. The fact that after 25 years of transcribing I am not a CMT doesn’t bother me one bit. Nor do I plan on taking the examination to become one. My professional experience forces me to concur with the veteran transcriptionist who wrote thatTo belong to AAMT means nothing. To be a CMT means nothing. Being a CMT doesn't automatically mean you are a good MT. It just means you had the money, time, and opportunity to take the test and passed it. With very few exceptions, being a CMT won't get you an extra dime.”

Not a pretty picture? Then let me tell you a little secret: MTs are not going to get anyone’s respect until they stop craving the approval of people who don’t know them, don’t care about them and have little or no understanding of the work they do. If you want approval and/or recognition, look to an informed source. A peer. Or yourself. But don’t assume that a credentialed fool with some alphabet soup after his name is the person who can give you your self esteem.

Only you can do that.

Much of our society is guided by standards and rules that make no sense. We live in a culture that worships a level of beauty few can attain. But as Judge Judy Scheindlin is quick to point out: “Beauty fades. Dumb is forever.”

Several years ago I had just finished showering at the gym when I overheard a buffed little disco bunny complain that his life was over because he was starting to develop love handles. As several men stood around naked in the locker room, I coaxed this pathetically insecure bodybuilder into revealing how old he was (33) and how much he weighed (136-1/2 pounds). “Listen very carefully to me,” I said, as I put a quick end to his orgy of self-pity. “I’m 15 years older than you are, I weigh 125 pounds more than you do and I have a healthier self image. You really need to go home and think about that.”

In certain areas of life where I have enjoyed personal success, I have been self taught -- not credentialed. The knowledge I gained was from first-hand experience.

This phenomenon has hardly been limited to my work as a medical transcriptionist. In 1977, when I was offered the chance to write an opera column for San Francisco’s leading gay newspaper, I decided to take the bull by the horns and do something radically different. I did not have a doctorate in musicology. Nor had music been my major in college. I was not a frustrated performer. Nor did I limit myself to discussing “opera’s golden age.”

Instead of writing mainstream music criticism, I tried to reach out to a different subset of readers by writing about opera from the perspective of someone who was excited by the art form. My goal was to deliver informed arts coverage while trying to capture the attention of a readership that was far more interested in rock singers like Sylvester and Donna Summer. For 15 years, I focused my writing on the growth of opera in America’s regional cities while championing young American artists whose careers were then getting started. I took my cue from Frank Sinatra.

I did it my way.

By breaking all the rules, I helped make a 400-year-old elitist activity accessible to the man on the street. The message I communicated through my writing -- that one’s love for an art form (coupled with an honest concern for maintaining high artistic standards) could be a truly exciting life force -- provoked readers to think. And I took pride in a job well done.

Many successful people are plagued by “the imposter syndrome.” Once, while visiting an old friend who had been a publicist for several opera companies, I confessed to being nervous that someone would accuse me of being a fraud simply because I had not taken the standard approach to becoming a professional music critic. She assured me that I would never face that problem because everyone in the industry knew I had been “doing it.” They respected my work. Even if my writing offended and outraged some readers, I had a reputation for being fair, clinically objective, and a passionate advocate for the growth of opera in America.

The intellectual freedom to make my own rules, shape my own thoughts, and occasionally guide my own future has helped immeasurably to build self esteem. I now believe that developing the confidence to reach your own conclusions (without trying to conform to what everyone else may be thinking) is a life-affirming process which extends to many other parts of a person’s life. It is a process which sharpens one’s critical thinking skills and allows a person to make informed decisions.

That kind of intellectual confidence is the foundation upon which medical transcriptionists must rely in order to perform their craft day after day, year after year, report after report. As they reach new levels of security with regard to their language skills, they deserve to be respected for the sharpness of their hearing, the acuity of their intellect and the strength of their critical thinking skills.

Last fall, when my company took on a new account, I was fascinated by some of the feedback we got. During one of the clinic’s Executive Committee meetings (and after the medical staff had finished grumbling about everything that had gone wrong that week) one doctor stated how happy she was with the new transcription service. Not only did the mood of the room immediately brighten, one of the head honchos on the medical staff made a point of thanking the administrator who had chosen our company to do their transcribing. The doctor’s choice of words said it all.

“For the first time in my career, I feel as if I’m in the hands of true professionals.”

Compliments like that help people like me take pride in our work. Happily, there was no need to fear that my partner and I would let the physician’s endorsement go to our heads. We took his compliment with a renewed sense of satisfaction in knowing that our company delivered top-quality work. After all, the work his clinic was receiving had to be good in order to measure up to our standards!

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