Who Would I Hire?

My business partner and I were having lunch recently when Tom suddenly put down his fork and asked a fascinating question: Given my druthers, would I prefer to hire someone who has a fairly strong background as a medical transcriptionist (but few if any computer skills) or someone with a minimal background in medical transcription who is a computer jock? My answer didn't surprise either one of us. But it might surprise readers of For The Record.

If, as business owners, we were forced to bet on who would give us a better return on our investment (ROI), we'd put our money on the computer jock. No doubt about it. I'm sure that staunch supporters of AAMT would be horrified by that statement. Those who teach medical transcription might be shocked by our choice. But don’t forget: They're selling a curriculum -- they're not necessarily trying to hire independent contractors who are ready to go to work.

“Ready to go to work” is a catchy little phrase that masks lots of hidden issues for any business owner. One of the first things you learn about working with ICs is to keep things squeaky clean with regard to the Internal Revenue Service's 20 rules that define whether someone is an employee or an independent contractor. An independent contractor is essentially someone who is running his/her own business and must shoulder the responsibility for success as well as the risk of failure. That person is responsible for maintaining hardware, software, an office space, delivering work according to agreed-upon specifications and meeting deadlines.

Nevertheless, in the initial period of working with an independent contractor, a business owner must be able to rely on that person to understand the scope of the project, certain specs that need to be met, which deadlines and responsibilities rate top priority and how the contractor’s work and work product must integrate into the smooth operation of the business. This often involves a “shakedown cruise” during which a new contractor will need some guidance, technical support, and extensive feedback on quality assurance.

Whenever I advertise for independent contractors, I hear from too many people who are much more in love with the fantasy of being a medical transcriptionist than they are with the reality of doing the work and delivering it on time. Here are some examples of that these people have told me:

• "I've read all about medical transcription being a hot new industry and I just know in my heart of hearts that I'm destined to do this work. Why should I buy reference books? My husband knows computers and Jesus will guide me."

• "I've already got MSWord on my computer and can't imagine why anyone would use such an old program like WordPerfect."

• "I just gave birth a few weeks ago to my first child. I'm ready to go back to work but I really need some money fast."

• "I'm disabled because of a previous back injury and can't sit for long periods of time but I thought I should be able to make a lot of money doing medical transcription."

• "I'm looking for work that I can do at home. I figure I can learn all I need to know about this in three weeks."

• "I know your ad says you'rel ooking for people in the San Francisco Bay area but I'm in Newfoundland and would really like to work at home."

• Last, but not least, was the person whose e-mail address began with “creepingdeath@........”and had the words “Jesus Rules” on her resume.

These people didn't even make it as far as an interview. On rare occasions we have been blessed with someone who has a strong combination of computer skills and a solid background in medical transcription. But in too many other instances we have ended up with people who did not have the level of skills they promised.

• MT#1 had just graduated from a very famous medical transcription correspondence course with strong endorsements from her teacher. Unfortunately, she didn't know the difference between the words “heroin” and “heroine.” Nor did she have the slightest idea how to move a file from one folder to another.

• MT#2 had glorious credentials, had taught medical transcription, had all the right equipment, and had a resume that could make you drool with envy. Unfortunately, she would request a ton of work and then fail to deliver it on time, did not return messages for days, and could not meet deadlines. I had no way of knowing whether she was depressed, drinking or doing drugs. All I knew was that I could not rely on her.

• MT#3 started off doing beautiful work.Then, one day, she went off one of her medications and kept falling asleep at the keyboard. Her work suddenly started looking like it had been done in kindergarten and required extensive revisions.

• MT#4 had recently whizzed through a college course in medical transcription, but had some severe personality problems. He would sulk, explode, or become extremely defiant, once demanding to know "Why are you criticizing me for all the words I miss? You should be congratulating me on all the words I get!"

• MT#5 was a lovely lady who was stuck in a totally dysfunctional family situation which she wanted to talk about for hours on end. I didn't have the heart to tell her that one of our clients came to us because he simply couldn't stand listening to her tales of woe anymore. When she finally stopped working with us I, too, breathed a large sigh of relief.

Wounded egos. Lack of quality assurance. Inability to communicate. Failure to meet deadlines. Lions and tigers and bears, oh my!

Here's a little reality check. I'm running a medical transcription service. Not a halfway house. Not a daycare center. Not a welfare-to-work program. I'm running a business where I need to find qualified professionals who can deliver the goods on time, every time, without my having to hold their delicate little hands through each little step of learning how to use a Windows operating system.

As a business owner, I'm forced to focus my attention on profit margins, quality assurance, turnaround time and my ability to deliver an extremely high level of service in order to remain competitive within this industry. And, because I also transcribe on a regular basis, my time is valuable. So when push comes to shove, the questions I'm going to be asking a potential contractor are: Do you want to work? Or do you just like to keep telling people about how you want to work? Can you really do the work? Or do you need to be coddled and nursed through every step and procedure?

As an independent contractor, you have to be willing to spend money to make money. But many medical transcriptionists have spent a good part of their professional careers working at hospitals or large services where the software, hardware and reference tools are provided by the employer. It is only in recent years that telecommuting from home offices has become a major phenomenon. Often, MTs talk about how they just can't afford to buy a reference book or software program that they need.

Computer jocks think very differently. They grew up with and accept a cycle of planned obsolescence as software upgrades hit the market on a regular basis. They understand the need to have a more powerful machine with more RAM memory that can help process commands faster. They are willing to invest in their equipment because, to them, it's like buying toys. They do it out of curiosity, out of need, out of a determination to stay current with the market, and above all, out of a desire to work at a maximum level of efficiency. Many of them understand the importance of meeting deadlines because they already work in industries where time sensitivity is critical to the completion of a project.

Why would those qualities make a computer jock with strong language skills attractive to a medical transcription service owner?

• It's easier to work with someone who knows his way around a computer and can easily navigate his way through any Windows program.

• It's much easier to work with someonewho can follow tech support commands over the phone than it is to work with someone who hasn't got a clue about the basics of file management.

• Because computer jocks are used to learning new software programs -- either intuitively or through the use of a manual or on-line tutorial -- they will probably learn how to work with my company's software faster and easier than a medical transcriptionist who has never moved past WordPerfect 5.1 for DOS.

• Because computer jocks are used to the interactivity of certain programs, they will quickly grasp the value of acquiring software add-ons such as word expanders, medical and pharmaceutical spell checkers, drug databases, etc.

• A computer jock won't waste an hour trying to find a referring physician's address on the Internet. S/he will understand that if the information was not delivered by the dictator, it's quite all right to leave a blank and let it be filled in by the administrative staff at a clinic that might have such information.

• Last, but not least, a computer jock is probably going to have stronger time management skills and will be less of a procrastinator than someone who has worked for many years at a hospital with an “employee” mentality.

When I'm out to hire independent contractors, trust is avery big factor in identifying and qualifying the talent I’m willing to work with. I'm not interested in MT wannabes any more than I'm interested in experienced MTs whose personal problems get in the way of their ability to work. The mere fact that someone knows medical terminology does not offer me any guarantee that that person is responsible, can communicate, and can deliver the goods.

Like any business owner, I need to build a team of people I can rely upon.