I’ve been following reports from the meeting as reported by Kathy Nicholls at her MT Tools Online blog, as well as the ACE365 website at Ning and I find myself wondering if medical transcriptionists can afford to let this organization continue to represent to legislators and the health information management community that it is the voice of the industry.

Granted, AHDI is being technically accurate when it represents itself as the largest organization for medical transcriptionists. What does that make the thousands of MTs who aren’t members? The largest disorganization for medical transcriptionists?

AHDI now counts among its membership over 10,000 members as a result of requiring KB users to be associate members of the organization.

Associate members are those individuals who have qualified for membership under a third-party vendor contract and have received this membership offering through the purchase of a contracted product or service, such as Benchmark KB. Only users/purchasers of those products and services qualify for this membership category.

Unfortunately, AHDI doesn’t go into detail about what associate members get with their membership, but it’s my understanding they cannot vote and they cannot hold office. In effect, therefore, there are only roughly 5,452 members in other categories. According to MT Tools Online, reportedly 30% of the total membership number is in the student category (also unable to vote or hold office), but that number is mixed with students who receive the KB as well. Subtract an unknown number of corporate, institutional and educational members and who knows how many that leaves in the individual professional category – those who can vote and hold office. Certainly, less than 5,000 and probably closer to 4,000. That’s down significantly from the 7000 individual professional members reported several years ago; and it is certainly a smaller and smaller pool of people who are eligible to hold office, much less vote.

Wow.

Actions this week at ACE that make it look like AHDI leadership has been taking their cues straight out of the Tricky Dicky book of Dirty Tricks. The House of Delegates’ (HOD) vote to retain the present members of the HOD for another year gives me flashbacks to an illegal secret Board meeting held in California years ago and reinforces the screw the membership mentality. If you don’t think your delegate is adequately representing your region – too bad. Like it or not, members will not get to hold an election of new delegates for next year.

Regardless of the reasons for this action, it’s illegal and a violation of AHDI’s own By-Laws, and possibly California law, where AHDI is incorporated. Niggling little things like that never seemed to stop this sort of thing in the past, so I guess nobody should be surprised that the dirty tricks continue. It should be frightening to realize that this is the same group that gives leadership seminars.

Frankly, I found Miriam Wilmoth’s comments on emergent resolutions before the HOD to be… well, enlightening.

… It is unfortunate, too, that any efforts to speak for members who are still confused, torn, or outright opposed to the way current issues before the House have been handled are met with accusations of dishonesty, that any dissenting opinion is met with an association-sponsored blitz of ad hominem attacks like none we have ever seen in this association – from the CEO, to selected (not all) board members, and even the Speaker of the House.

I’m having déja vú all over again.

I’m sure the response of the AHDI faithful will be – if you don’t like it, join and change it. OK, first of all – with no new delegates being voted in for next year, how much change can there be? I rather suspect the real purpose behind that move is to make sure the only changes made are the ones Dirty Tricks club wants made. And my personal response to that would be – been there/done that, got the T-shirt and what I experienced was eerily similar to what’s currently going on – burn the By-Laws, damn the torpedos and to hell with what the membership wants (what do they know, anyway?).

If we encourage our members to talk to us, to tell us what they think, to become engaged in the purposes of the association – yet when they open their mouths to speak effectively they find their integrity called into question – do we really think they will continue to speak?

And after reading this comment – again made by Miriam Wilmoth – is there any question that you would plop down your $ 135 annual membership fee only to be told screw you very much? Because that’s what’s already happened to current members.

I’ve already seen a slew of long-time members – members who were active in leadership positions – drop their membership and leave AHDI. And yet the insanity continues. Obviously, the number of core members – those in the individual membership category – has dropped drastically over the last couple of years. And instead of addressing the issues and concerns of members and former members and asking what they could possibly be doing wrong – many of those who remain at AHDI write off criticism as sour grapes or negativity and then drop their heads back into the sand. Because as long as you can write off the people who bring up the issues, you don’t have to actually take responsibility and address the issues. And I’m not even going to get into how AHDI has ignored the fact that nonmembers could be potential members. (More on that in another post, where I’ll talk about a publication by an AHDI staff member that makes it clear what the attitude is about us.)

In my opinion, this organization has been on a course that is detrimental to practitioner medical transcriptionists since they changed the name of the organization and got into bed with MTIA. They say they want to get online and into social networks. Great. I say the largest disorganization of medical transcriptionists in the world use the same social media to let the world know that this organization does NOT represent us.

MT Exchange

Go on any medical transcription forum and you will find a war raging about medical transcription schools. The common opinion among the most vociferous is that there are only two choices one should make and no other school or program is worthy of consideration.

I’m not going to name names but let’s call those two schools Harvard and Stanford.

Everyone wants to go to Harvard and Stanford, don’t they? Well, of course. Who wouldn’t want to go to the #1 schools in the country? Who wouldn’t want to make the lifetime connections and have the prestige on their resumes?

There are only two problems with this:

Harvard and Stanford have exclusionary admissions.

Not everyone can afford to go to a prestigious private school.

Not everyone who applies is admitted to a prestigious school

Just like the real Harvard and Stanford, the two schools generally considered to be the top programs have screening processes. Why? Because not everyone is cut out for their program. Heck, not everyone is cut out to be a medical transcriptionist. Screening improves the program completion rate and ensures that the people who attend the program and graduate are in the Most Likely to Succeed category. It’s self-fulfilling policy that, although difficult to practice at first, ensures that the reputation of the school grows with every class that graduates.

The additional benefit is that there are fewer people admitted to those programs who pay their money and THEN discover they’re in the wrong career or school. They may be told at the time they’re rejected that this isn’t the career for them, but what they do with that information is up to them – Stanford and Harvard will not be taking their money and attempting to massage them through the program so they can finally (marginally) graduate and proclaim that they are now a graduate of the fine institution. This is good for the school because someone who has to be massaged hand-held throughout the program most likely isn’t going to be the most successful MT and Stanford and Harvard have a reputation to maintain when it comes to their graduates. It’s good for MTs because they aren’t wasting their money – at least not at that particular institution.

There’s another aspect to exclusionary admissions: not everyone who wants to go to Stanford and Harvard ought to go there. Every school teaches in a particular style and some students aren’t suited to that teaching style. A student who might fail miserably if admitted to Harvard or Stanford might thrive on the teaching style at a community college. The reason variety is the spice of life is because we are all unique and uniquely human. Experience is not a one-size-fits-all proposition; what worked or didn’t work for one person produce the same outcome for someone else. And frankly, it’s pretty easy to say “I could’ve done better if I’d gone to Harvard” – but we’ll never know, will we?

Not everyone can afford to attend a prestigious school

Let’s face it – the top institutions can charge more because of their reputation. And not everyone has the means to pay for a top-grade education. That’s why public universities, junior colleges, community colleges and vocational schools exist.

But! but! but! We hear the school war mongers cry: they won’t do as well if they go to a lesser school! they should be willing to sacrifice, pay the extra to get so much more!

Well, there’s reality and there’s reality. If part of the reason we’re trying to steer people right is because we don’t want women who are already struggling financially “waste their money” on a substandard education, I’m not sure I see the justification for the argument. I don’t want to see them waste their money, either, but you’d have to define a substandard education. I’m sure the community colleges would assure you that although they know they aren’t Stanford or Harvard, they provide a perfectly adequate education, especially for the price. And they graduate people who are able to find jobs. Is it easier for people with a Stanford or Harvard degree to find jobs? Probably. Is it impossible for people with community college degrees to find jobs? No. That’s the reality.

For someone who is having difficulty buying groceries, wondering if she will even make enough money to pay back what seems like a huge sum, it’s not realistic (and perhaps a bit arrogant) to tell her she needs to cinch up a little bit tighter and pay 30% more to attend a school that will get her a job that won’t pay any better than the one she’ll get when she graduates from “the other” schools. The reality is, she can get a job with a certificate from the less expensive school. The reality is that someone who is motivated and has the basic skills will probably do well for themselves whether they go to Harvard, Stanford or the local community college. The reality is that there are some very decent vo-tech and community college MT programs in operation that don’t cost thousands of dollars.

Picking battles and soldiers

Every parent knows it’s important to pick your battles. The wars being fought in some of the MT forums are, for the most part, over schools that have a legitimate place in the industry. I concede some have aggressive (and tacky) marketing techniques but that doesn’t make them de facto “matchbook” schools or invalidate the education they provide. At the same time opinions and insults are flying back and forth over the decision to attend a third- or fourth-choice school, there’s someone over on Ebay selling a 20-page “e-book” on how to become a medical transcriptionist and the Google ads at the same site where the discussions rage are advertisements for yes – matchbook schools, alongside “lowest prices for medical transcription!” Do you even need to ask which I find more offensive?

There seems to be a great desire to make sure no misinformation is spread (indeed, this is frequently given as the reason why someone continually harps on a topic every time it’s raised), yet many who say they only want to correct misinformation are spreading misinformation themselves. People reading the forums need to know who the poster is, their motives for saying what they say and the experience that qualifies them to be an expert. Maybe as a working MT someone has a unique perspective on their own experience getting hired; however, that doesn’t equate to experience in hiring transcriptionists. “National companies aren’t likely to hire someone from a community college program.” I’m sorry – an MT with no management or hiring experience just doesn’t know enough to make such a generalized statement. I said this on the internet forums 10 years ago and I’m still saying it: know who you’re talking to online, the background of the person giving advice, and take that into consideration because a lot of them are talking off the top of their head, which seems to explode with regularity. I’ve been in this business for over 20 years. I’ve hired literally hundreds of MTs and had thousands of resumes cross my desk. I run a job site for MTs. I’m pretty sure I know what I’m talking about versus someone who’s worked as a production MT for a couple of years, never seen a resume besides her own and never been in a position to hire anyone except a babysitter.

If you really want to hear my pet peeve on this topic, it’s this: I’d really really like to know the purpose of telling someone who has already paid for school (non-refundable) that they picked the wrong one and they need to dump that investment and go to a different school. I’d especially like to know how the people who claim they’re looking out for the financial interests of women who can’t afford to make mistakes justify this position. To say it isn’t helpful is a huge understatement and the badgering that goes on does nothing more than create doubt and anxiety. If you want to be helpful, try something along the lines of: I think you could’ve gone with a better school but since you’re already there and paid up, here are some suggestions for overcoming what I feel are the shortcomings of that particular school.”

Conclusion

It would be great if everyone who wants to be an MT could get into Stanford and Harvard and had the means to do so. It would be great if every MT school aspired to be Stanford or Harvard. It would be great if everyone who wants to be an MT was actually qualified. It would be great if people who are told they shouldn’t ever become an MT would actually listen to that advice. Any other dreams you want categorized?

This article was originally published at MT Exchange on September 9, 2008.

MT Exchange

I’ve been following reports from the meeting as reported by Kathy Nicholls at her MT Tools Online blog, as well as the ACE365 website at Ning and I find myself wondering if medical transcriptionists can afford to let this organization continue to represent to legislators and the health information management community that it is the voice of the industry.

Granted, AHDI is being technically accurate when it represents itself as the largest organization for medical transcriptionists. What does that make the thousands of MTs who aren’t members? The largest disorganization for medical transcriptionists?

AHDI now counts among its membership over 10,000 members as a result of requiring KB users to be associate members of the organization.

Associate members are those individuals who have qualified for membership under a third-party vendor contract and have received this membership offering through the purchase of a contracted product or service, such as Benchmark KB. Only users/purchasers of those products and services qualify for this membership category.

Unfortunately, AHDI doesn’t go into detail about what associate members get with their membership, but it’s my understanding they cannot vote and they cannot hold office. In effect, therefore, there are only roughly 5,452 members in other categories. According to MT Tools Online, reportedly 30% of the total membership number is in the student category (also unable to vote or hold office), but that number is mixed with students who receive the KB as well. Subtract an unknown number of corporate, institutional and educational members and who knows how many that leaves in the individual professional category – those who can vote and hold office. Certainly, less than 5,000 and probably closer to 4,000. That’s down significantly from the 7000 individual professional members reported several years ago; and it is certainly a smaller and smaller pool of people who are eligible to hold office, much less vote.

Wow.

Actions this week at ACE that make it look like AHDI leadership has been taking their cues straight out of the Tricky Dicky book of Dirty Tricks. The House of Delegates’ (HOD) vote to retain the present members of the HOD for another year gives me flashbacks to an illegal secret Board meeting held in California years ago and reinforces the screw the membership mentality. If you don’t think your delegate is adequately representing your region – too bad. Like it or not, members will not get to hold an election of new delegates for next year.

Regardless of the reasons for this action, it’s illegal and a violation of AHDI’s own By-Laws, and possibly California law, where AHDI is incorporated. Niggling little things like that never seemed to stop this sort of thing in the past, so I guess nobody should be surprised that the dirty tricks continue. It should be frightening to realize that this is the same group that gives leadership seminars.

Frankly, I found Miriam Wilmoth’s comments on emergent resolutions before the HOD to be… well, enlightening.

… It is unfortunate, too, that any efforts to speak for members who are still confused, torn, or outright opposed to the way current issues before the House have been handled are met with accusations of dishonesty, that any dissenting opinion is met with an association-sponsored blitz of ad hominem attacks like none we have ever seen in this association – from the CEO, to selected (not all) board members, and even the Speaker of the House.

I’m having déja vú all over again.

I’m sure the response of the AHDI faithful will be – if you don’t like it, join and change it. OK, first of all – with no new delegates being voted in for next year, how much change can there be? I rather suspect the real purpose behind that move is to make sure the only changes made are the ones Dirty Tricks club wants made. And my personal response to that would be – been there/done that, got the T-shirt and what I experienced was eerily similar to what’s currently going on – burn the By-Laws, damn the torpedos and to hell with what the membership wants (what do they know, anyway?).

If we encourage our members to talk to us, to tell us what they think, to become engaged in the purposes of the association – yet when they open their mouths to speak effectively they find their integrity called into question – do we really think they will continue to speak?

And after reading this comment – again made by Miriam Wilmoth – is there any question that you would plop down your $ 135 annual membership fee only to be told screw you very much? Because that’s what’s already happened to current members.

I’ve already seen a slew of long-time members – members who were active in leadership positions – drop their membership and leave AHDI. And yet the insanity continues. Obviously, the number of core members – those in the individual membership category – has dropped drastically over the last couple of years. And instead of addressing the issues and concerns of members and former members and asking what they could possibly be doing wrong – many of those who remain at AHDI write off criticism as sour grapes or negativity and then drop their heads back into the sand. Because as long as you can write off the people who bring up the issues, you don’t have to actually take responsibility and address the issues. And I’m not even going to get into how AHDI has ignored the fact that nonmembers could be potential members. (More on that in another post, where I’ll talk about a publication by an AHDI staff member that makes it clear what the attitude is about us.)

In my opinion, this organization has been on a course that is detrimental to practitioner medical transcriptionists since they changed the name of the organization and got into bed with MTIA. They say they want to get online and into social networks. Great. I say the largest disorganization of medical transcriptionists in the world use the same social media to let the world know that this organization does NOT represent us.

MT Exchange

I was moseying along in the medical transcription blogosphere today – in my opinion, part of my duties as webmaster/owner of medical transcription sites – when I decided to check out a tweet sent out by Kathy Nicholls about some changes being proposed in AHDI governance. Here’s Kathy’s tweet:

KathyNicholls: AHDI proposes governance changes. What are your thoughts? http://bit.ly/dB8eeT

Now, I had nearly made a vow to leave AHDI alone. I’m not a member and haven’t been now for several years (not counting one year of corporate membership). I’d say I don’t care what they do, but by golly I run a forum for medical transcriptionists and they get discussed – so I decided to go see what Kathy was talking about.

This whole thing reminds me of a MTIA annual meeting a couple years ago, where I wanted to register in time to get the early bird discount – but there was no speaker schedule posted. Upon my inquiry (to AHDI, who is in charge of MTIA’s business), I was told one was not available yet. I then asked if the early bird discount would be pushed back so that it was available for a period of time AFTER the speaker schedule was available. I was told no, it would not. Therefore, in order to get the early bird discount, I had to buy a pig in a poke. Well, first it boggles my mind that any professional organization wouldn’t have a speaker schedule set by the time they started advertising their annual meeting; and second, that anyone would be expected to register for a meeting when they had no idea what educational sessions would be offered. Why offer an early bird discount at all, under the circumstances?

So now we have AHDI proposing another change in governance. Whether or not it’s a good change for the organization isn’t the point – I don’t know and I don’t really care. But, according to what I’m reading on Kathy’s blog, AHDI doesn’t even know the financial impact of what they’re proposing, yet it’s supposed to be taken to vote at the annual meeting the first week of August. Am I the only one who wonders why the rush?

Some of the comments at Kathy’s blog indicated that maybe members haven’t been very informed about this proposal. I consider Kathy – a former president on the national board of AAMT and a former HOD delegate and president of the HOD – to be pretty plugged in. If she doesn’t know about it, it doesn’t say much for how well information about this proposed change is being passed along to membership.

It appears the Town Hall meetings were first announced back in February – but the first Town Hall meeting wasn’t until the end of May, just 9 weeks prior to the ACE meeting and a vote on whether or not to implement this plan. Again, I’m reminded of the MTIA meeting – shouldn’t there actually BE a plan prior to announcing the plan? And what happened in the intervening months between mid-February, when this was first announced, and the end of May? According to comments made at the MT Tools Online blog, delegates were not allowed to disseminate information about these changes until a few weeks ago. Another comment was that the concept seems to change with every Town Hall meeting. There are, of course, the rah-rah posts – one commenter indicates she has been attending the BGG webinars “for several months” – which would be hard to do unless her definition of “several months” is what most of us would call a couple of months.

What I found most interesting were the comments by Miriam Wilmoth, a long-time member who has been very involved in the association for years.

Yes, there have been opportunities to ask questions – and to have some of them answered – but the “feel” of these meetings has all been one of an informational meeting and they have each projected that the BGG is a done deal, despite the fact that the House has yet to vote to move forward with it. Not once, when concerns have been raised, has anyone in leadership responded with the acknowledgement that yes, you have raised a valid concern and this is a problem with the new plan, or that anything needs to be taken back to the drawing board and re-thought. There is simply the continual message that this is the only salvation for our association and it must be done right now or we lose everything.

This doesn’t surprise me because this is de rigeur communication of the association to its members. I’ve said it before and I’ll repeat it: AHDI doesn’t actually hold discussions with members, they talk at them. The AHDI board has been very mother knows best with members, especially in the last couple of years. While I understand the need for the BOD to present a united front to membership and to keep its doubts and disagreements private, the united front seems unable to acknowledge the concerns of members or make members feel as though their input is valued, appreciated – or will even be considered. The end result is the feeling by membership that it’s being bludgeoned and the purpose of the Town Hall meetings isn’t actually to solicit input in order to formulate a plan – it’s window dressing for a decision that’s already been made and that will be rammed through because mother knows best.The fact that most of the people who serve in leadership at AHDI work very hard and are very passionate about what they’re doing is beside the point (the road to hell being paved with good intentions, and all).

Barb Marques, who is the current President-Elect to the AHDI BOD, says in her comment:

A couple of points I would make is that (1)perhaps all individual members have not heard first hand about the proposal, even though Townhalls have been open to any member. (2)I suspect the grassroot members will be hearing much more about this now that the component and state/regional association leadership, and the HOD, has been given several looks at the plan, several times now, and I hope ready to speak to their members on he subject with an assurance of understanding. Meetings with specific regional leadership (and anyone else they care to invite) will be held this and next week. The FAQs are available on the website for anyone to access.

I see no FAQ associated with that BGG. WHICH DOESN’T SURPRISE ME! After all, this is the same group of folks who start selling admission for a meeting with no agenda and asks people to vote on a plan that appears to still be in the planning stages. Link, please?

Of course the Town Halls were open to all members – but were all members adequately informed of them? Or are even members past the point of caring how AHDI reinvents its governance?

Keep in mind that the meeting where this vote is to take place is August 4-7, so all this discussion that’s going to take place is during the remaining two weeks before the vote. How many changes can be made after input from members in that short time?

If AHDI really feels it’s on the brink and needs salvation, and if it really wanted input from its members, it would have a frank discussion about the status of the association and present several alternatives, rather than offering up one “solution” to the problem for a vote in a few weeks’ time, especially when the proposed idea seems to be half-baked at this point. If the association is in such dire straits, surely it would be better served by a concrete plan and financial statement. The phrase out of the frying pan and into the fire comes to mind here, as does “a stitch in time saves nine.”

I’m going to go back to the proposal that got me into so much trouble with AAMT/AHDI several years ago and suggest that it’s past time for medical transcription to roll back into medical records. The case for this is even stronger now than it was the first time I brought it up. The evolving role of medical transcription in the medical records documentation process is bringing it more and more into the health information management sphere of influence. The people who really make the decisions about what happens in medical records – and in medical transcription – are in AHIMA, not AHDI. Let’s forget about MTIA for now – it’s a self-serving alliance of transcription service owners. The only comment of value about MTIA members I can make is to note that many of the C-level executives are most likely also members of AHIMA because they know the value of that organization to their business. At this point, AHDI seems to be spending a lot of time and energy struggling to make itself relevant, and reorganizing itself just to stay afloat. When it comes to legislation, it duplicates many of the efforts of AHIMA – only with less money and less effect. Doesn’t it make sense then to just roll it all into one organization? As a therapist I know once said: Sometimes a good divorce is better than a bad marriage. AHDI has, in my opinion, been a bad marriage for some time.

MT Exchange

You know you’ve really made the big time when your blog starts getting spammed by spammers who are actually on topic. That means your blog is ranking well for targeted search terms; in my case, that would be medical transcription.

I’d like to thank all the spammers out there who have tried everything imaginable to get their spammy medical transcription links on my blog pages. Now – cut it out.

Thank you. Have a nice holiday.

MT Exchange