Let’s Talk Money and Medical Transcription—Part 1

Medical TranscriptionNo Comments

money handA lot of us were raised with the idea that there are three things one should never talk about: religion, politics, and money. The reason being is that these things often have a lot of passionate opinions about them and easily end up in heated debate, but if no one ever talks about them, how does one become more informed? As you embark on a new career in medical transcription and editing, money is going to suddenly be at the forefront of your concerns, so let’s start talking about it!

When it comes to money and medical transcription/editing, the two most common questions are (1) How much can I expect to make when first starting out? and (2) Will I be able to make a living at it? The answer to the first question is, “I don’t know.” The answer to second question is, “I don’t know.” While I don’t know the answers for your unique situation, I do know some variables that will help you answer the questions for yourself.

Most MT companies are considered national companies. This means that you can live in California and work for a company in Washington that has accounts in Florida. National companies usually pay by the line, which means the faster you produce work, the more money you make. However, there is still a small number of local opportunities in many cities. Although these jobs are harder to come by and are not available everywhere, they do tend to pay better—sometimes even paying by the hour—while still offering at-home positions after some in-house training. Check your local hospitals and clinics for job boards, browse the local classifieds, and don’t be afraid to use the word-of-mouth method by asking your friends that already work in the local healthcare industry.

That’s not to say that only local companies provide pay worth working for. National companies can vary quite drastically, even among companies that offer the same cents-per-line rate, so if your main concern is pay, here are some things to consider and investigate before accepting a position.

Let’s say that Company A and Company B both offer 7 cpl for straight transcription, but Company A only pays for visible characters while Company B pays for visible characters as well as spaces. For the sentence, “The patient is an 86-year-old male who presents with multiple medical problems including shortness of breath, palpitations, dizziness, and a general feeling of fatigue but denies chills or sweats, nausea or vomiting, or loss of balance,” Company A would pay 21.5 cents for 200 characters while Company B would pay 25.3 cents for 235 characters. Maybe those few cents don’t mean a lot to you—and don’t worry if they don’t because not everyone has the same priorities when job hunting—but if they do, you might want to crunch some numbers to get an idea of how being paid or not paid for spaces might affect your yearly income. Talk about counting your pennies!

Other differences in pay include whether a company pays for templates and inputting patient information in headers and footers (such as patient demographics and cc names/addresses), as well as the number of characters in a line (a standard line is 65 characters, but it is not unheard of for a company to inflate a line all the way up to 80 characters).

Another choice that can affect your paycheck is whether you decide to work as an employee or an independent contractor. Each has its perks and pitfalls and what one sees as a perk, another might see as a pitfall, so you’ll have to decide for yourself what type of position is best for you and your pocketbook.

Employees tend to work a set shift. That shift might have some wiggle room, such as working a split shift or having a 12-hour window to complete an 8-hour workday, or it might be a strict shift that you have to clock into and out of on the dot. For some, having a set shift helps them be more productive. They know when they have to start work and when they get to be done with it and can better focus on the task at hand during that time. If there is no work available at some point during that time, some companies require their employees to make up that work at a later date or to use vacation pay. Other companies treat it as a let’s-send-someone-home-from-work-early situation, just as you might experience in a retail or food industry setting. Be sure to ask about the company’s policy before accepting a position so you’ll know what to expect.

Independent contractors usually agree to a minimum amount of lines or dictation minutes or certain days/hours they will work. Their schedules are generally quite flexible as long as they are fulfilling their agreement. Sometimes this flexibility proves to be too much for an unmotivated MT who then spends their day posting on Facebook, browsing Craigslist, and playing online games only to receive their paycheck and wonder why they can’t seem to make any money. When a dry spell happens, ICs have the option of adding another company to their workload while employees most often have their hands tied to one company due to a non-compete clause in their work agreement.

Other differences to consider between employee and independent contractor are whether you require minimum wage during your training period, to what extent you might be able to take legal advantage of tax provisions for ICs, and what sort of health benefits you need.

As you can see, there are a lot of variables to the questions at the outset and we’ve barely scratched the surface! You’ve likely heard MTs talk about production hurdles such as the number of dictators in their pool and the difficulty of their account specialty. Variables in the work setting and their impact on pay, both short-term and long-term, will be discussed in a later article, so be sure to visit our blog in the near future to benefit from this information!


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  1. Vickie Graser December 02, 2014

    Best article I’ve read so far on the pay and other things to think about when considering an MT career. I’m looking forward to reading the next article. Thank you.


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