The U.S. Department of Labor has recognized the industry shortage of U.S. transcriptionists and took action by recently declaring medical transcription to be an apprenticeable profession, which is the first step to establishing a national apprenticeship program. The Office of Apprenticeship Training, Employer and Labor Services approved the application for apprenticeability determination submitted by the Medical Transcription Industry Association along with the Association for Healthcare Documentation Integrity for qualifying graduates.

Yaniszewski plans to participate in these programs but recognizes that the lack of U.S. talent may be a “deal breaker” for her to remain exclusively on U.S. soil in the future.

According to Peteete, the field is suffering because it has lost its attractiveness as a profession due to low pay for the amount and intensity of the work. “It’s very difficult for a family to live on $30,000 a year,” he says.

Along with low pay, another issue is the ability of the field to attract diversity. Peteete notes that the current U.S. workforce is made up almost entirely of women, with a high percentage of those moving toward retirement age. In contrast, his operations in India employ an even split between women and men and encompass a variety of ages. “The aging workforce of U.S. transcriptionists has become a significant factor,” Peteete says. “The training supply is not keeping up with retirement.”

In light of the U.S. labor shortage, Iwinski suggests that India is a logical choice for a technology company. “The one thing that India still has in abundance are people who are highly educated and skilled in this market,” he says.

I found this statement fascinating. I admit that I haven't kept up with the latest information, but I've never seen estimates this high.

"And the trend continues to evolve. Industry statistics vary regarding what percentage of transcription services are currently conducted in overseas markets, with the range falling anywhere between 15% and 40%. However, David Iwinski, Jr, CEO of Pennsylvania-based Acusis, believes the percentage is much higher. “I would estimate that the offshore market is much higher than the official estimates,” he suggests, adding that some companies “quietly” outsource and say they are based in the United States. “I think a very significant part of this market goes overseas; companies just don’t admit it.”

Also found this statement interesting:

Yaniszewski believes that perceptions about the use of overseas labor and quality may continue to change as the decisions for contracts move out of the hands of mid-level staff. “Now, with more and more restraints being put on healthcare in general, more of the decisions are being made on the CEO level,” she says.

maller ones simply cannot handle the volume and/or is willing to work with the increasingly shorter and shorter (and in my book, not that anybody asked me) unrealistic TAT expectations of the client's these days.

The problem is that many (if not all) of the big companies are able to meet the TAT expectations, either. They're just more willing to agree to them. If you add in the marketing of various firms for "near real-time capability", usually for speech recognition, and you end up with a general expectation that this is the norm.

This is particularly true the farther you move from the actual transcription process. Transcription becomes a "black box" - voice goes in one end, and a medical document comes out the other. The faster it happens, the better, as far as the decision makers are concerned - as well as the cheaper the better. How that happens is something they aren't aware of, and unlikely to be willing to consider.

The industry hasn't done itself a huge amount of favors, either. I find it interesting that they're complaining about not being able to draw qualified people into the field - yet for most of them, their whole effort seems to be to drive people away from the field. You can't market the field as a career to stay-at-home moms, with "easy entry", while at the same time offering ever-decreasing pay scales combined with ever-increasing workloads. There's a reason why so many senior transcriptionists are advising people to not enter the field!

... but after the way this industry has gone down the crapper in the past few years I would be embarrassed to recommend anyone pay to get an education in this field.

Ditto that. I used to love this business - always interesting, always challenging, earned a good living, etc., but after the way this industry has gone down the crapper in the past few years I would be embarrassed to recommend anyone pay to get an education in this field. Such a shame too.

“The one thing that India still has in abundance are people who are highly educated and skilled in this market,”

Mr. Iwinski you forgot to include Philippines.