After more than 20 years in the industry, Donna Littrell believes medical transcription -- rather, the business surrounding it -- is headed in the wrong direction. Quality has given way to commodity; jobs (and private records) are going abroad; and mom-and-pop shops are fading, all for a better bottom line. And, according to Littrell, associations aren't doing anything to stop it.

"It seemed the associations out there are for the big players, not for the individual transcriptionist," she said. "I just don't think they cared enough about what's important to the actual transcriptionist getting started; what's important to the transcriptionist to maintain the business level they have."

So Littrell started the American Transcription Association (ATA), a new trade organization built on two principles: keeping transcription work in the U.S. and fostering community among transcriptionists. "I guess I got tired of waiting for somebody else to do it," she said.

The association launched a Web site last March and it already has 500 members. With an advisory board now in place, Littrell hopes to build awareness about the association and get the industry back on track.

Emphasis on "American"
As the main thrust of the ATA (and virtually the only membership requirement), transcriptionists and service organizations (MTSOs) must be U.S.-based. That means not only being headquartered in the U.S., but also conducting all business and subcontracting domestically. The reasoning is two-fold: keeping work within borders retains U.S. jobs and ensures information stays secure.

"If everything keeps going offshore, as transcriptionists retire, there's no incentive to get into this industry anymore," Littrell explained. "It's a great industry -- it takes a lot of skill and devotion for what we do."     

While some proponents of offshoring cite a dwindling domestic work force, Littrell said there are "plenty" of American MTs ready for assignment.

Littrell's other main concern -- and one shared by ATA members -- is the risk of offshored records falling into the wrong hands. HIPAA provides strong privacy protections, but U.S. regulations don't apply in foreign countries. The only safeguards are within the terms of the MTSO's business agreement, and that may not hold up overseas, Littrell noted. "They say you're protected by the contracts that the companies on shore have with their offshore partner. Well, who's really going to fight that? Who's going to uphold that?" she asked.

By working with ATA members, companies can be sure their records stay within the country. In time, Littrell hopes the association's logo becomes a "Good Housekeeping Seal of Approval" for domestic transcription. MTs and companies can post it on their Web sites to market U.S.-based services, and providers in need of transcription help can look for the symbol.

But keeping jobs in the U.S. also means giving MTs a wage they can live on. Businesses save money by sending work overseas, but cutting corners can lead to shoddy results. Littrell wants to move the industry away from paying based on line count and instead reward MTs for upholding high standards. "Quality cannot be based on the amount of widgets you're putting out," she said. "It's somebody's talent; somebody's time; and if they need to stop and research something, they shouldn't be penalized."

The ATA advocates for fair and reasonable compensation for MTs. Members believe you get what you pay for, and they're offering strong, reliable output.

"It's for the Members"
Associations thrive on membership, and the ATA is no different. But members aren't just there to pay dues; they'll play a critical role in shaping the fledgling organization.

"It's for the members," Littrell explained. "What the members are going to need and what they want is where the association is going to go." 

Whether it's a dynamic speaker, podcast or tip-sheet on using shorthand word expanders, if transcriptionists want it, the ATA will try its best to deliver.

With an online forum already buzzing with shout-outs, the association is on its way to being community-driven. Transcriptionists new and old are invited to ask questions, offer advice or simply say hello from one home-based office to another. The interaction can offer some real help, say, when a start-up MTSO is scouting software vendors.

"[In the past] it always seemed when we were looking for a new product or to upgrade our systems we had to start at square one," Littrell recalled. Soon, members will be able to get guidance from the ATA on topics like recommended vendors, cutting the hassle of blind research.

The ATA community may be its most unique feature. While membership is restricted to U.S.-based transcriptionists, the association reaches out to all transcription fields: legal, medical, corporate and others. Littrell said it's a way to get input from every facet of the industry.

The Road Ahead
The ATA's immediate agenda consists of building awareness among transcriptionists and physicians, to let them know the association is out there and its services are available. As membership grows, the board hopes to add perks like group health insurance. Plans are also in the works for a resume database, where facilities and MTSOs can search for qualified U.S. transcriptionists.  

The ATA hasn't heard any beef from other associations, Littrell said (and she's not looking for a fight), but they've had plenty of praise from MTs and service providers. The association has yet to do any formal marketing, so Littrell was thrilled when feedback, unprompted, poured in. "The e-mails I've received, the calls I've received, the posts that have been up on our forum have been amazing," she said. "It definitely was very heartwarming to see the amount of support we've received."

• For more information on ATA, visit www.ataus.org.

Cheryl McEvoy is an editorial assistant with ADVANCE.