Annual AHDI Conference


We asked Jay Vance, CMT, CHP, AHDI­F, Vice President of Operations for WahlScribe, LLC, “Why should MTSOs encourage their MTs to attend the AHDI Conference?” Here’s what Jay had to say:

“As a healthcare documentation services provider, our success or failure ultimately comes down to the caliber, competence, and commitment of our workforce. Regardless of how many accounts we can acquire, if our healthcare documentation professionals are not at their best, the prospects for long­term success as a company are dim. One of my favorite motivational quotes is from Sir Richard Branson, who said, ‘The way you treat your employees is the way they will treat your customers.’

With this in mind, WahlScribe not only encourages our employees to attend the annual Healthcare Documentation Integrity Conference, we offer financial assistance to help them do so. We understand that return on investment in the continuing education of our practitioners may not be readily measurable in dollars and cents, but there is no doubt that the benefits of a well­educated, well­connected, and highly motivated workforce are well worth the expense. The boost in morale and sense of belonging that accompanies attendance at AHDI’s annual conference directly translates into more effective and productive transcriptionists, editors, QA specialists, and supervisory staff.

At WahlScribe, we believe strongly that, as the saying goes, encouraging our employees to attend HDIC doesn’t cost, it pays—and the dividends are substantial.”

Register  Education  Hotel/Travel  General Info  Exhibits


AHDI’s Healthcare Documentation Integrity Conference will be held July 13­15 along the Riverwalk in San Antonio, TX. Register by May 1 to save $55. We look forward to seeing you and your employees there!

Simple is Not Easy

“Complexity is your enemy. Any fool can make something complicated. It is hard to keep things simple.” – Sir Richard Branson

I believe the above quote by Richard Branson is true. It not only feels true, I have witnessed this truth firsthand. But why is it true? What forces come into play to make complexity the path of least resistance, and simplicity a challenge to achieve?

To begin with, there is an inherent deceptiveness about complexity because it masquerades as simplicity. Take, for example, an average workspace. There’s a desk, drawers, and shelves populated with the usual accouterments: paper, pens and pencils, stapler, books, manuals, binders, a computer—you get the picture. You start out the day with everything organized and in its place. Then you begin to interact with these mundane items. You pick up a pen and write something on a piece of paper or in a notebook. You take a binder from a drawer or a book from a shelf. You use the stapler to—well, staple. There is nothing overtly complicated about any of these tasks, right?

But what happens as you repeat these seemingly simple activities throughout the course of a day? The pen likely ends up in several different places on the desk. Maybe the binder is hastily placed on the shelf while the book goes into the drawer. The more often you perform these individually simple tasks, and the more of them you engage in simultaneously, the greater the likelihood that the end result will be a state of disorganization. You can’t find a pen when you need it. The stapler ends up on someone else’s desk. The binder is not where it’s supposed to be. In other words, your workspace becomes complicated without any intentional effort on your part to make it so. This is just one of countless examples of how complexity hides behind a mask of simplicity. When was the last time you were actually able to park more than one vehicle in your two-car garage because you “simply” kept filling it up with stuff?

The problem is that we equate simple with easy and complicated with difficult; in reality, it’s just the opposite. You don’t have to do anything to grow weeds in your garden. Even in the most mundane situations and environments, it is much harder to maintain simplicity than it is to succumb to clutter and complexity. It takes intentional effort to put things back where they belong, every time. It may seem “simpler” to toss a folder on top of the file cabinet instead of opening the appropriate drawer and placing the folder where it belongs. But it only takes a few times of doing this before suddenly I can’t find the information I need when I need it. Somehow, “simple” turned into complicated!

So how is this relevant to the world of managing people, time, and resources? Our natural tendency is to look for the easiest approach to management, and convince ourselves that we’re making things simpler. But what is true in our everyday lives is also true professionally: the easy path leads to complexity, NOT simplicity.

Consider the following workplace scenario. When there is a personnel-related problem which needs to be addressed, the simple approach is to deal directly with the individual or individuals involved and work out a solution. But this requires time, effort, and managerial competence—in short, the simplest approach may very well involve some degree of difficulty.

On the other hand, the easy way out is to draft a company-wide policy describing in detail what is or is not acceptable with regard to that particular scenario, and send it out to all and sundry with the assumption that the handful of perpetrators will read the memo, realize the error of their ways, and change their behavior. No one has to get their hands dirty, confrontation is avoided, and everyone lives happily ever after.

But in reality, this “easy” solution has almost certainly created a multitude of complications which did not exist previously, thereby making the problem worse than it was to begin with. First of all, human nature being what it is, the few individuals who are at fault will either miss the point entirely or simply ignore the edict. Meanwhile, a much larger group of employees will be drawn into the drama unnecessarily, with a typical reaction being resentment that they are being scolded by management for something that did not involve them at all. So in contrast to a simple, straightforward resolution, the “easy” approach has not only failed to address the root problem, it has actually made things more complicated and much more difficult to resolve.

The most valuable managerial skills have less to do with knowing about THINGS and more to do with knowing about PEOPLE. Developing relationships with employees takes time and energy, and that in itself is one reason why many managers don’t do it. Or it may be that a manager wants to develop those relationships, but is prevented from doing so by ill-conceived and/or poorly implemented policies which place priority on tasks which are not people-centric. The most effective use of managerial talent is in simplifying processes and developing human resources. Spending time and energy to intentionally uncomplicate your employees’ work processes will pay enormous dividends.

Simplicity is the shortest and most enjoyable route to success; complexity makes the trip long and miserable for everyone.

Jay Vance, CMT, CHP, AHDI-F
Vice President of Operations
WahlScribe, LLC

Cybersecurity Is Everyone’s Business…and a Crazy Business It Is!

There has been a steady rise in the number of individuals whose confidential health and other personal information has been stolen or improperly accessed.

Within the realm of healthcare documentation integrity and information governance, few issues loom larger than the escalating threats to the security of personally identifiable information. Massive amounts of medical and other personal information stored electronically in centralized virtual and/or geographical locations are simply too tempting a target for identify thieves to resist. In recent years there has been a steady rise in the number of individuals whose confidential health and other personal information has been stolen or otherwise improperly accessed. The consequences of these thefts and intrusions range from relatively benign to catastrophic in nature, involving billions of dollars in lost assets, investigation and remediation expenses, and efforts to thwart future cyber attacks. The Association for Healthcare Documentation Integrity (AHDI) is fully engaged in efforts to identify and understand potential threats to confidential information and to provide information and resources to members, other healthcare entities, and to the general public to promote cybersecurity best practices. Read More…

7 Signs of Successful Employee Empowerment

7 Signs of Successful Employee Empowerment_wahlscribe

Empowering the people on your team to succeed is critical to a successful organization. Very few executives, managers, and supervisors would argue with this statement. But in actual practice, far too many leaders fail to walk their talk regarding empowering those whom they supervise. Either there is little to no real effort being put forth to help employees succeed, or there is the perception that empowerment is happening when in fact it is not.

So how can we determine whether or not our employees are receiving the support they need to succeed? Here are some examples of organizational practices which should be evident in a culture of empowerment.

  1. Confidence Is Conveyed

Your employees know you believe they can do the job. They have no reason to question your belief in or support of them. People are less likely to give their best efforts if they feel you will always second-guess them.

  1. Expectations Are Clearly Communicated

Team members know what a win looks like in your eyes and what is required of them to complete the task. You’ve not left them guessing. You stay available to them through the process if questions arise. 

  1. A Level Of Autonomy Has Been Granted

Personnel under your supervision know you trust them to get the job done in a way that works best for them, even if it’s not how you would do it. Your team knows that your first priority is to achieve the desired results, not to take credit or micromanage the process.

  1. Permission To Fail Is Granted

Team members know that if something doesn’t work, they will be encouraged to try again without recriminations or finger-pointing. Your emphasis is on solving problems rather than assigning blame.

  1. Resources Are Adequate

Your employees have the training and resources to accomplish the task—including your support.

  1. Their Back Is Protected

Your personnel know you will support their good-faith efforts even if every outcome is not optimal. If you’ve put together a team which hits the mark 99 times out of 100, they know you will be there to defend their efforts even when inevitable missteps occur. 

  1. Recognition Is Shared

Your team members are confident that their efforts will be recognized and acknowledged. They know from experience that you are more eager to help them succeed than you are to have your own ego stroked.

An organization which fosters a culture exemplified by these attributes is setting itself up for collective success because the individual members of the group are empowered to succeed. Amazing things can happen when it doesn’t matter who gets the credit.

The Way you treat your employees is the way they will treat their customers_richard branson

Selected content courtesy of Ron Edmonson (

The key to employee motivation

Who hasn’t struggled with motivation at one time or another? No matter how enthusiastic or committed we are to a cause, a project, a job, or a relationship, the truth is that there are those days when it’s hard to stay focused. In the workplace, one of the most important skills and responsibilities of a manager or team leader is to help employees stay motivated. To be honest, I’ve never been a big fan of the “self-help” concept. There is something inherently human about needing to be part of something larger than ourselves. We humans naturally tend to look for others like us with whom we can establish a personal rapport, and that tendency is no more apparent than in the job arena. The human connection in the workplace, even if it doesn’t rise to the level of friendship, is extremely crucial to employee morale. Employees who feel disconnected or disenfranchised at work are those most likely to be unhappy and to manifest that unhappiness in the form of poor work quality, decreased productivity, and conflicts with fellow employees.

To reiterate, wise managers and supervisors understand that one of their most important responsibilities is to help their team members stay motivated and reach their full potential. In all honesty, I find that many organizations fail to empower their mid-level managers and team leaders to be true motivators, choosing instead to mold those staff members into spreadsheet slaves and corporate policy enforcers. There’s a big difference between motivation through personal interaction and encouragement, and manipulation by threats of reprisals if quotas aren’t met.

Jon Gordon, author of Soup: A Recipe to Nourish Your Team and Culture, observes:post-pic

“Employees are in a funk. They are fearful, overworked, distrustful, and have less enthusiasm and passion than ever. And, many leaders are continually frustrated by their team’s performance and low employee morale and engagement.”

“The answer doesn’t involve fancy technology, a new piece of equipment, or extensive R&D. In fact, the answer lies in a basic human emotion: motivation. Now, more than ever, a leader’s job is to motivate and rally his or her team through challenging times. You can’t outsource motivation. It is the leaders and managers who must motivate.”

“Most business leaders want to take the emotion out of business, but that is a huge mistake. When fear and negativity are the primary emotions people in your organization are feeling, you have to counter that with an even more powerful emotion, like faith, belief, and optimism. And your success in that depends on your ability to motivate.”

“One of the most important things that a manager must do is to create the right environment and culture that fuels people and their performance. Culture drives behavior, behavior drives habits, and habits create the future. As the leaders at Apple Computer say, ‘Culture beats strategy all day long.’ Every employee contributes to the culture of their organization. Therefore, employees share the responsibility of motivation. In fact, you can’t motivate someone unless they want to be motivated.”

“Focus on investing in people: training them, mentoring them, appreciating them, recognizing them, encouraging them, coaching them, and caring about them. Very simple objectives, but too many organizations and managers don’t do them. Expect the best from the employees. You can settle for nothing less than excellence. But you also help each person achieve excellence. You help each employee be their best. You create the culture that is motivating, exciting, and flexible, and then you give employees room to grow in this culture. Don’t micromanage. Trust them. Develop relationships with them. Give them opportunities to share ideas and contribute, and they will. Also give them room to make mistakes. Nothing drains an organization’s energy more than fear of failure.”

(Quotes taken from Management Matters Most in Motivation by Susan Heathfield.)

Successful organizations realize that there is a better way to deploy managers and supervisors than having them endlessly poring over spreadsheets and constantly haranguing employees to comply with top-down, often misguided and counterproductive corporate policies. The most productive and ultimately cost-effective use of managers and supervisors is to give them the freedom to spend time interacting with their team members, encouraging them and helping them to succeed. Time spent motivating your workforce doesn’t cost—it pays!

Jay Vance, CMT, CHP, AHDI-F

Vice President of Operations

WahlScribe, LLC

The Sledgehammer Approach to Management “SLAPM”


It’s been 30 years, but I still remember the Radio Volume Incident like it was yesterday. I was working in the clinical laboratory at a large children’s hospital in a major metropolitan area in Tennessee. The lab was fairly large and staffed accordingly. At some point in the history of the lab, the decision had been made to allow employees to keep small portable radios at their workstations, which only a few actually did. However, not long after I began working there, one lab employee began complaining that one other employee’s radio volume was too loud. The complainer would surreptitiously turn the volume down, and inevitably the complainee would turn the volume back up—perhaps even a trifle louder than it was previously. This went on for days, and tensions began to rise and tempers to flare. Harsh words were spoken and threats were made. Finally the issue became so acute that the lab director was drawn into the melee. Discussions were held between the director, the pathologists, and various other powers-that-were. Interestingly, the employees in question were not addressed directly. The end result was that a memorandum was issued to all lab personnel establishing an official policy which specified in excruciating detail the maximum allowable volume level for all portable radios in the lab—right down to precisely how far from maximum the volume knob or other mechanism could be set. Management had allowed a minor problem to escalate to the point where a ridiculous official corporate policy was created which had that distinct passive-aggressive tone which, I have come to learn, is practically de rigueur for such all-encompassing epistles. And for all that, the individuals involved were even more antagonistic toward each other, the entire lab staff was distracted for weeks, and the perception of management as bumbling idiots was further solidified.

And all because of the Sledgehammer Approach to Management, aka “SLAPM.”

The Sledgehammer Approach can manifest itself in various ways, but in every instance there are common themes which can range in manifestation from extremely subtle to harshly overt: view your employees as a mass rather than as individuals, assume the worst about them, and treat them accordingly. Especially in large organizations where SLAPM is the status quo, there seems to be the perception is that it’s too much trouble, takes too long, and costs too much to identify the actual source of employee dissatisfaction, lack of productivity, or unmet expectations. It’s simply easier to SLAPM with company-wide policies which, in intent, outcome, or both, are often punitive and ultimately counterproductive in nature.  I’m sure numerous books, articles, and research papers have been written trying to explain how and where this management style originated. I could have spent copious amounts of Googling time trying to find examples of said tomes, but why bother when I can point to the enormous popularity of the multiple-award-winning TV series The Office or Scott Adams’ Dilbert comics? The SLAPM method is like a cockroach—it doesn’t really matter where it came from because now it’s everywhere, it causes chaos, and we all just want to kill it.

Of course, this begs the question: If something is so bad, why is it so prevalent? Why do we allow this destructive force to exist? The answers are pretty much the same for SLAPM as for a cockroach: we don’t know or don’t want to admit it exists, and it’s easier to just live with than try to eradicate. Tragically, ignorance, indifference, and resignation all contribute directly to the ongoing replication of the problem.

Let me be clear: the Sledgehammer Approach is one of most egregious examples of poor management. Whether the root cause is a lack of managerial competence, having too many plates spinning at the same time, or just plain laziness, the outcome is the same. As with the example of the Radio Volume Incident from 30 years ago, it’s easier to use a sledgehammer to try to smash a problem in one fell swoop than it is to find one loose nail and gently tap it back into place—or pull it out, if necessary. But what may seem easier or less confrontational or even cheaper in the short term very often turns out to be much costlier in a variety of ways.

Unfortunately, the long-term results of using the SLAPM method are just that: long-term, cumulative, and often not immediately noticeable. Nowhere is this more true than in the arena of employee morale. Many employees will suffer in silence under the pounding of the sledgehammer, at least for a time. Consequently, management assumes that what they’re doing is working fine because no one is complaining. Ironically, the same managers who assume that SLAPM is successful if no one makes a fuss may refuse to even consider the possibility that their management style is flawed when employees DO push back! A wise, competent manager is not afraid to look inward first before assuming the fault lies elsewhere. The first principle of good management is that it’s up to the manager to create a positive working environment for employees, not the other way around.

Since this article is being posted on a medical transcription/healthcare documentation company website, it is not only reasonable but imperative, in my view, to note that the Sledgehammer Approach to Management has wreaked havoc within our industry. Consolidation and amoral corporatization has transformed the very soul and nature of our profession, and not in a good way. There was a time when transcription companies tended to be smaller, and ownership and management were more closely tied to the actual practice of our craft. Now we have become just another commodity source, with management often literally and figuratively removed from those they manage, and more concerned about making money for investors than in treating their employees with dignity and respect.

Ironically, I predict it will be the SLAPM mentality that will ultimately destroy those organizations who refuse to acknowledge its toxicity. I truly believe that a shakeup of epic proportions in our industry is on the horizon, due to a convergence of powerful financial, political, and societal forces. But I also believe that when the dust settles, healthcare documentation companies such as WahlScribe, which understand that investing in the overall wellbeing of their employees is in fact the road to true success, will rise to the occasion and provide a resounding rejection of the SLAPM mentality. I’m immensely proud to be part of an organization whose principals have principles to which they are committed, and I’m encouraged to see other service providers in our profession who share that same commitment.

I’ll leave you with a paraphrase of a quote by Sir Richard Branson, a modestly successful businessman who has no use for the SLAPM mindset:

Manage people well enough so they can leave, treat them well enough so they don’t want to.”

–Jay Vance, CMT, CHP

Vice President of Operations

WahlScribe, LLC

Is Medical Transcription A Career With A Future?

Recently on one of the online forums I frequent, I was asked for my opinion of medical transcription schools which continue to recruit and graduate new MTs, in light of the fact that the demand for transcription has definitely declined in recent years due to the rise of offshore outsourcing, speech recognition technology, and especially the electronic medical record. To begin with, I believe this is a fair question, but there are no simple answers.

First of all, the mean age of today’s medical transcription workforce is somewhere in the neighborhood of 55, give or take. If there were no other factors in play, that one statistic alone tells us that in the next few years the pool of healthcare documentation specialists is going to shrink dramatically through retirement, etc. Furthermore, due to downsizing, decreased compensation, etc., there will be additional attrition from the MT workforce as practitioners change careers. Just those two factors alone guarantee that in 5 years the number of available MTs will be FEWER than the number of available jobs. In other words, from my observation and personal experience in the industry, even though the demand for transcription has certainly decreased, there are still a significant number of MTs jobs available now and, I believe, will continue to exist into the next several years at least. But even with new graduates coming into the MT field, that is not enough to offset the number of HDSs leaving the field. The net result, therefore, is that even as MT opportunities decrease, the number of available practitioners to fill the remaining jobs is decreasing even faster. So bottom line, the jobs are out there, even now, and will continue to exist for the foreseeable future.

The issue at hand is not whether or not there will be jobs for new HDSs; the question is how much money can they reasonably expect to make? For MTs who have been in this business for 25, 30, or 35 years, the compensation for the average MT today is so far removed from what they could make 20 years ago that many experienced practitioners cannot even imagine why anyone would want to get into this field. I understand that viewpoint. However, the expectations of a new MT coming into the field may not be the same as those of someone who remembers “the good old days.” There are people for whom the opportunity to make $20K-$25K a year or more without a college degree is appealing for any number of reasons–especially considering there are thousands of college graduates with expensive degrees and a ton of student loan debt who cannot get a job in their chosen field at all. So as long as the MT schools are not misleading students regarding what they can reasonably expect to make (and I realize that may be a big caveat), I personally believe we need more younger practitioners coming into the profession who are willing to work hard, not expect to make a lot of money at first, but are willing to keep learning and honing their craft. I believe there will continue to be decent job opportunities for practitioners with that kind of work ethic. I might add that I’m speaking from personal experience, as that is exactly how I started in this business: working long hours for not much money (even 15 years ago), but sticking with it, working hard, and making connections in the industry. As a result, I’m now in an upper management position with the opportunity to help transcriptionists reach their full potential and earn a decent wage. By no means do I believe our profession is on its last legs, and I would not discourage anyone from considering medical transcription as a profession—as long as they do their homework and have realistic expectations regarding what it takes to be successful in this industry.

Jay Vance, CMT, CHP, AHDI-F
Vice President of Operations
WahlScribe, L.L.C.
2015-2016 President
Association for Healthcare Documentation Integrity


According to an article by long-time news commentator John Stossel, he has lung cancer. Thankfully his diagnosis was made early, and his prognosis is good. But Stossel has a LOT to say about the state of the American healthcare delivery system, and his comments are well worth reading.

While Stossel’s article is dead-on, one area of grave concern he DOESN’T mention is the abysmal state of clinical documentation as a result of over-reliance on technology such as front-end speech recognition and electronic medical record systems (EMRs). As a medical documentation professional, I highly recommend that all patients ask for copies of their own medical records. Multiple studies have revealed alarming statistics regarding the percentage of medical records containing significant errors. I firmly believe this trend has been greatly exacerbated by the ever-increasing elimination of skilled healthcare documentation specialists, who serve as the front-line guardians of accuracy in clinical documentation, in favor of the latest and greatest technology. Doctors and nurses are now being required to either type in their notes themselves (high-priced data entry clerks), select options from endless drop-down menus in EMR screens, or use speech recognition to dictate their findings–often with little time for proofreading what the computer THOUGHT they said.

As the 2015-2016 President of the Association for Healthcare Documentation Integrity, I represent thousands of medical transcriptionists, editors, EMR data entry personnel, quality assurance experts, and many other medical documentation professionals who have historically worked hand-in-hand with physicians to ensure that patients’ medical records are accurate. But $30 billion in federal handouts literally created an instant windfall for electronic medical records vendors, and one of their primary marketing pitches was that their technology would eliminate the need for human transcriptionists and quality assurance professionals. But now that the Meaningful Use dust has settled, healthcare providers are realizing the (taxpayer-provided) multimillion-dollar technology foisted on them by administrators and CFOs is causing more harm than good in many cases. I know of many anecdotal instances where doctors have literally said they wished they had their transcriptionists back!

In response, our association, AHDI, encourages patients to find out what’s in their medical records through our Your Record Speaks campaign. If enough people would take the time to check their own health records, we believe there would be a grassroots demand for accurate clinical documentation, which can ONLY be assured by including skilled healthcare documentation specialists in the process. The health and well-being of American citizens—whether it’s you, me, or John Stossel–is too important to be left in the hands of computers and poorly-designed software.

Jay Vance, CMT, CHP, AHDI-F
Vice President of Operations
WahlScribe, L.L.C.
2015-2016 President
Association for Healthcare Documentation Integrity

Job changes coming for transcriptionists

Nearly 90 percent of medical transcriptionists say that transitioning to documentation roles with electronic health records means that gaps in skills need to be identified and new career paths charted, according to new a study.

New speech and language processing technologies have set the stage for a fundamental transformation in the way transcriptionists work, according to the survey – conducted by the American Health Information Management Association and the Association for Healthcare Documentation Integrity – which found that 87 percent of respondents are preparing for new ways of doing things.

A separate survey of transcription managers and supervisors, meanwhile, showed an overwhelming need to identify transition plans and career paths for traditional medical transcriptionists – even as 73 percent indicated no plan was currently in place, according to AHIMA and AHDI.

“The skills of a transcriptionist – to listen and be detailed- and research-oriented, with a familiarity of medical terminology and disease process – are still in critical need in HIM departments during this time of healthcare transformation,” said Lynne Thomas Gordon, chief executive officer of AHIMA, in a press statement.

“The transcriptionists that can demonstrate agility by moving into a new position can carve out a valuable niche for themselves,” she added.

The survey found that the top two job titles transcriptionists are transitioning to are chart integrity auditor and EHR technician/HIM analyst, performing direct documentation into the EHR and auditing for accuracy and completeness.

Other promising career paths within HIM for transcriptionists are coding professional and healthcare documentation technology trainer, the report suggests.

More than half of transcriptionists (53 percent) said they were “probably or definitely” willing to invest time and resources into obtaining an academic degree to transition directly into HIM roles working with the EHR, according to the survey.

“The rise of EHR is just one of many growth areas in health care where the skills of a transcriptionist will be valuable,” said Linda G. Brady, chief executive officer of AHDI. “Medical transcriptionists, also known as healthcare documentation specialists, are a valuable partner in facilitating successful transitions in how health records are documented. This workforce is well-positioned to identify important quality issues to preserve the integrity of the health record and serve as subject matter experts who can work with providers to create best documentation practices.”