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I don't paint everything with the same brush either.  Just as there are good people and bad people, I'm sure there are good MTSOs and bad MTSOs.  I think part of the problem has come about with the greed (or survival) if you want to call it that.  Let's say back maybe 20-30 years ago when MTSOs first gave medical facilities an option to deal with the fact that it was almost impossible to recruit qualified MTs.  Up until maybe 10 years ago one couldn't pick up a newspaper in any town big enough to support a hospital where the classified ads weren't begging for MTs. I travel a fair amount and always look at the classifieds and I haven't seen an ad for MTs in several years in ANY newspaper classified. 

The MTSOs were able to fill a gap.  They would pay whatever bonuses were necessary, often 2-3x usual pay rates to get the work out and MTs would crank it out.  The TAT as I recall was 24 hours for H&Ps unless they were stat.  DS, if I remember anywhere close to accurately, the TAT was something like 4 days.  Then more MTSOs came on board and in order for them to get in the action they offered shorter TAT with the argument that faster TAT meant faster $$$.  It got to the point it was and IS ridiculous.  Would a hospital go bankrupt if they didn't get their DSs within 3 minutes?  I doubt it. 

Next, we had the biiiiig MTSOs swallowing up the smaller ones until there are hardly any mom and pop MTSOs left.  Either they could sell out or be put out of business because there was no way they could compete.  Just like the big box stores, the big MTSOs can probably be profitable on maybe a 2% profit margin (volume), something that is totally impossible for a small MTSO.  I know this because I have been on both sides of the fence.  During my career I have worked for many hospitals and many MTSOs, some good, some not.  I never worked in a hospital where the facility and the medical staff did not appreciate and have great respect for their MTs and treat them with respect and dignity.

Then we have the MT training programs.  Again, probably good and bad.  We've all seen the ads that promise people they can take a short course and make $30,000 annually right out of the chute.  We all know better.  We all spent our blood, sweat and tears learning to be professional, COMPETENT MTs.  We all know that it takes a person generally in the neighborhood of 5 years to become proficient.  It takes a physician much longer yet we are expected to speak the language of medicine fluently in a relatively short period of time.  I cannot count the number of calls I have received and still receive from people who have taken this or that MT course and have never been able to find employment.  I tell them that the best I can do is give them a place where they can get an extensive list of MT companies who if they beg and plead MIGHT allow them to test and if they test and pass they MIGHT be offered a job.  I don't have the heart to tell them after spending their money to educate themselves, they would likely make more flippin' burgers.    I also have people asking me all the time how they can get into the MT business.  I have one word for them......DON'T.

Maybe MTs shouldn't go back so far as to be primma donnas as they were in the past but good grief!  MTs and medical records have always been non-revenue producing departments in medical facilities but for MTSOs MTs ARE the revenue producers.  It's kinda like killing the geese that lay the golden eggs.

I've seen the incompetence in medical records, including some of my family's records that have had to be corrected. We've all made mistakes because we are human but when someone transcribes pot of orange, it doesn't take much to see that person doesn't have a clue and the quality HAS sufffered because of inexperienced people trying to make a living under the most nefarious conditions.  I, for one, can't fault people for worrying about paying the rent and feeding their kids!