I signed up just to post here and, hopefully, help those still considering medical transcription. When I started, transcription jobs were abundant; now, they are scarce and have been mostly replaced with "editing" jobs, which pay 3-4 cents per line. It takes an enormous amount of lines to make any kind of a paycheck. Additionally, the companies that hire editors also keep raising their accuracy standards to now just a hair under 100%. Now figure in a heavy amount of ESL doctors who are difficult to impossible to understand, speed talkers, mumblers, poor sound, and QA who often don't agree about punctuation rules, or trying to remember the specific account rules for possibly numerous accounts. The MT/ME must maintain high productivity while also keeping quality scores extremely high, which is stressful and difficult for most, and are still lucky to make minimum wage. This means being scrutinized & tested daily with the threat of termination hanging over their heads, even for tiny errors, and all for low pay, and this is after paying for schooling.
However, even if a person can handle this day in and day out, the workflow is dwindling as more and more facilities are going with point and click and/or templates and very little dictation (if any), which means less overall available work. Plus, on top of all this, big companies have offshored work to foreign countries.
Finally, please note 4 observations that, to me, show the proof is in the pudding:
1. My MT school, which was highly respected & ethical, has closed their transcription program, and so have the community colleges in my area.
2. One giant MT company has filed for bankruptcy (2014).
3. MT companies are moving a few MT/MEs into training to become coders, while many MT/MEs at same companies complain about no work.
4. New regulations (meaningful use)-check it out.
5. Seasoned MTs having difficulty finding work.