“I am not a typing machine!”
Report on the Professional Status of Medical Secretaries in Nordic Health Care
September 2019
NOLO is a co-operation between Medical secretary Associations in Denmark, The Faroe Islands, Finland, Greenland, Iceland, Norway and Sweden. NOLO sent out a member survey and got 2103 answers from medical secretaries from the Nordic countries.
The NOLO survey shows that a vast majority of medical secretaries in the Nordic countries like their job and feel appreciated by their employers. But too many think that the professi- on is not appreciated as such and that the competence of medical secretaries are far down in an old-fashioned hierarchy.
There is also a wide-spread opinion that wages are too low. 43 percent out of the respon- dents are dissatisfied with their wages. 28 percent are rather dissatisfied and 15 percent are very dissatisfied. In contrast most medical secretaries are highly skilled — around 40 per- cent have invested in a post-secondary education.
More than a fifth out of the respondents say that their ideas for change at the workplace are not taken into account. The most common reason to why ideas are not used for improve- ment is that ”other professionals are more listened to” and ”economic factors are conside- red more important”.
NOLO believes that there is a need for employers to better reward skills and extensive work experience among medical secretaries. Employers in the Nordic countries must increase the attraction of the profession to young people. NOLO calls for:
Enhance the status of medical secretaries in Nordic health care and distribute more power to the profession.
Pay medical secretaries wages that is well corresponding with education and make sure that extensive work experience is better rewarded.
Offer modern and flexible working conditions and a healthy working environment.
Summary
NOLO är ett samarbete mellan medlemsorganisationer för medicinska sekreterare i
Danmark, Färöarna, Finland, Grönland, Island, Norge och Sverige. NOLO skickade ut en medlemsenkät som 2103 medicinska sekreterare i de nordiska länderna besvarade.
NOLO-enkäten visar att en övervägande majoritet bland nordiska medicinska sekreterare gillar sitt jobb och känner sig uppskattade av sin arbetsgivare. Men alltför många upplever att medicinska sekreterare inte får tillräckligt erkännande för sitt kompetens och att yrkes- gruppen hamnar långt ner i en gammaldags hierarki.
Det finns en utbredd uppfattning att lönerna är för låga. 43 procent av de svarande är miss- nöjda med sin lön. 28 procent är ganska missnöjda och 15 procent är väldigt missnöjda.
Samtidigt är medicinska sekreterare i regel välutbildade – runt 40 procent har investerat i en eftergymnasial utbildning.
Över en femtedel av de svarande uppger att deras idéer till förändringar på arbetsplatsen inte tas tillvara. Den vanligaste anledningen till att idéer inte används i utvecklingsarbete är att ”andra yrkesgrupper blir mer lyssnade på” och att ”ekonomin anses vara viktigare”.
NOLO menar att arbetsgivare måste se till att medicinska sekreterares yrkeserfarenhet lönar sig mer. Arbetsgivare i de nordiska länderna måste öka yrkets attraktivitet för att unga ska vilja söka sig till professionen i framtiden. NOLO vill:
Arbetsgivare måste uppvärdera kunskaper och kompetensen bland medicinska sekreterare och öka yrkesgruppens inflytande i den nordiska hälso- och sjukvården.
Medicinska sekreterares arbetslivserfarenhet måste löna sig mer och lönen måste motsvara de högt ställda kompetens kraven i yrket.
Arbetsvillkoren måste vara moderna och flexibla och arbetsmiljön måste vara hållbar.
Sammanfattning
NOLO is a co-operation between Medical secretary Associations in Denmark, The Faroe Islands, Finland, Greenland, Iceland, Norway and Sweden.
NOLO is sharing information and spreading inspiration in order to develop the profession, the education and to influence employers.
NOLO is promoting visibility of medical secretaries in media by presenting political state- ments. NOLO wants to highlight the importance of professional skills and education of high quality.
About NOLO
The survey was sent to medical secretaries in Denmark, Finland, Iceland, Norway, Sweden.*
2103 persons responded to the survey.
Nearly all respondents, 99 percent, are women.
The purpose is to highlight the importance of medical secretaries in the Nordic health care systems. NOLO aim to make the profession more appreciated and are promoting a higher professional status.
*Surveys was not sent out to medical secretaries in Greenland and The Faroe Islands though they also are members of NOLO.
About the NOLO Survey
Denmark Finland Iceland Norway Sweden 60 %
50 % 40 % 30 % 20 % 10 % 0 %
Respondents per country
15,4 %
8,7 %
2,4 %
17,5 %
56 %
Who is the Typical Medical Secretary in the Nordic Countries?
The typical medical secretary in the Nordic countries is female, has post-secondary education and likes her job to a high extent.
The most common education is high school which is the highest level of education for 33 percent of the respondents. 31 percent marked vocational university as their highest level of education. A rather large group, 9 percent, went to university or college.
The typical medical secretary is over 30 years old. 48 percent are between 31 and 50 years old and 47 percent are 51 years or older. Only five percent of the respondents are 30 years or younger.
Are There Major National Differences in the Profession?
1. Comparison by Age
The majority of respondents are 51–60 years old.
The majority of respondents from Iceland and Finland are 51 years or older. In Denmark, Norway and Sweden the majority are 50 years or younger.
Norway has the largest group (7 percent) of respondents under the age of 30. But in all of the five Nordic countries respondents under 30 are in minority.
30 or
younger 31-40 41-50 51-60 61 or older 60 %
50 % 40 % 30 % 20 % 10 % 0 %
Age (Overall in the Nordic Countrys)
5,4 %
18,7 %
28,9 % 36,6 %
10.4 %
2. Comparison by Education
Finland and Sweden has the highest share of medical secretaries that went to vocational university. 41 percent of the Finnish medical secretaries and 35 percent of the Swedish medical secretaries went to vocational university.
In Norway and Denmark the majority marked high school as their highest level of education, 38 percent in Norway and 54 percent in Denmark.
In Iceland more than 40 percent of the respondents went to university.
The younger medical secretaries are more well-educated in general. 41 percent went to university in the group under the age of 30 and 40 percent went to vocational university.
Primary
school High
school Vocational
university College/
University 60 %
50 % 40 % 30 % 20 % 10 % 0 %
Education (Overall in the Nordic Countrys)
9,2 %
33,2 % 31,2 %
26,4 %
3. Differences in Main Assignments
Writing journal entries and time-booking for patients are generally the most common as- signment in the Nordic countries, but there are several differences in the profession.
Time-booking for patients and follow-up documentation are the main assignments in Denmark and Finland. Writing journal entries and follow-up documentation are the main assignments in Iceland. The main assignments in Norway are time-booking for patients and working in the reception. In Sweden the main assignments are writing journal entries and time-booking for patients.
Writing jour
nal entries Handling r
eferrals Follow-up documenta
tion
Time-booking f
or patients Working in r
eception Handling s
tatistics
IT support Taking bl
ood sampl es
Updating web sites Billing and/
or economic adminis tration
Writing memosDRG Coding
Handling per
sonnel adminis
tration/Human r esources
Mentorship, introduction of students/
new coll eagues
Other, please giv
e examples in English 80 %
70 % 60 % 50 % 40 % 30 % 20 % 10 % 0 %
What are your main assignments? (You can choose more than one alternative) 71,3 %
42,1 % 50,2%
61,3 %
8,2 % 15,1 %
27,3 % 32,7 %
42,5 %
36,5 % 21,9 %
12,5 % 53,2 %
30,8 % 34,4 %
Medical Secretaries Like their Job!
A vast majority of medical secretaries appreciate their job.
Out of the respondents 59 percent like their job to a high extent and 36 percent like their job to some extent.
A smaller group appreciate their job in a lower extent. Just one percent like their job in a low extent and four percent neither enjoy nor dislike their job.
Less than one percent answered that they don’t like their job at all!
Yes, to a high extent
Yes, to some extent
I neither enjoy nor
dislike my job
No, in a low extent
No, not at all
60 %
50 % 40 % 30 % 20 % 10 % 0 %
Do you like your job?
58,6 %
36 %
3,9 % 1,3 % 0,1 %
58,6%
out of the respondents like their job to a high extent
We asked medical secretaries how satisfied they are with their wages. Almost half of the respondents (44 percent) are dissatisfied with their wages. 28 percent are rather dissatisfied and 15 percent are very dissatisfied.
However, more than one third of the respondents (36 percent) are satisfied with their wages.
27 percent are rather satisfied and 8 percent are very satisfied.
One out of five (20 percent) are neither satisfied nor dissatisfied with their wages.
Wages
15,3 %
I’m very
satisfied I’m rather
satisfied I’m not satisfied nor
dissatisfied
I’m rather
dissatisfied I’m very dissatisfied 60 %
50 % 40 % 30 % 20 % 10 % 0 %
8,3 %
27,5 %
20,4 %
28,4 %
How satisfied are you with your wage?
15,3%
of medical secretaries are very dissatisfied with
their wages.
Are there Major Differences in the Level of Satisfaction with Wages?
1. Comparison by Country
While medical secretaries in Finland, Iceland and Sweden are dissatisfied with their wages in a rather high extent, medical secretaries in Denmark and Norway are more positive to their wages.
Sweden has the highest share of medical secretaries who are very dissatisfied with their wages (23 percent), and Norway has the highest share of medical secretaries who are very satisfied with their wages (17 percent).
How satisfied are you with your wage? (by country) 60 %
50 % 40 % 30 % 20 % 10 % 0 %
Total (N=2080) Denmark (N = 320) Finland (N = 179) Iceland (N = 50) Norway (N = 360) Sweden (N = 1151)
8,3% 8,4% 4,5%
14% 17,2%
5,6%
27,5%
43,8%
23,5% 22% 30%
23,1%
20,4% 26,9%
18,4% 20% 22,5% 18,4%
28,4%
18,4%
40,2%
34% 24,7% 30,1%
15,3% 22,7%
2,5%
13,4% 10%
5,6%
I’m very
satisfied I’m rather
satisfied I’m not satisfied nor
dissatisfied
I’m rather
dissatisfied I’m very dissatisfied
How satisfied are you with your wage? (by education)
60 % 50 % 40 % 30 % 20 % 10 %
0 % Total (N=2080) Primary school (N = 186) High school (N = 680) Vocational university
(N = 645) College/University (N = 545)
8,3% 12,4% 11,3%
6,4% 5,7%
27,5%
39,2%
30,1%
26,2%
22,4%
20,4% 19,4%
22,5%
21,4%
16,9%
28,4%
19,9% 22,4%
30,1%
36,5%
15,3%
9,1% 13,7% 16,0% 18,5%
2. Comparison by Education
Medical secretaries with higher education are more dissatisfied with their wages than the ones with a lower level of education.
Respectively 53 and 44 percent who marked primary school and high school as their highest level of education are rather or very satisfied with their wages.
Respectively 46 and 58 percent who marked vocational university or college/university as their highest level of education are rather or very satisfied with their wages.
I’m very
satisfied I’m rather
satisfied I’m not satisfied nor
dissatisfied
I’m rather
dissatisfied I’m very dissatisfied
2. Comparison by Age
Younger medical secretaries are more dissatisfied with their wages than older ones.
The majority (53 percent) in the age group 30 or younger are rather or very dissatisfied with their wages.
On the other hand, 4 out of 10 (40 percent) in the age groups 51-60 years and 60 years or older are rather or very satisfied with their wages.
How satisfied are you with your wage?(by age) 60 %
50 % 40 % 30 % 20 % 10 % 0 %
Total (N=2080) 30 or younger (N = 112) 31-40 (N = 391) 41-50 (N = 602) 51-60 (N = 754) 61 or older (N = 216)
8,3% 6,3% 9,0% 6,1% 9,4% 10,6%
27,5%
21,4% 25,1% 25,9% 29,3%
33,8%
20,4% 19,6% 20,2% 22,8% 19,6% 18,1%
28,4%
35,7%
28,9% 30,6%
26,7% 23,1%
15,3% 17,0% 16,9% 14,6% 15,0% 14,4%
I’m very
satisfied I’m rather
satisfied I’m not satisfied nor
dissatisfied
I’m rather
dissatisfied I’m very dissatisfied
Are Employers Appreciating the Work of Medical Secretaries?
More than a third of the medical secretaries in the Nordic countries feel that the work they are doing is appreciated by the employer to a high extent. Almost half of the respondents think that their work is
appreciated to some extent.
In contrast only one out of five Finnish medical secretaries feel that their work is apprecia- ted by their employers to a high extent.
Only a smaller share, 6 percent, think that employers appreciate their job to a low extent or not at all.
Yes, to a high extent
Yes, to some extent
My work are neither appreciated
nor unappreciated
No, in a low extent
No, not at all 60 %
50 % 40 % 30 % 20 % 10 % 0 %
Do you feel that the work you’re doing is appreciated by your employer?
37,6%
48,7%
7,9% 5,2%
0,6%
Are Ideas for Change at the Workplace Taken into Account?
More than a third of the medical secretaries in the Nordic countries feel that the work they are doing is appreciated by the employer to a high extent. Almost half of the respondents think that their work is appreciated to some extent.
In contrast only one out of five Finnish medical secretaries feel that their work is apprecia- ted by their employers to a high extent.
Only a smaller share, 6 percent, think that employers appreciate their job to a low extent or not at all.
Yes No I don’t have
any ideas for change 70 %
60 % 50 % 40 % 30 % 20 % 10 % 0 %
Do you feel that your ideas for change at your workplace are taken into account and used for improvements?
68,2%
22,0%
9,9%
feel that ideas for change at
68%
their workplace are taken into account and used for
improvements.
Why aren’t Ideas for Work Improvement Taken into Account?
More than one out of five medical secretaries (22 percent) feel that their ideas for change at the workplace are not taken into account.
The most common reasons to why ideas are not used for improvement are that ”other
professionals are more listened to” and ”economic factors are considered more important”.
Other common answers are that “bosses has too little contact with the employee” and “my boss doesn’t want any changes”.
Some Free-text Comments:
” Our skills are not being acknowledged or appreciated. We are looked upon as some kind of typing machines.”
” I feel that our competence and our knowledge of the organisation is of- ten overlooked, and that medical secretaries are often forgotten when organisational changes are planned. We are an invisible group to the people higher up (…) ”
” It is a too big organization and the paths to change are very long at the
bottom of the hierarchy.”
Yes, to a high extent
Yes, to some extent
My work are neither appreciated
nor unappreciated
No, in a low extent
No, not at all 60 %
50 % 40 % 30 % 20 % 10 % 0 %
Does your employer provide enough education and competence develop- ment so you can do a good job?
16,9%
47,8%
17,6%
14,5%
3,1%
Competence Development
Why aren’t Ideas for Work Improvement Taken into Account?
Most medical secretaries answered that their employer provide enough competence development so they can do a good job.
Almost half of the respondents (48 percent) answered that their employer provides competence development to some extent. Almost two out of ten (17 percent) gets competence development to a high extent.
Roughly 18 percent answered that their employer don’t provides enough competence development.
The Nordic health care systems has different assets and challenges. Hence there are a great deal of variation in the profession of medical secretaries in the Nordic countries. But the job and the working conditions also have lots of similarities. A vast majority of medical secreta- ries in the Nordic countries like their job and feel appreciated by their employers. But there is a wide-spread opinion that wages are too low. And in contrast most medical secretaries are highly skilled — many have invested in a post-secondary education. NOLO believes that there is a need for employers to better reward skills and extensive work experience.
The NOLO survey shows that too many medical secretaries think that their ideas for change and improvement at work are under-used. In addition there consists a feeling that the
profession is not appreciated and that the competence of medical secretaries are at far down in an old-fashioned hierarchy. Other professions, as nurses and doctors, have more influence and tries to manage patient administration without the skills of medical secretaries.
NOLO believes that employers in the Nordic countries can address some of our common challenges in a mutual way. Our survey shows that medical secretaries urge for better wages that better reward medical secretaries for their high level of education and administration skills.
It is obvious to NOLO that medical secretaries can contribute to an efficient and modern administration even better than today. The skills of the profession is central for a high level of patient security. But the status of the profession has to rise in order to keep and attract well-educated medical secretaries in the future. A first step could be to increase the influence of the profession in developing service and administration in the Nordic health care systems.
Conclusions and Analysis
Enhance the status of medical secretaries in Nordic health care and distribute more power to the profession. Medical secretaries can contribute to an efficient and modern administra- tion that is crucial for a high level of patient security.
Employers in the Nordic countries must pay medical secretaries wages that is well corres- ponding with education and the high level of administration skills in the profession.
Extensive work experience should be better rewarded.
Offer modern and flexible working conditions which can raise the prestige of medical secretaries in the Nordic countries. Better working conditions and a healthy working environment can increase the attraction of the profession to young people.
