An interesting article...

This article was part of a reading assignment I had for one of my HIM classes.  It is an old article, but I think MTs can understand this situation quite well.  It just goes to show how quality is becoming decreasingly important in the healthcare industry.

http://www.nurseweek.com/features/99-5/allied.html

• An interesting article... - MT

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Please see article below that was published in 2003. Does anybody know if the law it mentions was ever passed in California?

Following news that a Pakistani medical transcriber threatened to post UCSF Medical Center patient records online unless she received more money,

a state senator said she will introduce legislation barring all California hospitals from allowing medical data to leave the country.

Sen. Liz Figueroa, D-Fremont, said she will introduce the bill in January when the state Senate returns for its next regular session. (A special session on financial matters is likely before then.)

"California already has the strongest medical-privacy laws in the nation, " Figueroa told me. "But not strong enough. There's always something you didn't anticipate."

What she and other framers of the state's medical-privacy laws, which prohibit the sharing of medical information unless for clear medical purposes, didn't see coming is the explosive growth of the $20 billion medical- transcription industry.

U.S. hospitals have such a huge need for help transcribing doctors' dictated notes into written form that the work is routinely farmed out to private transcribers throughout the country. Those transcribers, in turn, frequently subcontract with other transcribers.

In the case of UCSF Medical Center, three separate subcontractors were involved in handling the facility's records. The last link in the chain was a woman in Karachi, Pakistan, who sent an e-mail to UCSF earlier this month demanding help in resolving a financial dispute with the Texas man who'd hired her.

The Pakistani transcriber said she'd post UCSF's files on the Internet unless the medical center assisted her. She backed up her threat by attaching actual UCSF patient records to her message.

This was the first time an overseas transcriber had used confidential records to threaten a U.S. medical institution. The transcriber withdrew her threat only after receiving hundreds of dollars from another subcontractor in the case.

Figueroa said her bill would prohibit anyone possessing information involving California patients from sending that information abroad.

State hospitals would likely be barred from outsourcing transcription work unless they could guarantee that all related files remain within the country -- a move that would make hospitals accountable for any subcontracting that ensues.

"We're not banning the practice of overseas workers doing transcription," Figueroa said. "But we can regulate the practice of medicine within California. "

The law, at least on the health care front, may be on her side.

In most instances, federal law would trump state law, and the federal Health Insurance Portability and Accountability Act of 1996 outlines rules for safeguarding medical data. Anyone doing transcription work for a U.S. hospital would be required to uphold HIPAA standards, although the law is virtually unenforceable overseas.

A unique aspect of HIPAA, though, is a provision that if a state adopts more stringent restrictions, state law will prevail.

"If there were a statute that no health care information in California could be disclosed outside the country, HIPAA wouldn't have a problem with that," said Paul Smith, a San Francisco attorney specializing in health care issues.

"The state has a clear interest in protecting health information," he added. "This would seem a legitimate exercise of state regulatory authority."

At the same time, though, Matthew Nakachi, a San Francisco lawyer who specializes in trade issues, said it's unclear how the proposed legislation would square with federal laws related to commerce. A hospital might argue, for example, that it has a right to do business with whomever it pleases.

"If California decides to do this," Nakachi said, "it would probably go into the courts and take years to fall out."

For her part, Figueroa expects the health care industry to fight the legislation, just as the banking industry opposed state restrictions on the use of customers' information. But she thinks that in light of the public's increased sensitivity toward privacy matters, her bill would eventually pass.

"The interesting thing will be to see where our new governor stands on privacy issues," Figueroa said. "At this point, we don't know."

Mystery woman: The Pakistani transcriber at the center of the case involving UCSF is still something of a mystery.

In her e-mail to UC officials, she identified herself as Lubna Baloch, "a medical doctor by profession." Beyond that, little is known of her.

In May, however, an interesting little exchange occurred on MT Stars, an online network for medical transcribers. Baloch, using the same e-mail address she used in her threatening message to UCSF, posted her resume at the site in hopes of attracting work as a subcontractor.

Sheri Steadman, who runs MT Stars, of Phoenix, said she's against U.S. transcription work going abroad and routinely deletes postings from overseas transcribers. In Baloch's case, she said she was concerned by the vagueness of Baloch's resume, especially as to her whereabouts.

Steadman wrote to Baloch to say that MT Stars is only for U.S. job seekers.

"I am US based," Baloch replied.

"Not enough info," Steadman responded. "Where?"

"Santa Monica, LA," Baloch wrote back.

For Steadman, this wasn't a very good answer.

"Santa Monica isn't in Los Angeles and it's not in Louisiana," she told me. "It was pretty clear that Baloch wasn't in the country."

Steadman confronted Baloch with her suspicion. Baloch never wrote back.

"She was trying to gain work in any way, shape or form," Steadman said. "She was trying to sucker U.S. medical-transcription services into sending her business."

It didn't work that time. A few months later, though, probably using a different online service, Baloch was more successful in her efforts.

That would turn out to be a very dark day for UCSF.

David Lazarus' column appears Wednesdays, Fridays and Sundays. He also can be seen regularly on KTVU's "Mornings on 2." Send tips or feedback to dlazarus@sfchronicle.com.

EMR might not soon replace us after all....

http://health-information.advanceweb.com/common/Editorial/Editorial.aspx?CC=66392&CP=1

August 9, 2006 - EMR has revolutionized the healthcare industry in recent times. Many experts felt that EMR & Voice Recognition would totally replace Medical Transcription - however; the industry soon realized that transcription has certain advantages over point & click charting and many physicians preferred to dictate notes rather than document the data at the point of care themselves.

The most critical part of any Electronic Medical Record (EMR) is the method of data entry. EMR is about aggregation of patient encounter data at the point of care in order to provide a complete, accurate, and timely view of patient information. An electronic medical record is not just a typed record of the patient encounter, but an extremely useful decision support tool. The data can be entered into the EMR via any of the two general mechanisms: direct entry by the physician using point and click templates or transcription of dictated notes. Point and click template indicates that each data element, which is to be inserted, requires selection, navigation, point and click process for capturing patient information.

Transcriptions have been around for years for documenting patient encounters. A medical provider dictates the medical note into a phone or a recording device. The Transcriptionist receives the dictation and transcribes it. It may be reviewed by the supervisor for checking errors. The final computerized file is then either emailed directly to the healthcare provider or the file is transferred to a web site and is later downloaded by the provider.

Each method has its pros and cons.
Point and Click Templates
Most EMR systems allow providers to generate clinical documentation, by selecting variable terms from pre-structured point-and-click templates. Users simply point and click to select appropriate choices from lists of choices to record a patient encounter. The end result would be a document that closely resembles a transcribed procedure note.
 
Advantages 
Completely customizable templates. The doctor can specify the layout of the template, which helps him to adjust the template as per his practice & procedure.
§    Provide consistent, complete and accurate data. The chances of medical erros are reduced since the data is documented in customised forms.
§    Notes for similar type of exams will appear to be standard and similar
§    Store / organize data for subsequent retrieval. 
§    Each click adds data elements to the database. Point-and-click systems create data that can be used to generate clinically useful reports, such as health maintenance reminders, disease management etc.   
§    One of the major advantages of template based charting is the time needed to make the document available as a medical record. Since notes are created within the EMR, they are available immediately upon completion.

Disadvantages
§    It takes more time, and definitely more concentration for a physician to navigate through large data set and create progress notes using point and click templates. 
§    Templates must be customized as per the physician’s requirement. Customization can be inflexible and costly.
§    Well accepted by only tech-savvy doctors. 
§    The approach of direct data entry by the physician has generally failed because busy providers reject it altogether.
§    Output from these templates is too canned and identical. It loses individuality for each patient. 
§    It is difficult for a provider to capture complete patient encounter on computer in front of a patient.  

Medical Transcription
Transcription has long been the standard for documenting patient encounters. It is more convenient for a provider as compared to handwritten notes or electronic data entry.  There are many advantages of transcription in comparison to point and click charting. There are a few disadvantages as well.  
 
Advantages
 
§    Corresponds intuitively to the physician's usual method of working. Dictation remains the most intuitive and least time-consuming means of data entry.  
§    Physicians can dictate anytime, anywhere using PDA, Dictaphone or telephone at their convenience.
§    Providers need not change the way they practice just to accommodate an EMR. EMR can interact with transcription service so that transcriptions can be attached directly into the patient’s electronic medical record, if such a facility is provided by the EMR vendor.
§    It requires minimal training for physicians. 
§    Provides expressive power to describe patient’s condition and other health related events. 
 
Disadvantages
§   Details of the exam can easily be forgotten and omitted while dictating, if dictation is not captured immediately at the point of care
§   It cannot be queried for generating reports unless transcribed in pre-formatted templates
§   Transcribed reports are not immediately accessible. Physicians would normally have to wait for 12 to 24 hours for charts to be delivered, unless few vendors supporting 2-4 hours short turn around time.
§   Transcription provides for more efficient use of doctor's time.
§   Although average transcribed report costs $2 to $4, it can reduce the doctor's time spent on data entry. Considering the value of doctor’s time, transcription is not a costly proposition.
 
EMR should give the freedom to the physician to decide to use either Point & Click or Medical Transcription. For a physician, the EMR that fits into his practice workflow would be invaluable. A competent EMR must have a template driven charting feature and the ability to interact with a transcription service at the same time. Both are indispensable features of Electronic Medical Record Software, as doctors are not unanimous on point and click charting or transcription. Such an EMR will be both efficient and cost effective. 

The trends in transcription itself are changing with Medical Transcription service providers aiming to adopt new technologies. These technologies will evolve to increase efficiency & accuracy, decrease turnaround time and support data capture. While many of these technologies like such as digital dictation and electronic signature exist today, several technologies are still on the horizon.

I watched a show on MSNBC last night about identity theft.  You probably have seen it.  They follow the chain of theives all the way to Europe and then they cannot even arrest the people. 

About the medical records, the records would not be physically visiting any country, per se.  Once they are in a computer and uploaded somewhere, they are already out there, so to speak.  So, regardless of whose computer they are transcribed on or where that computer is located, the information is still out there.  I know many insurance companies have online access to medical records and some physicians offer that as well to their patients.  You're right, though, they should have asked that question.

BANGALORE -- After seeing patients at the Arizona Medical Clinic in Sun City West, dermatologist Anthony Santos describes their cases on a hand-held digital recorder. Mahesh Barat, Special to the Post-Gazette Parimala Jaggesh is an architect turned home worker in Bangalore. Each day, she receives audio files from doctors in the United States and types transcripts of their case notes for the Pittsburgh-based firm of Acusis Inc. Click photo for larger image. Before going home, he plugs the recorder into one of the hospital's computers. From there, his audio files are encrypted, compressed, shipped via the Internet through Pittsburgh and sent on to this bustling Indian city 9,100 miles away from Phoenix. A few hours later, Santos' words end up in the laptop computer of Parimala Jaggesh, an at-home worker for Pittsburgh-based Acusis Inc., who will type a transcript of his dictation. Santos and Jaggesh have never spoken to each other, so he has no idea that his voice is her favorite among the doctors whose dictation she transcribes. When the Acusis staffers in Bangalore call Jaggesh to ask her to do extra transcribing, they only need mention they have a digital recording from the clear-voiced Santos. "They know how to get work done from me," she says with a laugh. "They say it is Anthony Santos. Then I cannot say no." Jaggesh is one of about 350 home transcriptionists Acusis employs in Bangalore and other Indian cities. The company, founded by native Pittsburgher David Iwinski Jr., has a lofty goal: to become the dominant player in the medical transcription business in the United States, using its cyber-partnership with educated, English-speaking workers in India. Bangalore wakes up as night falls in the United States, so while American doctors sleep, Jaggesh and her colleagues transcribe their dictation. Jaggesh, an architect turned home worker, hits the shortcut keys on her Compaq laptop to insert familiar phrases and consults online reference files when she is stumped by an unusual medical or pharmaceutical term. Her finished work is downloaded to the Bangalore offices of Acusis. Editors there compare every line of her transcription to the original recording, make corrections if necessary, and grade her daily performance. Santos' transcripts are sent back to the Arizona Medical Clinic within 12 to 24 hours after the doctor plugs his recorder into a PC. They can be returned even faster, under two hours, for an extra fee. Faster, more accurate Even though the work is taking place halfway around the world, the result is speedier and more accurate than that done by a smaller local service, which used to take five to seven days to return transcripts, said Terry Daly, the clinic's chief information officer. Medical transcription has a huge potential market of perhaps $12 billion to $15 billion a year. The current transcription companies are fragmented, ranging from small mom-and-pop operations to the industry leader, New Jersey-based Medquist Inc., which employs 10,000 transcriptionists to serve 3,000 health-care providers. Acusis, just 3 years old, considers itself mid-size. The privately-held firm employs about 650 people here and abroad, 460 of whom are in India. The company serves about 40 hospitals and clinics across the country, including Children's Hospital of Pittsburgh. Iwinski's hopes for becoming an industry leader rest on proprietary software written by 50 company programmers in India to manage the nearly instantaneous flow of words from hospitals in the United States to home transcriptionists in India and back again. But it also relies on the cost advantages of Indian employees. The Acusis pay system for transcriptionists, based on volume and accuracy, ranges from 1 to 2 Indian rupees per line. Jaggesh may do 1,000 lines a day. At the average pay rate, that would earn her roughly $27 a day, or $135 for a five-day week -- good wages in India, where the average annual income is about $500. At the Acusis headquarters in Bangalore, each space has a name. A training area is called Gurukul, meaning "abode of the teacher" in Sanskrit. A visitor's room is named Athithi, or guest. Quality control is dubbed, in English, the Potter's Wheel; software development, the Cutting Edge; and startups, the Test Tube. "It's very challenging work," Naveen Janarbhan, a quality control specialist, said as he compared a transcriptionist's work to an original recording of a doctor reciting medical jargon at a fast clip, describing a patient who is a heavy smoker and has a family history of cancer. A mechanical engineer by training, Janarbhan carefully went over the transcript, taking extra care when it came to the medications the physician had prescribed for the patient. 'Concentration is the key' "We have to be careful. Our eyes should be here. Our ears should be here. Our mind should be here," Janarbhan said. "Concentration is the key." He found a few mistakes in the transcription he was editing, all minor and none involving medication or diagnosis. Nevertheless, he called the home Transcriptionist to ask her to be more careful. The system grades each transcriptionist and the results are available to everyone in the company. That peer pressure, according to Iwinski, is "a strong motivator" to do well. The job isn't that easy. Sometimes, doctors are munching an apple or eating lunch while they talk, making them difficult to hear. A nurse interjects to ask about a patient's medication. Papers rumple in the background. The topics can be technical, the jargon heavy. Occasionally, Jaggesh is distracted by music playing in the background of a doctor's recording, the noisy atmosphere of a hospital or extraneous chatting of passersby. But she takes most of it in stride. "It's fun. It's very challenging," said Jaggesh, who likes working in her three-story apartment, which she shares with two sons, two dogs and husband Navarasa Nayaka Jaggesh, a well-known comedy actor in Indian films whose screen name is simply Jaggesh. Parimala Jaggesh works around her family's schedule, taking her laptop with her as she moves from floor to floor, and occasionally typing in a serene rooftop garden overlooking the city. At other times, she works in a top-floor room that contains a figurine of the elephant god Ganesh, thought to bring good fortune. She keeps track of her daily reports, and if her accuracy dips below 96 percent, she studies the file so she doesn't repeat the same mistake. Sometimes she has a bad day, and she gets called by the office. "We do appreciate the feedback. You get a call that you have dropped down in accuracy on one file. Then it's a challenge," she said. "I take it that if my editors find the fault, I should have been able to do it." She enjoys the small personal things that sometimes show through in a doctor's dictation -- a laugh made over a mistake or a spouse in the background trying to hurry things along. E-mail this story  Print this story  Get home delivery of the Post-Gazette - click here for a special offer.		BMW Z3 2.8... $14,500 9th All Ford-powered Car Show. Sun., June... $10 Tahoe '03 White, Grey Lthr, P/roof... $9,900 Navigator '03 Taupe/blk 51k... $23,900 Explorer '04 Sport Trac... $17,951
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About India take on offshoring.  I don't think they are worried about loss of American jobs.

http://worldblog.msnbc.msn.com/archive/2008/10/17/1548054.aspx

The below quote is at least good news for US MTs. Now, if the rest of the hospitals and doctors would get in line, we might have a chance to keep our jobs here.

"Also in 2006, government investigators found that the VA's overseas contractors were handling personal information with lax security and oversight. The VA no longer uses international contractors, Budahn said."

So we're considered a thing of the past, ah-hem!  Here are the 10 jobs. ~

Administrative Assistant
Also known as virtual assistants, home-based administrative assistants use office experience and computer skills as support personnel. Many skills easily transition into this position which offers many part-time and temporary opportunities.

Advertising Sales Agent
It's said that Americans are exposed to more than 3,000 ad messages a day. Advertising sales representatives sell or solicit advertising space in print and online publications, custom-made signs, or TV and radio advertising spots.

Computer Software Engineer
Computer software engineers are projected to be one of the fastest-growing occupations over the 2002-2012 period. Duties include design, development, testing and evaluation of computer software, and continual training is suggested for the quickly evolving industry.

Corporate Event Planner
Employed by a private company rather than a hotel or convention facility, a corporate event planner coordinates staff activities including group meetings, client presentations, special events, conventions and travel.

Copy Editor
Copy editors mostly review and edit a writer's copy for accuracy, content, grammar and style. This is a competitive field; however, the growth of online publications and services is spurring the demand for writers and editors, especially those with Web experience.

Desktop Publisher
Desktop publishers use computer software to format and combine text, images, charts and other visual elements to produce publication-ready material. Duties of this fast-growing profession include writing and editing text, creating graphics, converting photos and drawings into digital images, designing page layouts and developing presentations.

Data Entry Clerk
Like administrative assistants, job prospects should be best for those with expertise in computer software applications. By typing text, entering data into a computer, and performing other clerical duties, these workers ensure companies keep up with information and technology.

Insurance Underwriter
Insurance underwriters serve as the main link between the insurance carrier and the insurance agent. Underwriters analyze insurance applications, calculate the risk of loss from policyholders, decide whether to issue the policy and establish appropriate premium rates.

Market Research Analyst
Market Research Analysts gather data on competitors and analyze prices, sales, and methods of marketing and distribution. They often design surveys, compile and evaluate the data and make recommendations to their client or employer based upon their findings.

Paralegal
While lawyers assume ultimate responsibility for legal work, much of their work is delegated to paralegals. Paralegals not only assist in preparation for closings, hearings, trials, and corporate meetings, they also perform a number of other vital functions including draft contracts, mortgages, separation agreements, trust instruments and may assist in preparing tax returns and planning estates.

I saw an interesting article on line from the local Rochester newspaper about captionists.  They are people who assist with deaf students in helping them take notes in class.

This is a brief side box from the article:

http://www.democratandchronicle.com/apps/pbcs.dll/article?AID=/20060329/NEWS01/603290337

I'm 57, learned on the job 28 years ago.  I can out transcribe people half my age.  I have no arthritis, no carpal tunnel syndrome, no fibromyalgia and only occasionally get a crick in my neck from my job.   My QA score is 100%, has been for years, and I type 90 wpm, transcribe 200 lph at least and that's on an account that is almost all ESL.   I could do this job another 20 or 30 years if I wanted to (barring sickness or accident that could happen at any age).

As far as the AAMT rep saying younger people are not lining up for this job - have they done anything to market MT to younger people?  I'm sure a lot of high school kids or even community college people would be interested in this work if they were educated about it. 

One last thought - the people they are offshoring this work to in India, Pakistan, Trinidad, the Philippines, are not spring chickens!!! 

I for one am sick of AAMT trying to justify their greediness by blaming their victims, the US MTs.

My first thoughts were like you, just another way to cheat us.  But then when I considered the possibility (trying to be kind here) that some companies are not giving us full credit for every character typed (as in perhaps counting 3 Keystrokes as 1 as has been mentioned here before), then even if they didn't pay us for spaces, we might make more in such a situation if they had to pay us for every single black character.  They can't hide that from us!  In other words, they would not be able to manipulate the line counting as much as I think they are doing now.  Now how much they would pay us for every black character might differ from company to company, but I think this might work in our favor overall.  If pay based on production is better for us than an hourly wage, we need to find what works most to our advantage.   And with the difference there is out there now in line counts from one company to another, pay by character might help us. 

And yes, even if it is a template, every character should still count as well as spaces, returns, tabs, demographic insertion, and also for our knowledge which comes into play every single time we keep the dictators from sounding like idiots and/or catching their mistakes.  Let's face it -- we do at least basic editing too, folks.  We are NOT just typists!  We should be reimbursed for our knowledge as well as production.   We're not donating our time to a charity here.  This is a way of making a living.  We should be paid for whatever we do for the company we work for, just like in any other job.  This might be a step in the right direction. 

I am cautiously almost hopeful. 

Read this

New Orleans: A Disaster Waiting to Happen
by George E. Curry
NNPA columnist
Originally posted 9/1/2005

I am angry. I am angry at the mayor of New Orleans. I am angry at the governor of Louisiana. I am angry at the Environmental Protection Agency (EPA). I am angry at the Federal Emergency Management Agency (FEMA), now part of the Department of Homeland Security. I am angry at George W. Bush. I am angry because they were warned last November that New Orleans was one of the “Disasters Waiting to Happen” – and did nothing about it. Consequently, hundreds, if not thousands, of people are dead. Needlessly.

In an eerie prediction of what happened as a result of Hurricane Katrina, an article titled, “What if Hurricane Ivan Had Not Missed New Orleans?” was published in the Natural Hazards Observer, a major journal headquartered at the University of Colorado in Boulder. It was written by Shirley Laska of the Center for Hazards Assessment, Response and Technology at the University of New Orleans. In other words, this was an article written by a reputable author in a reputable national publication that should have been read by people involved in disaster relief. If they had taken heed, many of the dead in New Orleans would be alive today.

Under the headline, “What if Ivan Had Hit New Orleans?” the author wrote, “New Orleans was spared this time, but had it not been, Hurricane Ivan would have:

- Pushed a 17-foot storm surge into Lake Pontchartrain;

- Caused the levees between the lake and the city to overtop and fill the city ‘bowl’ with water from lake levee to river levee, in some places as deep as 20 feet;

- Flooded the north shore suburbs as much as seven miles inland; and

- Inundated inhabited areas south of the Mississippi River.

“Up to 80 percent of the structures in these flooded areas would have been severely damaged from wind and water. The potential for such extensive flooding and the resulting damage is the result of a levee system that is unable to keep up with the increasing flood threats from a rapidly eroding coastline and thus unable to protect the ever-subsiding landscape.”

Until I read this article, I had said one of the positive things that I hoped would come out of this disaster is that relief experts would realize that they need to make special provisions for the poor, elderly and homeless. In essence, I gave them the benefit of the doubt. Now, however, I realize that there is no benefit in doubt.

The warning was there in black and white:

“For those without means, the medically challenged, residents without personal transportation, and the homeless, evacuation requires significant assistance.”

Laska spelled it out in even more detail.

During Hurricane Ivan in 2004, she continues, ‘Residents who did not have personal transportation were unable to evacuate even if they wanted to.
Approximately 120,000 residents (51,000 housing units x 2.4 persons/unit) do not have cars.

“A proposal made after the evacuation from Hurricane Georges to use public transit buses to assist in their evacuation out of the city was not implemented for Ivan. If Ivan had struck New Orleans directly it is estimated that 40-60,000 residents of the area would have perished.”

The additional problem of people having the means to leave, but refusing to do so was addressed in the article.

“Researchers have estimated that prior to a ‘big one,’ approximately 700,000 residents of the greater New Orleans area (out of 1.2 million) would evacuate,” Laska wrote. “In the case of Hurricane Ivan, officials estimate that up to 600,000 evacuated from metropolitan New Orleans between daybreak on Monday, September 13 and noon on Wednesday, September 13, when the storm turned and major roads started to clear…

“The fact that 600,000 residents evacuated means an equal number did not. Recent evacuation surveys show that two thirds of nonevacuees with the means to evacuate chose not to leave because they felt safe in their homes. Other nonevacuees with means relied on a cultural tradition of not leaving or were discouraged by negative experiences with past evacuations.”

Those that dismiss environmentalists as kooks, should pay special attention to the observations about marshes.

“Loss of the coastal marshes that dampened earlier storm surges puts the city at increasing risk to hurricanes,” the article noted. “Eighty years of substantial river leveeing has prevented spring flood deposition of new layers of sediment into the marshes, and a similarly lengthy period of marsh excavation activities related to oil and gas exploration and transportation canals for the petrochemical industry have threatened marsh integrity.”

Using the Hurricane Ivan model to predict what would happen if a major hurricane struck New Orleans, Laska wrote: “Should this disaster become a reality, it would undoubtedly be one of the greatest disasters, if not the greatest, to hit the United States, with estimated costs exceeding 100 billion dollars. According to the Red Cross, such an event could be even more devastating than a major earthquake in California. Survivors would have to endure conditions never before experienced in a North American disaster.”

It ended, “The hurricane scenario for New Orleans that these conveying risks portend is almost unimaginable. Hurricane Ivan had the potential to make the unthinkable a reality. Next time New Orleans may not be so fortunate.”


George E. Curry is editor-in-chief of the NNPA News Service and BlackPressUSA.com. He appears on National Public Radio (NPR) three times a week as part of “News and Notes with Ed Gordon.” In addition, his radio commentary is syndicated each week by Capitol Radio News Service (301/588-1993). To contact Curry or to book him for a speaking engagement, go to his Web site, www.georgecurry.com.

I am a volunteer at our local humane society and am active with several vets locally.  What this article suggests is absolutely ridiculous. 

On ''Asian'' and ''Oriental'' 

By Alan Hu

OK, so a long time ago, people in Europe used to refer to everything to the east of them as the Orient, including for example the Middle East, since orient means "east". So far, so good. This mysterious area was the source of all sorts of wonderful things like silk and spices, so the Europeans attached also sorts of exotic, mysterious connotations to the Orient. As Europeans gained a better concept of world geography, they eventually used "the Orient" and "Oriental" to refer to East and Southeast Asia, where people look "Oriental" in our current usage.

Anyway, that usage of "Oriental" has survived a long time, and it still frequently carries all of the exotic/foreign/inscrutable/mysterious connotations. These connotations happen to coincide with many of the stereotypes held of Asian Americans. Furthermore, by definition, the word "Oriental" is Eurocentric, referring to things east of Europe. For these reasons, some Asian American activist types decided that "Oriental" was a Bad Word, and that "Asian" was more accurate, less Eurocentric, and less loaded with strange connotations. No big deal, right?

Well, a lot of people didn't want to change their language usage. Some people grew up using "Oriental" and saw nothing wrong with the word. Others came from other parts of the world, where hip-activist-American-English-linguistic-evolution hadn't hit. Still others never encountered anyone aware of Asian American politics, so had never heard of this word usage change. Some people were exploiting the exotic mysticism connotations and resisted change. (Very early on, you would see articles about business and trade in Asia, whereas the travel articles would talk about visiting the Exotic Mysterious Orient.) Finally, some people were convinced that this was a typical case of left-wing-politically-correct-thought-police-mind-control (which it was) and decided in typical right-wing-politically-correct-knee-jerk-response that the word usage change was intrinsically evil and had to be resisted at all costs.

For a while, therefore, you could identify a person as being an American who was aware of and sympathetic to Asian American politics by his/her word choice. Now, however, many exploitation-types have realized that saying "Asian" instead of "Oriental" is the cool thing to do, without changing any of their stereotypes and misconceptions. (You can force a person to change his/her behavior, but you can't force a change in thought.)

The upshot is to use whatever word you feel most comfortable with, or that makes your listeners most comfortable, but don't be surprised if someone takes offense. And in the time you save by not worrying about word-usage, try to make the world a better place. 

LOL - I couldn't have said it better myself. 

Yes, here's the link to the article about determining your rates if self-employed

http://www.businessknowhow.com/officesupport/hourlyrates.htm

I always felt like I was "an accidental business owner" because when I got into MT work at age 25, I didn't realize how much of it was as an IC. I should have talked to an accountant from the start.

Diane

I looked all over this article and could not find a date of publication.  Everything vaguely says "later this year.'  Which year?  The only thing I could find on the entire page was 04/08/02 under the author's byline, and at the very bottom of the page, a copyright of 1995-2002.  When you click on the link to discuss the article in the forums, the new page never loads.  If you look up all other articles by this author, they are all dated 2000-2002. 

I think you are getting upset over nothing.  Call Time Warner directly and ask them what their plans are.