Found this article and wanted to share....
Posted By: Topaz on 2006-09-09
In Reply to:
Why I Love (and Hate) Being a Work-at-Home Mom
Find out how this entrepreneurial mom really feels about running a business from home.I created an entire business just so I could be a work-at-home mom. But is it a blessing or a curse? It depends on which day you ask me. Let me tell you what I really think. I hate being a work-at-home mom because: 
- No one respects that I'm actually at work. My husband, friends and family still call me throughout the day and expect me to be able to talk on the phone even if it's my precious work time.
- My children are almost more tortured having me work at home because throughout the day, I'm constantly having to tell them, "Not now, honey. I have to work". (If I worked at a "real" office, I'd only have to say good-bye once during the day.)
- When I'm on the phone with an important client, my child almost always comes in whining, pulling on my clothes or knocking over my pencil holder. If my husband or nanny manages to keep them out, I undoubtedly hear them whining or crying and then I'm tortured because I know I could calm them down.
- My office is often a mess and important papers are covered in crayon scratchings because I'll let my children do almost anything in my office just to get another minute on e-mail.
- My e-mails and phone conversations are incredibly brief so I can just get my point across, but now everyone thinks I'm rude and abrupt.
- I wake up to start work at 5:00 a.m. so I can work alone while my family sleeps. And then my 5-year-old decides to wake up early and join me. So I set him up on the computer playing "Dora The Explorer" so I can get some more work done. I try to focus as I type up some e-mails, but I can't really work for two consecutive minutes because he keeps needing my help.
- I've done live radio interviews from my home only to be embarrassingly interrupted by the barking of my dog.
- And at the end of the day, I realize there is no end of the day, because my office never leaves me. Most of us work from the time we wake up until our heads hit the pillow. But who are we kidding? We're even working then!
I love being a work-at-home mom because: 
- I get to be with my kids from the time they wake up until they go to sleep at night.
- I didn't miss out on their first steps or their first words.
- I can drop work any time and take my kids to the park without having to ask anyone's permission.
- My kids get to see me work and see that I get joy and stimulation out of being productive. I like to believe I'm a good role model for them.
- My daughter can see that you can have it all: a career, a family and happiness.
- As I write this at 6:00 a.m., I can look over at the video baby monitor and see my sweet baby sleeping happily.
- I get to decide when I go to work, when I eat and when I take a break, and no one's watching a clock but me.
- When I go out for a meeting, I can also squeeze in some personal errands and not have to worry about a boss disapproving of my long lunch.
- I can wear my pajamas all day long and no one ever has to know!
- I no longer have to sit in a car to commute, which automatically gives me an extra two hours per day, which adds up to a whopping extra 21 days in my year!
- My work is my home, and my home is my work, which can be a benefit for the write-off's alone! (Ask your accountant.)
Now, perhaps if you measured my two lists, the hate list might actually be longer. But the perks of working from home are invaluable. At the end of the day, I wouldn't trade it for anything in the world. But boy, it sure would be nice if my friends and family realized that I really am working! 
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Just wanted to share..
I just had a doctor, after stumbling over some words during dictation, say "I'm sorry, you have no idea the horrible handwriting I am dealing with"
Ok! I'm on a 15-minute break, but just wanted to share--
Below, I have read several posts about being productive and increasing line counts. This morning, I purposely closed down my e-mail (where usually it is running in the background and when incoming mail arrives, it notifies me and I'm checking it throughout the day), and I purposely did not come to this forum (which as my routine, throughout the day I'm going back and forth reading and posting). I actually started typing at 6:15 a.m. At 10:00 a.m. I have 1090 lines already. I know now where my time has been going, and will from this point on try and discipline myself as to checking e-mails and getting on-line wasting time. Just thought I'd share that bit of info.
can you please share what you found out
That would be greatly appreciated.
I just found this article! OMG!
Home > Business Processes
Medical Transcription: The Resurrection
Or is it? With about 12,000 people, and $125 million revenue, this industry was never really dead in the first place. It was just a tough phase of transition. The good news? That phase seems to be over
Balaka Baruah Aggarwal
Saturday, January 01, 2005
Circa 1997: A new industry is on the horizon. There is lot of excitement as people anticipate the benefits of the Internet age and talk of medical transcription as an opportunity that can potentially change the fortunes of many Indians. Along with computer training institutes, the medical transcription training institutes mushroomed in towns and cities promising placements to all trainees. Entrepreneurs were gung-ho as every mom and pop set up shop. And making hay in this excitement was the middlemen who promised abundance of business.
Circa 2001: It was clearly epitaph time for the industry. The booming industry had turned a whimper. The training institutes suddenly disappeared, companies downed shutters and the fledging industry died before it had learnt to walk. That was then.
Circa 2004: There is a sense of purposefulness and systematic ramp-up as the industry goes about its business. There is a steady flow of business despite the US backlash and some have even managed to raise funds. Led by a couple of US-based companies the medical transcription industry in India is in the resurgent mode.
Resurgent? Indeed! But sustainable? One can't help doubting the future of an industry that was once so hyped but which fizzled out as quickly. Judging by all parameters this growth looks sustainable. The industry seems to have learnt from its failure and is doing it right the second time with its focus on marketing, investment on technology and emphasis on delivery of quality service.
The Opportunity
According to US Bureau of Labor Statistics (BLS), there were a total of 97,810 medical transcriptionists working in the US in May 2003, the latest period for which data was available. Surprising though it may sound, almost every seven out of ten MTs in the US were employed by the hospitals or offices of physicians. Less than 15 percent were employed by professional outsourcing service providers.
That means Indian companies have to sell to a business community that has hardly outsourced. Naturally, the only appealing reason for them to offshore is cost saving. Considering this fact, it was not very surprising that this industry was centered only around cost. That, as we will see a little latter, is changing.
However, what is most noteworthy is the fact that between December 2002 and May 2003, there was a drop of slightly more than three percent in overall employment of MTs. This was despite the fact that the Bureau had predicted an employment demand growth for MTs faster than the average growth for all
occupation, even after factoring in the offshoring phenomenon. "Contracting out transcription work overseas," the 2002 Employment Outlook report noted, is "not expected to significantly reduce the need for well-trained medical transcriptionists domestically."
The drop in employment, say observers, has happened primarily because of an acute shortage of supply. This is reflected in a press release from the Medical Transcription Industry Alliance which said, "There are insuffcient number of qualified medical transcriptionists to meet the enormous demand."
This could work out in India's favor. Early signs-in fact the present resurgence-actually shows that it has already happened.
However, not everyone who started out pursuing this opportunity a few years back survives today to grab the second chance. Those who survive are the ones who invested in understanding the business and establishing a name for themselves in the market. These are the ones that are reaping the benefit. Fortune actually favors the prudent these days.
Growing Up, Wisely
Medical transcription, commonly perceived as the lowest end of the spectrum, was the first back-office work to be offshored to India in the early 90s by HealthScribe and Heartland who started their pilot projects from South India.
As the Internet took off in the 90s, the industry caught the imagination of many entrepreneurs who rushed headlong without a base in the nitty-gritty of the business. The first mistake was that entrepreneurs did not have a front-office presence and relied on the middleman. In the absence of direct marketing presence, early entrepreneurs had absolutely no clue about the demands of the market and were at the mercy of sub-contractors. This dependence led to undercutting of prices that reached unrealistic levels and became completely unviable.
Says Raman Kumar, CEO of C-Bay Systems, arguably the largest medical transcription company in India with a controlled workforce (direct and indirect included) of 3,500 people, "Companies in the early phase relied solely on the middleman to get business. That cannot be a viable business model because it is important to own the customers. Otherwise the customer begins to dictate terms to you."
The C-Bay model was completely opposite to what most people were following in India during those days. "We set up our front-end office in the US and focused on building our presence in the market. It takes much more investment to set up the front-office so that's where we focussed initially."
It managed its back-end by setting up relationships with franchisees who were trained by C-Bay and by keeping a strict control on the quality of the work. Kumar reasons that, "We did not waste our efforts in the back-end at that time. After consolidating our front end presence, we focused on the back-end."
C-Bay had bought over three companies in the US: Arrendale Associates and Advanced Transcription Solutions in 2002 and Emergency Dictation Services in 2004. These acquisitions gave a stable customer base to the company.
With the front-end in place, C-Bay turned its attention to the back-end and set up its own center in Hyderabad, Bangalore and a joint venture with Godrej in Mumbai. It also acquired some of its franchisees and is still actively negotiating for some more deals.
And that is a very significant difference in the strategy of the companies that are dominating the medical transcription industry today. Needless to say companies like HealthScribe, Heartland, Spryance, Accusis, Focus Infosys have strong presence in the US.
"This business is based on relationship and clients need an interface to understand their concerns and requirements for which a direct US presence is absolutely critical," says Jayesh Nagda, CEO of Focus Infosys headquartered in US with its delivery center in Bangalore.
Agrees Vijay Kaul, Head, Customer Service, with Spryance, a company which promotes home based transcription in India in a big way. "The importance of having a good marketing network cannot be undermined. We are positioned as a huge aggregator of work. That is our primary strength." Spryance aggressively promotes home based transcription and hires people for Quality Assurance and editing work only. It employs a workforce of 1000 people, 70 percent of whom are home-based Transcriptionist (HBT). Incidentally HBT is a concept that has become quite popular in India and is being experimented by quite a few companies.
The requirement for experienced professionals is high in this model although freshers are also trained by providing extensive feedback. That is why some companies like HeathScribe is a little reluctant about this model.
Says Suresh Nair, CEO of HealthScribe India, "We have a small number of HBT but that is not our primary model. Our HBTs are essentially ex-employees who may have moved to different cities or may have quit for personal reasons." HealthScribe employees 1350 people with only about 100 people working from home.
Acusis that actively promotes HBT finds it a viable model. "Technology has matured enough to allow people to work from home", says KB Anand, COO of Acusis. "We have a tech team of 50 people who have developed a customized solutions called Accusuite which manages voice from US to India and assign it to specific HBT."
Today there are workflow processes and adequate security measures in place to allow working from home. This is one development that really has the potential to change the face of the industry. While ITES has been touted as the industry that could harness the idle talent of housewives, young mothers and others by allowing people to work from home, medical transcription is the only industry that has actually done it. It is estimated that HBTs execute between 10-20 percent of the MT work that is offshored to India.Companies have invested a lot in technology to streamline processes and ensure secure workflow. With stringent regulations in US about the security of patient information, this investment is absolutely necessary for serious players. This is a sustained investment and requires deep pockets.
All the top players have made heavy investments in technology particularly in ensuring information security. The Patient Health Information System of Spryance has been audited by Ernst & Young and is HIPPA certified.
HealthScribe has also invested a lot on technology to have its systems HIPPA compliant. It has developed its own workflow management system that allows the system to assign work in a systematic and secure manner.
The industry is leaving no stone unturned to address the security of patient information. It is one of the reasons why MT companies in Bangalore have come together under a banner called Indian Medical Transcription Industry Association (IMTIA). Says Suresh Nair who is also the President of the association, "The idea is to share experiences and best practices amongst members. Most often, security breaches occur because people are not aware of it."
The Bottomline: Quality
Finally it is the quality of work that will decide the fate of the industry. The major reason why the industry went bust during the first phase of its growth was because the accent on quality was lacking. Hospitals were appalled at the poor quality of work that was being churned out by the industry. "Lured by the hype numerous garage start-ups came up with little focus on quality and processes which soon reflected in the shoddy work," says Som Marappa, President and CEO of US-based MedSoft with delivery centers in Bangalore, Coimbatore and Mysore.
Today the industry watchword is quality. "The industry has learnt that it is only the focus on quality that will see it through," says Suresh Nair. With 98 percent accuracy levels expected it is indeed a tall order.The industry is sparing no pains to gain this level of accuracy. The average training is of nine months and the employee gets productive only after a year. "The gestation period in training a medical transcriptionist can take up to two years and that is why it makes sense to look at destinations with lower cost structure," says V Raman Kumar.
Unlike the call center industry trainees do not have to get their accents right. They are trained in listening skills, introduced to medical language and taught some basic transcription skills. It is estimated that bigger firms invest anywhere between Rs 60,000 to Rs 1 lakh on training each transcriptionist while smaller firms may invest a little less.
The transcripts go through rigorous quality checks in India and US before it is sent to clients. Even companies who swear by the HBT model hire quality assurance people "because quality is the lifeline of the industry."
What is as critical as the quality is the turnaround time. Often turnaround time is 8-10 hrs, sometimes it can even be demanded with a few minutes. Says Nagda, "When we handle emergency dictation, doctors require notes immediately to perform surgery and the turnaround time is a few minutes then." Needless to say that 24x7 services command a premium in the market.
The Industry
According to bpOrbit estimates, there were close to 12,000 people working in the Indian medical transcription industry as of August 2004. bpOrbit also estimates the industry size to be $115 million in the year 2003-04 (April-March). There were close to 250 companies doing medical transcription work, out of which many worked as a franchisee for a bigger company, such as C-Bay.
The top six companies (see box) accounted for 75 percent of the revenue and close to 70 percent of the employment. There are another 5-6 companies that have 100 or more people. In that sense, the average employees per company among the rest turns out to be less than 20. So it has assumed the form of a cottage
industry.
The margins, contrary to popular belief, are not small. At 15-18 percent, it is quite healthy by the outsourcing industry standard. But that kind of margin is expected only after reaching a scale, due to deployment of technology as well as economy of scale.
The average per line price commanded by the companies for transcription is close to 6-12 cents. Depending upon experience, the average lines transcribed by an MT could vary from a low of 200 lines to a high of 750 lines per day. On an average, this yields close to $4.5 per hour, which is what the low end voice call centers with much higher capex and opex, as also the salary, realize. The added advantage in this industry is that as unlike the voice work, here it is not just the quality but even the productivity of an employee increases with experience, resulting in direct increases in revenue. With lesser attrition and higher productivity, this industry is good for long term players, with high scale.
Geared Up
The MT industry does not necessarily have to work at night except in cases of offering 24x7 service. The attrition rate at 15 percent is therefore far lower than the BPO industry. Says Veer Sagar, Chairman of Selectronics Equipment and Service, "This is intelligent work which requires an analytical and logical mind. This goes a long way in curbing attrition because the work is not repetitive."
India's opportunity emerges in the backdrops of the consolidation that the US MT industry is undergoing. The dynamics in the healthcare industry changed with the adoption of technology. Billing became more transparent and US transcription companies came under intense pressure as result of which offshoring became a popular option.
At the same time, there was a shortage of qualified transcriptionists. In the Journal of AHIMA, Carrie Boatman, Director of Professional Relations for the American Association for Medical Transcription said, "The problem facing employers is that the majority of the transcriptionists graduating from a program require additional training before they can be truly productive. Training staff is not a popular option. Training transcriptionists is an expensive proposition that can require six months to a year."
Not many hospitals and health practitioners are ready to bear that kind of cost burden. Which means two things. One, that the healthcare industry has to move away from the dependence on employed labor and has to turn out to offshoring. Two, with large training costs becoming imperative, those with a scale would benefit from it. So what we are seeing is a big consolidation.
Viewed from this perspective, it will not be an exaggeration to say that India could be the epicenter-and not just another location-of this new phase of consolidation. Also, with US elections almost round the corner, the India-factor will not be so much a sensitive issue. In any case, in this industry, it has never been such a problem. Says Raman Kumar, "It has to be very clear that offshoring of work occurred because of the shortage of qualified professionals. Never has offshoring of MT grown at the cost of jobs in the US." This explains why even at the height of the backlash against outsourcing in US, MT was not really an issue.
Many miles to go...
The industry would do well to gear up its security measures. Although big players are conscientiously addressing the issue, the same cannot be said for all small players. Americans are absolutely paranoid about their health information. The incident regarding Pakistani Dr. Lubna Baloch blackmailing the American subcontractor to expose patient information if the alleged payment dues were not fulfilled has sent shock through the industry. A similar incident in Bangalore by two Heartland employees threatening to release sensitive patient data in lieu of some concession has further hackled the industry. "Another Lubna Baloch or Heartland could well be the beginning of the end of the transcription industry overseas," says Marappa of Medsoft.
Another threat is the emergence of the voice recognition software. The industry can ill-afford to remain ignorant of new technology trends. Voice recognition has not fully matured and shall still require editing skills. In anticipation, some companies like Focus Infosys have experimented with the software in-house. But there needs to be many more initiative to address this challenge.
A recent marketing trend is hospitals belonging to a particular group or chain are aggregating transcription work and offloading it to offshore vendors as a single deal. "The consolidation of suppliers in a bid to get better price from vendors has begun to happen," says Nair. This has the potential to squeeze the margins of major vendors.
Many of the medium and small Indian vendors are currently servicing the clinic segment in the US and the large hospitals remain untapped. The clinics account for between 30-40 percent of the overall market.
While marketing challenges can be over some with innovation concerns regarding security are potentially more explosive which can upset the applecart even before growth has stabilized. However with the growth momentum building up and a determined industry bent on success, it is unlikely that the industry will stumble the second time round.
Top Companies
C-Bay
Mode of operation: Own centers and franchisees
CEO: V Raman Kumar
No of employees: 3,500
Presence in India : Hyderabad, Mumbai, Bangalore
Website: www.cbaysystems.com
Heartland
Mode of operation: Own center, JV
CEO: Bryan Black
No of employees: 1500
Presence in India: Delhi, Bangalore, Coimbatore
Wesite: www.heartlandis.com
HealthScribe
Mode of operation: Own center and HBT
CEO: Suresh Nair
No of employees: 1350
Presence in India: Bangalore
Website: www.healthscribe.com
Spryance
Mode of operation: Own centers/HBTs
CEO: Raj Malhotra
No of employees: 1000
Presence in India:
Wesite: www.spryance.com
Acusis
Mode of operation: Own center/HBTs
COO: KB Anand
No of employees: 550
Presence in India: Bangalore, Chennai, Mysore, Coimbatore,
Website: www.acusis.com
Focus Infosys
Mode of operation: Own centers
CEO: Jayesh Nagda
No of employees: 500 +
Presence in India: Bangalore
Website: www.focusmt.com
THE US INDUSTRY MT EMPLOYMENT BREAK-UP1
Industry Employment (%)
General medical and surgical hospitals 40.2
Offices of physicians 33.2
Business support services 12.5
Offices of other health practitioners 2.3
Medical and diagnostic laboratories 2
Others 9.8
1May 2003 figure
Source: US Bureau of Labor Statistics
US STATES WITH HIGHEST MT EMPLOYMENT2
STATE MTs EMPLOYED
Michigan 5,590
Wisconsin 3,830
West Virginia 980
South Dakota 780
North Dakota 520
2May 2003 figure
Source: US Bureau of Labor Statistics
MORE INFO
American Association of Medical Transcription
www.aamt.org
US Bureau of Labor Statistics: Medical Transcriptionists
http://www.bls.gov/oes/2003/may/oes319094.htm
American Health Information Management Association
www.ahima.org
this was an article she found...not HER...geez..sm
lighten up!
Just found this lovely article about India
on the Kansas City Star's website:
Chamber formed to foster U.S.-India business
A group of area professionals and business executives have formed the Indo American Chamber of Commerce — Kansas City to provide a bridge between Indian and U.S. businesses in the region.
The organization was officially launched last weekend, in time for the Feb. 8 visit to Kansas City by Ronen Sen, the Indian ambassador to the U.S. The group also is organizing a conference on “Doing Business With India,” scheduled for April 10 at the Kauffman Center. The Chamber of Commerce of Greater Kansas City also is planning a business mission to India in the fall.
The new group’s founders are Raj Bhatia, chairman and managing director, and Sanjay Kohli, president.
I'm not sure what all this means, but why are we wanting to force more business "friendships" with these people?!!
hmm so do you think he wanted to be found out? why put the gun back then
seemed to want to be found, and then on another he would appear to have wanted to not be.
leaves computer
but....puts gun back in her parents' house
shoots family
but....openly leaves on a plane where he can be tracked
None of it makes sense to me. Oh well, maybe that's the method in his madness.
Congrats, girl, and get your share of any money that you share before he wipes you out. nm
s
New. Wanted to put in a better card to support a game my 17yo DD wanted to play.
x
Share, share, I've been looking for some time...sm
sending out resumes gallor, have great experience, but they sound like clones of each other in what they offer, yet what they want is it all!!! I'm so discouraged, in the depression boat myself! They want you to commit to FT, new equip, DSL, on and on!!!
wanted to try it but wanted to make sure
nm
Oh, I found it really creepy when you said you found the flowers not so skillfully arranged on your
steps, and from your own flower bed. That's what I was worried about, having gone thru some psycho kids myself with my pups. Someone's been in your yard and in your garden and at your door without your knowledge. Its just creepy to me, and I'd still be very, very careful. Especially valid sounded the other MTs warning you about potential fake molestation charges. You just NEVER know nowadays, and these people have already turned on you big time once. Luckily (though I don't believe in luck), you had it on film to save yourself and your puppy. You might not be that lucky next time, and the whole thing just sounds very unstable to me right now. I know you feel sorry for the little girl, but probably the only time I have ever made BAD decisions regarding my life is when I felt sorry for someone, particularly kids. My son even has an evil kid in his life, but one who has a million reasons for sympathy, and I was saying how we should "be bigger" than the situation and invite this kid over to play. Thankfully, I regained my sanity long enough to remember - ever time I have done something like that on a personal basis for someone just because I feel sorry for them AFTER horrible behavior, it has always been a disaster... Be kind, but you don't have to risk your family again. Be kind from a distance. Its sorry she went thru this horrible experience, but YOU didn't cause it, and its not really your problem. But it could be your problem if this kid acts out in your life. Know what I mean?
I think I found it, found multiple recipes with the same
exact ingredients so I figure this must be it.
Found it, Prolastin, also found
alpha-1
Please share...
Favorite small appliance. I have 2 jobs now, love my crock pot but am looking for something a little more versitile... Something I can throw everything into in the morning and just set it and forget it! Any suggestions? Thanks! 
share
share any work ??
share
That is great pay. Where do you work. I read so many people who love where they are but yet no one shares the info. I have been looking the past few months but have yet to find one that starts out with a decent pay. I would have to take a cut in pay just to get more flexibility which I don't think is a fair trade.
Share what?
Our jobs that are limited as it is? So when we all lose our jobs to people in India, China, etc., can we assume you personally are going to share the money from what used to be our jobs with us so we can keep our homes and feed our families? I think not. Transcribe for your own damn doctors and leave the American patients to us.
yes please share with us !
Just had to share
Our Rottie had puppies Saturday morning!!!!! 11 in all, 6 girls and 5 boys. We lost a baby girl yesterday morning, but the rest are doing great. We're exhausted, but they're fine. They're sooooo cute..... 
Yes, please share
info about this.
Share What?
There are a lot of claims by a lot of MTs that cpl is the only way to go, and claiming that they are being paid more than most astronauts, but being given a salary/hourly rate to be recognized as the professionals that we are would be nice. When I started out the main issue was understanding the content of what you were transcribing and it was expected that you kept updated on all new terminology, meds, etc. You definitely would not find a nurse or other professional agreeing to be paid by how many blood draws they do and yes, it does boil down to the same thing.
Happy Thanksgiving Everybody!
had to share, doc just said...sm
The patient was taped to the operating room..... Wish I could see that!
Let me share with you....
not really sure what you mean by the long-time MTs getting angry, maybe you can share- I didn’t have internet at all prior to 2004. OMG but made really big money years ago and has it ever dropped now days! But back to sharing… my grandkids who you know can show us all we need to know about the latest gadgets, computers, blackberries, whatever went with me up to my father's home. He was in his late 80s then. I asked the 14-year-old gdaughter to go in the bedroom and call someone for me. She went back but soon returned to where we were and called her brother, a 16-year-old with a puzzled look on her face. Finally the both of them came back into the living room and said they had no idea how to use granddaddys phone- it was a rotary. Laugh, laugh. See it is all when you grow up and with what.
yes PLEASE SHARE
We would all like to work for a great company to! Email me if you prefer.
Just have to share - sm
I have a discharge summary - the guy was in the hospital for a month. It's 42 minutes long. The doctor is dictating every consult that saw the patient every day, their impression, and then just reading the assessment and plan, numbering the recommendations, and then....."Thank you for allowing us to see this patient." Do they even think about what they're dictating???????
had to share this one!!
"She wil be put in an Aircast splint and with crutches and treated with Motrin 800 every 8 hours as needed for pain with food."
often HR will share your ap
Like, I applied for coding and ended up being recruited as an MT (and they never DID fill the coding position as that department was undergoing "internal issues").
Although it is a major slam when you apply for clerical work you get pushed towards being part of the janitorial staff! Do you have very little MT experience? I could understand if they offered you something in medical records, but wow, that's quite a leap to think you'd want to wash dishes!
just had to share this one - s/m
a local college has a job posted for an ESL instructor. Any takers? 
had to share
ESL dictates, "MRS. So-and-so is a 10-year-old female." Might be able to be a MRS. in your country but not in the USA. 
Could you please share
the name of this company? It sounds an awful lot like what Medquist is doing to us. Thanks in advance.
I think you and I share the same sm
sense of irony! I totally get where you are coming from... :)
article
51, trained on the job 26 years ago,
article...
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.
article
There was an article in the news online that said it has spread to 3 more countries through ducks and geese and that it's only a matter of time before someone carries it here.
one article
Boy do you have it wrong, we have both stated our sources about googliNG pet food ingedredients, and if you choose not too, that is your problem, I am sorry for your pets, but you need to read up, not one article but thousands. I hope you check your facts, sincerely,
Article
Can anyone tell me where this article was originally published? I forwarded it to a friend who asked... I wasn't able to tell her.
Thanks!
Article.........sm
http://health-information.advanceweb.com/common/EditorialSearch/AViewer.aspx?AN=HI_06may22_hip18.html&AD=05-22-2006
Try pasting this in your browser - it's an article from the latest Advance magazine called A New Set of Shoes for MTs!
I saw that article too
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.
Here is the article
http://www.networkworld.com/net.worker/news/2002/0408networker.html
I think her article is a little sm
outdated in reference to VR. Apparently she hasn't been out there in trenches lately. There is a LOT of VR work out there and unfortunately the pay isn't great, in fact it's awful for the work involved. Although it won't actually replace the MT, but rather move them into a different area, the pay is never going to match the effort that must go into it.
FYI - article
I just read an article yesterday in the Oakland Press that Oakland County, Michigan, is getting rid of all their court reporters and going electronic to save money.
EMR Article
I have done transcription for about 19 years. Over the years I have been concerned about off-shoring and voice recognition, but still felt fairly confident about still having work for a long time. Now, with the EMR system coming into play, along with the other factors mentioned above, I feel that eventually, not too far off, this is a losing battle.
I love doing this type of work. It has supported my family while my kids were growing up, I had a secure hospital job, and the luxury of working at home, I have to face reality though.
I am going to go back to school and maybe look into being a radiology tech and/or ultrasound. I will not take anything in medical records, such as coding or biling, as I think that will also become automated eventually, and is already in some instances.
I think doing the editing and/or transcription (if there is any) would be a good part-time second job to have in addition to another job, but not fulltime, as I don't think you could support yourself. I still have a good 15 years or more of working left and do not want to be left out in the cold whle hoping that this is not really going to happen.
I think if the off-shoring could be addressed it would keep more work here in the long-run to keep us working until we have other options. I have seen postings here regarding contacting the president regarding off-shoring transcription (which is a good idea) but you need to also write your local congressman in your particular area. That is what they are there for (that is very important.)
It is ridiculous that the medical records of patients are so highly confidential, but yet we will send it to another country, and with the economy as horribile as it is too.
Maybe the government should retrain us LOL.
I do feel sorry for the newbies, and that these MT schools keep recruiting people into this occupation, and they probably know full well what is going on.
Just my opinion.
EMR article HERE
From Medscape Family Medicine
Physicians Are Talking About...
The Government Push for Electronic Medical Records
Posted 02/24/2009
Nancy R. Terry
The economic stimulus plan currently being considered by Congress allocates $20 billion to health information technology such as electronic medical records (EMRs). Recent postings on Medscape Physician Connect (MPC), a physicians-only discussion board, offer frank opinions about the utility of EMRs in clinical practice -- opinions that are decidedly mixed.
"EMR is the worst thing that has happened to me professionally in over 25 years of practice. My care of patients is impeded and the quality of my care is worse as a direct effect of the introduction of EMR," says a MPC contributor who championed the installation of an EMR system for his physician group.
"I absolutely love our EMR," says a nephrologist. "It has improved the quality of our practice immensely. I spent a lot of time customizing for our practice, but it was worth it. Everything is point and click. To improve care and cost, all patients need a Web-based collection of medical records that include hospitalization, lab reports, x-rays, as well as office notes. That would be the ultimate care."
Physicians who are dissatisfied with EMR systems cite loss of productivity, the negative impact on patient care, and high maintenance requirements. Physicians who have embraced EMRs cite the increased efficiency the systems have brought to their practices. EMRs tend to get high marks from subspecialists and low marks from primary care physicians.
Some of the MPC physicians least satisfied with their EMR systems are those practicing at large healthcare companies or medical centers. "My hospital solicited medical staff support for EMR," says one MPC contributor. "After implementation, administration took over and now EMR is solely for the benefit of medical records as a storage device. To he11 with the medical and nursing staffs. RNs are input clerics rather than beside nurses."
"The very few efficiencies were all on the administrative side," says a regional medical director who helped bring an EMR system to a nationwide healthcare company. "A good sales pitch with nice graphics and testimonials sell it, then the clinical staff is left to suffer."
"EMRs need to address work flows and clinical efficiencies and not seek to provide administrative support," says a general practice physician. "Unfortunately, the administrators are the ones with the time and energy. The rest of us are seeing patients."
In smaller practices, issues of EMR maintenance and support infringe upon patient care. "In my clinic," says a family medicine physician, "provider meetings are completely dominated by EMR issues and problems. There is virtually never time left for discussing topics pertinent to improving patient care."
In speaking about their day-to-day experience with EMRs, primary care physicians complain that entering patient information is cumbersome and time consuming, often because of a template-based system that does not reflect the patient encounter.
"The assumption of the EMR is that you already know the diagnosis when the patient arrives." says an MPC contributor. "This may be better for specialty care, but in primary care, patients come in with fatigue, rash, insomnia, diarrhea, and cough. It's difficult to enter all this until after the visit."
An internist who describes herself as "tech savvy" says that her system's scripted entries for patient information are inadequate. "If you free-text, it is much more time consuming. And we are discouraged from free-texting by our administration because it doesn't trigger adequate billing codes. Not only has it reduced my time with patients, it has added an extra 2 to 3 hours of work each night from home."
The Choice of Systems
"My advice to practitioners," says one MPC contributor, "is wait for a decent EMR that produces useful notes that accurately describe a patient encounter in a way that helps a clinician."
Waiting may not be an option for much longer, however. One provision of the government stimulus plan would impose reduced payments on physicians who are not "meaningfully using" information technology. Whatever is meant by the provision's phrasing, one thing is clear: the push is on to go electronic. Physicians must learn how to make information technology work for them. One EMR expert says that it starts with the choice of systems. "Primary care practices should stay away from templates and stick to a new program by Praxis® [Infor-Med Medical Information Systems, Inc., Woodland Hills, California] that uses pattern recognition of similar cases as well as rare cases. It decreases the workload immensely. For specialty practices, I recommend templates, and Visionary™ Dream EHR [Visionary Medical Systems, Inc., Tampa, Florida] is excellent in being very user friendly," says an MPC contributor whose research in medical management focuses on EMR systems.
Another MPC contributor notes that the technologically adventurous can customize an EMR system by using open-source software. In open-source systems, he explains, the source code needed for programming is included in the software, making the program infinitely adaptable. "When you buy most proprietary software, you have to accept the functions that come with it, as designed by the developers. With open-source systems, you can modify the software to your heart's content."
Is a Choice of Systems Really a Choice?
For some physicians, however, EMR systems remain a nonissue, and the heavy government funding of healthcare information technologies is nothing more than a smokescreen obscuring the real issues in primary care.
"The government and the public are not able to deal with the real problems facing medical practice and the real solutions necessary to turn it around (ie, reasonable reimbursement rates, malpractice reform, regulation of the unscrupulous practices of the insurance industry)," says an otolaryngologist. He adds that once healthcare information technology is "fully implemented and solves nothing, we can start to talk about real reform and real answers."
Author Information
Nancy R. Terry, medical writer and editor, Jackson Heights, New York
Disclosure: Nancy R. Terry, has disclosed no relevant financial relationships.
Medscape Family Medicine. 2009; ©2009 Medscape
How funny. I have my share as well and when I
was trying to break my boys of the habit of leaving their dirty clothes wherever they took them off, I wondered how much it would take.
I taught them to do their own laundry when they were about 11 or 12 and then I stopped doing it for them. They were in control of it; if they didn't get it done, they wore dirty clothes.
However, they had a bad habit of taking their socks off in the living room and leaving them there, or in the bathroom and leaving their clothes there. They had clothes baskets in their rooms and in the laundry room for that. I would ask them to pick up and it was always, "later" or "in a minute" but those times never came around.
Finally, I started telling them one time then when they went to bed or left the house and it was not done, I started collecting those things in an old shopping bag. Each night I would quietly put the bag in the trunk of my car. I mean this went on for a few days...quite a few. They had a tendency to wait until the weekend to do their laundry and I remember the frantic desperate search for their clothes. They couldn't find them! Hadd I done their laundry? Nooo. Had I seen their clothes in the bathroom or their socks in the living room? Nooo. They were accusing each other, even! Hahaha They had practically nothing left to wear. HAHAHA I finally told them to bring in the stuff I had in the trunk (of course, they delayed all day on doing that -- all day while they were whining about not finding their clothes and it could have been resolved earlier) and when they did, they had a few bags of dirty stinky laundry! Hahaha I told them next time, I would not store it in the trunk of the car but store it in the garbage dump. They have done pretty well since. On occasion I ask them to pick something up and they realize if it isn't, it goes out in the garbage without another word. Hahahaha
Please share which program your are using.
From what I have read, it seems that EditScript is the only VR program that seems to work quite well. I hope this is not the one you are using. Could you tell us which one?
Well, share in the wealth, how?nm
x
Share your secret, PLEASE!
Who do you work for? I used to do that, but got a crappy account now. I miss those paychecks.
You have every right to be happy. I'm happy for you (and jealous LOL)!
Had to share this e-mail (sm)
Little Johnny says "Daddy, how was I born?"
Daddy says "Well, son, I guess one day you will need to find out anyway. You see, your mom and I first got together in a chat room on MSN. Then, I set up a date via e-mail with your mom, and we first met at a cyber cafe. We sneaked into a secluded room where your mother agreed to download from my hard drive. As soon as I was ready to upload, we discovered that neither one of us had used a firewall, and since it was too late to hit the delete button, nine months later a blessed little Pop-Up appeared and said You've Got Male!"
Let me share my dog story...
Our little girl was scared to death of animals!! Especially dogs. A dog showed up on our porch and we did everything we could think of to get rid of her, i.e. throwing shoes at her (that was my daughter's idea), shooing her away. We didn't feed her hoping she would move on to the neighbor's house. Anyway, she didn't leave....she adopted us! After a couple of days, my daughter became more comfortable with her (she finally stopped crying whenever the dog was in sight) and we fell in love with her. She is a real doll!! Needless to say, that was six years ago and the dog is still just as sweet as ever.
With that story told, have you called the game warden? They will come and get stray dogs. Maybe they can find out who owns her? Also, an area SPCA would take her. Just a thought. Good luck!!
Would you share the exact name -sm
of this keyboard? I'd like to find one with wrist rests like you describe. I have one that is split, but the wrist rests are quite right. TIA.
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