How does outsourcing dictation allow doctors to see more patients?
Posted By: tia on 2005-10-14
In Reply to:
In an article in the MT News section, it states this. Do they really need to see more patients? Most of them herd them in and out like cows.
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We need actual examples of patients harmed by outsourcing
to take to the media. Then we could probably get enough interest for someone to do an expose on it.
Not sure when doctors graduate their patients but
I have boys and we stopped when my oldest was 11 because they always made them strip down to their undies for checkups and checked their privates and I didn't feel that was necessary and my boys hated it.
Doctors patrolling themselves? What a joke! They barely have time to see ALL their patients....
Doctors today are totally incompetent for the most part. YOU cannot worry about it when it comes to transcribing their gawd awful reports. THAT is between the patient and the doc. Just knock the report out as fast as you can and make sure it's accurate and then after that, forget about it.
The docs make the big bucks - you don't! Let THEM worry about things that will eventually catch up with them, one of which is called the Karma bug, and that little bug ALWAYS bites those who don't deal fairly right in the butt! And big time, too! 
we should just once, as patients (sm)
go to the dr's office and waste THEIR time!!! Let them know how it feels for a change. But then again, the doc wouldn't wait two seconds on a patient, now would they? Wow, whatta double standard! 
Patients
On a really bad day, I feel like a vampire for making money off of other people's misfortunes.
Maybe sometimes we have too much time to think! I don't know.
Just because 2 patients have the
same dx does not mean they are treated the same and symtoms are the same in many dxs. Do you have your degree?
Well, too bad that they have 30 patients - sm
to see so they don't want to spell things out. Do they cut corners on patient care, as well, when they have 30 patients to see - or is that reserved for us peon MTs? So they're "frustrated" with 30 patients - well, cut your patient load! We're not paid to "guess" or have to look up everything they don't feel like spelling, especially other doc's names. Just won't do it.
By the way, I wonder if they know how many documents we have to type a day (30 maybe?) to even eke out simple minimal wage - but that's OK, I suppose, compared to their 5 or 6-figure salaries.
Just give everybody the bum's rush because you have 30 patients. Suppose we did the same?
A party for our patients...
Every year, the staff in our clinic takes it on ourselves to throw a party for our patients. We all cook finger food, make snack trays, cookies, baked good, cheezes, bread, meat trays, the works. We have breakfast foods and lunch foods. We decorate tables in our lobby to spread this out on. We usually do this one day a week for the four weeks before Christmas so many patients will get to enjoy it. We have coffee, hot chocolate, orange juice, cokes and punch. We have fruits and dips....something for everyone, even diabetics. The patients are touched that we go to the trouble and we are touched by how much they love it! These patients have gone through enough suffering with their diseases and some are elderly and don't have family members. Some tell us this is their only Christmas! We have been doing this several years now and the patients are beginning to tell us to be sure we appoint them to return on the days we are having our "Christmas spread." I just thought I'd share the Christmas party that means the most to me... and this is definitely it! Just the look on their faces as they are enjoying it is Christmas to me.
It is not our job to judges the patients sm
or why or where they seek treatment. It is our job to transcribe the dictated reports. If you don't like the healthcare system, then go out and change it.
Just how many lives do YOUR patients have?
Apparently mine have more than one because I have one dictator who likes to use the following phrase: Patient was told that he might have death and loss of current life. 
Now we have to insist patients
being treated are actually examined before treatment is rendered?
Wasn't it bad enough medicine when ER docs would proclaim a diagnosis before exam, only to have to backpedal after taking a look?? I guess if they are going to do things in that order, doing physical exams is going to result in their looking stuupid, so their solution is not to do that part.
Big grrrr.
If the patients were aware of that, they could
nm
Do any of you ever feel sad for the patients?
Maybe it is because I am on my period and am more emotional than usual, but today typing all these terminal cancer reports is making me want to cry. I feel so sad for the patient and their families. I just cannot imagine being told that I only have a few months left of my life. And the doctors sound so cold about it. I know they are very used to it....I just know that I could never be a doctor. I could never get used to telling someone they are going to die.
A question regarding patients' rights
I was just wondering this. My mother was recently sent to a "liver specialist" who is local gastrointestinal doctor because of concern over persistently elevated liver function tests. He drew a LOT of blood work on her and only told her that it looks like she might have a fatty liver. He set her up to come back in six weeks to "get the results of her lab tests." SIX WEEKS! With her being very concerned, of course, we immediately searched the net and found out that fatty liver occurs in patients 1). who drink alcohol (she never has), 2). Patients who are overweight (she is not) or 3). Patients with diabetes (she hasn't got that, either). It says that a liver biopsy is how they find this out. He never mentioned doing one of those. My question is.. would a physician want to wait 6 weeks to find out lab results? You know it doesn't take 6 weeks to get the results back, they probably had them back within a day or two. In the meantime, she is stressing big time about what could be wrong. 
No thanks. Anorexic geriatrics patients don't do it for me.
x
Very true, but a list of patients?
An invoice by the patient? Some clients need to do their own book keeping. It is bad enough you have to worry about the content of the reports. To have to retype a patient name into an invoice with the line count is utterly ridiculous especially as an IC. IC's get taken advantage of. As an IC, yes you should be charging for "everything". If you're an employee, they can put it under "other duties as needed". Business is business. If it takes more time, that takes more money. End of story. Don't do nothing for nothing. Your clients sure do not. They go all this time with this Transcriptionist with her invoicing and then all of a sudden decide they want each patient name and line count? Cut me a break. You don't think there should be a charge for that? You can work for free, but I certainly WILL NOT! To make statements like be paid to walk to the computer is really being a bit of a smarty pants in my opinion. Keep it to yourself if you want to work for free, most people don't! Have a great day making nothing to do A LOT!
I read it... does it mean US patients would have to travel - nm
.
A lot of physicians refer to their patients
as heterosexual or having same sex partners, it is very relevant in some aspects, as in exposure to AIDS/HIV, etc.
New Doctor, some patients already typed
I got a new doctor. They girl who had been working for him left him in a big mess, undone dictations, etc. The office gave me a flashdrive to do with about 30 patients on it over the holiday weekend. Today they've told me ten patients had already been typed, how did I want to handle that? It seems they don't want to pay me for these. My husband says to bite the bullet and not charge them, since this is a new account and I'd like to keep it, is possible. What do you think? I know it's a land of confusion there from what is done to what is not done. Thanks!
It's called BEING FAIR TO PATIENTS
. Why should patient care suffer?! The patients haven't done anything wrong, even if management sucks. I thought that's what MTs were ultimately hired to benefit, the patients.
And that is because the GYN forgets to tell his patients that when changing pills you have to use an
alternate method of birth control for a month until the new level of hormones in the pills kick in, whether higher or lower. That is how come so many get pregnant on the "pill." The facts...my cousin is GYN and he tells all of his patients that.
Just wondering, for you MTSOs, about how many patients/reports per day...
For, say, an orthopedic surgeon, or a family practice doctor. Or, maybe, how many minutes of transcription on average per day.
THANKS.
these are the docs that I don't think care about their patients. my opinion. nm
ss
The clock does play into how much time is spent with patients
The way the CPT codes bill insurance have guidelines for the physicians built into them that give amounts of time spent with the patient (in addition to certain information covered in the ROS/PE), especially in consultations (whether inpatient or out), hospital discharge codes and critical care time (inpatient or out).
Yes, that computer is in fact billing the insurance company because it not only saves not having to pay an MT, it bypasses a billing clerk (eliminating that salary), and if the doctor's office space is paid for by a hospital, that file is sent to the hospital's database where a *scrubber* compares what the MD submits versus coding guidelines. If it is an independent office, the MD can upload all that day's billing before he walks out the door and leave it unattended to update patient accounts and reconcile the days money intake.
In a nut shell, your doctor is no longer just practicing medicine. Your MD is doing the documentation and billing and saving money on two warm bodies.
I understand your concern as I see it more and more in today's medical care, but yes, this is the way things are going. I am fortunate that my MD has been very computer literate for a long time, so the amount of time he spends with his laptop is minimal. Once he enters the info, he kicks his shoes back and we chat and get into a deeper discussion both professionally and personally (we've known each other a long time). Give your MD a chance to play catch up to what he or she is doing with that computer and you should see a more relaxed physician soon.
Good luck.
I do reports all the time where patients have asthma, COPD, emphysema, and
even cancer and continue to smoke. In our local paper they are following a woman in her battle with cancer. She continues to smoke, as does her husband. They were broke before the cancer diagnosis, having to borrow daughter's babysitting money to pay bills. Just think how much money they've blown on cigarettes.
I've even known one man with a trach who smoked through his trach.
I wasn't clear. I guess patients' names is what irks me the most. SM
and you know how famous they are for dictating "Krenazcyssky, Jane, that's J-A-N-E.
neat web site 'chemo angels'. Help cancer patients
http://www.chemoangels.com/
My nurse said most patients make calls with their cell, no problem
x
OUTSOURCING....
http://msn.com.com/2100-9589_22-5757832.html?part=msn&subj=ns_5757832&tag=tg_itdc
outsourcing
In this day and age, especially with globalization, any one of us can be replaced quite easily..not just in the MT field, in all fields. When I heard they are outsourcing radiology work to India and hospitals are letting some radiologists go, I almost choked! The other day when I called the local court house to postpone my jury duty service, I talked with a lady who had a thick Indian accent. I was tempted to ask, are you in India.
outsourcing ad
about 20 or so posts down, subject "censorship" ... two advertisements at top of page, one soliciting transcription to be sent to india for great savings, etc. outrageous.
Outsourcing
Great article-- but do you think the CEOs care? They are too busy with their big 6-7 figure salaries and bonuses to worry about us. All they care about is the bottom line-- how to save an extra nickel so they can line their pockets and buy that new yacht every year.
Outsourcing
I think it will get to the point where everybody will outsource at least some of the work. With all these companies begging for employees it doesn't seem like there's enough of us. The employer I just left was a private owned company and one of the biggest accounts decided to outsource. Don't know who they chose to do this for them, they didn't say, but my income was cut from 4500. a month to 1300. a month. Right now just desperate for a good job.
outsourcing
No way. It's here to stay. There just aren'the enough transcriptionists out there to do all the work and turn it around as quickly as it is expected these days. I would not worry. There is enough work for everyone.
Outsourcing
...I hear you. The more we rely on technology, the greater the risk, and the more our private information goes bye-bye to India, Timbuktu, or where ever, the greater the risk we are putting ourselves. Interesting to find out China, the sleeping giant, has thrown out all things MICROSOFT in the country. See, there're thinking ahead, years down the road. They use only Linux, won't chance anything to a world wide shut down someday by terrorists or otherwise. THAT, I find interesting. I also wonder if our powerful men in politics, especially our President and his administration have arranged to keep their private healthcare records state side ... hmmmmm...
outsourcing
I agree with the posters. Check your medical reports, some of them contain serious errors, I was misdiagnosed in an op report as having a serious condition I was determined "not" to have.
I also was treated like a common criminal by a foreign country because I bought a laptop from someone who lost their job in 9/11. I paid a little more than I should have because I felt sorry for him and unless I pretended to be "him" they would not help me. I finally after two months got the right part from an American company and my laptop worked just fine after two shipments of the wrong part and a whole lot of aggravation and misinformation.
They are a third world country and we will take their place soon if we don't watch out. They'll be taking over more than our jobs. It's very dangerous. It is life-threatening as far as information goes. Some will be saving money but losing lives.
outsourcing
What worries me is it's bad enough when they mess with our finances because they don't understand how things work in our country. But now with transcription being outsourced, they are literally messing with our lives! A transcription mistake of left versus right, Klonopin versus Clonidine, 0.5 mg versus 50 mg, could mean disfigurement or death if not caught in time by an overworked nurse or doctor.
Outsourcing...
In response to: People say outsourcing will happen.....It is happening!! There are a few National companies (which will go unnamed, but you know who they are) who have contracts with facilities who know the work is being outsourced and they want it because it cut their line rates significantly. This is our biggest competition right now. Overseas, the piddly line rates of 6 cents/line is a lot of money to those people. They are getting better and better at it (the offshore countries), and in time, they will be so good that there will be little editing needed. It is just like newbies here in the US, it just takes time for them to improve and learn...and before you know it, we'll wake up one day and poof...very little if any work in US, all overseas! It is a global economy and what we think is peanuts, they think is a fortune! I am currently retraining in another profession (nutrition) because I have been watching this evolution for the past 7-10 years. I managed a company back in 1997 that first sent transcription overseas and I had to proof and edit that crap! I think in 9 years, they are probably getting better at it and with time, they will improve even more. Don't be so sure that outsourcing will not continue to be a current event! IMHO.
Outsourcing
I originally posted this on the "Company Board," but one kind soul there suggested I repost it on the Main Board, so here it goes:
I'll tell you my personal take on this. I'm a very small MTSO and am fighting like heck to keep my jobs in the good old USA - hiring only Americans, etc.
We face stiff competition from companies who offshore, use EMR, etc. I charge my clients what the market will bear. I've already had to lower my rates to 2 of my largest clients because even at the lower cpl rates I was charging them at the time, they were ready to walk to India, and in fact were testing out some Indian MT companies - this after I had, in fact, already lost 2 other doctors' offices to offshore Indian companies. I feel I am fair and pay my IC transcriptionists 2/3 of whatever I make from my clients. But whenever I advertise for experienced transcription help, I am pretty much told to go jump in the lake with the rates that I'm able to afford to pay, even though it's good, steady work. So the bottom line is that I really find it difficult to get any competent help from American MTs. Not that there aren't many around, just that I and many like me can't afford them. Not blaming the MTs (American OR Indian) for wanting to make a living either, I'm just saying this to demonstrate the dilemma I find myself in. I suspect it's the same for other small MTSOs. Can't really raise my rates, because from prior experience, many doctors offices have no scruples about sending work offshore. I've never resorted to offshoring anything, but I'd be lying if I said I wasn't tempted.
Not singing the blues, just telling the facts. Personally, I'd rather be selling hotdogs on the beach.
outsourcing
I am the only Transcriptionist in a doctor's office. We started sending some work to a transcription company in November and later found out they were outsourcing to India. I thought my doctors would be upset, but guess what??? NO!!! It has been the biggest "mess" for me to correct. It has been far more trouble for me than if I just typed everything. I started leaving all the blanks, etc. and let the doctors start dealing with this and as of 6/15/07 we are no longer using that transcription company. We found someone locally (IC) who is typing our work for the same amount per line. YEAH!!!!!
ASR/VR/Outsourcing
Right. Hopefully the other companies do not do the same as Medquist. One company can ruin it for everybody.
The truth of the matter is if you can get the same item at a different store for half the price, you are going to go to that store to get it (which in turn would cause the other stores to have to lower their price).
I am just putting a warning out there for people to know that this is out there. Medquist will tell you that you will be able to produce more work and will lower your cpl to 5 cents/line; however, as you said, the quality VR puts out is horrible and it takes just as long to edit the VR work as it would to type it. They (Medquist) are also outsourcing work to the Phillipines. Our pay is lowered as the cost of living goes up.
maybe it goes along with outsourcing.
If you can outsource paperwork, why not babies? The article says all nationalities are involved. It does make one wonder.
Outsourcing sm
Our jobs are going overseas and I had an idea! Lets outsource the US Government to India.
I'd bet it would cost a lot less. When candidates are running for office, they can use those Indian phone banks to explain their platforms. The accents are thick, but what does it matter? Politicians are not outstanding speakers and when it comes to listening to the people their skills are nil. Employ an Indian to run your rhetoric...raise funds...and sit in a caucus.
Let Indians do the accounting for the feds. I am willing to bet that for 3 cents a line a "highly educated" Indian could find all the wastage of $100 hammers and $1000 toilet seats. Let them type up bills to be put before congress, they type cheap and we all know that. I can't speak for the accuracy, but it is CHEAP.
Better yet, buy American! Shun the goods from China, India, and all those third world countries. Keep it at home.
And um, Mr. President? Exporting democracy doesn't mean you export American jobs...
Outsourcing
Can anyone enlighten me just how an individual such as myself could check to see if a company that adverises on MT Job Boards has any affiliations with India or outsourcing? Thanks for your help.
Not outsourcing
All our hospitals/facilities Outsource - to us.- so unless we all want to loose our jobs, we need to be careful what we complain about. It's Offshoring that we're protesting.
outsourcing
I recently lost my job due to outsourcing and it is killing me emotionally. I loved the company had been with them for a year and it was okay, could have been better but I felt good about the work, company etc. Monday, got the call and just been ship wrecked every since. I expected more out of them...nothing like we will find you another account, it was just we are going to be sending it to India due to the cost. I am still hurting from it....not really financially, but mentally.
Outsourcing
Our manager has fought off that demon more than once. She is very supportive of in-house transcription. It's great to have someone finally stand up for us!!!
Outsourcing
I just have to vent my frustration! I had an appointment with my orthopedic doctor this morning and we started on the subject of transcription. When I asked if he had inhouse or a service he told me they send all their work to India. They have several physicians and PACs which dictate and they were spending over $100,000 a year for transcription. Their service was charging them .12 a line. They pay .06 a line in India. Obviously the service could not compete. :( I should have asked him about quality and TAT!
Outsourcing
It is rightly mentioned by “none” that “this is not the only industry that outsources”. One just has to look around our house or a store nearby to find that there are lots of electronic goods, clothes etc. which are not made in the United States. These have been true since decades.
Frankly speaking it was the western world and US which wanted these economies to open up so that American products could be sold there. Now these countries have a Nike, Pepsi, Ford, Whirlpool etc. but they are now producing it too and at a cheaper rate. The job losses through manufacturing have been huge but this sector innovated. My take is that MT industry also has to innovate because technology has made outsourcing inevitable.
And those of you who say that we should not visit a doctor who sends work overseas, my question is are you using only American made products? If you are then you can say that otherwise please don’t say things which you don’t follow yourself. Maybe lot of American jobs would be created if all the things we use in our daily life were made in US and not in China or India.
Outsourcing
This just recently happened at the company I work for (not just psych but psych was included), they went with another service to do their work (we were just doing overflow) and part of the deal was they had to take all the inhouse transcriptionists...well from what I hear they are making it real difficult for the transcriptions, I think so they'll quit and they can bring newer people in at a lower rate. Just my opinion.
About outsourcing...
It's not just us - but darnit, I'm still mad!!!
http://www.comcast.net/data/fan/html/popup.html?v=928157451&pl=newestFinance.xml&config=&launchpoint=Link&cid=fanlink&attr=featured_sidebar&tab=featured&attr=finance_sidebar
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