If there's any question on my knowledge in these matters,

I am a college educated and certified computer technician who has been in the technology field for 20 years now.  FWIW, Atomic Clock Sync has rave reviews from PC Magazine, but merely synchronizing your computer clock doesn't fix the underlying problem.  If the battery on your computer's motherboard goes completely dead, your CMOS settings will go byebye, which is a royal PITA to fix.

http://www.decosystech.com/Techsupport/Batteries.htm

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And you're miffed her E-mails are horrendous? Big deal!  She's paying you; you're not paying her. 

Where exactly DO you get off? 

She's entitled to fire off horrendous E-mails every hour on the hour if she wants to, and under the circumstances, she should - they don't have to be correct with every 'I" dotted and every "T" crossed, but the work she's paying you guys to do needs to be correct to the "T,"  so be thankful she was gracious enough to give those who do a substandard job notice and that she just didn't up and clean house. 

And you're miffed her E-mails are horrendous? Big deal!  She's paying you; you're not paying her. 

Where exactly DO you get off? 

She's entitled to fire off horrendous E-mails every hour on the hour if she wants to, and under the circumstances, she should - they don't have to be correct with every 'I" dotted and every "T" crossed, but the work she's paying you guys to do needs to be correct to the "T,"  so be thankful she was gracious enough to give those who do a substandard job notice and that she just didn't up and clean house. 

the ability to see an opportunity and make it work. As an MTSO you will need to be able to find a way to have transcription done and delivered, accurately and in a timely fashion. So you will have to have something in place in case you get sick or go on vacation, or your computer goes down. You will have to choose a file transfer system. You will have to have QA in place. You will have to have the ability to walk into a physician's office, know what data you need to make a proposal, then go home and put something together that has every step covered. You will need to anticipate problems and be ready to solve them (trouble shooting is a must). You will have to have an idea of what is going on in your field, what the going rate is, and how to use variables to your advantage. By that I mean, as above, things like don't print for the doctors! You don't get paid for any line you print, just the ones you type! Let the office secretary do that. She is paid by the hour, not you.

You will have to be ready to get the work done, no matter what, with no excuses and no compromising quality. And you will have to be resourceful and flexible to deal with things that come up.

That being said, it's a bunch of fun to run your own business

What is the most difficult part of the process, whether it be finding a physician, figuring out a program for the pc, getting a legal binding contract.  How much is the start up fee.

I have been considering this for awhile but to be honest i'm just too lazy.  BUT, the thought of making around 11-12 cpl, having only one or two docs that I know like the back of my hand where I can make tons of macros, tons of money and work less, is so appealing, that might jump start me.  Am I seeing the big picture here or just dreamin?

Dianna -

I use Lanier VoiceWrite EX daily and unfortunately, the Lanier "undertones" are such that you cannot use anything else besides the VW Ex, as the main station or server "reads" the remote unit and you have to connect digitally before it will even let you into the system.  Some companies have interphase software that will do this (not familiar with it myself) but I have not found anything personally compatible with Lanier except Lanier.  I used to use a C-phone and loved that I could check work remotely or even re-record but with Lanier, I have not found anything else to work except the actual Lanier equipment.  Maybe someone else has found a solution, but I have not heard of one. 

Best of luck to you !

I start med school (been an MT for 24 years) August 2006. 

One of my classes last semester was Intro to Medical Practices.  I especially inquired about pro bono work by all the physicians and dentists who spoke to the class as guests each week.  All gave significant amounts of their practice to pro bono work.

One physician in particular impressed me.  He is a cardiovascular surgeon.  His main area of expertise is doing cardiac bypasses.  To make a long story short, because of insurance changes (MCare) over the past few years, he only makes about $650 per bypass for his own pocket and that is gross.  Of the $1850 MCare and insurance companies pay him for this procedure, it costs him $1200 in overhead for that procedure.  Until last year, he would often do the procedure for free for patients who could not afford it and had no insurance.  However, for 2 years he had to BORROW MONEY to pay his OVERHEAD because he did so much pro bono work.  He finally decided he just could not go bankrupt doing that.  So now, he STILL does HIS PART for free but the patient has to pay his overhead.  He tells them to call their family, friends, churches and if they have the $1200 for his overhead, he will donate HIS skills/time/energy for free.

The physician (maxillofacial surgeon) who directed this class said his annual pro bono work runs around $250,000 a year. 

As well, while dentists recoup 95% to 100% of the fees charged for their services (they are ALWAYS getting their money up front), physicians (with the exception of cosmetic plastic surgery) only recoup an average of 31% of their fees.  For every $1000 they spend on a patient, they will only get back approximately $310 and must write off the rest. 

Now that is INSIDE information - direct from the physicians and dentists we had in class.  I was shocked.  Not deterred, but shocked. 

Regarding that lovely cardiologist who gives so much away, take into consideration that the $650 for HIS skills/time/energy for ONE cardiac bypass -- he invests a total of 12 to 15 hours for that one procedure (that is WITHOUT complications happening) including his consult/operative time/followup visits, hospital rounds, etc.  That comes out to about $54 an hour -- and plumbers and electricians around here make more than that.  My Ford dealership in town gets $76 an hour. 

And now, since we are starting to do bypasses endovascularly through the femoral artery, he has to really put the money down for more education to train to do this or he will be out of business shortly. 

Interesting huh?!  When people make comments to me about my future as a physician as a way to "get rich", I tell them not necessarily so!!  LOL  I'm not doing it for money!  You couldn't pay me enough to go through all this at this time in my life!!  LOL  

anyone who will listen.  They love young bright eyed students. I expected the MT world to be just like medicine.  

Why is cost the only issue? It is unprofessional to only think about money. What about pride in the profession and wanting to share knowledge? Isn't that how professions advance and grow? 

I am surprised.