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Serving Over 20,000 US Medical Transcriptionists

Interesting article on this topic

Posted By: sm on 2006-07-09
In Reply to: Who is 30 and younger and in this biz? - Just curious...nm

http://www.trxinc.net/transcription-news-item.aspx?id=3

Scroll down to "Current state of the industry" and it talks about the average age of today's MTs.


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Probably not the same article, but this DOL case is related to topic -sm
http://www.dol.gov/sol/media/briefs/tumsupp-8-18-03.htm

It's a long article and requires close reading, but here is an excerpt:
...
Whether waiting time is compensable "hours worked" within the meaning of the FLSA depends on whether an employee is "waiting to be engaged" or "engaged to wait." See generally, Skidmore v. Swift & Co., 323 U.S. 134, 136 (1944). In Skidmore, 323 U.S. at 136, the Court stated that "hours worked" under the FLSA is not limited to active labor: "No principle of law found either in the statute or in Court decisions precludes waiting time from also being working time," and "[f]acts may show that the employee was engaged to wait, or they may show that he waited to be engaged." Accord Owens v. Local No. 169, Ass'n of W. Pulp & Paper Workers, 971 F.2d 347, 350-51 (9th Cir. 1992). See also 29 C.F.R. 785.7, 785.14; The Fair Labor Standards Act § 8.II.B (Ellen C. Kearns and Monica Gallagher eds. 1999).

Thus, "idle" or waiting time is compensable "work" under the FLSA where it is controlled by the employer and is spent predominantly for the employer's benefit. See, e.g., Armour & Co. v. Wantock, 323 U.S. 126, 133 (1944) (a companion case to Skidmore).(4) The Secretary's interpretive regulations explain that an employee is "engaged to wait," and therefore performing work, when the periods of inactivity are unpredictable and of short duration:

In either event the employee is unable to use the time effectively for his own purposes. It belongs to and is controlled by the employer. In [such] cases waiting is an integral part of the job. The employee is engaged to wait.

As in 'hot' topic...interesting...lots are interested...nm
tt
Off topic whining. Got an interesting phone call today.
DH used to have a pretty good job until the proverbial stuff hit the fan a few months ago.  With no warning whatsoever and no bad performance reviews ever, he was told his job had been phased out and he was denied his overdue promotion.  That left him unemployed and scavenging for a job.  He did find a job at maybe a third of what he used to make.  I doubled my workload and cut back the budget to try to make up some of the difference, but things still really stink financially.  The stress is about killing me with the extra hours on top of everything else I do.  Anyway, the phone call today was to let us know that he should never have been denied his promotion and his job will not be phased out now.  Unfortunately, it's too late after how his boss handled it and what was said.  He won't go back to working for that person ever again.  Sigh...  I can't blame.  I wouldn't either.  It's nice to know we were right, but it doesn't fix anything.
Interesting article

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.


Interesting article

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


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


Interesting article about EMR


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.


interesting article regarding
our future ?? -- http://www.obgyn.net/displaytranscript.asp?page=/avtranscripts/israel2k_tadir
Interesting article (sm)

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.


Here's an interesting article...
Regarding medical record security:  http://www.cnn.com/2008/HEALTH/06/05/ep.online.records/index.html
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


Interesting article but very long.









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.




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Interesting article about best careers in 2006. sm
http://biz.yahoo.com/special/job06_article1.html
Interesting Article on eScription President
Interesting interview of eScription's CEO

http://health-information.advanceweb.com/Common/editorial/editorial.aspx?CC=94859
Very interesting article today on offshoring

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


Interesting article. Curious as to what company?

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."


Interesting article I just read about 10 jobs you can do at home. (sm)

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.


An interesting article for Rochester, NY transcriptionists who might want a change. sm

 


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:


About the job

Those training to be C-Print captionists must type at least 60 wpm. Beginning in June, they'll take 10 weeks of online training and upon completion begin work in the fall. They'll earn $15.74 an hour and work a 35-hour week for 10 months. For more information about training, contact: AccessServices@ntid.rit.edu

 


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


Interesting article on MSNBC regarding repetitive motion strain and malaise.
http://www.msnbc.msn.com/id/9814810/
On the topic.......
I would certainly hope that any woman, young or old, has the common sense to wear what is most attractive on her. Of course, that doesn't always happen, but ya can't lump any group together by age, etc., and say that one particular style won't look good on all women in that particular group. We're all unique and what may look fine on you will look like hell on me. Or vice versa.

I'm a size 1-2-3, depending, and even though I'm almost 48, I do have to do most of my clothes shopping in juniors. Not all, mind you, but the majority. I hate to admit it, but I own shorts from the girls' rack (size 12). I also work out on a daily basis and have my natural brown hair. The makeup I own could be stored in a single small Glad bag with room left over. I wanted to switch from bikinis to one-pieces this summer, but friends told me that I would be crazy to do so.

I wonder......are you talking about someone like me?

Please think before ya post; you just might offend someone. :)
Off the topic but really need help with my dog. sm
My 7-month old little cocker was neutered on Friday. Overall, he is doing good, eating fine, drinking fine, up and around and in generally good spirits. The only thing we have had to do is give him Benadryl and 1/2 aspirin three times a day to keep his agitation level down since he was extremely off the wall the first 36 hours. He has one of those clear lampshade collars. Now, my question is, I would like to take the collar off since he can't scratch his ears or play with his toys-and he does love his toys. How on earth do I keep him from licking the surgical site? Does anyone have any good ideas? The aspirin is helping, but he still wants to lick. My son told me he used lots of vaseline with red pepper mixed in for his dog, but I'm afraid to try that. My luck he would get it in his eyes or in his sutures. I had a female years ago that was spayed, but never had a ounce of problems. She didn't lick once.
off topic...
I would say there is no such thing as "Somewhat unfaithful." That is like being a "little pregnant." SO, first just say it - your husband was unfaithful and you worked through it.

No, you do not have a right to feel angry and betrayed by your mother-in-law. You did not marry her nor she you. The 2 of you did not exchange vows. You have a right to feel hurt that she's having a relationship with the other woman and not you, but who she communicates with is her business. Now you know, mom-in-law is NOT your friend. Most mothers-in-law are not friends with their son's wives, so join the club.

You say your marriage is now stronger than ever - that's where your focus should be, not on your mother-in-law. Be cordial with her, but she's given you evidence of her true colors and you should not take her into your confidence again.


There is never a topic here (sm)
As far as comfort goes, I think it is great.  If the frame would make it higher, then that would be good for an older person as they would probably have a problem getting down on the floor.  (I know)
Along the same topic as below...

What do you find makes a man sexy? Is it his eyes? his smile? his ruggedness? his sensitivity? Or is it all of the above?


For me, it's all of the above.  I love a rough and rugged man, not a sissy man that's afraid of getting his hands dirty! Deep eyes that can see right through you...a smile that still looks like a child...and sensitive enough to cry over The Notebook...


Hey, that describes my husband to a T!!! Woohoo lucky me!!!


Off topic, but why...
did you take the "O" out of God? Just curious...odd to me that you would do that...no flame here, just an honest-to-goodness curiosity question
Trying to keep this topic near the top! sm

I wanted to do some research on the stuff we're discussing (offshoring), but unfortunately I cannot find recent information.  I googled "bills to stop offshorting" and came up with this article:


Markey Introduces Bill to Block Offshoring of Consumers' Personal Data


WASHINGTON, DC -- May 13, 2004 -- Representative Edward J. Markey (D-MA), a senior Member of the House Energy and Commerce Committee, and the Co-Chair of the Congressional Privacy Caucus, today announced that he is introducing legislation to clarify the rights and responsibilities of companies, their regulators and consumers regarding the protection of privacy in global commerce.


Rep. Markey said, “It is becoming increasingly clear that both our jobs and our privacy are being shipped offshore, and federal regulators aren’t doing nearly enough to stop it. In effect, regulators are telling consumers to ‘check your privacy at the shore.’ The bill I’m introducing today will help stop this dangerous trend from continuing.”


The bill Rep. Markey introduced today, the “Personal Data Offshoring Protection Act of 2004” (HR 4366), would prohibit companies from transferring personal information to any person outside the United States without notice and consent. Specifically, the Markey bill:



  • Requires any business enterprise that transfers personally identifiable information regarding a US citizen, such as the citizen’s name, address, financial information, medical records, or other personal information to first provide prior notice to the citizen;

  • Requires such businesses to allow consumers to block (or “opt out”) of information transfers to any countries that the Federal Trade Commission (“FTC”) has determined provide adequate and enforceable privacy protections, such as the European Union (EU);

  • Requires such businesses to obtain the prior consent of the consumer (or “opt in”) before personal data can be sent to other countries that the FTC determines do not provide adequate and enforceable privacy protections;

  • Bars companies from refusing to provide goods or services to consumers who elect to exercise their “opt out” or “opt in” consent rights, or from charging consumers more if they chose to exercise such rights;

  • Provides for enforcement of the bill’s restrictions by the FTC by defining violations of the bill as a violation of the Federal Trade Commission Act’s prohibition on unfair and deceptive acts or practices, thereby allowing the FTC to seek injunctions against violators and to impose financial penalties of up to $11,000 per violation;

  • Provides for additional civil remedies against violations, including authorization to the state attorney’s general to bring civil actions to enjoin violations and impose monetary penalties of actual monetary losses or up to $10,000 per violation, whichever is greater; and,

  • Provides a citizen whose privacy rights are violated with a private right of action to sue a business who has violated the act for actual monetary damages or up to $10,000 per violation, whichever is greater.

Rep. Markey noted that Senator Hillary Clinton (D-NY) recently introduced similar legislation in the Senate (S. 2312).


 


It is a few years old, but I thought someone might be able to use this as a place to start.  I also attend college and am going to try to use the school library resources to find out some more information.


Off topic
Did anyone seen the Today show this morning? I have seen and heard it all now.... The Ultimate Outsourcing- people going to India for surrogate mothers!!! OMG.... compared to about 80 grand they would pay here in the US, they would pay only 30 grand (This includes travel for the perspective parents to india).
Off your topic, but
x
On Topic
Well aware of that - just in a rush while typing - but thanks - so do you have an answer to my question?
Off topic -- but regarding the CMT behind your name, SM

what does this mean and what does one have to do to get it?  I am also a CMT and just wondered how this works.  You may email me if you want.  Thanks.


This is a different topic really and I don't
IMO, newbie MTs should not work on ASR. They typically do not have the knowledge base required, at least with regard to acute care, to be able to discern when what they are seeing and/or hearing is incorrect in the context of the report.

ASR editing requires a different skill set than straight transcription and new MTs need to focus on developing their knowledge base.

The problem is that the experienced, quality MTs that should be working on ASR and properly training the platform should never take the crummy wages wages paid for ASR editing. So the MTSOs have created a catch-22. They don't pay enough to attract quality MTs that will improve the quality of the ASR platform which would in turn improve production across the board so the settle for newbie or subpar MTs who will work for the measly pay they offer, but the quality of the ASR never improves or even gets worse, which slows production causing MTs to speed up to make more money and miss errors, which the ASR adopts as correct, etc., etc.,
The topic is about
whether or not one "can" or "should" transcribe in public. Was just pointing out that I cannot because of a written policy. I am very happy in my stable hospital work-at-home job thank you very much.
On the granparents topic..what would you do.sm

In our house, the kids have been raised that if they do something wrong then we should hear about it from them, not someone else.  This helps to foster responsibility and open communication so things can be discussed as the growth and get into mishaps of the ages.


Hubby's mother has always wtached the kids while we are on vacation.  This year I was a bit leary and so I made other plans, which he had a fit about it would hurt her feelings, blah blah blah.  I left STRICT instructions for my good friend to be called for ANY trouble with the kids as she is not known for being good at standing up to the kids...hence the worry with 3 teens.


Anyway, we get back from vacation, everyone is weird the first night we are home.  The kids all go off to school the next day and even weirder is that my MIL stays in her room until hubby is up.  THEN she comes out bawling and blubbering about how we should not be mad.  After 30 minutes of her crying jag it comes out my son was arrested while we were gone.  She did her ususal, no punishment, no in trouble of any kind and let him sit on his ass while suspended.  To top it all off, AFTER she leaves I find out he was suspended AGAIN only 3 days later and nobody bothered to tell me this...I am told by a daughter who informes me she waited for her bother to tell me or her grandmother as my son had thrown the origial mail to me away.  I just blew up..to say the least...suspended twice and arrested in 10 days....whole new territory to me and all she can do is cry about how we should not be mad at him and not to punish him.  Really?


Now, I REFUSE to let my children go there as I do not feel she has any idea what dangerous behavior is and even when she had the names and numbers of others to deal with any problems decided to hush things up and not use them.  To top it all off, SHE told my children not to say a word to us when we got back....basically having them lie to our faces when we asked how things went, etc. when we got back.  I am sooo furious I could spit.  Hubby cannot believe I will not let her have my children any more and says I am insane. 


I want other opinons if YOU would entrust your children to someone who pretends such activites did not happen and sweep it under the rug and break huge house rules of being truthful with the parents.  She pulled the "if you love me you won't tell your mom and dad" crap and do not feel she can be trusted with supervising teenagers for any time whatsoever.


Yes I am. That's what the original topic was, after all.
agree with you on the Nagin/Blanco thing. Did you want to change the subject?

I don't have tunnel vision.
You can usually tell by the topic whether or not it pertains to MQ.

Jumping in topic....
A third of my work is radiology and the rest is basic four reports.  I prefer doing rad because of the fast pace.  It's a small hospital with a rotating doctor and I do anywhere from 50 to 150 (this is not counting combined reports) reports a day which only takes a couple of hours of my day.  Would really like to do more rad but afraid of the committment it would mean.  Any suggestions?
off topic...need help with cat problem..sm
does anyone know of a good over the counter tape worm medication.  the cat has fleas and a tapework. I know the frontline is the best for fleas, but unsure of the tapeworm.  Thanks for any advice!
I think it means it's a hot topic -
been viewed a lot of times.
off topic, but bear with me here
would you be upset if your husband had been somewhat unfaithful in the past, but the two of you worked through your problems and sought counseling and now had a stronger marriage than ever?  except you didn't know for certain about the somewhat unfaithful part until after you had reconciled and renewed your vows?  but then you find out that your mother-in-law knew about the infidelity and preached to you about marriage and family without telling you the whole story?  because it was her son's place to tell me, not hers.  and now you find out that she is friends with this other woman and calls and emails her on a regular basis, which is more than she does with you?  do I have the right to feel angry and betrayed here?  or am I seriously just overreacting and freaking out about something that's in the past?
Off topic - please do not flame...
I will be moving to a smaller house (simplifying and paying off my mortgage in the process..yay!) and will need an Aerobed for guests. For those of you who own them, are they comfortable enough for an elderly person? I have seen some really high ones and see that you can now purchase a separate frame. Any thoughts? TIA.
Off Topic. Does anyone take Lexapro?

I was on it for generalized anxiety disorder and it worked great.  I felt like me minus the anxiety.  No side effects at all.  But I did some research about weight gain and so I stopped taking it.  I was only on it for one month and the weight gain supposedly starts to appear after a few months to a year.  And we arent just talking 5 pounds or so.  People are reported 30-50 pounds.


I would like to go back on it but I have been really good with my exercise routine and am really looking forward to fitting nicely into that bikini this summer.  I am torn. 


Anyone out there who takes Lexapro and has not gained weight????


why not start this topic? sm
Those who want to participate can and those who don't won't. The lady asked for help and advice not insults. Grand for you, you were smart enough not to put yourself there but this girl made a bad choice and her aunt is asking for some help, support and ideas.

Why be ugly about it?
I know this is off topic, but I just had to share with everyone that
$30,000.00 scholarship for her community involvement going back to 7th grade. She wrote a paper on how all people should get involved and make a difference in other peoples lives. I'm the proudest mom in the whole wide world! :D
Great Topic! sm
I use the basic sites:  Google, One Look, Rx List.  Here is another great word and equipment site that I saw posted on this forum:  www.eneel.com .  Here's an interesting site to search hospitals & nursing homes: www.zapconnect.com .

off topic, but still re: cats
How on earth do you keep a cat from getting on the hood of cars? My cat is five years old and only does it occasionally. For some reason it is always late at night. I can peek out the window and see him perched just as proudly on my car and--gasp--a time or two on a neighbor's car. I hate him getting on mine and I surely don't want him on anyone else's car. A couple of times that I've caught him on mine I hit the alarm from inside the house hoping to scare him enough that he'd be afraid of the car and never get on it again. No use. I only catch him every week or so. Any advice???
great topic
I worked for a company out of Ohio for a day. I had problems getting into their system on my first day but did what I could. I e-mailed her the problem and what needed to be transcribed yet, etc. She e-mailed me back and fired me along with a good butt chewing! Wow! Mind you this was day 1 and no orientation given on their part. I shrugged it off and moved on!
Here's the link to your topic...

 


       http://forum.mtstars.com/company/v/1/31498.html


      


Topic is now losing by 2%
Please go vote so others in this country might be made a little more aware of the problems outsourcing is causing this country!
figured it was a hot topic
just wasn't sure.  any other "secrets" I should know about?
Another topic that might be addressed
in this context would be the potential for identity theft. I am sure that if I, without a larcenous bone in my body, could think of the following scenario, others could too.

Suppose an unscrupulous overseas MTSO "contracted" with an ID theft ring in the US to supply names and SS numbers harvested from medical records.

This MIGHT have already happened to me; there's no way to know for certain. But last August, I went to the local GI clinic for "that procedure" that they recommend for everyone over 50. I used my credit card for my copayment, of course.

I happen to know from my local MT contacts that this practice offshored its work to India a few years ago.

Not too long after my procedure, I received several dubious "male enhancement vitamin" products in the mail. Huh? And then my credit card was charged for the products. Since I didn't order them, the credit card company reversed the charges. The identity thief was too stupid to actually change the mailing address, in addition to thinking that the "vitamins" would perform as advertised. (Anybody want 'em? I still have them. I wasn't going to pay to ship them back, no way.)

The timing of this COULD be sheer coincidence... but it's just a little suspicious to me. My credit card number was stolen from SOMEWHERE.

This town is small enough that if my local congress-critter (and his wife) have had "that procedure," they probably had it done at the same practice where I did.... I do believe I shall write him a letter; but I will have to compose it in words of one syllable or less, because he is really, really stupid.
Kind of off topic, but....
I worked for an attorney once, in his office, and he had a phone in the bathroom in the office.  He would go to use the bathroom and call me at my desk from the phone in the bathroom and have a conversation with me while dropping logs in the toilet!  He was ALWAYS calling me, non-stop, for everything, I mean it was demeaning!  So, then one day he was at his house and called the office and I happened to be using the restroom, so I didn't answer.  When I got back to my office he had already called probably 5 times and I was the only one there, so I answered and he asked me why I didn't answer.  I told him I was using the restroom and he told me from now on to use his restroom and answer the phone when it rings in there.  Uhhhhh NO, I told him.  I told him that when I need a private bathroom moment I'm taking one and don't care to be talking on the phone while I do it.  He was crazy!
on the topic of looking/feeling younger

I dont really know how to say this, so here it goes...sometimes older women in denim shorts and tank tops look...like older women trying to look young. I am not trying to disrespect anyone, but come on ladies, we've all seen them.  The person in the skimpy shorts and low cut top and bleached blonde hair, she turns around and lo and behold, she's your grandmother! That is not attractive! Women can dress and feel sexy without having to borrow our daughter's clothes! Just IMHO!