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Serving Over 20,000 US Medical Transcriptionists

Outsourcing Concerns

Posted By: We all need to get involved on 2007-05-17
In Reply to:

Did any of you watch the special the other night on identity theft?  I think it was maybe on Dateline.  If so, you heard them say the identity theft ring reaches far beyond the shores of the US.  It involves many of the countries that are receiving outsourced transcription work. 


The first thought that came to mind when watching that was our medical records.  I often have dictation that gives me a SSN and DOB.  I also often have dictation on a new patient giving me other details, such as where the individual works, how many children they have, etc.  I always get their height, weight and race.  With these details, the individuals being outsourced to have everything they need to supply a terrorist or identity theft ring information to enable them to pose as someone else.  This is very frightening to me!


What do we do?  How do we wake America up to what we're facing?  Sure, we can write our elected officials, but you all know as well as I do that such correspondence falls upon deaf ears.  Does anyone have any suggestions on where we go from here?  At this point, it isn't only about losing our jobs, its about national security.




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sometimes this concerns me as well
I talked with my account managers about the future of MT and does she really feel there is a shortage. On the 1 hand she said yes there is a lack of qualified MTs, but what she also did say is that those with experience have more job security, which makes sense.

For ideas, have you ever thought of possibly becoming a paralegal or perhaps a legal secretary? Also, what about maybe delving into possible general transcription? I did a bit of that myself and it was not too bad. At least some of the skills you have learned being a Transcriptionist can still be used. I always try to keep a mental list of 5 different "paths" I could pursue if things got bad, but luckily things have never gotten to that point.

Like I said in my heading, sometimes the future of MT concerns me, but the reality is there is no such thing as a stable job anymore. I also got into transcription during my college years, 2 year actually. I ended up completing my AA as well and went on to pursue a degree in IT with an emphasis in networking, but it really bored me to death. Your family should not look at you like you did not succeed. So many people that I know from friends and family all think it is so great that I get to work at home and do so well for myself.
concerns--sm
I tend to agree with the other poster below. Do not discuss things with your mother. You already know how she is going to react and it only serves to aggravate you. If you have genuine concerns about your aunt or any other family member's health, try to address it to the doctor directly. As far as your mother goes, it sounds to me like you are seeking her approval and acknowledgement for your accomplishments. Apparently you are not going to get that. I have a mother who is the same way and it angered me to the point where I confronted her a couple of times about it. It only caused alot of hurt and anger when I did that, so now I just turn the other cheek and try to ignore it. The only person you have to prove yourself to is you and the good Lord. Since He already knows your worth, you need to work on your own. Don't look to others to validate your worth. You don't need to. You are already special. :^) Have a good day, and think positive thoughts of yourself and your abilities.
Concerns/questions

As always, if you have concerns/questions/comments regarding DSG, I have an open door policy.  Please feel free to contact me at kdenson@dsg-inc.net.


Thank you.


Offshore concerns

They are smart , and that is why the jobs are going to them! Jobs don't make people smarter; smart people do their jobs well. If you don't believe this then you must question the wisdom of the American MTSOs and companies that outsource. As I have said before, all Indian MTs are not bad and all US MTs are not good. I've seen excellent quality from India and poor quality from the US - that's the other side of the story which none of you wants to see, let alone admit.


 This is why I call US MTs insular. If you will only look outside of your own town/state/country you will see how the world has changed and the so-called developing countries have advanced in many ways. 


The problem with the US is it has been functioning too long in a  cocoon, sheltered and protected. But with the coming of the global age, competiton has become fierce and jobs are moving overseas and it is now finding it difficult to cope in this new business climate.


You say "sadly" because it affects you but have you ever wondered how Indians like it when American companies dump poor quality goods on them and Indian businesses have to shut shop because they can't bear the  competition? Of course most of you would not have heard that pesticides were found in  bottles of a premier American brand of soft drink sold in India!


Instead of treating "offshoring" as some terrible phenomenon, it is high time US MTs learned to accept the situation because this is the New Age Economy where everything is decided in competition.


 


You are an IC -- state your concerns
You need to get some faith in yourself.  If you are an IC and if you agreed on a certain rate of pay, they need to adhere to that.  If you have a plumber come and work for you and you don't agree with his rate of pay, you cannot halfway through the job decide to pay him less.   It is the same thing.  I give an offer to my IC's and if they want to work for that they can but I cannot suddenly change halfway through without re-negotiating with them and they must agree to a lower rate, etc.  So if you agreeed fine -- accept it but if they just did it, don't.  It is hard around the holidays but is appears you are not making that much anyway so what do you have to lose especially if they took away half of your job.   You need to read and see what an IC actually means and if they are calling the shots you are an employee and can raise a little bit of trouble for them.  But talk to them as sometimes until you stand up to them, they will walk all over you. 
Your concerns are valid, unfortunately : (

EMR and voice recognition has put me out of a job.  On my former job, there was one other Transcriptionist besides me.  Because she had been there longer, she got what was left over after most of the docs jumped on the voice recognition bandwagon.  They use Dragon Naturally Speaking.  I have seen it at work myself and it is quite accurate.  There is no editing being done on their work.  Now, I'm doing a job that is just that, a JOB.  I enjoy transcribing and am looking for another job, but MT jobs seem to be few and far between where I am.  I can't get high speed internet where I live, so most services are out.  I may move onto a different career if something doesn't come around soon.  I thought about legal transcription.  Anyone have experience with that?


 


What concerns me about newbies is
that often they write these excited posts and reveal how tiny their working English vocabulary is. That's a terrible place to start out from. I try to be polite, but I do remember being a newbie for hospital work and how appalled the trainer was with the other MTs who had tiny English vocabularies. She about dropped her teeth because the first time I had to spell shotty adenopathy I spelled it right. I couldn't believe anybody would think "shoddy adenopathy" would make any sense. It's not logical.

How do you train people to THINK and be logical in their transcription? Those are things the person should bring to the table if they want to go into a career in the written word. Then you can build on that logic as you interpret MD slurring.


I've had similar concerns
about blacklisting. After all, anybody can see how easy it would be to paint a dark picture of a company on this board so why wouldn't companies have a similar board somewhere to do the same with employees? I think the answer is because it would be considered blacklisting which would likely violate some employment laws and it would be too difficult to keep it a secret. But I could be wrong.

Faxing and HIPAA concerns
I need to know the regulations imposed by HIPAA for MTSOs faxing medical reports to referring doctors.  Thanks.
Of course they do. That was one of the concerns about Medquist. Info from the VA
was going offshore. The info included the location of the soldier's troop when he was wounded in combat and more.
Offshore concerns blog

I mentioned this a few messages below, but the blog has its first post. I am NOT supporting any Ad things on there and will not be making anything off this. 


http://violatingamerica.blogspot.com/


If you have a link that would be useful to others to write their gov't reps, companies, news sources, etc, feel free to post them or e-mail me so i can get them up there.  I am also looking for any news stories or any information we can get.  One way or the other, we might be able to make a difference. 


Know is old post - but valid concerns

I don't kow what they could do to help you RE: Katrina but companies need to verify the NEED to cut back or do it across the board, at least in the department / job level. I worked for this company for 6 yr & had several cuts in my take home. The platforms used became slower & slower because of the amazing amt of data in the programs. I had 3 gig memory & STILL took forever & you aren't making a dime for that several minute while a report is sending & the next coming in & then doing the demographic page.


I've been trying to find out if there was anything of that investigation - I never did get that paper that so many other employees got. And I had a definite beef.


Please use Offshore Concerns board for those topics. (NM)
Goldbird
be sure to mention HIPAA concerns with offshore...nm
..
Anything an MT can do when you have grave concerns about patient care?

Is there anything at all an MT can do when you have grave concerns about the care a patient is receiving? I know the answer to this is probably no, but I am so completely frustrated with my one of "my" doctors right now.  I know that one of his patients is not receiving the proper care, and I am really worried for this patient. I wish I could contact the patient's mother and let her know my concerns, but I know that is not allowed and I would be fired for doing so. I know that I'm not anywhere near as smart as a doctor, but my son has the same condition that this patient does and I know that the patient is not receiving the proper care or even the correct diagnosis. It is hard to go into all of the details for confidentiality reasons. I just know, 100% sure, that this patient deserves better care than he is receiving. 


Sometimes the virtual world that we work in is great, and other times it really stinks. If I were working in the doctor's office I could gently share my concerns (maybe I would still be fired but I could give it a shot). Here in this virtual world where the doctors don't even know I exist I can do absolutely nothing.


I'm just so frustrated at the doctor and so very worried for this patient.


Interesting info on Offshore Concerns board
OSI offshores and that is why they can't keep quality MTs

In Reply to: Today, I landed a client that was using and Indian service. They said the service - Kansas MTSO sm

The MTs they do keep are basically no more accurate than the Indians. The QA department is a joke because they hire people fresh out of MT school. It is a sad company and is destined to fail if they don't start thinking more about quality than keeping the brownnosers happy. This could be true for other companies that offshore as well.

D I T T O D I T T O
Taking 2 polls on offshore concerns board

Please participate!


Thank you!


d~


Take your medical degree into the office and voice your concerns.
How do you know the patient isn't getting the proper care? No two patients are alike, just because your child has the same condition doesn't mean anything. This parent probably has googled her child's condition and is working along with the doctor. As an MT, you should not talk about any patient even with the other people in the office. It is confidential information and very unprofessional.
Comedy Stop & Offshore Concerns were the last 2 boards to be changed over to the new format.
Archives will be available soon.
Please post offshore topics on Offshore Concerns board. (NM)

Thank you. 


Goldbird


This thread belongs on Offshore Concerns; thread locked. (NM)
Goldbird
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


outsourcing
A lot of them do. Usually they start outsourcing discharge summaries. No matter where you work, inhouse or at home for a national, it can be sheer drudgery at times and the holidays are usually the worst of it.

Changing careers can be a good idea and a welcome change but with the uncertain times we live in who knows???? It's hard to make decisions when everything seems to be in the throes of bankruptcy, bailout and the old rules seem to be gone forever.

Things will get better in time. I hope.
outsourcing
Girl (or guy), I feel your pain! Unfortunately, it's not just transcription. I had heard that radiology reports were read by off-site radiologists now (in India, or wherever), and we experienced it firsthand a couple of months ago when my husband went to the ER and had several tests done. What took the longest time for us to get out of there was having to wait for the radiology report to be faxed back to the hospital. Sure, I guess they still have to have someone on site to take the pics, but I guess those are lower level, tech jobs. Crazy.
outsourcing
Hi
I too am concerned about losing my job. I've already lost one good job due to outsourcing, a gastroenterology office. My main job now is putting in system where info will be put in computer at time of patient visit thus, not needing transcription. Yes, I am very concerned about it.
outsourcing
Bless your heart... I just don't know if us transcriptionists can turn this around:( I called the Obama campaign line & reported what is happening to him & I also left a post on change.org about it. I just don't know if transcription is going to continue to spiral downhill or what, but I am so worried:( I am seriously thinking about going to college to do x-ray tech just so I can be multifunctional for the hospital if I get the shaft with transcription.
Outsourcing...
In my experience, the doctors who are either on staff and/or have admitting privileges to a particular hospital are basically at the mercy of the hospital board and administrators, as the revenues generated by the physicians to the hospital are filtered through all the departments, so that each gets their share of those revenues, with the hospital gain outweighing the physicians. So, although doctors may not necessarily like it if dept A is outsourced, they're still weighing that loss against depts B, C, D, etc. Does that make sense? Perhaps if they keep barking loudly enough as more and more departments are eventually outsourced, the powers that be will finally take notice and listen! Unfortunately, by the time that happens, those suits will all be standing around wondering what happened to THEIR jobs!
outsourcing
Working such rigid hours is a very common Eastern Asia thing. I know it is a stereotype but that is how one family can run a 24-hour store, because they are very strict with their hours. While IC used to be you work when you want as long as you get the minimum amount of work in each day that you said you would it is becoming more like just a glorified telecommute position. You still have to be online and ready to work certain hours and if you aren't you are disciplined like with any job. I see this a lot with jobs that are overseas companies and even American based companies are adopting the program. It prevents problems like were listed in another post - everyone taking the same days off and no work getting done.

Your best bet is to make sure the contract does not say you have to work certain hours, just submit so many lines a day AS WORK IS AVAILABLE...I've seen people get in trouble for not submitting lines but there wasn't work enough to get those lines.

We aren't given the freedom we used to, but there are still jobs out there if you dig far enough! Good Luck!!
OUTSOURCING PLAN...
Okay, here is the plan.  For all of these hospitals with heavy ESL dictation loads, outsource these yourselves to India, Pakistan, Trinidad or where ever they speak that English as an unknown language.  It won't matter if it is correct as typing those documents is just a best guess scenario anyway.  Leave all of the English as a First Language (EFL) here in the US for those of us to type as we have been working long and hard to gain our experience and deserve to have decent work.  If a hospital has a lot of ESLs that they have brought stateside to staff their hospitals as hospitalists as they work cheaper then it should be their responsibility to give them English classes and monitor their progress until they can speak English clearly, concisely, and accurately.  The solution to this problem with ESLs  is in our HANDS and we know it.  The large companies and hospital clients need to take note before it is too late and we are all retired.  You need us more than we need you.