Reality and how it is in 2005 and my

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On page 146 that those are legit but it looks like q.4h is typed out in the book as q.4 h. (with a space in between the 4 and the h). 

There is a list of abbreviations that have been since classified as dangerous and q.d. was one of them and is now supposed to be typed as "daily."  You can do a search on that thread, I think, and it should come up. 

The BOS book says to find dangerous abbreviations in the list from "Institute for Safe Medication Practices."  I'll have to check that out...the only list I have access to is from a site I had to join through owning of a piece of software and i tried to post that link once and I couldn't due to password protection :( 

The payroll schedule for MedQuist states PayDate as 07/11/05 (Monday). 

Love it!

You're looking for a minimum of 10 per line as a subcontractor????   

Don't you realize that docs are such notorious cheapskates, and the vast majority of MTSOs are charging that amount, perhaps a cent or two more if they're lucky, so how is it YOU expect to be paid a minimum of 10 per line????? 

I had to totally laugh out loud when I read your post.  I mean, you DO feel it's okay if the MTSO makes a LITTLE bit of profit, don't you?  Or do you expect them to sweat blood and tears in this business for their health and give you the whole shebang? 

It always irritates me to no end when I read a post such as yours.  If you're looking for a full line rate, get it from obtaining your own accounts!!  Don't expect an MTSO to give you 99.9% of the pie dear!!!  Really, I've had such a belly full of SCs with the attitude of gimme, gimme, gimme I could just scream!!!  

Like you and so many others, I have watched my wages as both an IC and an employee go down, down, down.  I worked for a company owned by an MT.  She paid very good wages but sold the company to an Indian company, who got rid of all the Americans except for a few who would accept very low pay.  It's funny...clients want 100% accuracy but they don't want to pay for it.  They agree that they can't just randomly pluck people off the street to do MT, that they have to hire experienced or trained people.  But they don't want to pay us for our experience or our training.  I am doing my last MT job. I have my bachelor degree almost completed and I'm outta here.  The lack of respect for MTs, from employers, other MTs, from offshore companies, from clients, from AAMT, is so disheartening.

over the same period in 2004.  It had been decreasing all year until the fourth quarter when it skyrocketed.  The only thing that's changed is that we now have 150,000 Katrina evacuees living in our city.

Please don't misunderstand.  I am quite sure that the majority of the displaced New Orleanians are good people.  There are, however, more than 1500 missing sex offenders running around Houston, gangs of thugs trying to take over and out and out warfare in some areas of the city.

Prior to Katina, New Orleans had the highest per capita murder rate in the country and I now see why.  I definitely believe in helping those in need; in fact, not only did I donate money but also donated old clothing and furniture and the like.  It now really pains me to say it, but I wish they would all just go home.   I want my city back the way it used to be before they all came here and tried to make it theirs.

Here is an important post from 2005.  It is lengthy and I have edited it to make it more concise…

Posted By: n on January 05, 2005 at 21:35:45:

In Reply to: offshore posted by beth on January 05, 2005 at 19:58:08:

Offshore medical transcription is a large enterprise financed with capital. The Soros money is in the Spheris deals. Look for more and more to go overseas.

From GeBBS Health Care Solutions http://www.gebbs.com/pressrelease062004.htm  : In a world of steadily rising medical costs, Nitin Thakor thinks he has a cure. It works like this: A doctor treats a patient and sends the medical record to Thakor's company, GeBBS HealthCare Solutions of Englewood Cliffs. The company ships the records electronically to India, where employees - earning about one-tenth of what they would get in the United States - process a bill for the patient's treatment, create a claim, and send it electronically to the insurance company. The process costs the doctor about half what he would pay in the United States, Thakor says. "It's faster. The quality is better," he says, brimming with confidence. "It makes perfect sense." It's also part of a growing trend in the health-care administration industry: sending work to low-wage countries - mainly India - in the same way that offshore outsourcing has sent U.S.-based IT, call center, and other jobs around the world.

The health-care work ranges from simple tasks - such as transcribing notes dictated by the doctor - to more complex processes, such as assigning a treatment code and filling in forms that doctors submit to insurance companies for reimbursement. In North Jersey, GeBBS, Allserve Systems of New Brunswick, and ClaimPower Inc. of Fair Lawn do work in India. Marlton-based Medquist, one of the largest transcription company's in the United States, also sends work offshore. Other players across the country include Perot Systems Corp. in Texas, HealthScribe Inc. of Virginia, and Alpha Thought of Chicago. "There is not a lot of offshoring yet," said Barbara J. Cobuzzi, president of Cash Flow Solutions Inc. of Brick, which does billing, coding, and collection. "But they [offshore companies] are going after it. ... They are approaching companies like mine and saying, 'Get rid of your staff and use us.

Cobuzzi said she spoke from experience: In October, she terminated a contract with a Florida-based company with offices in Chennai, India, to put patient demographic information into a computer. She said the work contained too many errors. "I'm sure the doctors would rather use someone who is not offshoring," Cobuzzi said. "But the doctors have this huge pressure to get their costs down." So, too, do their contractors, said Marilyn Grebin, president and CEO of Silent Type in Fort Lee, which transcribes doctors' notes. Though offshoring has not yet had a big effect on Silent Type's bottom line, the company has lost work, Grebin said. For instance, last week, she said, she lost a $50,000 contract with the John T. Mather Hospital on Long Island. Grebin said the hospital, which had been her company's client for five years, hired a company that will do the job in India. "I went to the client and said, 'What can I possibly do to help you, she said. "And they said, 'No, you can't possibly charge what we are getting - half the price.

On Long Island, hospital vice-president Kevin Murray said the non-profit community facility moved the work offshore in a pilot program - a small part of the facility's $500,000 annual spending on transcription services - to see what the quality of the work is like. "The hospital lost a significant amount of money last month," said Murray, putting the loss at $1 million and noting that many hospitals in New York face similar budgetary problems. "Every month is a struggle. ... This was one of our cost-saving ideas." Thakor knows the scenario well.  With about 85 employees in the United States, GeBBS provides health-care administration services and also develops software for the same field. The company's two centers in Mumbai, India, employ about 180 people, of whom 100 process health claims. Last year, the company had revenue of $12 million, and it expects to make $16 million this year, Thakor said. He reaps the benefit of Indian workers - all of whom have degrees - who earn about $2,800 to $3,300 a year, compared with the $35,000 to $45,000 that U.S.-based employees would make for the same job, he said. "We're making a 45 to 50 percent gross margin," Thakor said of his own company. "A client is seeing a 45 to 50 percent cut on their cost structure. So we're happy. They're happy."

Concerns about patient confidentiality in the offshoring era were heightened last October when a woman in Karachi, Pakistan, threatened to post patient medical records from a San Francisco hospital on the Internet unless she was paid the money owed her for transcribing notes dictated by doctors.

The woman dropped the threat after she was paid. But the incident helped bring the issue to the attention of lawmakers.

Sen. Hillary Rodham Clinton, D-N.Y., and Rep. Edward J. Markey, D-Mass., have introduced bills that would require companies to notify customers before they send confidential information overseas, giving the customer the right to refuse. Still, industry insiders are concerned. Cobuzzi and others said the main problem is that anyone who violates U.S. patient confidentiality laws abroad would be beyond the reach of U.S. prosecutors. But offshore companies say there is no danger of leaks. Thakor said GeBBS' facilities in India have guards and an electronic security system, along with a full-time privacy officer to ensure the company complies with U.S. confidentiality laws. In addition, the computer system that health-care administration employees work on is sealed, he said: The terminals have no hard drive and no connections to the Internet, floppy disk, or CD writers, or even a printer. They can only open files on the server, change the contents, and close them, he said. "So there is no way - unless you can memorize all the information - that you can take it with you," he said.  

The medical transcription business is drawing people from other sectors. That’s because the income can be quite substantial. Transcriptionists are paid anywhere between 60 paise to Rs 2.0 per line. At a minimum of 6 hours and transcribing 800 lines per day, transcriptionists can make around Rs 1,200 a day. Working 26 days a month, they earn more than Rs 30,000 (USD 450 - 500) a month. They send their reports to an Editor for proof-reading who are paid upwards of Rs 40,000 per month. 

As a result, hundreds of professionals are quitting their regular jobs to assist US doctors in transcribing their conversation with patients. X-ray, pathology, surgery and discharge reports of US patients are also being transcribed out of India.

To be a transcriptionist, an aspirant has to acquire skills in medical terminology. The next step is the editor. Level three is a quality analyst (QA) who has to work out of the office of the MT firm.

It’s a daily ritual for thousands of homemakers across India. After sending husbands to work and kids to school, they download voice files and start transcribing medical illnesses of patients in the US.  

Sowly, medical transcription from home is becoming a phenomenon, particularly in tier-II cities where the BPO boom hasn’t yet caught on and educated women are still not being encouraged to venture out of home.

“Almost half of our 600 home employees are women. Working from home allows them to spend more time with family,” said Mr Rajiv Shetye, VP, Spryance, a Boston-based medical transcription firm which now has 1,200 employees in India.

According to estimates, India has about 100 medical transcription companies and the big ones include Accusis, Spryance, Stheris and Heartland. About 10,000 people work in the $120 million-strong industry.

Still, there is a lot of untapped potential. The US market for market transcription is about $12 bn per annum, which is more than double the BPO exports of India. More than 700 million hospital events need to be recorded every year. According to Nasscom, about 1.6 lakh such transcriptionists will be needed in India by 2008. Earnings depend on how much time a person is able to devote. Billing is based on the number of lines transcribed.

HARSIMRAN SINGH

With the deaths of three people that I grew up with on TV, and now with what I hard yesterday from  Dr. Phil yesterday he reminded us that if we have 20 years left in our life it -- and that sounds like a long time, but that equals out to only 1040 weeks which then makes you realize as the weeks go by so fasssssssssssssssst that it is not very long and we need to make the best of those weeks as we can.  So that made me stop and realize what is really important and what is not and what is worth fighting about and what is not.  This may not stay with me but I am going to keep thinking about those weeks instead of years and hopefully it will make me enjoy the weeks that I am here. 

I did not attack you,  and if you believe I did it's your own insecurities. I'm just telling you how it is.     And by the way, I'm not looking to be employed as a SC as I'm an MTSO, dear and have been for many, many moons!  Thanks for the offer anyway!

What you expect to receive line-rate-wise is laughable!  Now, you ARE aware of the economy and the current climate of the MT profession, are you not?  If you're not, allow me to throw a few clues your way in order to help bring you back to reality so that you realize the line rate you expect is WAY out of line:  

 India, Pakistan, Canada, VR, EMR, Bush (as in Bush trying to wipe out the middle class/middle-class jobs and so far brilliantly succeeding!), undercutting, and newbies who'll practically work for free, just to name a few!

See, it doesn't matter how many years of experience you have.   You could have 100 plus for all most MTSOs could care.  The bottom line is what are the docs paying - now subtract the MTSO costs - now add MTSO profit (yes, surprise - they are entitled to make one!!  ) - and you'll see the line rate you expect is outrageous.

Don't believe me?  Then I refer you back to the clues above. Go Google on all of them and find out for yourself!!

/

WE should "get out" if we don't like the relationship between the two? 

How can we produce a high quality report when we are too busy sweating the small stuff or trying to remember all the rules and the exceptions to the rules and wondering which QA tyrant is going to be checking our work today so we can make sure to remember their rules in additiont to everything else.  And on top of all that, we have to produce, produce, produce.

Something's gotta give and it can't be the MTs cause we've given enough already!  We've given in our pay, we've forfeited our better judgment and our education and intelligence when we've typed verbatim instead what is correct just because we are told to do so.  We've given in our time.  We've even started losing our jobs to overseas outsourcing even though we produce a better product simply because we think and question the status quo, where as the India MTs do as their told without question for 2 cpl.

Personally, I would like to see reformation in the MT industry.  I would like to see uniformity across the board as far as style, format, rules and regs.  I would like to see an organization that represents the MT and not the MTSOs.  I would like to see QA departments adopt a set of rules and that's that.  I would like the MTSO to treat MTs like they have a brain in their heads and can make judgment calls without being penalized for not typing verbatim that incoherent jibberish Dr. Alibaba dictated.

So instead of leaving the industry, I'm staying to effect change.  I'm in the midst of going back to school to prepare for my RHIT credentials and by golly, I'm going beat 'em at their own game and change transcription once I move up that ladder.

If you don't like the us vs. them reality, YOU get out.  You're probably contributing to the problem as it is!

A good English course may help with your test scores judging from your posts. Even with verbatim accounts, you still need to be proficient with grammer usage and have a good grasp of the English language. All companies look at this, and score on this.You cannot slack on this if you want to be able to keep a job in this industry. When you are new to a company, they will audit (QA) every single report you type for a while, looking at grammer, terminology, etc. Remember, you will be typing for a lot of ESL (English as a Second Language) dictators who do not have a good knowlege of English and you have to be able to recognize and correct their errors.

Verbatim does not mean you do not have to edit. Every verbatim account has its own rules, but many of them require that you correct such things as subject/verb agreement, a versus an, he/she discrepancies, plurals, etc., much of which many ESL dictators (and even English as a First Language dictators) have no concept of. In my opinion, a verbatim account is a bad place for a newbie to start as you will pick up a lot of bad habits that will haunt you later on should you need to work on non-verbatim accounts later on, but just my opinion.

Getting out into the *real world* can be rough at first and a real reality check, but work on your English skills on top of terminology and I am sure you will do fine. I don't know what course you are taking, but there are only a few who truly prepare you for the real world of transcription and that is a shame. Start testing now for companies (many have online testing on their websites) to learn what you need to work on before you finish your course, it is a great tool for newbies.

I wish you the best of luck.