Thanks so much for the insight and advice, guys, I really appreciate it, books are informative but

• Need to prepare -- Anyone out working at home delivered by C-section? I know they say 6 weeks to - memt
  • Every person's body is different and heals at a different rate. - 2 C-Sections
  • Four weeks for me, sm - Gone from MQ
  • Hysterectomy - Babe
  • Thanks so much for the insight and advice, guys, I really appreciate it, books are informative but - memt
    • Exactly (sm) - Mom_of_3
  • C-sections - sienna
  • I went back at 5 wks. I was ready to turn cartwheels after a week. - Easiest of my 3 deliveries. No sore privates. NM
  • Had to work the next day - got discharged - MTCS2
  • Going back to work after c-section - Brandy
  • Back to work - Mom_of_3
  • I was working PT at home one week after my C-section and - me
    • Then again you could end up w/one that nurses q2h like mine did! Lucky to get a shower in even. nm - Milk machine
      • I had a little breast addict too. Thank goodness for her swing! - and playpen, when older, so I could shower, etc. (
      • I used to say he nursed for 30 minutes every 30 minutes. I was trying to figure - yep BTDT too
      • I hear ya (sm) - Mom_of_3
        • My little guy - Been there
          • know what you mean - Mom_of_3

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have Stedman's Medical Dictationary on CD and I do use it quite a bit, but that's more because the actual print dictionary is so darn heavy to pick up and look a word up!

In my experience, I have come across many QA who are not that good.  They don't know the BOS.  I have wondered how quite a few even became QA.  I know that there is a lot of differences between QA.  I've experienced it personally as an MT and as a QA.  I would like to see companies start going toward a base hourly pay for QA.  It seems lately the industry standard is becoming production pay for QA.  I might work on 10 accounts in one day; all with their own style preferences.  On production pay, it is difficult to keep all the P's and Q's straight.  If an MT messes up or overlooks demographics, it takes time to fix that.  In the time it takes to correct demographics for me, I could type a 30-line report.  Fixing demographics, looking up doctors names (even though they are easily found but left blanked) takes a lot of time.  It is hard to leave positive feedback when most QA these days are being rushed. 

Keep in mind that most of the reports sent to QA are not the easy ones.  We should see the hardest dictators and the drugs that sometimes seems impossible to find.  So I could see a 30-line report (at 5 cpl) with only one blank.  But that one blank may be extremely tough.  It might take me 15 minutes to find it.  On production, I would not give it that much effort.  On hourly pay, I would spend the time to research it.  So keep in mind that it would only take a few minutes to type the whole report but the time it takes to research this one blank might be 5-10 times longer. Paid production, far lower than typing.  I simply made more money as an MT.

The production pay for QA is happening because simply there are some QA staff that abused the hourly pay system.  They didn't work.  They didn't do their required amount of reports.  So the bad apples out there have spoiled the whole bunch.

I feel frustrated myself lately with the industry as a whole.  If I'm not QA'ing overseas MTs who do not understand American slang, than I'm being production to find the impossible words on the hard ESLs.

I've worked with many QA over my career.  I've seen some good QA and I've seen some that are just really rotten.  They don't know anything about style.  They shouldn't be in QA.

I worry sometimes that correcting something according to the proper guidelines is going to cause conflict because there are some rules to the BOS that not a lot of QA are aware of. 

I do agree that QA needs to be uniform in their feedback.  It would make my life easier as a QA as well. 

But also keep in mind that some things in our field that there are 3 right ways to do it.

One example is the word followup.  Now follow-up used to be an adjective.  It is being tossed out lately.  It is still NOT wrong but the BOS is leaning toward removing it all together.  So why not just let it go and use followup instead?

You might see one QA correct it and another leave it.  Neither are wrong.

It is almost impossible to input the BOS with your companies preferences on a ver batim account and not make someone mad at you!

My advice, ask where they document their correction from so that you may look up the rule yourself for future reference?

If you can, email and say where in the Book of Style may I find this or account specifics, etc.

Best wishes to all of you and please keep this in mind that a lot of QA are being pushed to their limits and we don't make enough money.  We are supposed to be superior MTs (which is why we are in QA).  But most of us don't make near as much as we did typing.

My company is giong to be offering to train on voice recognition/speech.  I currently do straight typing but I am going to take them up on the offer to get cross-trained for the experience. 

I will at first admit I really don't know much about VR.  It seems to me that the doctor transcribes, the computer transcribes it and then the MT listens and makes sure the document is correct?  Is that what this is? Is it really that difficult? 

I'm am not trying to cause waves but I would just like some clarification/insight on this.  Thanks so much!

All you MTs who are wondering why it's so hard to get work and decent pay check out these websites:   Spheris India Pvt Ltd  and Indiadaily.com

Spheris says it doesn't outsource to India but guess where a lot of the old accounts have disappeared to.  When they say there is no work, they mean for USA MTs.

It seems that now getting your own accounts is the only way to go (at least for the time being until the pervasive mood of the industry corrupts even in that area).  My curiosity though lies in how those who are claiming that they work for services are able to do this. 

Also, congratulations to you for your success in getting your own accounts, and thank you for sharing your insight in a manner that doesn't imply that you're trying to belittle those who don't have their own accounts like I've seen others do on this board.

P.S.  On the matter of panhandlers, in the area of the country where I live an investigative reporter did a feature on just this subject a couple of years ago.  Believe it or not, it was estimated that panhandlers in this area average approximately $120K per year.  I tell you, I'm in the wrong profession ...

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.  

nm

I have been an MT for over 10 years.  I also am getting burnt out, tired of my job, day in day.  However, I do love transcription and make excellent money at it, have grossed over $50,000 per year the last 5 years.  I decided to go back to nursing school and am very happy with my choice.  However, over these 10 years of transcription I have had my ups and downs.  My biggest issue with being at home working is lack of socialization, being home day in and day out with just the kids and the animals really gets to a person, sure hubby is home at night and thinks working from home is the easy life, thus the return to school and boy has my overall enjoyment of life changed once I realized I was the problem, not everyone else and I needed to find myself again.

Anyway, my biggest advice to you three-fold:

1.  Get into counseling for yourself, find out who you are and what your needs are, whether or not you think you need to, I sense you are feeling overwhelmed and need someone other than your family to talk to that can be nonjudgmental to your feelings and needs.

2.  If you're only making $100 after you pay preschool you can either keep doing it and be miserable, or quit because you are lucky enough to have a husband who can support the family without your income. (See how fast his mind changes just by losing the income you do have as to whether your job means anything.)  Or look for a different company or office that you like more and are more productive if you really want to do transcription (lots of fish in the sea as far as companies).

3.  Find a local "mom's" group where you can get out and socialize.  MOPS (mother's of preschoolers) is an excellent one that is nationwide, they have a website.  Also Mom2Mom is in a lot of areas.  They provide a once a week time for moms with kids the same age to get together, socialize, (some offer spirtual guidance some don't) and each week a different mom takes a turn watching everyone else's children at the facility that hosts it so the other moms can talk about things they have in common.  Every stay-at-home and work-from-home mom needs to socialize with adults, without their kids, or they will have a nervous breakdown eventually no matter how much they love their kids.

Sorry so long but it does get better but you have to take the first step at making yourself happy.

and contact the Dept of Labor.  If they were stupid enough to put their broken promises in writing, you have every right to start a lawsuit.  We all have complaints about different companies, but what they've done is downright illegal !!!

That's what cracks me up