U.S. Parents Outsourcing Child Care Overseas
Posted By: Frustrated on 2008-04-13
In Reply to:
http://pop.youtube.com/watch?v=vxj1RDbp_iE&feature=user
Sorry, but with all the serious stuff this morning ,had to send this !!!!
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Overseas outsourcing SM
I don't know where you have been for the past several years but a whole bunch of people are screaming bloody murder about this to their congressmen/women. There are plenty of petitions being circulated to put a stop to foreign outsourcing. Most MTs I know have not only sent letters to congress but have called the senators from their states to complain about this. My friends refuse to see a physician who outsources medical records - and they ask up front who does the transcription and make it know that their records are not to be sent to a foreign country.
There's lots of stuff going on. Do a search on the Web and you will more than likely more than you ever imagined.
Outsourcing doesn't always mean overseas, you
A physician who uses an MTSO for their transcription work, American or otherwise, is outsourcing. That practice has benefitted most of us, so I assume you just mean offshoring.
Don't you think that eventually foreign MTs will up the ante and start asking for more money? I do. Greed usually takes over and I predict it won't be long before they wake up and see that their services are worth more. If that happens, I think we will see less offshoring because the reason most companies offshore is the cost advantage. I've already seen some of the Indian companies requesting more, i.e., it used to be they wanted only 3-4 cpl and now they are saying 5-6 cpl. As an MTSO myself, I get quite a few emails from foreign MTs looking for work so I am just speaking from my personal experience. (I personally do not offshore and never will.)
There are some companies that offshore because they can't find enough MTs that want to work the graveshift and foreign MTs will gladly work it due to the time difference. That practice doesn't bother me as much as the companies just looking for cheap labor despite quality issues.
Overseas outsourcing is here to stay
I've been reading some very interesting posts regarding off-shore outsourcing. I worked as a supervisor in a large MTSO in the 1990s when this subject was being "bantered" around the office, but it was my mistake that I didn't start taking it more seriously at that time.
As I have seen transcription issues evolve over the past 10+ years, I can think back to a time when, in fact, we had lots of "visitors" coming to our office, looking at servers, etc. in what I quite naively thought were server upgrades. Some of these so-called "visitors" were indeed of foreign descent. I lived in the southwest at the time so there was a fair amount of "overseas occupants" and I didn't think much about it. Now, in hindsight, it's plainly and perhaps painfully clear that this was the beginning of outsourcing.
One thing I will say upfront is the fact that overseas outsourcing companies employ smart and very patient people. I don't doubt this very concept of $.03 cpl transcripton is very palatable to foreign entities where there is so much poverty. I also remember reading in some of the transcription magazines around that time that doctors and nurses were quitting their jobs in India to transcribe because they made more money! I laughed outloud when I read that, but I guess the joke was on us.  I also remember reading ads for medical editors in Saudi Arabia for $40-50,000 with a full housing allowance, but the employee had to sign a two-year retainer agreement. One MT I knew took a job in Saudi Arabia. I did hear from another MT who was writing to her that there were huge personal safety issues and she would be glad when her time was up so she could "come home."
If we want to know how persistent outsourcers can be, especially with medical office/hospital administrative staff making critical decisions without actual hands-on experience and think MTs are just "typists," just look at our current situation. We in the USA don't seemingly have the patience to look at the broader picture and the dollars matter more. Don't get me wrong but the spiraling out-of-control cost of healthcare has always been an issue and with more sophisticated scanners, research, etc. being necessary just to compete with the hospital/clinic across the street, dollars have to be taken from somewhere and voila! it's comes from 'discretionary funds' called MT. There is only one very large medical institution still in his country who tried outsourcing in the beginning and when the quality of the work was so poor they wouldn't stand for it anymore, they cancelled the remainder of the "standard" contract and vowed never again to outsource whatever the cost. To this day, they are still one of the most prestigious medical centers in the world and all transcription is being done in-house.
I truly believe there is safety in numbers and hope I live along enough to see a radical change from off-shore outsourcing to bringing MTs "bread-and-butter" home where it belongs!
HIPAA, unfortunately, did not plan for outsourcing overseas. sm
Unfortunately, when HIPAA was implemented, they did not anticipate the outsourcing of medical records overseas. My question is: With all the controversy regarding HIPPA's regulations in regard to patient confidentiality, and the fact that once the information leaves our country the rules do not apply, why has HIPAA not made changes to specify a ban on U.S. citizens' medical records leaving the country. They know darn well that their rules do not apply and cannot be regulated once that patient's name, SS#, DOB, address, phone number, leave the country. Total lack of competency in my opinion. I guarantee that there are few, if any other countries, who allow their citizens medical records to leave their home country. Our government needs to reflect on the bad choices they have made in regard to patient medical confidentiality. This is the most private aspect of a person and deserves to be respected. I bet 80% (or probably many more) U.S. patients have no idea when their medical records are being transcribed by an overseas transcriptionist. I have been in this profession for many years and can honestly say most doctors have no clue where their dictation is going. Only the hospital administrators, in some cases, can verify who is transcribing their physician reports. Many times, even hospital or clinic administrators are betrayed, as many foreign transcription companies set up base in the U.S. with an address and toll free number, which leads the administrator to believe the MT company is located in the U.S. Laws must become more stringent in this arena before any change is seen. All caring U.S. MTs should write to their congress, senate, and federal government in attempt to have someone make a difference.
do you know how many kids come in the ER on an overdose and the parents say "Not my child?" nm
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What? Do you really think those parents or their friends thought the child would be awake and roami
x
She brought a child in this world with 2 parents, not just a one night stand or something..
She left him because he became abusive and used to try to attack her with knives. It was in her and her daughter's best interest to raise her on her own. One of the reasons she did not seek child support because she was afraid of him. Living from experience, you can get restraining orders all you want. If someone wants to hurt you bad enough, they can usually succeed at doing it. She only went after him for child support after she lost her job. He would give her money here and there before, but she never knew how much or when. She didn't care though because she was able to take care of her daughter very comfortably on her own. She had the same job since high school, was a very valuable employee, worked in the fitness club business as a manager of a gym. She cannot find anyone will to pay her that. She was making that much money because she had been there since high school and she always met sales goals and got bonuses. She is not depending on the government to provide anything. Never has. All she wanted was insurance for her child until she gets on her feet. Do you know there are quite a few countries that have government insurance for everyone?
My sister-in-law left her boyfriend she was with after having her child because he was having a long term affair with another person. She has battled constantly for child support. He owns his own business and does not report all his earnings for tax reasons. She has only been able to collect off what he claims. He is 6+ months behind. She has filed grievances, everything. Meanwhile, he drives a brand new extended cab, he bought a house and he has a jet ski. What the hell good is it to go after the dad if the government is not going to consistently enforce its own court orders?
After divorce, child chronic illness, involuntary job change, parents illnesses and death, was force
I frequently regret it, the changes it has made to my life, but when life hands you horror, at least there is this "final solution" to your financial situation. I must admit, I sleep better, and I can finally hold my head up, and I no longer feel hopeless. Find the attorney you can work with,get your free consultation and DO WHAT HE TELLS YOU TO DO. If you have doubts, see a 2nd and a 3rd attorney, till you're comfortable with the person you choose.
I do, because they took care of me. If they were absentee parents, then I'd say no. nm
x
Oh I am SO glad that you were never a child that needed care!
Too bad all children cannot be like yourself.
Too bad that everyone cannot be a full grown, bitter adult from birth.
Think how much easier life would be! Gosh. Hahahaha
Do you use child care so you can work? Write
x
I have children, and paid child care so what is your point?
I am saying this is talked about time after time after time. Now a post saying MTs unskilled, first nonprofessional and now unskilled workers. Talking about wanting to work from home because you want to be a stay at home mother lousy reason to start this job. The post above says it well, you need to concentrate to learn, you have a small baby you need to take care of, something suffers.
ProScript Documentation Services does not send work overseas or employ any overseas MTs. (nm)
Go to NBC10.com - Our local news has "Wednesday's Child" which is a child for adoption.
Every Wednesday they introduce a child who needs a home and a family. There should be some information there as these kids are up for adoption.
www.NBC10.com -
Hope that helps!
WRONG! A child that has a fear of discipline = a well behaved child.
I have a beautiful, intelligent 11 year old daughter that hasn't had a spanking in 6 or 7 years and probably only 3 her entire life. She is very well behaved and I get compliments on her behavior constantly. When she does get out of line all I have to say is, "Shall I call your father?" Call it what you want, it works. She respects and obeys me and her father. Why??? For fear of the facing the consequences of misbehaving. Having a total lack of fear or respect for authority is exactly what's wrong with Generation X/kids today. I turned out just fine as did my siblings. Why?? Because my parents took "time out" to bust our a$$es whenever we got out of line.
Is that clear enough for you???
Not all of us are parents. Not everyone had caring parents. nm,
nm
Kinship care versus foster care/adoption
Having been placed in a position where I now have custody of my 3 YO granddaughter and going through the legal system, I sought an online network of relative caregivers for children. I would encourage you, especially since you are in Georgia, that if you take any children into foster care with the idea of adopting them, there is federal law that requires the state to take certain actions in a specific time frame. When a child is removed from it's bio parent(s), the state is required to investigate any possible relatives who can take the child before foster care is considered, but even before that, reunification with the parents is the priority. Once a child enters the system and is in the system for 15 out of any 22 months, the state is required to find permanent placement for the child.
The problem with this is that there are case workers who may favor a foster family and do not seek out relative care. I have a good friend in Georgia who had to fight all the way to the state level to get custody of her grandson after the child was placed from the hospital into a foster care home with the promise that the foster parents would be allowed to adopt. She has now adopted her grandson, but it was a long, hard battle to get the state to admit their own interests were placed above those of the child and/or family.
If you get a child placed through the state, please make certain there is not a relative who wants that child before you get your hopes up. The courts are now favoring return of children to relatives even after a child has spent years with a foster family who hoped to adopt them.
States get bonus federal funds by complying with the time lines and being able to close the case, so some states place children in foster care because it is easier than trying to locate relatives.
Didn't mean to go off on a tangent, but I can't imagine my sweet bella going to someone outside her family.
If it was a clinic, it might have been urgent care, but it was NOT acute care. sm
Acute care refers to work in an acute care setting, a hospital, doing at least History and Physicals, Discharge Summaries, Consultations, Surgery notes, Emergency Department notes, and much more, including GI procedures, Cardiology procedures, Neurological procedures, Pulmonary Function Studies. It goes on and on and it means and acute care hospital setting, not a clinic.
Also, they could be done overseas..
I proofed Indian work a few years ago and they sound like similar reports--blanks, everything wrong.
For everyone's info, the clinic in town that outsourced to India still dislikes the quality intensely, after all these years, but still uses them because they are cheaper. Go figure.
overseas
The doc that I work for now used to use a service and paid 9cpl.
re:overseas
We could do this, but then we'd have a small choice of credit cards, cell phone providers, computers, toilet paper, paper towels, food in general, entertainment such as cable and internet providers, clothing, tires, and I could go on and on, but what would be the point? The simple fact of the matter is that this is widespread and there's no turning back on it now. Even in our industry we have plenty of overseas working alongside of us. The way I see it, these people have families to feed as well and want to make a living for them as well. I've worked with U.S. companies that employ both American and Overseas MTs and I have to say that they are more than willing to put in the time and effort to get it right. They are also willing to take English classes to do better. I just think it's time that we end this whole caste system everyone wants to push on the MT world. There is plenty of work to go around, instead of pushing them to the side, why don't we include them and help them become better at this job?
overseas
May I ask what company this is? I would like to work overseas as well.
overseas
Haven't decided yet! Maybe Spain
overseas
haven't decided yet! France maybe?
overseas
The system is not accepting the 3-digit password, after I write out my message, why not?
I always figure if they don't care about their dictation, they probably don't care about their
nm
Dont care how many languages you took. Care
x
My parents use it
I can't help you with the pre-exisiting conditions question, but my parents use AARP for all of their insurance needs. They saved a lot of money when they switched and have been very happy with them.
I don't think that her parents did it, but I do think..sm
that they are covering up for the person who did it (maybe the brother).
OUTSOURCE OVERSEAS
and you will be begging for work. get ready to brown-nose to get enough money to live on.
good luck. you could do much better.
They have to be using overseas employees...sm
So remind her that while they claim HIPAA compliance, truth of the matter is that once the records leave the US soil there's really no protection.
They use overseas labor.
.
how did you get an overseas account in the UK?
x
Has anyone ever lived overseas?....sm
A friend of mine is moving to Italy and I am really considering going with her. Just wanting to know if anyone has lived outside of the US (not necessarily in Italy, just anywhere).
Thanks
Overseas posters?
I can't find anywhere on the site that prohibts off shore MTs from posting.
jobs overseas
Personally, I do not worry about this. There are plenty of companies who hire MTs purely in the US. For other jobs, just you wait, there is going to be relocalization of jobs/services, etc in the coming years. I already see/read about towns relocalizing. I would never consider going abroad for any major medical procedures. I proudly support my local medical team. There is probably a reason that medical care is cheaper abroad.
With the comment made in this article about importing physicians, does anyone wonder why medical costs have skyrocketed? I am sure a good portion of these physicians have come over here to make all sorts of money versus what they could make in their country of origin. I am sure they would not have left their country of origin if they were doing well for themselves.
Military Overseas
When companies state no overseas applications or solicitations does that include Overseas Military?? I have DSL and we have a US Post office here on base. Curious cause i'm about to start school and want to know it wont be wasted while we are stationed overseas.
Thanks!
Don't kid yourself. The overseas companies are going in at 0.13 and 0.14 now. nm
nm
Overseas jobs?
Does anyone have any sources for info on overseas MT jobs?! I have been Googling but haven't come up with a single MT position in Australia, New Zealand, Japan, or Costa Rica -- only Saudi Arabia, the UAE, and Dubai.
Thanks.
never worked overseas....
If I could get up the courage to fly over the ocean I may have been able to answer this one for ya... :)
But I dont know why you wouldn't be able to take your work with you... you just have to have access to everything you use on a daily basis... Right now I'm away from my home away from home, visiting my sister (and new niece!!!) for Christmas and here I am working away... :)
Good luck!!! and how awesome for your son
Working overseas
If you worked for an American company say in Scotland all well and good, transcribing for U.S hospitals and the work contained in the U.S., BUT if you transcribe for British or European hospitals/doctors, the work contained in those countries, it is VERY difficult. The spelling is very different. I was born and raised in Britain x25 years and when I started working here in the U.S. I found the American spelling very difficult - although less characters per word. British spelling adds a lot. Just a thought! Plus the accents are hard too. They don't say period, they say full stop which sometimes sounds like part of the text, but you have probably already experienced that. Good luck, it sounds wonderful.
They did not contract an overseas
company. The company they contracted with was sending it overseas.
Just because the records go overseas
does not mean the laws are being broken. Granted, they cannot be enforced, however, if the company doing the overseas transcription does not follow the guidelines, then something might be done. However, unless there are specific cases, you cannot say laws are being broken. I am sure their contracts state they have to abide by our laws.
It is more of a risk overseas. SM
If some company operating from an offshore country with a "store front" in the U.S., decides to retaliate against Dr. John Doe, and spreads 50 of his patient's medical records over the internet, how easy do you think it would be to track down the so-called contact (whose name cannot even be pronounced) for the transcription company who is nowhere to be found? HIPAA has now power to fine, penalize, or imprison any overseas operation because the HIPAA laws only apply here in the United States. IMO, there is a substantial safety risk in having medical records leave the country.
working overseas
Can a U.S. citizen travel while working for an American transcription company, as long as they have a legal U.S. residence? Is there any legal reason not to hire someone who likes to travel and visit foreign countries while they work? I'm not talking about off-shoring.
To the poster that said the parents just let them go to
party and drink was sad.
My parents "spared the rod" and I'm now (sm)
a self-sufficient, responsible, mature adult, furthering my education, handling my responsibilities, and not calling home begging my parents for money. So just because some parents "spare the rod" doesn't mean their kids are going to turn out to be spoiled little bloodsuckers the rest of their lives. There are other ways to discipline kids without spanking. Yes, some kids need a good spanking once in a while, IMHO, but there are other forms of discipline that are equally as effective. Just my opinion.
Up to the parents, but they dont do it
Hey, I feel like this, the parents have the only ones who have a right to spank or otherwise discipline kids
I don't have issues with my parents are they are
both deceased, but I have "disowned" all my brothers and sisters and nieces and nephews. I grew up believing I was the black sheep of the family and maybe I am, but their lives are so screwed up and I never heard from them unless they needed something and there was lots of bitterness and anger about various events - mainly my parent's death. The only way I was able to deal with the issues was to disown them. I was not interested in making things better because they aren't willing to make an effort and I just don't have time for that.
My oldest sister hated my mom and was very ugly to her. My mom did so much for her. All I heard was what a lowsy mother she was. Well, my sister's daughter had a baby and gave it away, did drugs big time, drinking big time, has lived with several guys. Her son is gay and can't hold a job, has had so many wrecks he has lost his license twice that I know of. They just keep buying him vehicles very time he wrecks one. He can barely make a move without having to ask mommy, is a druggie/drinker/liar. Only my sister can't see all of this. We all make mistakes and I don't claim to be a perfect parent, but.....
My parents are retired and
do very well on their savings. It's called preparation. People make their own choices. If you don't PREPARE and do not take RESPONSIBILITY, you will eventually be in such a sad situation. It's not anyone's fault but their own for making poor decisions or failing to make better ones.
Morally, yes - I think other aid should become available to the "mom and pop" situation you are talking about but not reporting and paying taxes on income? No. That is wrong, period.
My boys were taught to pay taxes on their incomes from various jobs. They paid taxes and they paid tithes on it, no matter what it was.
It's called DOING THE RIGHT THING...which seems to be a forgotten concept among the older ones and a brand-spanking new concept among the young ones.
Tax evasion, dear, is ANYONE who fails to report appropriately. They may spend the bulk of money going after big bucks tax evaders but the crime is still the same. It is dishonest and it cheats every loyal, law-abiding citizen.
It doesn't matter if the job is easy or or not (i.e., your reference to house cleaning not being easy). THat has nothing to do with whether a person deserves to report/pay taxes on their income or not.
I am a few miles away from there. SIL parents
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