I think I've made it pretty clear where I stand on the outsourcing American jobs overseas. I have been keeping a list of medical transcription services who offshore work. This list is a work in progress and I will continue to add to it whenever I come across another service that offshores.
Here is my list so far. If you would like to add to the list, please do so by emailing me or posting a comment.
Focus Infomatics
Medquist
Heartland
OSI (Outsourcing Solutions Inc.)
Transcend Solutions
MDI-Florida (Bought by Transcend)
SPI Information
Spheris
Shapin Medical Transcription
All Type Transcription
Medware
ATSI
CyMed (Bought by SPI)
CBay
eSmartmed
Transform
ProMedScribe
Transcription Matchmaker (Technically not a transcription service, but advocates outsourcing overseas by placing MTs with services that do offshore, so they make the list!)
It's time we made it very clear that American jobs should stay in America. Not only does this issue affect American medical transcriptionists, but it affects the foreign transcriptionists who work for slave wages. These companies are sweat shops. Remember all the hoopla not too long ago about Wal-Mart and other major discount chains selling clothes that were made in sweat shops in Mexico, India, Asia, etc.? This is the same thing! Doctor's offices, hospitals, and clinics are unknowingly paying for reports that were transcribed in a sweat shop in India or the Phillipines. Let's make them aware. Healthcare facilities should only outsource to and medical transcriptionists should only accept positions with American-owned, American-based, and American-employee only services!
Wednesday, December 13, 2006
Tuesday, December 12, 2006
QA Gone Bad
Quality Assurance – it sounds so important and it is. Mistakes in a medical report can adversely affect patient care. I have to wonder, though, how adversely affected was the patient when I forgot my comma before the conjunction but? How adversely affected was the patient when I spelled out two instead of using the numeral 2? And what about the compound modifier where I forgot my hyphen? Gosh, I sure hope that patient survived his hospital stay!
I have nothing against the medical editor. Heck, I've been one. Still am one, if you want to get technical. I consider medical editing a vital part of the transcriptionist's job. We all make mistakes and as such we do need a system of checks and balances in place. I'm all for checks and balances. I want to know when I've made a mistake. I want to know how I can correct it so I don't make that mistake again, but who provides the checks and balances for the QA department?
The QA department is a wonderful learning tool for the medical transcriptionist. Problem is, there are some editors who don't view themselves a resource. They think of themselves as the medical transcription expert. Some don't know what they are talking about and simply exist to fill in the blanks, right or wrong, and send the report on as fast as possible. Some refuse to believe they make mistakes and refuse to acknowledge their mistakes when made. Some take sadistic pleasure in finding errors in reports no matter how minor the error, as if it were a game of cat and mouse.
The problem with QA is that it has ceased being a resource and has become a rival with the MTs. It is us versus them. When did this war between QA and MT begin? It began with the shift from hourly pay to production based pay for MTs. Quality is held over our heads like a guillotine - anything less than 98% and the guillotine blade drops and cuts off our paychecks, our benefits, our livelihood.
Don't get me wrong. I fully believe that quality is very important - more important than quantity. The problem is quality is extremely subjective in this business. Just ask the AAMT! They supposedly set the standard with the Book of Style and then RESET the standard with their second edition. Then figure in the personal preferences of the QA editor, the personal preferences of the client, and the personal preferences of the service owner, and it's enough to give the average medical transcriptionist an aneurysm trying to keep it all straight. The plan, I guess, is to keep changing the rules on us so they can keep dropping that guillotine blade, chopping at our pay little by little until we simply type for free because we've been penalized for our mistakes.
What is the solution? I'm not sure, but maybe it should start with the medical editor remembering that they were medical transcriptionists once, remembering that they are human and fallible, and remembering that their preference isn't necessarily the right way to do things, but just simply ONE of the right ways. The medical editor, who expects us to take their criticism gracefully, should just as gracefully take our criticism. Accept when your wrong and say "I'm wrong!" Don't let your ego get in the way. Remember, you are here for US, we are not here for you. Your job depends on us, ours does not depend on yours.
Finally, let's tell the AAMT to take a hike and take their Book of Style with them. All they have done for us is muddy up the waters. We end up doing it the way the client wants in the end anyway.
We are all part of the same team. It's time we started acting like it.
I have nothing against the medical editor. Heck, I've been one. Still am one, if you want to get technical. I consider medical editing a vital part of the transcriptionist's job. We all make mistakes and as such we do need a system of checks and balances in place. I'm all for checks and balances. I want to know when I've made a mistake. I want to know how I can correct it so I don't make that mistake again, but who provides the checks and balances for the QA department?
The QA department is a wonderful learning tool for the medical transcriptionist. Problem is, there are some editors who don't view themselves a resource. They think of themselves as the medical transcription expert. Some don't know what they are talking about and simply exist to fill in the blanks, right or wrong, and send the report on as fast as possible. Some refuse to believe they make mistakes and refuse to acknowledge their mistakes when made. Some take sadistic pleasure in finding errors in reports no matter how minor the error, as if it were a game of cat and mouse.
The problem with QA is that it has ceased being a resource and has become a rival with the MTs. It is us versus them. When did this war between QA and MT begin? It began with the shift from hourly pay to production based pay for MTs. Quality is held over our heads like a guillotine - anything less than 98% and the guillotine blade drops and cuts off our paychecks, our benefits, our livelihood.
Don't get me wrong. I fully believe that quality is very important - more important than quantity. The problem is quality is extremely subjective in this business. Just ask the AAMT! They supposedly set the standard with the Book of Style and then RESET the standard with their second edition. Then figure in the personal preferences of the QA editor, the personal preferences of the client, and the personal preferences of the service owner, and it's enough to give the average medical transcriptionist an aneurysm trying to keep it all straight. The plan, I guess, is to keep changing the rules on us so they can keep dropping that guillotine blade, chopping at our pay little by little until we simply type for free because we've been penalized for our mistakes.
What is the solution? I'm not sure, but maybe it should start with the medical editor remembering that they were medical transcriptionists once, remembering that they are human and fallible, and remembering that their preference isn't necessarily the right way to do things, but just simply ONE of the right ways. The medical editor, who expects us to take their criticism gracefully, should just as gracefully take our criticism. Accept when your wrong and say "I'm wrong!" Don't let your ego get in the way. Remember, you are here for US, we are not here for you. Your job depends on us, ours does not depend on yours.
Finally, let's tell the AAMT to take a hike and take their Book of Style with them. All they have done for us is muddy up the waters. We end up doing it the way the client wants in the end anyway.
We are all part of the same team. It's time we started acting like it.
Monday, December 11, 2006
The American MT
The American MT is usually a working mother who manages her household, children, and husband while working full time from her home office. She works piecemeal for pennies per line. She is expected to produce at least 1200 lines in an 8 hour day. She is expected to be well versed in medical terminology, human anatomy and physiology, pharmacology, and the English rules of grammar, punctuation, and spelling. The American MT is usually an independent contractor receiving no healthcare benefits. The American MT does all of this for an average of 8 cents per line.
The American MT is now losing her job to overseas outsourcing. Many medical transcription services are now sending more than half of their U.S. based transcription accounts to India and Pakistan where it is typed by English-as-a-second-language "medical transcriptionists" who work for 4 cents per line or less. The work of these overseas transcriptionist usually require extensive editing before actually becoming part of the American patient's medical record. Who edits and corrects these reports? The American MT who is now expected to edit and correct these reports for 4 cents per line or less.
Medical transcription has steadily declined since I began as an MT almost 20 years ago. Of course, in those days working at home was merely a pipe dream realized only by transcriptionists willing to pick up standard size cassette tapes from doctors offices, transcribe and print reports at home, and hand deliver them back to the office. Therefore, the majority of MTs worked in offices making $12 an hour which at that time was a very good wage. We were considered medical professionals with a very distinct and specialized skill.
With the fast pace of the medical field came an emphasis on production and faster turnaround times, but MTs were compensated for their efforts. Still making our hourly wage, we were offered incentive bonuses that equaled 4 to 5 cents per line for production of over 1000 lines a day. We were making very good money, were treated like professionals, and felt like we were making a contribution to the care of the patient.
Eventually, the emphasis on production turned into an obsession and with the internet came the realization that medical reports could be typed and sent electronically and turnaround times became shorter. With the digital boom, came the realization that everything could be done electronically through our personal computers and MTs could work at home without the hassle of picking up tapes and delivering work. We virtually never had to leave our homes.
Medical transcriptionists gradually lost their face. We became words on a screen, an email address, and finally machines much like the computers we type on. When we ceased to be "real" people, so ceased the hourly wage. We became machines paid only for what we put out. And just like with all technology, we became outdated, nearly obsolete. We've been forced to adapt, accept a humilatingly low per line rate. We've been forced to compete for our jobs with workers who live in poverty and are willing to take almost anything and call it a wage. We are being told that all that knowledge we've worked so hard to build up and keep up has been for nothing. It is worth nothing. No, it is worth about 8 cents per line.
Well, I think it is time to show our faces again. For too long medical transcriptiont has been considered the red-headed stepchild of the Health Information Management department, too easy to forget, and even easier to get rid by sending the work out. By sending the transcription work out, hospitals got rid of the MTs, and freed up more office space for more "important jobs." For too long the medical transcription service owners have treated us like slaves, cracking the whip over us and saying "faster, faster!" We need to make our presence felt by refusing to accept the peanuts they throw at us. We need to boycott the services who send transcription overseas. We need to let our government know that a global economy benefits only the greedy and does nothing for the little guy or girl.
I started this blog to post my thoughts, my rants, and my suggestions for my profession, medical transcription. I plan to rock the boat of medical transcription and in the next few weeks I will be posting a list of medical transcription services that outsource overseas. I encourage everyone who reads my blog to post comments, suggestions, or your rants. We are in this together. If you don't agree with me, let me know. If you do agree with me, let me know.
The American medical transcription industry has become a sweat shop in a third-world country, only the sweat shop is right here in American, in our own homes.
If you'd like to contribute to my boycott list of MTSO's, email me or post a comment!
The American MT is now losing her job to overseas outsourcing. Many medical transcription services are now sending more than half of their U.S. based transcription accounts to India and Pakistan where it is typed by English-as-a-second-language "medical transcriptionists" who work for 4 cents per line or less. The work of these overseas transcriptionist usually require extensive editing before actually becoming part of the American patient's medical record. Who edits and corrects these reports? The American MT who is now expected to edit and correct these reports for 4 cents per line or less.
Medical transcription has steadily declined since I began as an MT almost 20 years ago. Of course, in those days working at home was merely a pipe dream realized only by transcriptionists willing to pick up standard size cassette tapes from doctors offices, transcribe and print reports at home, and hand deliver them back to the office. Therefore, the majority of MTs worked in offices making $12 an hour which at that time was a very good wage. We were considered medical professionals with a very distinct and specialized skill.
With the fast pace of the medical field came an emphasis on production and faster turnaround times, but MTs were compensated for their efforts. Still making our hourly wage, we were offered incentive bonuses that equaled 4 to 5 cents per line for production of over 1000 lines a day. We were making very good money, were treated like professionals, and felt like we were making a contribution to the care of the patient.
Eventually, the emphasis on production turned into an obsession and with the internet came the realization that medical reports could be typed and sent electronically and turnaround times became shorter. With the digital boom, came the realization that everything could be done electronically through our personal computers and MTs could work at home without the hassle of picking up tapes and delivering work. We virtually never had to leave our homes.
Medical transcriptionists gradually lost their face. We became words on a screen, an email address, and finally machines much like the computers we type on. When we ceased to be "real" people, so ceased the hourly wage. We became machines paid only for what we put out. And just like with all technology, we became outdated, nearly obsolete. We've been forced to adapt, accept a humilatingly low per line rate. We've been forced to compete for our jobs with workers who live in poverty and are willing to take almost anything and call it a wage. We are being told that all that knowledge we've worked so hard to build up and keep up has been for nothing. It is worth nothing. No, it is worth about 8 cents per line.
Well, I think it is time to show our faces again. For too long medical transcriptiont has been considered the red-headed stepchild of the Health Information Management department, too easy to forget, and even easier to get rid by sending the work out. By sending the transcription work out, hospitals got rid of the MTs, and freed up more office space for more "important jobs." For too long the medical transcription service owners have treated us like slaves, cracking the whip over us and saying "faster, faster!" We need to make our presence felt by refusing to accept the peanuts they throw at us. We need to boycott the services who send transcription overseas. We need to let our government know that a global economy benefits only the greedy and does nothing for the little guy or girl.
I started this blog to post my thoughts, my rants, and my suggestions for my profession, medical transcription. I plan to rock the boat of medical transcription and in the next few weeks I will be posting a list of medical transcription services that outsource overseas. I encourage everyone who reads my blog to post comments, suggestions, or your rants. We are in this together. If you don't agree with me, let me know. If you do agree with me, let me know.
The American medical transcription industry has become a sweat shop in a third-world country, only the sweat shop is right here in American, in our own homes.
If you'd like to contribute to my boycott list of MTSO's, email me or post a comment!
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