All Things Transcription

Well, it seems I was a little premature in deserting my soapbox labeled “outsourcing.” On 6/13/09, I posted an article about outsourcing. That article was in response to an incident involving a Pakistani medical transcriptionist and her attempt to extort a large amount of money by threatening to put private medical records out on the internet. This article is in response to an article that was published in both the Economic Times and The Daily Mail in regards to a British TV station that purchased a large number of medical records from some Indian men that were outsourced from the London Clinic. The London Clinic is a well-regarded private clinic in London. Some National Health hospitals also outsource their records to Indian companies as well. Please, read the articles. You really need to see the reason these guys were selling the records.

Follow up:

As a medical transcriptionist and a healthcare consumer, I have a huge problem with the outsourcing of medical records. Like most industries, MTs are having a lot of problems finding work. However, it’s not all due to the current economic climate. The jobs in this sector have been bleeding out for a while now due to outsourcing. That is not the only issue.

To begin with let’s talk about the quality of the work being done by Indian transcriptionists, shall we? On 9/01/09, I posted an article entitled “Bloopers From Far, Far Away.” Now, this was a humorous look at some instances of mistakes made in transcription by Indian transcriptionists. However, it is not really funny when you put it in the context of a patient’s medical record. If they are actually making these kinds of mistakes in grammar and terminology, what about mistakes in drug names and dosages? Those types of things can be really important to patient care. In fact, although figures differ somewhat, the figures run into the thousands about drug mistakes killing patients each year. Do you really want some Indian transcriptionist dealing with your information when you can’t even decipher what some of them are trying to say when they are writing about even the simplest subjects?

Truly, take a look at the information about some replies in response to my comments on a medical transcription site that I made regarding outsourcing and HIPAA laws. I wasn’t really shocked by the response in general, but I was awed by the slaughter of the English language in the responses. I was so awed in fact, that I edited the article to include them. Please note the question I posed at the end of the article.

As I mentioned in the article about the Dell situation here in North Carolina, I really don’t care about the state of the countries these jobs are going to. In this case, I mean I really don’t care. I care about getting US citizens back to work transcribing US medical records. I do not want these incompetent people transcribing my medical records. Their skills are sub par, no matter what their websites say.

Now let’s move on to another problem with this. Not only is outsourcing medical transcription a bad idea based on the skill level of these folks, it is also a bad idea in relation to the HIPAA laws here in the US. There is no such animal in India. That isn’t to say that there are not violations of those laws here. Many healthcare workers have lost their jobs in situations regarding celebrity medical records. The most recent examples off the top of my head are George Clooney and that crazy woman, Octomom. (She matters so little to me I do not remember her name.) Folks were fired just for accessing these records when they were not directly involved in their care.

However, these men were selling British patient records not only to make money from that sale, but to allow other people to further violate their privacy to make even more money from them. The UK has similar measures in place regarding privacy in healthcare. (Again, read the articles.) Suddenly, your email runneth over with yet more spam. Guess what, some people read these ads and actually make purchases from them. That’s why the spammers spam. There really is money in it.

Finally, let’s move on to a subject that is still important, but only to medical transcriptionists. Money again, but this time we’re talking about salaries. Indian transcriptionists will work for anything from .01 cents per line to .03 cents per line. This is starting to change a little bit because, of course, the more people get the more they want sometimes. This change will not come about fast enough to prevent the trend that US transcriptionists are facing now. If you talk to some MTs that have been working for several years, you will hear a lot of them say that they are making less money now then they did when they started. Not all of them, but enough to influence the starting salaries on new MTs. Now, if we are realistic, we do not expect to earn top salaries as newbies. However, it would be nice if, after training for this profession, you could make a living wage at it.

Again, this is not always the case. Some MTSOs are still paying some pretty good wages. There are many of them that are not. The industry is changing. Voice recognition is one of the top reasons that salaries are dropping. Once again, there are many MTs that are making pretty good money doing VR editing. Some of them love it and are making more doing that than straight transcription. Some of them do not enjoy it and VR is making their salaries drop. It depends on who is paying them.

If you refer back to the figures that Indian transcriptionists are making, you need to know that some companies are offering MTs salaries as low as .04 and .05 cents per line. That's pretty close, isn't it? Well, that’s not a living wage, my friend. It is especially not a living wage when you are a newbie starting out. I know that some of these people are making below minimum wage in some cases and questioning why they went into this in the first place.

Hmmm, did I say this only matters to MTs? Wrong! It produces the same results regarding the economy that lowered salaries in any other profession produce. People make less money, they have less buying power. Less buying power means that the people trying to sell their products sell less of them. Their business suffers so they lay off people, outsource jobs, or close completely. That does not help the state of the economy much, now does it?

So I want to say to physicians and hospitals everywhere that are outsourcing their patient’s medical records, "Please, stop doing this!" Take the time to find out if the MTSO you are using does this. If you have a contract with them, finish it and tell them “No, thanks,” next time; do not continue to use their services. Make sure you tell them why.

People, the next time you visit your doctor, ask if your records are being transcribed by someone in another country. If they say “yes,” tell them this is unacceptable and you do not want your records being sent to a country that has no patient privacy laws. If you do not take the time to consider this issue and do something about it, the next time you check your email you may find an ad trying to sell you a drug related to your condition that you really didn’t want anyone to know about. Then it is too late. Your privacy has already been violated.