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company before.  Have always had my own clients but lost 3 last year so went with a company.    Has anyony ever had a pay per line decrease for not meeting the required daily limit?  I started at 10 line for 1600 lpd.  Just was told that I dropped to 1345 and would now be making 9 per line.  Jobs were extremely low from Nov-now and there were just no jobs to be had.  Is this normal procedure?

When staying in a hotel with a desk and internet connection to work, where do you put your keyboard?  Anyone have any suggestion for a portable table to use that is the right level.  The desks are too high.

Thanks!

It seems like there is more job security in court reporting -- and much better money.  I'm really thinking of getting out of medical transcription... just so tired of getting paid less and less to do the same job.  I was just laid off a great in-house job and I am really wondering if transcription is right for me anymore.  

To give a brief summary, I developed technical problems after my ISP decided to do some upgrades 2 weeks ago.  The problems resulted in my getting kicked off line every few minutes.  Upon contacting technical support I found myself consistently running into people that had no English comprehension skills and their responses had nothing to do with my problem or how to fix it.   I found another ISP that would provide the services I needed and signed up with them 3 days ago, then called my main one today and told them they were fired because of their non-US based labor who couldn't help anyone.  The lady I spoke with apologized and said this was an experiment they were doing with outsourcing technical support, but I told her that their experiment cost them a customer who had been with them for almost 4 years. 

I've fired off e-mails to everyone in management that I could get ahold of telling them exactly why they were fired, and sharing the idiotic responses I received on my technical assistance requests. 

It occurred to me that it may be something we mention when writing/calling our government. 

I know that when Levi Strauss closed their factory in Roswell, NM, and sent it down to Mexico (thanks, NAFTA), they gave their workers money to retrain in a new profession.

Surely this is something that can be fought for.  We know darned well the MTSO's won't take money out of their own pocket to do this, but there was/is a government program called TAA which is supposed to help people who have lost work as a result of imports.  I think a case can be made for medical records transcribed overseas as qualifying as "imports". 

I found an old document on line at http://www.edd.ca.gov/pdf_pub_ctr/de8714x.pdf which describes that 3 or more workers who have been affected by imports can petition for federal money for assistance and retraining.  There's also JTPA/WIA which established one-stop career centers and I believe being laid off because of work being sent offshore (or just laid off, period) would qualify people for this program.

There's also this article, which I included a part of, that is talking about IT workers for Computer Sciences Corp (my brother happens to work for them and has survived the layoffs) filing suit....

*The department has long held that programmers who've lost jobs to cheaper, foreign workers aren't eligible for the TAA program because their employers, or employer's customers, are not importing a physical good in the same way as, say, steel manufacturers. A number of federal and state lawmakers have introduced bills that would automatically grant eligibility under the act to IT workers and other white collar professionals, but none has become law.

The labor department initially said that although CSC moved production of its Vantage-One insurance software from East Hartford to CSC India, the software was not an imported "article" as defined by the act. In a lawsuit, the workers asked the U.S. Court of International Trade to overturn the department's ruling. In January, trade court judge Nicholas Tsoucalas ordered the department to revisit the case, noting that, "Labor's interpretation of the law, that software code must be embodied on a physical medium to be an article under the Trade Act, is arbitrary and capricious."

In a Federal Register note published April 11, the Labor Department conceded the point and ruled that the four CSC workers would be eligible to apply for TAA assistance. In ruling, the department said it would henceforth look upon software, whether shipped into the U.S. on a disc or transmitted into the country via telecommunications networks, as a physical product.

Software and similar intangible goods that would have been considered articles for the purposes of the Trade Act if embodied in a physical medium will now be considered articles regardless of their method of transfer," the department wrote.*

Something to think about.

Also, I'm pretty sure we've been far OVERestimating how much money offshore people are paid for transcription.  Their companies might get 1 cent a line after it goes through 3 or 4 edits, but I'm pretty sure the person typing the report and mangling the English is paid more like 1/5 cent per line, which is still pretty good money for them.  My math is based on there being 40 rupees to a dollar, and 1/40 of 8 cents per line is 1/5 cent.  There was that article quoted on the company board from Manilla where they were gloating that their workers got $1 to $2 an hour and, if they're required to transcribe 1200 lines a day, that comes to 1/10 cent per line.  But that was back in 2005.

Back to the 1/5 cent.  So if the report goes through 3 or 4 edits, each getting paid their 1/5, then the Indian company keeps the 2 cents per line which is left over and our dear old MTSO here in the States charges the hospital what...11 cents?..pays our US MT 3 or 4 cents to edit.  So, 3 cents/line to the offshore company, 4 cents/line to our US editor, and the MTSO still pockets the 4 cents/line left over?  Why do you think we're seeing 7 cents/line more and more often as the going rate of pay?

Well, just some things to think about - I get my best ideas late, late at night!

Does anyone have experience with CR training?  Anyone made the transition from MT to CR, or the other way around?  I am looking into this as an alternative to MT.  My chief regret is that it is rather late in life for me to invest in expensive/lengthy training.  I should have seen the writing on the wall long before this, as far as MT is concerned. 

My post on a court reporter board met with thundering disinterest...not a single reply.  Would appreciate input on this if anyone has first or even secondhand experience.

Chili, salad, cornbread. 

Please see article below that was published in 2003. Does anybody know if the law it mentions was ever passed in California?

Following news that a Pakistani medical transcriber threatened to post UCSF Medical Center patient records online unless she received more money,

a state senator said she will introduce legislation barring all California hospitals from allowing medical data to leave the country.

Sen. Liz Figueroa, D-Fremont, said she will introduce the bill in January when the state Senate returns for its next regular session. (A special session on financial matters is likely before then.)

"California already has the strongest medical-privacy laws in the nation, " Figueroa told me. "But not strong enough. There's always something you didn't anticipate."

What she and other framers of the state's medical-privacy laws, which prohibit the sharing of medical information unless for clear medical purposes, didn't see coming is the explosive growth of the $20 billion medical- transcription industry.

U.S. hospitals have such a huge need for help transcribing doctors' dictated notes into written form that the work is routinely farmed out to private transcribers throughout the country. Those transcribers, in turn, frequently subcontract with other transcribers.

In the case of UCSF Medical Center, three separate subcontractors were involved in handling the facility's records. The last link in the chain was a woman in Karachi, Pakistan, who sent an e-mail to UCSF earlier this month demanding help in resolving a financial dispute with the Texas man who'd hired her.

The Pakistani transcriber said she'd post UCSF's files on the Internet unless the medical center assisted her. She backed up her threat by attaching actual UCSF patient records to her message.

This was the first time an overseas transcriber had used confidential records to threaten a U.S. medical institution. The transcriber withdrew her threat only after receiving hundreds of dollars from another subcontractor in the case.

Figueroa said her bill would prohibit anyone possessing information involving California patients from sending that information abroad.

State hospitals would likely be barred from outsourcing transcription work unless they could guarantee that all related files remain within the country -- a move that would make hospitals accountable for any subcontracting that ensues.

"We're not banning the practice of overseas workers doing transcription," Figueroa said. "But we can regulate the practice of medicine within California. "

The law, at least on the health care front, may be on her side.

In most instances, federal law would trump state law, and the federal Health Insurance Portability and Accountability Act of 1996 outlines rules for safeguarding medical data. Anyone doing transcription work for a U.S. hospital would be required to uphold HIPAA standards, although the law is virtually unenforceable overseas.

A unique aspect of HIPAA, though, is a provision that if a state adopts more stringent restrictions, state law will prevail.

"If there were a statute that no health care information in California could be disclosed outside the country, HIPAA wouldn't have a problem with that," said Paul Smith, a San Francisco attorney specializing in health care issues.

"The state has a clear interest in protecting health information," he added. "This would seem a legitimate exercise of state regulatory authority."

At the same time, though, Matthew Nakachi, a San Francisco lawyer who specializes in trade issues, said it's unclear how the proposed legislation would square with federal laws related to commerce. A hospital might argue, for example, that it has a right to do business with whomever it pleases.

"If California decides to do this," Nakachi said, "it would probably go into the courts and take years to fall out."

For her part, Figueroa expects the health care industry to fight the legislation, just as the banking industry opposed state restrictions on the use of customers' information. But she thinks that in light of the public's increased sensitivity toward privacy matters, her bill would eventually pass.

"The interesting thing will be to see where our new governor stands on privacy issues," Figueroa said. "At this point, we don't know."

Mystery woman: The Pakistani transcriber at the center of the case involving UCSF is still something of a mystery.

In her e-mail to UC officials, she identified herself as Lubna Baloch, "a medical doctor by profession." Beyond that, little is known of her.

In May, however, an interesting little exchange occurred on MT Stars, an online network for medical transcribers. Baloch, using the same e-mail address she used in her threatening message to UCSF, posted her resume at the site in hopes of attracting work as a subcontractor.

Sheri Steadman, who runs MT Stars, of Phoenix, said she's against U.S. transcription work going abroad and routinely deletes postings from overseas transcribers. In Baloch's case, she said she was concerned by the vagueness of Baloch's resume, especially as to her whereabouts.

Steadman wrote to Baloch to say that MT Stars is only for U.S. job seekers.

"I am US based," Baloch replied.

"Not enough info," Steadman responded. "Where?"

"Santa Monica, LA," Baloch wrote back.

For Steadman, this wasn't a very good answer.

"Santa Monica isn't in Los Angeles and it's not in Louisiana," she told me. "It was pretty clear that Baloch wasn't in the country."

Steadman confronted Baloch with her suspicion. Baloch never wrote back.

"She was trying to gain work in any way, shape or form," Steadman said. "She was trying to sucker U.S. medical-transcription services into sending her business."

It didn't work that time. A few months later, though, probably using a different online service, Baloch was more successful in her efforts.

That would turn out to be a very dark day for UCSF.

David Lazarus' column appears Wednesdays, Fridays and Sundays. He also can be seen regularly on KTVU's "Mornings on 2." Send tips or feedback to dlazarus@sfchronicle.com.

If you had the choice between a shift lead type position at somewhere between $14 to $16 an hour or production on an account with a lot of normals.  The shift lead gets you experience editing, supervising, etc., but the production account you are just transcribing. You can make a lot more money at the production job, but the shift lead will get you started in a more management type of position, which would you choose? You will be stuck at that hourly wage with the lead position, but there are possiblities of moving up with the company.  But, the money on the other account is quite good, as there are a lot of free lines.  I am just so confused and have to make a decision, as I cannot work them both at the same time.   Any suggestions, comments, or feedback?  Thanks.

I have been an IC working for other transcription companies and doing several pick up/delivery one-doctor practice freelancing work for many years.  This summer I want to kick things up several notches by getting some bigger offices to send me their work and enlisting the assistance of IC MTs.

I am getting ready to do some serious marketing, but if an office ultimately decides to switch over to my company I am not sure how to proceed with the transfer and setup.  

Can anyone recommend a good TASP/FTP/other software to use that charges reasonable rates by amount of use with no big up front costs?  I prefer it to work with Stedman's Smartype expander, which does work with MS Word. 

What part of the setup would the office be expected to pay, such as the dictation hardware/software or would I pay for that as part of the transcription suite and pass it on to them in billing? 

How do you work inputting physician information and how do you set up a patient demographic automatic feed or even know if this is possible with the technology they have at their office?  If demographic feed is not possible automatically, how do you arrange to get demographics from them...by daily fax?

Christine

Could anyone tell me how to start an English ivy?  I have a plant from my grandmother that both my sisters want a start from.  I am lucky it has still survived with me, but is quite healthy looking and grows like crazy!  How can I make a start from this plant?

Thanks!

Hello,

I've had a Bytescribe pedal for about seven years now.  I think it might be "going bad."  I have two questions.  Has anyone experienced your pedal taking a few seconds to play after you've pressed play, like a lag?  It also seems to go back further than I have it set for rewind when I take my foot off.  These are new happenings with this pedal, so I'm wondering if this is a sign that it might be time to get a new one. 

Next question is can I use Express Scribe with this pedal that I have now, and does any have any opinions on Express Scribe?  If I do have to buy another pedal, I don't have to buy a specific pedal as long as I have the correct software to play the files, is this right?  There are so many software and pedal options out there, and money is tight, so I don't want to leap on something and it not be what I need.  I also don't want my pedal to break down in the middle of working.

Thank you in advance!

With the holiday commercials in full swing, I keep seeing the I-Pen commercial.  I forget the name brand, and it may be called something else, but I am talking about the pen that works like a mouse and a pen where you write with the pen and then transfer it to your computer.  Has anyone thought about or even tried to use the I-Pen for transcription?  I'm wondering if it would give the wrists a break to be using a different input device than the keyboard.  Any ideas would be appreciated.  While I'm talking about productivity, has anyone become more productive using Dragon Speaking Naturally? 

TIA!

What is the most popular or should I say proper way of setting up a heading for an operative report, order, spaces, tabs etc?  I know the doctor's way is always right but some doctors do not give enough information and some give too much.  Just wondering if you tab over diagnosis and align or place list under headings.  And spaces after each heading.

DATE OF PROCEDURE:

PREOPERATIVE DIAGNOSIS:

POSTOPERATIVE DIAGNOSIS:

PROCEDURE PERFORMED:

SURGEON:

ASSISTANT:

COMPLICATIONS:

ESTIMATED BLOOD LOSS:

FINDINGS:

PROCEDURE IN DETAIL: 

A doctor's office is using Informatix program for their electronic record program. Does any IC use this program and how is the pay rate determined? Thanks!

I have 15 years of experience at home transcribing for family practice and currently work part-time at home as an IC.  I would like to keep the account I have but perhaps add another to bump up my hours a bit.  Almost every job I see posted requires acute care experience.  Does anyone have input as to whether it is possible to obtain work without the acute care experience?  I love the work I have done.  Yes, it is probably easier than ESL or acute care but it does require attention to detail and accuracy just like everything else. 

Please advise what someone in my position should do.  I am sure these jobs do not appreciate people posting without the experience listed so I have not done so. 

My current work is local and is on tapes but I am willing to learn a new system or possibly obtain different equipment.  Any input will be appreciated!  Thanks in advance.

Doc was dictating and beeper went off and ASR trascribed it as "she, she, she, she"!!

If I double-click on the EXText icon first, it will not load Word and I get a "dump" message. If I load Word manually, the EXText program doesn't respond. However, if I load Word first, EXText loads just fine, I TransNet also connects, but none of the EXText keyboard commands are working.

If anyone else had this problem, how did you solve it?