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Serving Over 20,000 US Medical Transcriptionists

Actually, the article was out of AdvanceHealth Mag, and

Posted By: MTbucket on 2005-10-26
In Reply to: what is that suppose to mean sm - long time MQr

on the cover is how American companies are training blind people to type in braille, in INDIA, like all about how they are helping overseas...

I am going to ask they stop sending me that magazine anymore, because every issue is more and more about AAMT pushing for the certs, telling American MTs we need to "keep up with the changes in technology," although no one ever says how, and what technology, etc., not even when I have e-mailed the great Ms. Tessier, et al.

they also are pushing the mobile point-of-service devices, which will be standardized text, no more free-form dictation they say by 2010, and really support AAMT and overseas outsourcing, in my opinion...

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51, trained on the job 26 years ago,

I'm 57, learned on the job 28 years ago.  I can out transcribe people half my age.  I have no arthritis, no carpal tunnel syndrome, no fibromyalgia and only occasionally get a crick in my neck from my job.   My QA score is 100%, has been for years, and I type 90 wpm, transcribe 200 lph at least and that's on an account that is almost all ESL.   I could do this job another 20 or 30 years if I wanted to (barring sickness or accident that could happen at any age).

As far as the AAMT rep saying younger people are not lining up for this job - have they done anything to market MT to younger people?  I'm sure a lot of high school kids or even community college people would be interested in this work if they were educated about it. 

One last thought - the people they are offshoring this work to in India, Pakistan, Trinidad, the Philippines, are not spring chickens!!! 

I for one am sick of AAMT trying to justify their greediness by blaming their victims, the US MTs.


There was an article in the news online that said it has spread to 3 more countries through ducks and geese and that it's only a matter of time before someone carries it here.
one article
Boy do you have it wrong, we have both stated our sources about googliNG pet food ingedredients, and if you choose not too, that is your problem, I am sorry for your pets, but you need to read up, not one article but thousands. I hope you check your facts, sincerely,
Can anyone tell me where this article was originally published? I forwarded it to a friend who asked... I wasn't able to tell her.


Try pasting this in your browser - it's an article from the latest Advance magazine called A New Set of Shoes for MTs!

I saw that article too

My first thoughts were like you, just another way to cheat us.  But then when I considered the possibility (trying to be kind here) that some companies are not giving us full credit for every character typed (as in perhaps counting 3 Keystrokes as 1 as has been mentioned here before), then even if they didn't pay us for spaces, we might make more in such a situation if they had to pay us for every single black character.  They can't hide that from us!  In other words, they would not be able to manipulate the line counting as much as I think they are doing now.  Now how much they would pay us for every black character might differ from company to company, but I think this might work in our favor overall.  If pay based on production is better for us than an hourly wage, we need to find what works most to our advantage.   And with the difference there is out there now in line counts from one company to another, pay by character might help us. 

And yes, even if it is a template, every character should still count as well as spaces, returns, tabs, demographic insertion, and also for our knowledge which comes into play every single time we keep the dictators from sounding like idiots and/or catching their mistakes.  Let's face it -- we do at least basic editing too, folks.  We are NOT just typists!  We should be reimbursed for our knowledge as well as production.   We're not donating our time to a charity here.  This is a way of making a living.  We should be paid for whatever we do for the company we work for, just like in any other job.  This might be a step in the right direction. 

I am cautiously almost hopeful. 


Here is the article
I think her article is a little sm
outdated in reference to VR.  Apparently she hasn't been out there in trenches lately.  There is a LOT of VR work out there and unfortunately the pay isn't great, in fact it's awful for the work involved.  Although it won't actually replace the MT, but rather move them into a different area, the pay is never going to match the effort that must go into it. 
FYI - article
I just read an article yesterday in the Oakland Press that Oakland County, Michigan, is getting rid of all their court reporters and going electronic to save money.
EMR Article
I have done transcription for about 19 years. Over the years I have been concerned about off-shoring and voice recognition, but still felt fairly confident about still having work for a long time. Now, with the EMR system coming into play, along with the other factors mentioned above, I feel that eventually, not too far off, this is a losing battle.

I love doing this type of work. It has supported my family while my kids were growing up, I had a secure hospital job, and the luxury of working at home, I have to face reality though.

I am going to go back to school and maybe look into being a radiology tech and/or ultrasound. I will not take anything in medical records, such as coding or biling, as I think that will also become automated eventually, and is already in some instances.

I think doing the editing and/or transcription (if there is any) would be a good part-time second job to have in addition to another job, but not fulltime, as I don't think you could support yourself. I still have a good 15 years or more of working left and do not want to be left out in the cold whle hoping that this is not really going to happen.

I think if the off-shoring could be addressed it would keep more work here in the long-run to keep us working until we have other options. I have seen postings here regarding contacting the president regarding off-shoring transcription (which is a good idea) but you need to also write your local congressman in your particular area. That is what they are there for (that is very important.)

It is ridiculous that the medical records of patients are so highly confidential, but yet we will send it to another country, and with the economy as horribile as it is too.

Maybe the government should retrain us LOL.

I do feel sorry for the newbies, and that these MT schools keep recruiting people into this occupation, and they probably know full well what is going on.

Just my opinion.
EMR article HERE
From Medscape Family Medicine
Physicians Are Talking About...
The Government Push for Electronic Medical Records

Posted 02/24/2009

Nancy R. Terry

The economic stimulus plan currently being considered by Congress allocates $20 billion to health information technology such as electronic medical records (EMRs). Recent postings on Medscape Physician Connect (MPC), a physicians-only discussion board, offer frank opinions about the utility of EMRs in clinical practice -- opinions that are decidedly mixed.

"EMR is the worst thing that has happened to me professionally in over 25 years of practice. My care of patients is impeded and the quality of my care is worse as a direct effect of the introduction of EMR," says a MPC contributor who championed the installation of an EMR system for his physician group.

"I absolutely love our EMR," says a nephrologist. "It has improved the quality of our practice immensely. I spent a lot of time customizing for our practice, but it was worth it. Everything is point and click. To improve care and cost, all patients need a Web-based collection of medical records that include hospitalization, lab reports, x-rays, as well as office notes. That would be the ultimate care."

Physicians who are dissatisfied with EMR systems cite loss of productivity, the negative impact on patient care, and high maintenance requirements. Physicians who have embraced EMRs cite the increased efficiency the systems have brought to their practices. EMRs tend to get high marks from subspecialists and low marks from primary care physicians.

Some of the MPC physicians least satisfied with their EMR systems are those practicing at large healthcare companies or medical centers. "My hospital solicited medical staff support for EMR," says one MPC contributor. "After implementation, administration took over and now EMR is solely for the benefit of medical records as a storage device. To he11 with the medical and nursing staffs. RNs are input clerics rather than beside nurses."

"The very few efficiencies were all on the administrative side," says a regional medical director who helped bring an EMR system to a nationwide healthcare company. "A good sales pitch with nice graphics and testimonials sell it, then the clinical staff is left to suffer."

"EMRs need to address work flows and clinical efficiencies and not seek to provide administrative support," says a general practice physician. "Unfortunately, the administrators are the ones with the time and energy. The rest of us are seeing patients."

In smaller practices, issues of EMR maintenance and support infringe upon patient care. "In my clinic," says a family medicine physician, "provider meetings are completely dominated by EMR issues and problems. There is virtually never time left for discussing topics pertinent to improving patient care."

In speaking about their day-to-day experience with EMRs, primary care physicians complain that entering patient information is cumbersome and time consuming, often because of a template-based system that does not reflect the patient encounter.

"The assumption of the EMR is that you already know the diagnosis when the patient arrives." says an MPC contributor. "This may be better for specialty care, but in primary care, patients come in with fatigue, rash, insomnia, diarrhea, and cough. It's difficult to enter all this until after the visit."

An internist who describes herself as "tech savvy" says that her system's scripted entries for patient information are inadequate. "If you free-text, it is much more time consuming. And we are discouraged from free-texting by our administration because it doesn't trigger adequate billing codes. Not only has it reduced my time with patients, it has added an extra 2 to 3 hours of work each night from home."
The Choice of Systems

"My advice to practitioners," says one MPC contributor, "is wait for a decent EMR that produces useful notes that accurately describe a patient encounter in a way that helps a clinician."

Waiting may not be an option for much longer, however. One provision of the government stimulus plan would impose reduced payments on physicians who are not "meaningfully using" information technology. Whatever is meant by the provision's phrasing, one thing is clear: the push is on to go electronic. Physicians must learn how to make information technology work for them. One EMR expert says that it starts with the choice of systems. "Primary care practices should stay away from templates and stick to a new program by Praxis® [Infor-Med Medical Information Systems, Inc., Woodland Hills, California] that uses pattern recognition of similar cases as well as rare cases. It decreases the workload immensely. For specialty practices, I recommend templates, and Visionary™ Dream EHR [Visionary Medical Systems, Inc., Tampa, Florida] is excellent in being very user friendly," says an MPC contributor whose research in medical management focuses on EMR systems.

Another MPC contributor notes that the technologically adventurous can customize an EMR system by using open-source software. In open-source systems, he explains, the source code needed for programming is included in the software, making the program infinitely adaptable. "When you buy most proprietary software, you have to accept the functions that come with it, as designed by the developers. With open-source systems, you can modify the software to your heart's content."
Is a Choice of Systems Really a Choice?

For some physicians, however, EMR systems remain a nonissue, and the heavy government funding of healthcare information technologies is nothing more than a smokescreen obscuring the real issues in primary care.

"The government and the public are not able to deal with the real problems facing medical practice and the real solutions necessary to turn it around (ie, reasonable reimbursement rates, malpractice reform, regulation of the unscrupulous practices of the insurance industry)," says an otolaryngologist. He adds that once healthcare information technology is "fully implemented and solves nothing, we can start to talk about real reform and real answers."

Author Information
Nancy R. Terry, medical writer and editor, Jackson Heights, New York

Disclosure: Nancy R. Terry, has disclosed no relevant financial relationships.

Medscape Family Medicine. 2009; ©2009 Medscape
That was a really good article
understand it.  Alas, many will not listen.  Many would not even read the article if you printed it up and delivered it to their front door.  Many don't care.  Many believe it's a lot of "hype."  But this country IS falling apart.  And the big whigs know it too.  I don't know if it's so much that they don't care, but that this is actually part of their plan.  When the U.S. finally comes unraveled, they'll step in with a new dictatorship, and there will be precious little any of us can do about it.
chilling article

Read this


New Orleans: A Disaster Waiting to Happen
by George E. Curry
NNPA columnist
Originally posted 9/1/2005

I am angry. I am angry at the mayor of New Orleans. I am angry at the governor of Louisiana. I am angry at the Environmental Protection Agency (EPA). I am angry at the Federal Emergency Management Agency (FEMA), now part of the Department of Homeland Security. I am angry at George W. Bush. I am angry because they were warned last November that New Orleans was one of the “Disasters Waiting to Happen” – and did nothing about it. Consequently, hundreds, if not thousands, of people are dead. Needlessly.

In an eerie prediction of what happened as a result of Hurricane Katrina, an article titled, “What if Hurricane Ivan Had Not Missed New Orleans?” was published in the Natural Hazards Observer, a major journal headquartered at the University of Colorado in Boulder. It was written by Shirley Laska of the Center for Hazards Assessment, Response and Technology at the University of New Orleans. In other words, this was an article written by a reputable author in a reputable national publication that should have been read by people involved in disaster relief. If they had taken heed, many of the dead in New Orleans would be alive today.

Under the headline, “What if Ivan Had Hit New Orleans?” the author wrote, “New Orleans was spared this time, but had it not been, Hurricane Ivan would have:

- Pushed a 17-foot storm surge into Lake Pontchartrain;

- Caused the levees between the lake and the city to overtop and fill the city ‘bowl’ with water from lake levee to river levee, in some places as deep as 20 feet;

- Flooded the north shore suburbs as much as seven miles inland; and

- Inundated inhabited areas south of the Mississippi River.

“Up to 80 percent of the structures in these flooded areas would have been severely damaged from wind and water. The potential for such extensive flooding and the resulting damage is the result of a levee system that is unable to keep up with the increasing flood threats from a rapidly eroding coastline and thus unable to protect the ever-subsiding landscape.”

Until I read this article, I had said one of the positive things that I hoped would come out of this disaster is that relief experts would realize that they need to make special provisions for the poor, elderly and homeless. In essence, I gave them the benefit of the doubt. Now, however, I realize that there is no benefit in doubt.

The warning was there in black and white:

“For those without means, the medically challenged, residents without personal transportation, and the homeless, evacuation requires significant assistance.”

Laska spelled it out in even more detail.

During Hurricane Ivan in 2004, she continues, ‘Residents who did not have personal transportation were unable to evacuate even if they wanted to.
Approximately 120,000 residents (51,000 housing units x 2.4 persons/unit) do not have cars.

“A proposal made after the evacuation from Hurricane Georges to use public transit buses to assist in their evacuation out of the city was not implemented for Ivan. If Ivan had struck New Orleans directly it is estimated that 40-60,000 residents of the area would have perished.”

The additional problem of people having the means to leave, but refusing to do so was addressed in the article.

“Researchers have estimated that prior to a ‘big one,’ approximately 700,000 residents of the greater New Orleans area (out of 1.2 million) would evacuate,” Laska wrote. “In the case of Hurricane Ivan, officials estimate that up to 600,000 evacuated from metropolitan New Orleans between daybreak on Monday, September 13 and noon on Wednesday, September 13, when the storm turned and major roads started to clear…

“The fact that 600,000 residents evacuated means an equal number did not. Recent evacuation surveys show that two thirds of nonevacuees with the means to evacuate chose not to leave because they felt safe in their homes. Other nonevacuees with means relied on a cultural tradition of not leaving or were discouraged by negative experiences with past evacuations.”

Those that dismiss environmentalists as kooks, should pay special attention to the observations about marshes.

“Loss of the coastal marshes that dampened earlier storm surges puts the city at increasing risk to hurricanes,” the article noted. “Eighty years of substantial river leveeing has prevented spring flood deposition of new layers of sediment into the marshes, and a similarly lengthy period of marsh excavation activities related to oil and gas exploration and transportation canals for the petrochemical industry have threatened marsh integrity.”

Using the Hurricane Ivan model to predict what would happen if a major hurricane struck New Orleans, Laska wrote: “Should this disaster become a reality, it would undoubtedly be one of the greatest disasters, if not the greatest, to hit the United States, with estimated costs exceeding 100 billion dollars. According to the Red Cross, such an event could be even more devastating than a major earthquake in California. Survivors would have to endure conditions never before experienced in a North American disaster.”

It ended, “The hurricane scenario for New Orleans that these conveying risks portend is almost unimaginable. Hurricane Ivan had the potential to make the unthinkable a reality. Next time New Orleans may not be so fortunate.”

George E. Curry is editor-in-chief of the NNPA News Service and BlackPressUSA.com. He appears on National Public Radio (NPR) three times a week as part of “News and Notes with Ed Gordon.” In addition, his radio commentary is syndicated each week by Capitol Radio News Service (301/588-1993). To contact Curry or to book him for a speaking engagement, go to his Web site, www.georgecurry.com.

Relevant article
Not trying to start an argument, just another point of view.

here's the entire MQ article
Press Release Source: Medquist Inc.

MedQuist Announces Preliminary, Partial and Unaudited Financial Results
Friday August 19, 5:14 pm ET

MT. LAUREL, N.J., Aug. 19 /PRNewswire-FirstCall/ -- MedQuist Inc. (Pink Sheets: MEDQ - News) announced today certain preliminary, partial and unaudited financial results. Once the Company completes the financial assessment and review of its billing practices disclosed in the Company's previous filings with the SEC, the Company expects that an independent registered public accounting firm will review and/or audit the Company's financial statements, as appropriate. While, at this time, the Company cannot estimate the total costs of (i) the billing review, (ii) defense of the class action matters, (iii) the SEC investigation, and (iv) compliance with the Department of Justice investigation, all of which have been previously disclosed in either the Company's filings with the SEC or the Company's press releases, the costs incurred to date by the Company in connection with the foregoing have been included in the results set forth below. Because the completion of the billing review and resolution of the litigation and governmental investigatory matters are pending, the Company is not certain whether any changes to the accounting treatment of any component of its consolidated financial statements will be required and, if any changes are necessary, whether any such changes would have a material impact on its consolidated financial statements. Accordingly, the financial information set forth below is preliminary, unaudited, and subject to change based on the completion of the financial assessment and review of the Company's billing practices and the completion of the review and/or audit of its financial statements, as appropriate.

The information set forth below is derived from the Company's internal books and records. The Company cautions investors not to place undue reliance on the information presented below. As a result of the developments described above and in the Company's previous SEC filings, the Company's financial statements have not been audited or reviewed by an independent registered accounting firm. The information contained in this press release also has not been audited or reviewed by an independent registered accounting firm. Such information is not a substitute for the information required to be reported in the Company's Forms 10-K and Forms 10-Q that have not yet been filed. There can be no assurance that the results of the billing review, and resolution of the litigation and governmental investigatory matters will not have a material adverse effect on the Company's revenue, results of operations and financial condition.

MedQuist Inc. - Preliminary and Unaudited Financial Information (in

Years Ended
12/31/2002 12/31/2003 12/31/2004

Revenue (1) $486 $490 $456

Operating income (1) 71 61 23

Cash (3) 103 162 196

Debt (3) <0.1 <0.1 <0.1

Quarters Ended
12/31/03 3/31/04 6/30/04 9/30/04 12/31/04 3/31/05 6/30/05

Revenue (2) $121 $118 $114 $113 $112 $108 $106

income (2) 13 13 7 6 (3) (2) (6)

Cash (3) 162 180 183 192 196 199 198

Debt (3) <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 -

(1) Information presented for the twelve months ended
(2) Information presented for the three months ended
(3) Information presented as of the date

Twelve months ended December 31, 2003

Preliminary, unaudited results indicate that the Company's revenue increased from approximately $486 million for the twelve months ended December 31, 2002 to approximately $490 million for the comparable 2003 period. The increase was largely the result of twelve months of Lanier operations being reflected in 2003 results as compared to six months of Lanier operations being reflected in 2002 results, as the acquisition of Lanier Healthcare LLC took place on July 1, 2002, largely offset by transcription service volume declines as well as declining pricing from both new and existing transcription clients.

Operating Income:

Preliminary, unaudited results indicate that operating income declined from approximately $71 million, for the twelve months ended December 31, 2002 to approximately $61 million for the comparable 2003 period. The decline in operating income is largely the result of transcription service volume and rate declines, partially offset by the result of twelve months of Lanier operations being reflected in 2003 results as compared to six months of Lanier operations being reflected in 2002 results, as the acquisition of Lanier Healthcare LLC took place on July 1, 2002.

Balance Sheet Highlights:

At December 31, 2003 the Company had $162 million in cash and cash equivalents. At December 31, 2003, the Company had less than $100 thousand in total debt. Other than minimal exercises of stock options, there were no additional issuances of capital stock or other securities for the twelve month period ended December 31, 2003.

Twelve months ended December 31, 2004


Preliminary, unaudited results indicate that the Company's revenue decreased from approximately $490 million for the twelve months ended December 31, 2003 to approximately $456 million for the comparable 2004 period. The decline in revenues includes the impact of decreasing transcription service volume from existing and lost clients, partially offset by new clients, as well as the impact of pricing declines attributable to a competitive pricing environment. Additionally, the Company has recognized declines in revenue from its front-end speech recognition products as it transitioned from TalkStation to SpeechQ for Radiology.

Operating Income:

Preliminary, unaudited results indicate that operating income declined from approximately $61 million, for the twelve months ended December 31, 2003 to approximately $23 million for the comparable 2004 period. The decline in operating income includes: 1) the impact of approximately $11 million in costs incurred in 2004 related to the ongoing billing investigation and associated litigation, 2) approximately $4 million in costs associated with separation and replacement of the Company's management team, including members at the executive level and 3) approximately $3 million associated with the write-off of intangible assets associated with products no longer being offered. In addition, the base business, as described above in the Revenues section, experienced a decline in transcription service volume from existing and lost clients and a decline in transcription service rates charged to customers. The impact of the revenue decline was partially offset by several cost saving initiatives including reductions in telecommunications costs, office consolidations and associated staff reductions.

Balance Sheet Highlights:

At December 31, 2004 the Company had $196 million in cash and cash equivalents. At December 31, 2004, the Company had less than $100 thousand in total debt. Other than minimal exercises of stock options, there were no additional issuances of capital stock or other securities for the twelve month period ended December 31, 2004.

Six Months ended June 30, 2005


Preliminary, unaudited results indicate that the Company's revenue decreased from approximately $232 million for the six months ended June 30, 2004 to approximately $213 million for the comparable 2005 period. The decline in revenues includes the impact of the result of reductions in contracted transcription service rates from existing clients, further affected by new transcription business service volume replacing lost transcription service volume at a lower average price. Management expects these pricing pressures to continue and for revenue in the second half of 2005 to decline from first half levels.

Operating Income:

Preliminary, unaudited results indicate that operating income declined from approximately $20 million for the six months ended June 30, 2004 to an operating loss of approximately $8 million for the comparable 2005 period. Operating income includes 1) approximately $16 million in costs incurred in 2005 related to the ongoing billing investigation and associated litigation, which represents an increase of approximately $11 million over similar costs incurred for the comparable time period in 2004 and 2) approximately $3 million in costs associated with separation and replacement of the Company's management team, including members at the executive level, which represents and increase of approximately $2 million over similar costs incurred for the comparable time period in 2004. In addition, the base business, as described above in the Revenues section experienced a decline in transcription service rates charged to customers. The impact of the revenue decline was partially offset by several cost saving initiatives including reductions in telecommunications costs, office consolidations and associated staff reductions. The Company continues to strive for improved profitability through service and technology enhancement initiatives, along with other cost reductions.

Three months ended June 30, 2005


Preliminary, unaudited results indicate that the Company's revenue decreased from approximately $114 million for the three months ended June 30, 2004 to approximately $106 million for the comparable 2005 period. The decline in revenues includes the impact of the result of reductions in contracted transcription service rates from existing clients, further affected by new transcription business service volume replacing lost transcription service volume at a lower average price. As noted above, management expects these pricing pressures to continue and for revenue in the second half of 2005 to decline from first half levels.

Operating Income:

Preliminary results indicate that operating income declined from approximately $7 million for the three months ended June 30, 2004 to an operating loss of approximately $6 million for the comparable 2005 period. Operating income includes 1) approximately $9.5 million in costs incurred in 2005 related to the ongoing billing investigation and associated litigation, which represents an increase of approximately $5.5 million over similar costs incurred for the comparable time period in 2004 and 2) $1 million in costs associated with separation and replacement of the Company's management team, including members at the executive level. In addition, the base business, as described above in the Revenues section experienced a decline in transcription service rates charged to customers. The impact of the revenue decline was partially offset by several cost saving initiatives including reductions in telecommunications costs, office consolidations and associated staff reductions. The Company continues to strive for improved profitability through service and technology enhancement initiatives, along with other cost reductions.

Balance Sheet Highlights:

At June 30, 2005, the Company had $198 million in cash and cash equivalents and no debt. There were no additional issuances of capital stock or other securities for the six month period ended June 30, 2005.

About MedQuist:

MedQuist, a member of the Philips Group of Companies, is a leading provider of electronic medical transcription, health information and document management products and services. MedQuist provides document workflow management, digital dictation, speech recognition, mobile dictation devices, Web-based transcription, electronic signature, medical coding products and outsourcing services.

Disclosure Regarding Forward-Looking Statements:

Some of the statements in this Press Release constitute "forward-looking statements" within the meaning of the U.S. Private Securities Litigation Reform Act of 1995. These statements are not historical facts but rather are based on the Company's current expectations, estimates and projections regarding the Company's business, operations and other factors relating thereto. Words such as "may," "will," "could," "would," "should," "anticipate," "predict," "potential," "continue," "expects," "intends," "plans," "projects," "believes," "estimates" and similar expressions are used to identify these forward-looking statements. The forward-looking statements contained in this Press Release include, without limitation, statements about the Company's results of operations and financial condition. These statements are only predictions and as such are not guarantees of future performance and involve risks, uncertainties and assumptions that are difficult to predict. Forward-looking statements are based upon assumptions as to future events of the Company's future financial performance that may not prove to be accurate. Actual outcomes and results may differ materially from what is expressed or forecast in these forward-looking statements. As a result, these statements speak only as of the date they were made, and the Company undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. The Company's actual results may differ from the forward-looking statements for many reasons, including any direct or indirect impact of the matters disclosed in the Form 12b-25 filed by the Company on August 19, 2005 on the Company's operating results or financial condition; any continuation of pricing pressures and declining billing rates; difficulties relating to the implementation of management changes throughout the Company; and the outcome of pending and future legal and regulatory proceedings and investigations.

Source: MedQuist Inc.
Thanks. Good article. NM
Interesting article

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.

Interesting article

EMR might not soon replace us after all....


Boy do you have it wrong....one article and you believe it!

I am a volunteer at our local humane society and am active with several vets locally.  What this article suggests is absolutely ridiculous. 


That article was written by extremists.  Get involved yourself to become truly educated and leave the radicals where they belong….an obscure site shouting to get attention and spread their ignorance.   By just passing on what you read without firsthand knowledge, you are just adding to the pile of dung that everyone else has to wade through.  Again….get involved…get educated
I just found this article! OMG!

Home > Business Processes
Medical Transcription: The Resurrection

Or is it? With about 12,000 people, and $125 million revenue, this industry was never really dead in the first place. It was just a tough phase of transition. The good news? That phase seems to be over

Balaka Baruah Aggarwal
Saturday, January 01, 2005

Circa 1997: A new industry is on the horizon. There is lot of excitement as people anticipate the benefits of the Internet age and talk of medical transcription as an opportunity that can potentially change the fortunes of many Indians. Along with computer training institutes, the medical transcription training institutes mushroomed in towns and cities promising placements to all trainees. Entrepreneurs were gung-ho as every mom and pop set up shop. And making hay in this excitement was the middlemen who promised abundance of business.

Circa 2001: It was clearly epitaph time for the industry. The booming industry had turned a whimper. The training institutes suddenly disappeared, companies downed shutters and the fledging industry died before it had learnt to walk. That was then.

Circa 2004: There is a sense of purposefulness and systematic ramp-up as the industry goes about its business. There is a steady flow of business despite the US backlash and some have even managed to raise funds. Led by a couple of US-based companies the medical transcription industry in India is in the resurgent mode.

Resurgent? Indeed! But sustainable? One can't help doubting the future of an industry that was once so hyped but which fizzled out as quickly. Judging by all parameters this growth looks sustainable. The industry seems to have learnt from its failure and is doing it right the second time with its focus on marketing, investment on technology and emphasis on delivery of quality service.

The Opportunity
According to US Bureau of Labor Statistics (BLS), there were a total of 97,810 medical transcriptionists working in the US in May 2003, the latest period for which data was available. Surprising though it may sound, almost every seven out of ten MTs in the US were employed by the hospitals or offices of physicians. Less than 15 percent were employed by professional outsourcing service providers.

That means Indian companies have to sell to a business community that has hardly outsourced. Naturally, the only appealing reason for them to offshore is cost saving. Considering this fact, it was not very surprising that this industry was centered only around cost. That, as we will see a little latter, is changing.

However, what is most noteworthy is the fact that between December 2002 and May 2003, there was a drop of slightly more than three percent in overall employment of MTs. This was despite the fact that the Bureau had predicted an employment demand growth for MTs faster than the average growth for all
occupation, even after factoring in the offshoring phenomenon. "Contracting out transcription work overseas," the 2002 Employment Outlook report noted, is "not expected to significantly reduce the need for well-trained medical transcriptionists domestically."

The drop in employment, say observers, has happened primarily because of an acute shortage of supply. This is reflected in a press release from the Medical Transcription Industry Alliance which said, "There are insuffcient number of qualified medical transcriptionists to meet the enormous demand."

This could work out in India's favor. Early signs-in fact the present resurgence-actually shows that it has already happened.

However, not everyone who started out pursuing this opportunity a few years back survives today to grab the second chance. Those who survive are the ones who invested in understanding the business and establishing a name for themselves in the market. These are the ones that are reaping the benefit. Fortune actually favors the prudent these days.

Growing Up, Wisely
Medical transcription, commonly perceived as the lowest end of the spectrum, was the first back-office work to be offshored to India in the early 90s by HealthScribe and Heartland who started their pilot projects from South India.

As the Internet took off in the 90s, the industry caught the imagination of many entrepreneurs who rushed headlong without a base in the nitty-gritty of the business. The first mistake was that entrepreneurs did not have a front-office presence and relied on the middleman. In the absence of direct marketing presence, early entrepreneurs had absolutely no clue about the demands of the market and were at the mercy of sub-contractors. This dependence led to undercutting of prices that reached unrealistic levels and became completely unviable.

Says Raman Kumar, CEO of C-Bay Systems, arguably the largest medical transcription company in India with a controlled workforce (direct and indirect included) of 3,500 people, "Companies in the early phase relied solely on the middleman to get business. That cannot be a viable business model because it is important to own the customers. Otherwise the customer begins to dictate terms to you."

The C-Bay model was completely opposite to what most people were following in India during those days. "We set up our front-end office in the US and focused on building our presence in the market. It takes much more investment to set up the front-office so that's where we focussed initially."

It managed its back-end by setting up relationships with franchisees who were trained by C-Bay and by keeping a strict control on the quality of the work. Kumar reasons that, "We did not waste our efforts in the back-end at that time. After consolidating our front end presence, we focused on the back-end."

C-Bay had bought over three companies in the US: Arrendale Associates and Advanced Transcription Solutions in 2002 and Emergency Dictation Services in 2004. These acquisitions gave a stable customer base to the company.

With the front-end in place, C-Bay turned its attention to the back-end and set up its own center in Hyderabad, Bangalore and a joint venture with Godrej in Mumbai. It also acquired some of its franchisees and is still actively negotiating for some more deals.

And that is a very significant difference in the strategy of the companies that are dominating the medical transcription industry today. Needless to say companies like HealthScribe, Heartland, Spryance, Accusis, Focus Infosys have strong presence in the US.

"This business is based on relationship and clients need an interface to understand their concerns and requirements for which a direct US presence is absolutely critical," says Jayesh Nagda, CEO of Focus Infosys headquartered in US with its delivery center in Bangalore.

Agrees Vijay Kaul, Head, Customer Service, with Spryance, a company which promotes home based transcription in India in a big way. "The importance of having a good marketing network cannot be undermined. We are positioned as a huge aggregator of work. That is our primary strength." Spryance aggressively promotes home based transcription and hires people for Quality Assurance and editing work only. It employs a workforce of 1000 people, 70 percent of whom are home-based Transcriptionist (HBT). Incidentally HBT is a concept that has become quite popular in India and is being experimented by quite a few companies.

The requirement for experienced professionals is high in this model although freshers are also trained by providing extensive feedback. That is why some companies like HeathScribe is a little reluctant about this model.

Says Suresh Nair, CEO of HealthScribe India, "We have a small number of HBT but that is not our primary model. Our HBTs are essentially ex-employees who may have moved to different cities or may have quit for personal reasons." HealthScribe employees 1350 people with only about 100 people working from home.

Acusis that actively promotes HBT finds it a viable model. "Technology has matured enough to allow people to work from home", says KB Anand, COO of Acusis. "We have a tech team of 50 people who have developed a customized solutions called Accusuite which manages voice from US to India and assign it to specific HBT."

Today there are workflow processes and adequate security measures in place to allow working from home. This is one development that really has the potential to change the face of the industry. While ITES has been touted as the industry that could harness the idle talent of housewives, young mothers and others by allowing people to work from home, medical transcription is the only industry that has actually done it. It is estimated that HBTs execute between 10-20 percent of the MT work that is offshored to India.Companies have invested a lot in technology to streamline processes and ensure secure workflow. With stringent regulations in US about the security of patient information, this investment is absolutely necessary for serious players. This is a sustained investment and requires deep pockets.

All the top players have made heavy investments in technology particularly in ensuring information security. The Patient Health Information System of Spryance has been audited by Ernst & Young and is HIPPA certified.

HealthScribe has also invested a lot on technology to have its systems HIPPA compliant. It has developed its own workflow management system that allows the system to assign work in a systematic and secure manner.

The industry is leaving no stone unturned to address the security of patient information. It is one of the reasons why MT companies in Bangalore have come together under a banner called Indian Medical Transcription Industry Association (IMTIA). Says Suresh Nair who is also the President of the association, "The idea is to share experiences and best practices amongst members. Most often, security breaches occur because people are not aware of it."

The Bottomline: Quality
Finally it is the quality of work that will decide the fate of the industry. The major reason why the industry went bust during the first phase of its growth was because the accent on quality was lacking. Hospitals were appalled at the poor quality of work that was being churned out by the industry. "Lured by the hype numerous garage start-ups came up with little focus on quality and processes which soon reflected in the shoddy work," says Som Marappa, President and CEO of US-based MedSoft with delivery centers in Bangalore, Coimbatore and Mysore.

Today the industry watchword is quality. "The industry has learnt that it is only the focus on quality that will see it through," says Suresh Nair. With 98 percent accuracy levels expected it is indeed a tall order.The industry is sparing no pains to gain this level of accuracy. The average training is of nine months and the employee gets productive only after a year. "The gestation period in training a medical transcriptionist can take up to two years and that is why it makes sense to look at destinations with lower cost structure," says V Raman Kumar.

Unlike the call center industry trainees do not have to get their accents right. They are trained in listening skills, introduced to medical language and taught some basic transcription skills. It is estimated that bigger firms invest anywhere between Rs 60,000 to Rs 1 lakh on training each transcriptionist while smaller firms may invest a little less.

The transcripts go through rigorous quality checks in India and US before it is sent to clients. Even companies who swear by the HBT model hire quality assurance people "because quality is the lifeline of the industry."

What is as critical as the quality is the turnaround time. Often turnaround time is 8-10 hrs, sometimes it can even be demanded with a few minutes. Says Nagda, "When we handle emergency dictation, doctors require notes immediately to perform surgery and the turnaround time is a few minutes then." Needless to say that 24x7 services command a premium in the market.

The Industry
According to bpOrbit estimates, there were close to 12,000 people working in the Indian medical transcription industry as of August 2004. bpOrbit also estimates the industry size to be $115 million in the year 2003-04 (April-March). There were close to 250 companies doing medical transcription work, out of which many worked as a franchisee for a bigger company, such as C-Bay.

The top six companies (see box) accounted for 75 percent of the revenue and close to 70 percent of the employment. There are another 5-6 companies that have 100 or more people. In that sense, the average employees per company among the rest turns out to be less than 20. So it has assumed the form of a cottage

The margins, contrary to popular belief, are not small. At 15-18 percent, it is quite healthy by the outsourcing industry standard. But that kind of margin is expected only after reaching a scale, due to deployment of technology as well as economy of scale.

The average per line price commanded by the companies for transcription is close to 6-12 cents. Depending upon experience, the average lines transcribed by an MT could vary from a low of 200 lines to a high of 750 lines per day. On an average, this yields close to $4.5 per hour, which is what the low end voice call centers with much higher capex and opex, as also the salary, realize. The added advantage in this industry is that as unlike the voice work, here it is not just the quality but even the productivity of an employee increases with experience, resulting in direct increases in revenue. With lesser attrition and higher productivity, this industry is good for long term players, with high scale.

Geared Up
The MT industry does not necessarily have to work at night except in cases of offering 24x7 service. The attrition rate at 15 percent is therefore far lower than the BPO industry. Says Veer Sagar, Chairman of Selectronics Equipment and Service, "This is intelligent work which requires an analytical and logical mind. This goes a long way in curbing attrition because the work is not repetitive."

India's opportunity emerges in the backdrops of the consolidation that the US MT industry is undergoing. The dynamics in the healthcare industry changed with the adoption of technology. Billing became more transparent and US transcription companies came under intense pressure as result of which offshoring became a popular option.

At the same time, there was a shortage of qualified transcriptionists. In the Journal of AHIMA, Carrie Boatman, Director of Professional Relations for the American Association for Medical Transcription said, "The problem facing employers is that the majority of the transcriptionists graduating from a program require additional training before they can be truly productive. Training staff is not a popular option. Training transcriptionists is an expensive proposition that can require six months to a year."

Not many hospitals and health practitioners are ready to bear that kind of cost burden. Which means two things. One, that the healthcare industry has to move away from the dependence on employed labor and has to turn out to offshoring. Two, with large training costs becoming imperative, those with a scale would benefit from it. So what we are seeing is a big consolidation.

Viewed from this perspective, it will not be an exaggeration to say that India could be the epicenter-and not just another location-of this new phase of consolidation. Also, with US elections almost round the corner, the India-factor will not be so much a sensitive issue. In any case, in this industry, it has never been such a problem. Says Raman Kumar, "It has to be very clear that offshoring of work occurred because of the shortage of qualified professionals. Never has offshoring of MT grown at the cost of jobs in the US." This explains why even at the height of the backlash against outsourcing in US, MT was not really an issue.

Many miles to go...
The industry would do well to gear up its security measures. Although big players are conscientiously addressing the issue, the same cannot be said for all small players. Americans are absolutely paranoid about their health information. The incident regarding Pakistani Dr. Lubna Baloch blackmailing the American subcontractor to expose patient information if the alleged payment dues were not fulfilled has sent shock through the industry. A similar incident in Bangalore by two Heartland employees threatening to release sensitive patient data in lieu of some concession has further hackled the industry. "Another Lubna Baloch or Heartland could well be the beginning of the end of the transcription industry overseas," says Marappa of Medsoft.

Another threat is the emergence of the voice recognition software. The industry can ill-afford to remain ignorant of new technology trends. Voice recognition has not fully matured and shall still require editing skills. In anticipation, some companies like Focus Infosys have experimented with the software in-house. But there needs to be many more initiative to address this challenge.

A recent marketing trend is hospitals belonging to a particular group or chain are aggregating transcription work and offloading it to offshore vendors as a single deal. "The consolidation of suppliers in a bid to get better price from vendors has begun to happen," says Nair. This has the potential to squeeze the margins of major vendors.

Many of the medium and small Indian vendors are currently servicing the clinic segment in the US and the large hospitals remain untapped. The clinics account for between 30-40 percent of the overall market.

While marketing challenges can be over some with innovation concerns regarding security are potentially more explosive which can upset the applecart even before growth has stabilized. However with the growth momentum building up and a determined industry bent on success, it is unlikely that the industry will stumble the second time round.

Top Companies

Mode of operation: Own centers and franchisees
CEO: V Raman Kumar
No of employees: 3,500
Presence in India : Hyderabad, Mumbai, Bangalore
Website: www.cbaysystems.com

Mode of operation: Own center, JV
CEO: Bryan Black
No of employees: 1500
Presence in India: Delhi, Bangalore, Coimbatore
Wesite: www.heartlandis.com

Mode of operation: Own center and HBT
CEO: Suresh Nair
No of employees: 1350
Presence in India: Bangalore
Website: www.healthscribe.com

Mode of operation: Own centers/HBTs
CEO: Raj Malhotra
No of employees: 1000
Presence in India:
Wesite: www.spryance.com

Mode of operation: Own center/HBTs
COO: KB Anand
No of employees: 550
Presence in India: Bangalore, Chennai, Mysore, Coimbatore,
Website: www.acusis.com

Focus Infosys
Mode of operation: Own centers
CEO: Jayesh Nagda
No of employees: 500 +
Presence in India: Bangalore
Website: www.focusmt.com

Industry Employment (%)
General medical and surgical hospitals 40.2
Offices of physicians 33.2
Business support services 12.5
Offices of other health practitioners 2.3
Medical and diagnostic laboratories 2
Others 9.8

1May 2003 figure

Source: US Bureau of Labor Statistics

Michigan 5,590
Wisconsin 3,830
West Virginia 980
South Dakota 780
North Dakota 520

2May 2003 figure

Source: US Bureau of Labor Statistics

American Association of Medical Transcription

US Bureau of Labor Statistics: Medical Transcriptionists

American Health Information Management Association

The View Article
I was just looking at an internet article. Supposedly Star was suppose to make the announcement on Thursday and Barbara feels betrayed by what she did. It goes into pretty good detail.
Interesting article about EMR

August 9, 2006 - EMR has revolutionized the healthcare industry in recent times. Many experts felt that EMR & Voice Recognition would totally replace Medical Transcription - however; the industry soon realized that transcription has certain advantages over point & click charting and many physicians preferred to dictate notes rather than document the data at the point of care themselves.

The most critical part of any Electronic Medical Record (EMR) is the method of data entry. EMR is about aggregation of patient encounter data at the point of care in order to provide a complete, accurate, and timely view of patient information. An electronic medical record is not just a typed record of the patient encounter, but an extremely useful decision support tool. The data can be entered into the EMR via any of the two general mechanisms: direct entry by the physician using point and click templates or transcription of dictated notes. Point and click template indicates that each data element, which is to be inserted, requires selection, navigation, point and click process for capturing patient information.

Transcriptions have been around for years for documenting patient encounters. A medical provider dictates the medical note into a phone or a recording device. The Transcriptionist receives the dictation and transcribes it. It may be reviewed by the supervisor for checking errors. The final computerized file is then either emailed directly to the healthcare provider or the file is transferred to a web site and is later downloaded by the provider.

Each method has its pros and cons.
Point and Click Templates
Most EMR systems allow providers to generate clinical documentation, by selecting variable terms from pre-structured point-and-click templates. Users simply point and click to select appropriate choices from lists of choices to record a patient encounter. The end result would be a document that closely resembles a transcribed procedure note.
Completely customizable templates. The doctor can specify the layout of the template, which helps him to adjust the template as per his practice & procedure.
§    Provide consistent, complete and accurate data. The chances of medical erros are reduced since the data is documented in customised forms.
§    Notes for similar type of exams will appear to be standard and similar
§    Store / organize data for subsequent retrieval. 
§    Each click adds data elements to the database. Point-and-click systems create data that can be used to generate clinically useful reports, such as health maintenance reminders, disease management etc.   
§    One of the major advantages of template based charting is the time needed to make the document available as a medical record. Since notes are created within the EMR, they are available immediately upon completion.

§    It takes more time, and definitely more concentration for a physician to navigate through large data set and create progress notes using point and click templates. 
§    Templates must be customized as per the physician’s requirement. Customization can be inflexible and costly.
§    Well accepted by only tech-savvy doctors. 
§    The approach of direct data entry by the physician has generally failed because busy providers reject it altogether.
§    Output from these templates is too canned and identical. It loses individuality for each patient. 
§    It is difficult for a provider to capture complete patient encounter on computer in front of a patient.  

Medical Transcription
Transcription has long been the standard for documenting patient encounters. It is more convenient for a provider as compared to handwritten notes or electronic data entry.  There are many advantages of transcription in comparison to point and click charting. There are a few disadvantages as well.  
§    Corresponds intuitively to the physician's usual method of working. Dictation remains the most intuitive and least time-consuming means of data entry.  
§    Physicians can dictate anytime, anywhere using PDA, Dictaphone or telephone at their convenience.
§    Providers need not change the way they practice just to accommodate an EMR. EMR can interact with transcription service so that transcriptions can be attached directly into the patient’s electronic medical record, if such a facility is provided by the EMR vendor.
§    It requires minimal training for physicians. 
§    Provides expressive power to describe patient’s condition and other health related events. 
§   Details of the exam can easily be forgotten and omitted while dictating, if dictation is not captured immediately at the point of care
§   It cannot be queried for generating reports unless transcribed in pre-formatted templates
§   Transcribed reports are not immediately accessible. Physicians would normally have to wait for 12 to 24 hours for charts to be delivered, unless few vendors supporting 2-4 hours short turn around time.
§   Transcription provides for more efficient use of doctor's time.
§   Although average transcribed report costs $2 to $4, it can reduce the doctor's time spent on data entry. Considering the value of doctor’s time, transcription is not a costly proposition.
EMR should give the freedom to the physician to decide to use either Point & Click or Medical Transcription. For a physician, the EMR that fits into his practice workflow would be invaluable. A competent EMR must have a template driven charting feature and the ability to interact with a transcription service at the same time. Both are indispensable features of Electronic Medical Record Software, as doctors are not unanimous on point and click charting or transcription. Such an EMR will be both efficient and cost effective. 

The trends in transcription itself are changing with Medical Transcription service providers aiming to adopt new technologies. These technologies will evolve to increase efficiency & accuracy, decrease turnaround time and support data capture. While many of these technologies like such as digital dictation and electronic signature exist today, several technologies are still on the horizon.

here is a link to the GMA article
I just read this article...
Wow...those people are downright scary! I don't understand their beliefs at all...a sign in a picture with this article says "God is your enemy"...thought they were all about God? Confusing yes, but they are still scary!
interesting article regarding
our future ?? -- http://www.obgyn.net/displaytranscript.asp?page=/avtranscripts/israel2k_tadir
PS: See article - AND the name of the guy who wrote it!

On ''Asian'' and ''Oriental'' 

By Alan Hu

OK, so a long time ago, people in Europe used to refer to everything to the east of them as the Orient, including for example the Middle East, since orient means "east". So far, so good. This mysterious area was the source of all sorts of wonderful things like silk and spices, so the Europeans attached also sorts of exotic, mysterious connotations to the Orient. As Europeans gained a better concept of world geography, they eventually used "the Orient" and "Oriental" to refer to East and Southeast Asia, where people look "Oriental" in our current usage.

Anyway, that usage of "Oriental" has survived a long time, and it still frequently carries all of the exotic/foreign/inscrutable/mysterious connotations. These connotations happen to coincide with many of the stereotypes held of Asian Americans. Furthermore, by definition, the word "Oriental" is Eurocentric, referring to things east of Europe. For these reasons, some Asian American activist types decided that "Oriental" was a Bad Word, and that "Asian" was more accurate, less Eurocentric, and less loaded with strange connotations. No big deal, right?

Well, a lot of people didn't want to change their language usage. Some people grew up using "Oriental" and saw nothing wrong with the word. Others came from other parts of the world, where hip-activist-American-English-linguistic-evolution hadn't hit. Still others never encountered anyone aware of Asian American politics, so had never heard of this word usage change. Some people were exploiting the exotic mysticism connotations and resisted change. (Very early on, you would see articles about business and trade in Asia, whereas the travel articles would talk about visiting the Exotic Mysterious Orient.) Finally, some people were convinced that this was a typical case of left-wing-politically-correct-thought-police-mind-control (which it was) and decided in typical right-wing-politically-correct-knee-jerk-response that the word usage change was intrinsically evil and had to be resisted at all costs.

For a while, therefore, you could identify a person as being an American who was aware of and sympathetic to Asian American politics by his/her word choice. Now, however, many exploitation-types have realized that saying "Asian" instead of "Oriental" is the cool thing to do, without changing any of their stereotypes and misconceptions. (You can force a person to change his/her behavior, but you can't force a change in thought.)

The upshot is to use whatever word you feel most comfortable with, or that makes your listeners most comfortable, but don't be surprised if someone takes offense. And in the time you save by not worrying about word-usage, try to make the world a better place. 

LOL - I couldn't have said it better myself. 

I wonder how their accuracy is given this article

Speech recognition technology shows double-digit error rate11/30/2006

By: Jonathan S. BatchelorCHICAGO -


A study of radiology reports generated by speech recognition software at a prestigious U.S. academic medical center found that even with fully trained system users the technology was introducing significant errors in almost one out of five signed, final reports. We structured a study where we could look at the types of errors and frequency of errors in attending dictated reports using Voice recognition software, said Dr. Ronald Dolin, who is from the department of radiology at Thomas Jefferson University Hospital in Philadelphia. Dolin and his team retrospectively reviewed radiology reports dictated and signed by attending radiologists from February to March 2006 at Thomas Jefferson.


According to Dolin, all radiology reports at the institution were generated using PowerScribe 4.7 from Dictaphone/Nuance Communications of Burlington, MA, which had been implemented for 16 months prior to the start of the study. A total of 395 reports, consisting of five to 10 consecutive reports from each of the 41 attending radiologists, were reviewed, according to the researchers. They categorized the dictation errors into 10 subtypes, such as missing word errors, wrong word errors, extra word errors, nonsense phrase, unclear meaning phrase, or abnormal phrase with meaning intact. Errors were classified as significant if they altered or obscured the meaning of the sentence in which they appeared, Dolan said.


A total of 239 errors were identified in 146 of 395 reviewed reports for an overall error rate in final reports of 37%, he reported. In addition, he noted that at least one error was identified in reports from 40 of the 41 attending radiologists at Thomas Jefferson. The researchers found that missing or extra words that did not alter the meaning of a sentence constituted 113 of the 239 errors, or 47% of the total. This type of error was found in the reports of 33, or 81%, of the attending radiologists, Dolan said. Other common errors reported by the scientists included the wrong word, which accounted for 21% of the total errors; typographical or grammatical errors accounted for 8.8% of the total; a nonsense phrase with unknown meaning showed up in 11% of the total errors; and an error in the dictation date presented in 2.9% of the erroneous reports. Most of the speech recognition technology errors, 83%, did not alter the meaning of the report, Dolin noted. However, the remaining 17% of the errors could have impacted patient care. Significant errors -- errors that could conceivably alter a patient outcome -- accounted for 40 of the 239 error total. He said that significant errors were found in 54% of the attending radiologist reports and that five radiologists had two or more significant errors. Dolin acknowledged that he set the criteria for classification of significant errors and determined what was and was not a significant error.


During a discussion of the research after the presentation, a few audience members vigorously expressed their belief that Dolin's standard for significance had not been inclusive enough. Rather than being a condemnation of the technology, Dolin believes that his study can provide a method for Quality Assurance and continuing education in the vagaries of speech recognition software. A periodic audit of a relatively small number of radiology reports, such as five to 10 reports per radiologist, can identify significant Voice recognition error patterns among the group and by individuals, and can assist in efforts to mitigate these problems, he said. By Jonathan S. BatchelorAuntMinnie.com staff writerNovember 30, 2006



Anyone else read the article
about India having a shortage of skilled workers and how they are worrying about having to pay them higher wages due to the shortage?  Anyone else also find that they had a big old smile on their face after reading the article? 
Article in Advance
Did anyone read the article in Advance: Is Mandatory Credentialing Next?

The article says: "we have more and more companies paying premium for credentialed MTs." Is that true? The author is president-elect of AHDI. You all know what that is? Never heard of em. Or is it that new organization that used to be called something else, what was it... I think it had the words Medical Transcription in it. Maybe we should write a letter to tell about the reality of working out here.

good article - sm
I think the only way to get what we want is to get those bills passed. These companies that offshore are going to say just what that guy did - everything is protected and accurate. People aren't going to want to hear us whine about jobs getting sent overseas - well, most people anyway. But if they have to be informed that their information is being sent overseas, I would imagine that at least some people would refuse, forcing doctors to use US companies.
That's an eye-opening article -
and scary, too.  My MTSO was just taken over by Acusis......... 
Here's the link to that article

Yes, here's the link to the article about determining your rates if self-employed


I always felt like I was "an accidental business owner" because when I got into MT work at age 25, I didn't realize how much of it was as an IC. I should have talked to an accountant from the start.


Newsweek article
If anyone ever has the opportunity to review the page 24 article in Newsweek this week - dated September 24 - "Good doctors spot mistakes, save lives" - I found this extremely interesting - especially that since I am a transcriptionist, we oftentimes "hear" the mistake after the fact. This is pretty much just about doctors and their practice - but I think everyone would find it interesting - I would see this doctor any day. I wish I could copy t and post it but cannot. Please take the time at your grocery or newsstand to review page 24 of this issue.
did you read the article
Newspaper article
The Sunday paper in my area had an article on headphones and the 3 that were compared were Bose,Sennheiser, and Clear Harmony. They basically said that Sennheiser has the best quality of sound and blocks noise the best. They are all very expensive but if you go online to E-Bay there are new ones listed that are about half-price. I have been looking at the Sennheiser, but like you, I have a very small head. The ones I use now I bought at Radio Shack. They also have very competitive headphones. Good luck.
Is this the article you were referring to?
"Foreign Medical Graduates May Get New Test" in the NY Times? If so, it was printed on May 1, 1988. It also stated that the foreign medical graduates have to take an English profiency exam, NOT that they will NOW have to take one if the new test guidelines occur. The new requirements are that they have to take the United States Medical Licensure Examination (USMLE) Step 1 and Step 2, the Test of English as a Foreign Language (TOEFL) and the Clinical Skills Assessment. This is before they can even begin a residency in the U.S. Might be nice if you had some reading comprehension skills.
What is the date of this article?

I looked all over this article and could not find a date of publication.  Everything vaguely says "later this year.'  Which year?  The only thing I could find on the entire page was 04/08/02 under the author's byline, and at the very bottom of the page, a copyright of 1995-2002.  When you click on the link to discuss the article in the forums, the new page never loads.  If you look up all other articles by this author, they are all dated 2000-2002. 

I think you are getting upset over nothing.  Call Time Warner directly and ask them what their plans are. 

the article is by Forbes and here it is
in part: (p.s., i said "I believed" a sale was iminent, and yes there IS mention of a sale -- note last sentence:)

that it may seek an injunction against a possible 'fire-sale' ...
Costa Brava manager Andrew Siegel said in the letter to Medquist director Clement Revetti that Costa Brava 'reserves all of its rights and claims in connection with any sale of MedQuist'.

The warning follows a Dec 31 AGM in which neither of the six Costa Brava nominees were elected to the MedQuist board of directors....The nominations followed a Nov 2 statement from MedQuist indicating it is considering a sale of the entire company after Philips indicated it was willing to sell its 70 pct stake in the unit.

can't see the article anymore...nm
Interesting article (sm)

I watched a show on MSNBC last night about identity theft.  You probably have seen it.  They follow the chain of theives all the way to Europe and then they cannot even arrest the people. 

About the medical records, the records would not be physically visiting any country, per se.  Once they are in a computer and uploaded somewhere, they are already out there, so to speak.  So, regardless of whose computer they are transcribed on or where that computer is located, the information is still out there.  I know many insurance companies have online access to medical records and some physicians offer that as well to their patients.  You're right, though, they should have asked that question.

magazine article
I'm sorry, but I have a very difficult time believing this. I believe that there was an article written, but the content is ridiculous. If we went to medical school, I'd want the same pay as a physician, wouldn't you all ? For us "old-timers" in medical transcription and having been a CMT for 15 years, we were never, ever told that and I'm certain that as strict as AAMT used to be, we would never be certified to transcribe.
Posted Article

"...Alongside those numbers, the AHDI estimates that global medical transcription expenditures are between $12 billion and $20 billion annually, with the largest share of that occurring in the United States.

Tessier points to industry frustrations over the high cost of medical transcription alongside a demand that currently outweighs the supply of medical transcriptionists. Add to that concerns about turnaround time and quality, and many are seeking ways to improve the process."

It's a shame that we, as transcriptionsts, aren't responsible for these high costs; i.e., we don't get decent wages. With the rates of transcriptionists seemingly falling  every month or so, it's a wonder anyone can make decent money anymore.

Also, with the president wanting EMR within 4-5 years, I will be glad to retire. I was going to work until my fingers would no longer move, but he is "helping" me make the decision. I just wish the young'uns would realize this is not the place to be.

Here's an interesting article...
Regarding medical record security:  http://www.cnn.com/2008/HEALTH/06/05/ep.online.records/index.html
this is from an article (see inside)

then go to transcriptionstar.com, and check out careers. Mostly it seems they are looking for editors, with 5 to 7 years experience, but all locations are in Chennai.
And here's the followup article to that one...
See link below:
SF Chronicle article
regarding what can happen with off-shoring. A friend who runs a local MTSO posted this article on her website. She herself had to get a job at the hospital as a transcription supervisor when she lost her largest account to --you guessed it-- India.

An interesting article...

This article was part of a reading assignment I had for one of my HIM classes.  It is an old article, but I think MTs can understand this situation quite well.  It just goes to show how quality is becoming decreasingly important in the healthcare industry.


Great article. . .
So much said. . . and yet so much left unsaid. The possibilities for compromise of personal,private,confidential, "nobody else's business but me and my doctor" is totally lost sending medical records offshore... all in the interest of saving a buck. Right now I'm grateful to be home working and able to care for my demented dad . . .another health care casualty. . . but the work seems to be siphoned away exponentially day by day.

Thanks for sharing. . . I can't wait to forward a copy to my super. . .
Can't find your article....
I've looked under letters to the editor, opinions, etc.... I do not find it.
Just a comment about an article
in our local newspaper. All the hospitals in the county are going to EMR (electronic medical record) by 2011. They are putting all records on computer and state the hardest, most time consuming is the history and physical to put on EMR. I guess this means the end of MT around here! A friend of mine works for one of the hospitals as an MT and she has been abstracting instead of MTing to help put the most important facts on the EMR. Time to think about another career.