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Serving Over 20,000 US Medical Transcriptionists


Posted By: old grandma on 2005-07-06
In Reply to: If they're not willing to go to war for - US, can you explain this? sm

Soy intelligente y no necessito trabajar mas!  Y tu??

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    Okay, here is the plan.  For all of these hospitals with heavy ESL dictation loads, outsource these yourselves to India, Pakistan, Trinidad or where ever they speak that English as an unknown language.  It won't matter if it is correct as typing those documents is just a best guess scenario anyway.  Leave all of the English as a First Language (EFL) here in the US for those of us to type as we have been working long and hard to gain our experience and deserve to have decent work.  If a hospital has a lot of ESLs that they have brought stateside to staff their hospitals as hospitalists as they work cheaper then it should be their responsibility to give them English classes and monitor their progress until they can speak English clearly, concisely, and accurately.  The solution to this problem with ESLs  is in our HANDS and we know it.  The large companies and hospital clients need to take note before it is too late and we are all retired.  You need us more than we need you.
    And it is you and your "oh so thankful to have a job" kind that have gotten those of us that are MTs and will never be MLSs into this ESL cesspool by allowing it to happen.  Anything for money, right??

    Sure, my world is called Affirmative Reaction, taking back what was ours by right of being an MT before the almighty dollar spoke and we allowed our hospitals to actively solicit these ESLs, bring them stateside, pay for their malpractice coverage, and employ them as hospitalists, and now we are stuck with a language barrier that, in all other fields, requires a certified translator but now that we have been awarded the title of MLS we are supposed to type an accurate medical document while listening to an ESL's attempt to speak English??  This is your world now, I have done my time, and you are welcomed to all the ESLs you can handle or rather fool yourself into believing that you can do so very accurately.       

    Okay, this string is not a question of what our ancestors did, it is to get those of you that are new to the MT business to realize that if we don't do something about this outsourcing of medical transcription, your "oh so wonderful jobs" may be forfeit.  Look at IBM, laying off over 13K stateside and hiring 14K in India.  Any Capitol One sending all of its customer service to Manila--that's right, your credit information.  Think money has anything to do with that??  Open your eyes, your job is slipping through your fingers...
    If these ESL doctors are such wonderful humans, why don't they stay in their homelands and help their own people?  There would be no third-world problems if the privileged and educated people stayed in their homeland and actively helped their own, rather than fleeing to the US to live the good life that their own countrymen will never see.  Charity starts at home, remember. 
    How could it happen?  Very easily.  Many of the national companies actually have policies in which they state that, should an MT notify them of a difficult/hard to understand dictator, they will alert that dictator and work with him/her to enhance their dictating skills, along with notifying the client that a particular dictator presents an accuracy problem in that their English is not clearly understandable in order to be transcribed accurately.  Unfortunately, most of these companies do not enforce their policies and allow the client to send these dictators as overload work since their own in-house staff doesn't want to type them either.  These national companies could address these issues, the dictator would benefit from the help provided, and the MT would be able to produce an accurate product.  There are even self-help tools for these ESLs to better their dictating skills.  If these clients/hospitals do not choose to help their ESL dictators, then they should either type their dictated product in-house or pay more for the handling of such a poor dictation product.  MTs are not the garbage men or clean-up crew.  If one wants an accurate medical document, one must provide an accurate and understandable dictated product.  We are not magicians, we are MTs. 
    No, not a newbie, more notches on my belt from nursing and working as an MT than you will ever see...

    Not off base at all.  Yes, they are part of the healthcare system, and their documentation is very important.  But if the dictation that constitutes their documentation is substandard then the risk of mistakes rises and patient care is at risk.  Having worked with these doctors, I know that they generally do take constructive criticism well and do try to make things better once the problem has been pointed out and a solution offered.  You can't solve a problem by ignoring it exists.

    It does exist, won't name the companies without their permission, but even the in-house supervisors will attest to the fact that they do offer suggestions to these difficult dictators in hopes of making the dictated product better.  Guess you haven't looked in the right places??
    outsourcing plan
    I totally agree with you grandma, but please, let us not forget the American Docs who can barely speak English or don't care enough to slow down so that we can understand them. What about that?
    HIPAA, unfortunately, did not plan for outsourcing overseas. sm
    Unfortunately, when HIPAA was implemented, they did not anticipate the outsourcing of medical records overseas. My question is: With all the controversy regarding HIPPA's regulations in regard to patient confidentiality, and the fact that once the information leaves our country the rules do not apply, why has HIPAA not made changes to specify a ban on U.S. citizens' medical records leaving the country. They know darn well that their rules do not apply and cannot be regulated once that patient's name, SS#, DOB, address, phone number, leave the country. Total lack of competency in my opinion. I guarantee that there are few, if any other countries, who allow their citizens medical records to leave their home country. Our government needs to reflect on the bad choices they have made in regard to patient medical confidentiality. This is the most private aspect of a person and deserves to be respected. I bet 80% (or probably many more) U.S. patients have no idea when their medical records are being transcribed by an overseas transcriptionist. I have been in this profession for many years and can honestly say most doctors have no clue where their dictation is going. Only the hospital administrators, in some cases, can verify who is transcribing their physician reports. Many times, even hospital or clinic administrators are betrayed, as many foreign transcription companies set up base in the U.S. with an address and toll free number, which leads the administrator to believe the MT company is located in the U.S. Laws must become more stringent in this arena before any change is seen. All caring U.S. MTs should write to their congress, senate, and federal government in attempt to have someone make a difference.
    You're confusing the new QA plan with the new pay plan. New pay plan is still completely under wr
    I am talking about the QA plan I dont know what the new pay plan is.
    In this day and age, especially with globalization, any one of us can be replaced quite easily..not just in the MT field, in all fields.  When I heard they are outsourcing radiology work to India and hospitals are letting some radiologists go, I almost choked!  The other day when I called the local court house to postpone my jury duty service, I talked with a lady who had a thick Indian accent.  I was tempted to ask, are you in India.
    outsourcing ad
    about 20 or so posts down, subject "censorship" ... two advertisements at top of page, one soliciting transcription to be sent to india for great savings, etc. outrageous.
    Great article-- but do you think the CEOs care?  They are too busy with their big 6-7 figure salaries and bonuses to worry about us.  All they care about is the bottom line-- how to save an extra nickel so they can line their pockets and buy that new yacht every year.

    I think it will get to the point where everybody will outsource at least some of the work.  With all these companies begging for employees it doesn't seem like there's enough of us.  The employer I just left was a private owned company and one of the biggest accounts decided to outsource. Don't know who they chose to do this for them, they didn't say, but my income was cut from 4500. a month to 1300. a month.  Right now just desperate for a good job.

    No way. It's here to stay. There just aren'the enough transcriptionists out there to do all the work and turn it around as quickly as it is expected these days. I would not worry. There is enough work for everyone.
    ...I hear you. The more we rely on technology, the greater the risk, and the more our private information goes bye-bye to India, Timbuktu, or where ever, the greater the risk we are putting ourselves. Interesting to find out China, the sleeping giant, has thrown out all things MICROSOFT in the country. See, there're thinking ahead, years down the road. They use only Linux, won't chance anything to a world wide shut down someday by terrorists or otherwise. THAT, I find interesting. I also wonder if our powerful men in politics, especially our President and his administration have arranged to keep their private healthcare records state side ... hmmmmm...

    I agree with the posters. Check your medical reports, some of them contain serious errors, I was misdiagnosed in an op report as having a serious condition I was determined "not" to have.

    I also was treated like a common criminal by a foreign country because I bought a laptop from someone who lost their job in 9/11. I paid a little more than I should have because I felt sorry for him and unless I pretended to be "him" they would not help me. I finally after two months got the right part from an American company and my laptop worked just fine after two shipments of the wrong part and a whole lot of aggravation and misinformation.

    They are a third world country and we will take their place soon if we don't watch out. They'll be taking over more than our jobs. It's very dangerous. It is life-threatening as far as information goes. Some will be saving money but losing lives.  

    What worries me is it's bad enough when they mess with our finances because they don't understand how things work in our country. But now with transcription being outsourced, they are literally messing with our lives! A transcription mistake of left versus right, Klonopin versus Clonidine, 0.5 mg versus 50 mg, could mean disfigurement or death if not caught in time by an overworked nurse or doctor.

    In response to: People say outsourcing will happen.....It is happening!! There are a few National companies (which will go unnamed, but you know who they are) who have contracts with facilities who know the work is being outsourced and they want it because it cut their line rates significantly. This is our biggest competition right now. Overseas, the piddly line rates of 6 cents/line is a lot of money to those people. They are getting better and better at it (the offshore countries), and in time, they will be so good that there will be little editing needed. It is just like newbies here in the US, it just takes time for them to improve and learn...and before you know it, we'll wake up one day and poof...very little if any work in US, all overseas! It is a global economy and what we think is peanuts, they think is a fortune! I am currently retraining in another profession (nutrition) because I have been watching this evolution for the past 7-10 years. I managed a company back in 1997 that first sent transcription overseas and I had to proof and edit that crap! I think in 9 years, they are probably getting better at it and with time, they will improve even more. Don't be so sure that outsourcing will not continue to be a current event! IMHO.


    I originally posted this on the "Company Board," but one kind soul there suggested I repost it on the Main Board, so here it goes:

    I'll tell you my personal take on this.  I'm a very small MTSO and am fighting like heck to keep my jobs in the good old USA - hiring only Americans, etc.

    We face stiff competition from companies who offshore, use EMR, etc.  I charge my clients what the market will bear.  I've already had to lower my rates to 2 of my largest clients because even at the lower cpl rates I was charging them at the time, they were ready to walk to India, and in fact were testing out some Indian MT companies - this after I had, in fact, already lost 2 other doctors' offices to offshore Indian companies.  I feel I am fair and pay my IC transcriptionists 2/3 of whatever I make from my clients.  But whenever I advertise for experienced transcription help, I am pretty much told to go jump in the lake with the rates that I'm able to afford to pay, even though it's good, steady work.  So the bottom line is that I really find it difficult to get any competent help from American MTs. Not that there aren't many around, just that I and many like me can't afford them.  Not blaming the MTs (American OR Indian) for wanting to make a living either, I'm just saying this to demonstrate the dilemma I find myself in. I suspect it's the same for other small MTSOs.  Can't really raise my rates, because from prior experience, many doctors offices have no scruples about sending work offshore.  I've never resorted to offshoring anything, but I'd be lying if I said I wasn't tempted.

    Not singing the blues, just telling the facts.  Personally, I'd rather be selling hotdogs on the beach.


    I am the only Transcriptionist in a doctor's office.  We started sending some work to a transcription company in November and later found out they were outsourcing to India.  I thought my doctors would be upset, but guess what??? NO!!!  It has been the biggest "mess" for me to correct.  It has been far more trouble for me than if I just typed everything.  I started leaving all the blanks, etc. and let the doctors start dealing with this and as of 6/15/07 we are no longer using that transcription company.  We found someone locally (IC) who is typing our work for the same amount per line.  YEAH!!!!! 

    Right. Hopefully the other companies do not do the same as Medquist. One company can ruin it for everybody.

    The truth of the matter is if you can get the same item at a different store for half the price, you are going to go to that store to get it (which in turn would cause the other stores to have to lower their price).

    I am just putting a warning out there for people to know that this is out there. Medquist will tell you that you will be able to produce more work and will lower your cpl to 5 cents/line; however, as you said, the quality VR puts out is horrible and it takes just as long to edit the VR work as it would to type it. They (Medquist) are also outsourcing work to the Phillipines. Our pay is lowered as the cost of living goes up.

    maybe it goes along with outsourcing.
    If you can outsource paperwork, why not babies? The article says all nationalities are involved. It does make one wonder.
    Outsourcing sm
    Our jobs are going overseas and I had an idea! Lets outsource the US Government to India.

    I'd bet it would cost a lot less. When candidates are running for office, they can use those Indian phone banks to explain their platforms. The accents are thick, but what does it matter? Politicians are not outstanding speakers and when it comes to listening to the people their skills are nil. Employ an Indian to run your rhetoric...raise funds...and sit in a caucus.

    Let Indians do the accounting for the feds. I am willing to bet that for 3 cents a line a "highly educated" Indian could find all the wastage of $100 hammers and $1000 toilet seats. Let them type up bills to be put before congress, they type cheap and we all know that. I can't speak for the accuracy, but it is CHEAP.

    Better yet, buy American! Shun the goods from China, India, and all those third world countries. Keep it at home.

    And um, Mr. President? Exporting democracy doesn't mean you export American jobs...
    Can anyone enlighten me just how an individual such as myself could check to see if a company that adverises on MT Job Boards has any affiliations with India or outsourcing? Thanks for your help.
    Not outsourcing

    All our hospitals/facilities Outsource - to us.- so unless we all want to loose our jobs, we need to be careful what we complain about.  It's Offshoring that we're protesting. 

    I recently lost my job due to outsourcing and it is killing me emotionally.  I loved the company had been with them for a year and it was okay, could have been better but I felt good about the work, company etc.  Monday, got the call and just been ship wrecked every since.  I expected more out of them...nothing like we will find you another account, it was just we are going to be sending it to India due to the cost.  I am still hurting from it....not really financially, but mentally. 
    Our manager has fought off that demon more than once. She is very supportive of in-house transcription. It's great to have someone finally stand up for us!!!
    I just have to vent my frustration!  I had an appointment with my orthopedic doctor this morning and we started on the subject of transcription.  When I asked if he had inhouse or a service he told me they send all their work to India.  They have several physicians and PACs which dictate and they were spending over $100,000 a year for transcription.  Their service was charging them .12 a line.  They pay .06 a line in India.  Obviously the service could not compete.  :(  I should have asked him about quality and TAT!
    It is rightly mentioned by “none” that “this is not the only industry that outsources”. One just has to look around our house or a store nearby to find that there are lots of electronic goods, clothes etc. which are not made in the United States. These have been true since decades.

    Frankly speaking it was the western world and US which wanted these economies to open up so that American products could be sold there. Now these countries have a Nike, Pepsi, Ford, Whirlpool etc. but they are now producing it too and at a cheaper rate. The job losses through manufacturing have been huge but this sector innovated. My take is that MT industry also has to innovate because technology has made outsourcing inevitable.

    And those of you who say that we should not visit a doctor who sends work overseas, my question is are you using only American made products? If you are then you can say that otherwise please don’t say things which you don’t follow yourself. Maybe lot of American jobs would be created if all the things we use in our daily life were made in US and not in China or India.


    This just recently happened at the company I work for (not just psych but psych was included), they went with another service to do their work (we were just doing overflow) and part of the deal was they had to take all the inhouse transcriptionists...well from what I hear they are making it real difficult for the transcriptions, I think so they'll quit and they can bring newer people in at a lower rate.  Just my opinion.


    About outsourcing...

    It's not just us - but darnit, I'm still mad!!!


    A lot of them do. Usually they start outsourcing discharge summaries. No matter where you work, inhouse or at home for a national, it can be sheer drudgery at times and the holidays are usually the worst of it.

    Changing careers can be a good idea and a welcome change but with the uncertain times we live in who knows???? It's hard to make decisions when everything seems to be in the throes of bankruptcy, bailout and the old rules seem to be gone forever.

    Things will get better in time. I hope.
    Girl (or guy), I feel your pain! Unfortunately, it's not just transcription. I had heard that radiology reports were read by off-site radiologists now (in India, or wherever), and we experienced it firsthand a couple of months ago when my husband went to the ER and had several tests done. What took the longest time for us to get out of there was having to wait for the radiology report to be faxed back to the hospital. Sure, I guess they still have to have someone on site to take the pics, but I guess those are lower level, tech jobs. Crazy.
    I too am concerned about losing my job. I've already lost one good job due to outsourcing, a gastroenterology office. My main job now is putting in system where info will be put in computer at time of patient visit thus, not needing transcription. Yes, I am very concerned about it.
    Bless your heart... I just don't know if us transcriptionists can turn this around:( I called the Obama campaign line & reported what is happening to him & I also left a post on change.org about it. I just don't know if transcription is going to continue to spiral downhill or what, but I am so worried:( I am seriously thinking about going to college to do x-ray tech just so I can be multifunctional for the hospital if I get the shaft with transcription.
    In my experience, the doctors who are either on staff and/or have admitting privileges to a particular hospital are basically at the mercy of the hospital board and administrators, as the revenues generated by the physicians to the hospital are filtered through all the departments, so that each gets their share of those revenues, with the hospital gain outweighing the physicians. So, although doctors may not necessarily like it if dept A is outsourced, they're still weighing that loss against depts B, C, D, etc. Does that make sense? Perhaps if they keep barking loudly enough as more and more departments are eventually outsourced, the powers that be will finally take notice and listen! Unfortunately, by the time that happens, those suits will all be standing around wondering what happened to THEIR jobs!
    Working such rigid hours is a very common Eastern Asia thing. I know it is a stereotype but that is how one family can run a 24-hour store, because they are very strict with their hours. While IC used to be you work when you want as long as you get the minimum amount of work in each day that you said you would it is becoming more like just a glorified telecommute position. You still have to be online and ready to work certain hours and if you aren't you are disciplined like with any job. I see this a lot with jobs that are overseas companies and even American based companies are adopting the program. It prevents problems like were listed in another post - everyone taking the same days off and no work getting done.

    Your best bet is to make sure the contract does not say you have to work certain hours, just submit so many lines a day AS WORK IS AVAILABLE...I've seen people get in trouble for not submitting lines but there wasn't work enough to get those lines.

    We aren't given the freedom we used to, but there are still jobs out there if you dig far enough! Good Luck!!
    Spheris outsourcing
    Spheris is using more and more MT' and editors from their operation in India. Because of the difference in what they pay them their goal is to eventually eliminate the need for American MT's. More and more US MT's are leaving the company and going elsewhere. Spheris has a well deserved reputation among MT's as one of the most dishonest and possibly the worst company to work for in the health care business.
    Why Outsourcing Hurts Us


    Interesting article!

    America's Lost Hegemony
          By Paul Craig Roberts

          The historian who chronicles America's decline will lay the blame on free market ideology.

          I say this as a believer in the market. My books and scholarly articles demonstrate the superiority of market systems over government allocative schemes. The problem arises when market economics ceases to be thoughtful and becomes ideological or a dogma.

          A good example of the latter is a recent Heritage Foundation study that argues that global outsourcing is the best way to equip the US military with the best technology at least expense. The study brushes away concerns with the erosion of the American manufacturing, science, and engineering knowledge base by asserting that such concerns imply protectionism and that protectionism means the death of innovation. ['Buy America' Provisions Don't Help Homeland Security or National Defense by Alane Kochems, June 21, 2005]

          Protectionism can be problematical for innovation, and the study is correct to point this out. Where the study fails is in ignoring that innovation does not take place in a vacuum. Innovation requires a material base and depends on a strong manufacturing, science and engineering foundation backed by R&D programs.

          In an interview with Manufacturing & Technology News (August 8), the study's project leader, Jack Spencer, sees protectionism as the only threat to American innovation, which he otherwise takes for granted:

          "Our belief is that subjected to the free market, the United States is still going to produce most things because our comparative advantages are innovation and new technology. If liberated from protectionism, we can compete and that is where we will always emerge as winners." [Heritage Foundation Says Congress, DOD Should Learn To Live With Globalization; Providing Troops With Best Equipment Usurps Making It In America by Richard McCormack]

          This belief is simply untrue. As this belief is the basis for the study, the study has done nothing but confirm a preordained belief.

          The US has no God-given comparative advantage in innovation and new technology. We were leaders in these fields, because we were leaders in manufacturing.

          We were leaders in manufacturing, because Europe and Japan destroyed themselves in wars, and the rest of the world destroyed themselves in various forms of socialism and cronyism.

          America's hegemony in manufacturing, science and engineering was the product of historical circumstances. Moreover, it occurred despite American protectionism.

          The historical circumstances have changed. The US gave away its scientific and engineering education and its agriculture. It did this partly for idealistic reasons and partly as cold war strategy.

          Once socialism collapsed in Asia, US corporations began outsourcing abroad the manufacture of products for US markets. Success with offshore manufacturing has led to offshore outsourcing of research and development and now innovation itself.

          As a recent report from the National Research Council recognizes, "product development and technical support follow manufacturing." One consequence for America is the loss of many manufacturing capabilities and "the increasing availability abroad of unique technologies not found in the United States."

          This development is taking a huge toll on America's human resources in manufacturing skills, engineering and science. The first American victims were blue collar workers. Millions of them lost their jobs and experienced sharp declines in the quality of their lives. But as research, engineering, design, and innovation followed manufacturing abroad, now it is white collar workers in information technology and university graduates in engineering and physics who are being displaced.

          American university enrollments in science and engineering are declining because there are no jobs for graduates. It is pointless to invest money, sweat and toil in an education that has no payoff. Markets do work. Markets are working to shrink the demand for, and supply of, American engineers and scientists.

          The next impact is going to be on project manager jobs, practically the sole remaining source of career related employment for many engineers and technical people. Project management jobs require people experienced with the technology of the job. The loss of technical and engineering jobs empties the pipeline of people who have the experience to assume management positions. Far from being able to innovate, the US will even lack the human resources to manage technical and scientific projects.

          Many uninformed people believe the problem is that America doesn't produce enough scientists and engineers. Manufacturing & Technology News reports that "a group of 15 US business organizations has launched a national campaign aimed at doubling within 10 years the number of bachelor's degrees in science, technology, engineering and mathematics."

          What is the point of this when there is a huge supply of unemployed engineers and technical people who have been displaced by offshore outsourcing and by H-1b and L-1 work visas for foreigners? I know an American software engineer in his thirties whose job was outsourced. After searching fruitlessly for a job for four years, he took a job in Thailand writing software programs for $850 per month.

          The anecdotal stories are legion. Yesterday, a friend reported to me that the service technician who repaired his garage door opener said his company was flooded with resumes from college graduates and engineers who cannot find work and are willing to take jobs installing garage doors.

          US executives, with an eye to quarterly earnings and their bonuses, continue to spend considerable resources lobbying for increases in work visas that enable them to replace their American engineers, scientists, and technical people with lower cost foreigners. These executives lie through their teeth when they assert the lack of qualified Americans for the jobs. The fact of the matter is, the executives force their American employees to train their foreign replacements and then fire their American workers.

          In a word, American capitalism is destroying itself by dismantling the ladders of upward mobility that have made large income inequalities acceptable. By rewarding themselves for destroying American jobs and manufacturing, engineering and scientific capabilities, US executives are sowing a whirlwind. American political stability will not survive the turning of an American university degree into a worthless sheet of paper. Libertarians and free market ideologues who rejoice in freedom should open their eyes to freedom's destruction.

          Dr. Roberts, [email him] a former Associate Editor of the Wall Street Journal and a former Contributing Editor of National Review, was Assistant Secretary of the Treasury during the Reagan administration. He  is the author of The Supply-Side Revolution and, with Lawrence M. Stratton, of The Tyranny of Good Intentions : How Prosecutors and Bureaucrats Are Trampling the Constitution in the Name of Justice. Click here for Peter Brimelow's Forbes Magazine interview with Roberts about the recent epidemic of prosecutorial misconduct.


    Spheris outsourcing
    Could it be they are outsourcing because of so many lazy US-based MTs?
    is outsourcing being REVERSED ya think ?

    Do you guys think the trend is starting to reverse itself ?  Im sort of, kind of, starting to hear about unhappy hospitals / doctors lately - who miss our on-the-spot turnaround time. 

    What are your thoughts on this topic ??

    Janie the homebody

    No end in sight for outsourcing
    I believe some of the accounts will come back state side, but the outsource offshoring will continue - no end in sight. To look at the bigger picture, our healthcare system is in a mess with no solutions actively being worked on. As monies become tighter in the future and if nothing is being done about fixing our healthcare mess, the motivation is strong for financial officers to send more work offshore because of the cheap labor. Some hospitals now accept offshoring as a solution and when the hospitals themselves directly use this service, well, not much hope to keep the work state side. I believe there are some facilities that will not accept inferior work from any one, state side or otherwise, but I am also seeing that some hospitals WILL accept inferior work motivated by the cheap price. This is happening across all sectors of business in this country. More than 50% of IT jobs are now in India and China with no end in sight. More and more business are trying to find ways to dump their benefits - #1 is health insurance and this affects all of us as more and more people are going without health insurance.
    The danger of outsourcing
    My brother recently put in an order with a well-known computer company for two laptops with all the bells and whistles. Something came up and he needed at least one of them ASAP. He called to see if he couldn't get at least one of them in a couple of days and got someone from God knows where who told him the order had been cancelled. When he inquired as to why, the person then proceeded to tell him that it was because he was trying to "commit a fraud" - direct quote from the customer support person. He went up to the next level, got the run around from another ESL person and finally got with an English-spearing person. When he applied for his credit application with this two-initial company, they approved him and then did a seconary check on his employment. He is a union electrician and works out of a union hall. Duhhhhhh. The first person said he was not employed by the union hall and accused him of attempted fraud and cancelled the application and the production of his computers. Of course, he is not employed by the union hall - he works OUT of the union hall and probably has enough pocket change to pay her yearly salary and that of the rest of her family for the next year. I know - because I happen to know he is a tightwad. After all, he's my brother. What I love best, is that his wife works for a mega law firm and he actually threatened them with a law suit for slander and had everyone wallowing and apologizing. I myself have now started telling ESLs I do not want to talk to them I can't understand them and want to speak to an English person after someone at Bellsouth called me to pay my phone bill 3 days before it was due and there was no past due balance involved. I've had it with these compaines and I will NOT put up with these people any longer. This is the US, get with it or stay in your country and learn English before you get over here or stay there and learn it or whatever just learn the darn language before you start telling me about what you want or expect. There, I feel better.
    there's no stopping outsourcing now
    what many people don't understand is this is just the beginning. We and our children will be competing against the best in the field from ANY country- Ireland, China, India...so one better find a job that has to be done HERE - which could be anything from window-washing to nursing...or be prepared to be very good at what you do...
    Hospitals Using Outsourcing
    Really not so unusual for all hospitals in one city to contract out transcription. Little Rock, AR for example where I used to live, did just that, save for one hospital (Baptist), so I moved east to Memphis, because I could not stand working out of my home to land a hospital job to work in. Cost-cutting measures you know.
    There is a difference between outsourcing
    and offshoring. If a facility outsources, it may be going to an American MT company,rather than an offshore company. When I started in this business almost 20 years ago, I was told my field would be nonexistent within the next 5 years, still not so.