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Serving Over 20,000 US Medical Transcriptionists

PS: See article - AND the name of the guy who wrote it!

Posted By: sm on 2006-12-03
In Reply to: But of course, only in North America for the most part. - sm

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. 




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Yep! But once I lay down.... that's all she wrote!
I'm done for the day whether i've reached my quota or not.
Thanks to all who wrote sm
Thanks to all who replied. I appreciate the kick in the gluteus maximus and the kind words as well. Everything just came down at once on me and I won't go into detail. We all have those days if we stay on this planet long enough. Just a little overwhelmed. Bought a new computer last evening and the keyboard is very "tinny" and smaller, will just switch it with my old one, take a break and go back and try again. They also did not load all the things on that I asked for and I had to carry it back myself. They saw me struggling with the door and just watched me struggle. I believe in "paying it forward" and wanted to "give away" some things with no information on them to clear out my work space as well as study my new reference books before I tested. I should have done that before I went on line to test. I was dog tired. Seems everything is made of cheaper and smaller plastic. No, I don't want to go back to a typewriter, thanks for asking though, sweet of you to make that comment. I did "donate" my typewriters and my reference books to students years ago, along with anything else that could help them along in this business. I also "gave away" very lucrative accounts to those coming along when I had enough work for myself. I never asked for a dime and never looked back. Yes, I did do acute care and some of  those accounts would scream at the new "BOS" styles in the 2nd Edition, they hate change. I do not. They want it done "their way" or will mark you wrong and "fire" you. They also insist on allergies being bolded and underlined or it gets thrown back in your face.  In one instance, if you number the diagnoses, they do not allow it.One doctor called me a name because I asked him not to abbreviate in the final diagnoses. I have had the "f" word used on me by some of these dinosaurs. In another instance, writing "continued" at the end of the pages got me almost fired. So there's a lot to think about when you "test" for people who don't know what a good Transcriptionist can do for them. You have to have two mindsets, one for the testing people and one for the accounts who just won't budge on their rules.  I'll do just fine, just having a bad day. Thanks again. Over and out.  Karma
No..not at all. Somebody wrote me SM

out of the blue from MTStars (no hellos or introductions) and asked me to send her my ShortHand dictionary.  I worked months and months on it and have 48,000 entries.  I felt selfish too not giving it to her, but I was stressed that she would even ask me.  I thought about making a mock dictionary (Mary Morken's abbreviations) and stuff I gathered from ProductivityTalk.com so that if people in the future ask I could send them that.


So, in short, no--I do not think it is unreasonable for you to not want to send out your brochure at all.


Chickadee


I love what you just wrote
Right this moment, my almost 15-month old boy and my 5-year-old niece are playing and fighting over the toys. It does require a lot of skill and patience to do two jobs (one that is 24/7), but I have never regretted giving up my old career for my little baby.

I transcribe and while the file downloads, I do the laundry, wash the dishes or play with my baby - yep - multitasking is the key!
What are you talking about I WROTE THEM....some of them!!!!
They arent bad  I PROMISE.  Now you HAVE TO READ THEM. 
I know. I wrote this before you posted the other.
She also stated that she has not had any time away from the kids for 8 years. I hardly think that is needing so much time away from them. Just my opinion though. You might think you should take your kids everywhere you go, but it is healthy for a relationship to have alone time, even if your kids are perfect angels.

I personally am looking very forward to this buisness trip. This is about as close as me and my husband have ever been to a honey moon. I will miss my kids why I am gone, even though I will enjoy the time away. Everyone is entitled to a little "me time."
What we did 3 years ago was we wrote
everything down from least to most. We took the smallest bill first and put everything we could on that bill and paid minimum on everything else until they were paid off. I even settled on a few cards just to get them paid off. Yes it shows on my credit report that I settled but 3 years later my credit score is well over 750 and we are debt free. We have NO credit cards. If we cannot pay by cash, check or debit card we don't buy!

Doing it like we did, settling with the companies or working with a credit agency does not look half as bad as going BR.
I wrote here last week.....

About my incompetent lawyer, if you can be so kind as to call him that.  To recap, I paid for my divorce to be filed in January and he never filed, and so my ex-husband filed around April or so.  I had to take out a loan in order to pay him, to get things up and going.  Two different times, I made sure I told him to include my vehicle, my VIN number and all on my divorce decree, so I could get the ex's name off title, because he takes the title to the pawn shop and my car gets repossessed.


At any rate, my hearing was in July and I never so much as got a copy of the decree, so I went to the courthouse and got one myself, and guess what? the car's not on there.  I spoke with him to BE SURE right before the hearing, and my mother was in my presence and can confirm this.


I called him 4 times during the course of the 7 months, wondering what was going on with my case (since he hadn't filed it!), and then just recently 2 times about the car.  I got a bill today for an extra $116 for him having to amend the decree about the car, and for the phone call I placed to him regarding it.  I haven't gotten any paperwork about the car being put on the decree yet (which I'll probably have to get from the courthouse myself), and indeed, once I do, I'm going to file with the chamber of commerce and state bar, a complaint, but is this bogus or what?  I shouldn't be charged extra for something he should have done for what I initially paid him, should I?  I kind of wonder if he'll hold onto the stuff until it is paid, but I think this is baloney.


Thanks for any input.


By law...you wrote it, they are yours period

Those belong to you, end of story. The law automatically states that if you wrote it, it is yours.  Registered copyrights cover if someone distributes.  The link below provides the forms.


 


http://www.copyright.gov/forms/


Do you like this letter I wrote
to an attorney there at Cohen & Grigsby??

Lawrence M. Lebowitz
Cohen & Grigsby
Attorneys at Law
Pittsburgh, PA, USA
June 20, 2007

Dear Mr. Lebowitz:

I understand you are an expert at helping foreigners get jobs in our country.

I would like to start a company that helps foreigners come to this country on temporary visas to work as attorneys.

This will be good for America because, although we have many attorneys here already, they are too expensive for the average American, who is unable to find a good job because companies like yours are getting temporary visas for foreigners to take their jobs. These unfortunate Americans will now be able to afford attorneys to sue attorneys who help companies find loopholes in the system to be able to hire cheap foreign professionals.

My other idea was to get the laws changed so that we can hire foreigners to be our politicians. I understand they require much lower salaries than domestic politicians. I did an unofficial poll of some nice illegal immigrants in my area, and many of them believed we could hire a President of the United States from their country for a mere $25,000 a year. Think of the savings if we can assume we could hire foreign senators for $17,00 a year. We just need to change a few laws that our forefathers put in place for the protection of this country! But this idea might get a little more complicated and time-consuming, so I thought my foreign attorney idea might be implemented more expeditiously.

Can you please help me with my new business idea?

You might want to buy a nice home in Mexico now, because you might have to change your citizenship in the future in able to be able to find work in America!

Xxxxx Xxxxxx, NC

(How do you sleep at night?)


Wrote the book on this sm
When advertising for someone to take up some of my slack, these are some of the calls I got, will not use quotation marks - I can do that, I've been sick a lot. My Dad was a pharmacist, so I know those terms. My wife can type and I'm looking for a job for her. I have been approached by people I buy gas from, groceries, etc., they all have a cousin, an aunt, a relative who can type and they're going to send them over to me. A former boss sent his wife who has never had a job in her life but because I used to work for him (in retail) she just walked up to me and said, "Okay, when do I start?" Unbelievable!!! One person said, "Oh, all you need is to know how to type and you have to buy the paper." Another neighbor bought a medical dictionary for her computer and immediately sent out brochures, undercut me by 1/2 and actually docs tried her out. When docs offices called, they always asked, "What do you charge?" They never asked me what kind of experience I had. As you can tell, been doing this for years. The whole situation disgusts me.
I had that problem but i wrote it off ...sm
on my taxes as a deduction for each expense. My job was for a nonprofit homeless shelter clinic so I felt okay about it, like it was a charitable thing to do. I posted below regarding employee status vs IC because I am so confused about how many IC jobs I see on job listings on this site. I was employee x8yrs, then IC x16 yrs, then employee again x8yrs, but I thought the IRS/courts had become really restrictive on this issue. Now all the companies seem to be drifting back to IC but still telling you when to work so I'm stumped. In fact, I'm almost afraid to post this less I get "flamed."
I was also appalled and wrote the manufacturer
.
I could have written what you wrote, but I have 1 more thing to add..
I find that most of the MTs where I do QA are so very nice and take their feedback very well. They try so hard at the difficult ESLs (which is all of them) and I too know that it has to be grueling to do some of them knowing my take-home money depended on those dictators. We have a wonderful group of MTs, some good, some trying, but they sit there day after day and endure. I will give them credit.

I have also seen very poor quality for no reason, but I won't go there. Those folks should not be in the profession at all. I have seen that at many companies.

Hats off to all of you MTs who endure the hard work and continue to hang in there. You are recognized for what you do at least by some.
I could have wrote your post in the past about my ex..

Believe me, I am so glad he is my ex.  Life is just to short to spend it feeling that way.


I wrote the Lifesaver company once (m)
and asked them if that was true. They responded with the history of Lifesavers candy and did not mention the hole being there for that reason. They also sent posters and a bunch of other stuff. I always thought they probably distance themselves from the hole being a lifesaver thing because of liability issues, but FWIW, they don't admit to the truth of that story.
What an excellent post you wrote! (sm)
Everything is a hit-the-nail-on-the-head ACCURATE description of the mess the MT industry has become today. If the doctors & hospitals truly don't care about such gross mistakes in their dictated LEGAL documents, I wonder why they even bother at all.

I also wonder how long MTSO's really think they are going to get the most experienced MTs out there by continuing to chip away at their pay and benefits. I'm expected to turn out perfect medical reports, which means, even with 30+ years of experience, that when doing difficult accounts, I can't blast away at Mach II on my reports - I have to spend a little more time looking up state-of-the-art treatments, drugs, etc., and then extra time proofreading each report afterward (which is difficult when you're proofing your own work). And yet in order to earn what would normally constitute 8 hrs. worth of pay, I often end up working 12-hour days. And yet my rent (which is way below-market, I might add) still consumes more than half of my income each month. (I went to school for WHAT??)




Hi, Nissa, I am also with you, Elle wrote...sm
a fantastic, heart-felt, and very knowlegdeable note to you; it really can be hard, and one of the biggest stumbling blocks to production, when you are constantly switching huge accounts, all fields and ethnicity of strange (to you!) dictators, little feedback from QA, as is the case with many larger nationals...I also have been doing this close to 20 years, in all capacities, and the shortcut/expanders are great, all the on-line technology with dictionaries and references, all the new transcribing platforms can be great once you get proficient with them....but the very best money I made was always either with a local service or clinic, even though there were ESLs or specialties I was not all that great with, or when I worked in-hospital and of course got used to all the many docs over and over again, all their "normals" and phrases they usually used, etc. In short, if you love this field, as most of us do, if you are dedicated and organized, then many times if you go with a smaller company with less accounts, less dictators, and most importantly the ability to truly get thorough feedback from your supervisor, MTSO, or QA person, you will be learning and getting quicker by the week!! Have faith, and e-mail me anytime for a pep talk, we all have to stick together!
Can't you read? I specifically wrote...
"..for us, the MTs.'
I wrote the post and I am not offended, I took it how you meant it.
and like I said.... I love warm  milk, drink it almost every night.
I don't care who wrote it either, be it Paul Harvey or anyone else.
and the way the majority of people apparently feel in this country who are sick of being made to feel that for some reason we must tip-toe around minorities and disregard our own culture.

I'm sick of it and the person who wrote this article apparently is too.
I'm with you - I once wrote a letter to the makers of Sensodyne (sm)
toothpaste, as on the box, it said something about "receeding gums."  They wrote me a letter and thanked me (I was hoping for $) - but they told me they had enclosed a coupon for a free tube (BUT IT WASN'T IN THERE!! - On my son's high school graduation program, it listed the class song and the class "moto."  That one killed me. To this day I ask him if he remembers his class moto.   I notice it everywhere - drives me crazy.  What about street signs - there is one around here for the "bussiness district." 
MEATLOAF wrote and sang that song
Celine Dion did it close to 20 years later - Meatloaf has always been like he is - even when he was younger.
Actually READ my post. I wrote "A GOOD COMPANY"
Thick, thick, thick.
I wrote it down! JK Lasser's "Small Business Tax Guide," and see msg.
The other was 1001 Deductions and Tax raks for Personal Deductions. I don't have an author for that one.
so what if they wrote the check to feed their kids that were starving, would you buy them some groce
some people just can't make ends meet. what i see as wrong with that is our government.
He wrote the song, but it was sung by Celine Dion...around 1996 I think. nm
x
Of Course Endiqua read your post. It is irrelevant to her what you wrote and she is fully prepared
Hush and take notes. Endiqua is the authority on all things and doesn't need to read your post or even understand it. She's got an opinion and by gawd you will listen. QA is annointed boss of you.


Yes, he was peaceful because he was so whacked out on drugs. He was a drug addict who wrote songs.
Pure and simple - no big thang...
Love it. I wrote it down but hope I can remember it. Would lose impact if I had to look in purse for
nm
Sombeody actually wrote a really good letter to Advance a few issues back. sm
It was in the Jan. 12, 2009, issue, letter to the Editor titled, "What Good is Change for MTs?" by Wendy Keller. She does attack AHDI in a very intelligently written letter.
article
51, trained on the job 26 years ago,
article...

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.


 


article
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,
Article
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.

Thanks!
Article.........sm
http://health-information.advanceweb.com/common/EditorialSearch/AViewer.aspx?AN=HI_06may22_hip18.html&AD=05-22-2006

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
http://www.networkworld.com/net.worker/news/2002/0408networker.html
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.

http://www.townhall.com/columnists/thomassowell/ts20040601.shtml
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.
ADVERTISEMENT


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
millions)

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

Operating
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 -

Notes:
(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

Revenues:
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

Revenues:

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

Revenues:

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

Revenues:

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.


Actually, the article was out of AdvanceHealth Mag, and
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...
Interesting article

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


http://health-information.advanceweb.com/common/Editorial/Editorial.aspx?CC=66392&CP=1