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What do you suppose - Will happen

Posted: Jan 04, 2013

When all these US MTSOs are hit by their clients with the demand that no work be outsourced off shore? If the trend in lawsuits continues, that could easily happen. along with that, what do you think will happen when the problems with EMR systems that don't include transcribed reports but only documents produced by the medical providers with point and click and fill in the blanks lead to law suits and illegal insurance claims?

What will happen perhaps - Been around awhile

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I think what might happen is that hospitals and clinics will decide that is in their own best legal and financial interests (not to mention the patients' best interest) to take the transcription back in house where (I think) it belongs. Overflow will continue to be outsourced when necessary, as it used to be, but in a manageable quantity so that the transcription department can look very closely at the documents that come back (as it used to be.) Of course, technology will change transcription, but realistically, if accurate medical reports are the goal (and losing some major lawsuits will certainly make that the goal instead of lowering the cost of transcription as much as possible which seems to be the goal at present) then there will still be a need for skilled MTs. I think it will still be possible for many MTs to work at home if they wish but they will be employed by the hospital and supervised by the hospital. Personally, I prefer working inhouse. When I started working at home many years ago it was because I could make so much more money working on production in those days. And it was nice to get away from the clattering of a dozen typewriters or more in the background.

I wonder how it works though seriously - for injury claims by (sm)

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an employee working from home. If I fall in my kitchen, is that workers' comp or does it have to be only injuries I've sustained in my office? Am I ergonomically correct at home like I would be on-site?

Other Issues: I worked remote as an employee for a hospital and they did not offer to pay my internet, a part of my electric bill, for my office furniture, etc., nothing. I got regular pay as if I was on-site, and I used my own personal PC to do the work that I bought and financially maintained the upkeep on.

I think it should all go back in-house although I looooove working from home. When I contemplate this line of work though, it should really be done on-site and we should have access to the dictators like the old times. This QA is crap. QA is not needed and never was in my opinion. The QA MTs guess just like we do and we get in trouble for guessing. Just my opinion.

What might happen - AJ

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I couldn't agree more. But since budget is the main concern at the hospitals it will be when the loss from the lawsuits costs more than the cost of in-house staff. All things considered, I think their bottom line is the only thing they look at, it is just business to them. No feelings involved, face it if they really cared about their employees and the best possible patient care they wouldn't send it off shore to begin with. But that is just my opinion.

You can bet your bottom dollar when the lawsuits cost them more they will start claiming how they need our "professional skills", which were not at all important to them when they outsourced. Whatever pays the piper.
AJ

I don't know, but I'd love to see them all sued, - regulated & legislated out of existence! (n_m)

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*

)there has to be some illegal activity (sm) - incognito

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Regarding the practice of making your lines to get your benefits, and then not provide enough work so that the MT is in a catch-22 position, among many other certainly illegal ways they gouge us.

Certainly an employment lawyer could see the holy-grail lawsuits that surely would come from this?

We need specific regulation of this "career".

MTSOs totally scoff at U.S. labor laws, all the while - contributing to demise of the middle class. nm

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nm

My hope is that - these hospitals

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who thought they could get their work done the cheapest (and I mean cheap, not inexpensive) way possible will eventually get their cumuppance and have to bring staff back in-house. Unfortunately they will not be able to find anyone with the skills to do the work and train the next generation of MTs and be up the creek without a paddle because we old timers who have been so badly burned and disgusted by this whole mess will refuse to step in and help them fix it.

I know, I'm probably just dreaming.

what would happen regarding EMR legal claims would be - medicare not paying if they did away with it.

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.

What will happen - your premise

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is that hospitals have no clue where their transcription is being done. They know. They don't care.

What "trend" in lawsuits? (I recall 2 lawsuits which is hardly a trend.)

Transcription is, always has been, always will be a cost to hospitals. Any way they can save money on it, they will do it, even if that means using offshore labor themselves (and many do) or signing on with an MTSO who they know uses offshore labor.

All the wondering, wishing, and hang wringing is not going to stop global economy.

Your comment about trends - been around awhile

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There is truth to what you say; I cannot say you are wrong, however, I don't think anyone is handwringing. These are just observations and speculation posted by MTs who all it seems, like me, have been in this business for many many years. I don't think you should discount what we are saying, we have seen the evolution (or rather devolution) of this business.

Every single medical malpractice law firm in this country is eyeing those law suits and the huge settlements, and you can be sure they will now be checking where the medical reports were done as well as everything else. Also, the medical report is not really a cost -- it is actually the end product -- because it is actually what the hospitals use for billing. It is what generates revenue. If the medical report is flawed, it can cause all kinds of revenue trouble for the hospital. These days I see all sorts of problems with these sloppy medical reports that I did not see when I worked inhouse or as a local independent contractor.

These mistakes are happening simply because the hospital is not supervising the production of the reports the way they should and used to do. The reports are flawed in ways inherent to the way we are doing things now.

In the pre-MTSO days, the all MTs worked in the hospital, with the exception of a small local service or even just a few individual MTs who contracted with the hospital. They (we) maintained close connection with the hospital. If an MT either in-house or an IC had problems with the report, she (or he) could pick up the phone, a local phone call, and call the floor, the admitting office, the doctor's office, etc. You could also pull the chart and check the information yourself if you had doubts. Not to mention the fact that we had daily contact with the hospital when we delivered our printed reports and picked up tapes. We would get timely feedback. Plus there were other "ears" available in the office when you got stuck, and above all there was a highly skilled supervisor to oversee everything and kept things consistent. Another thing that we did was to put sticky note on the report if we saw a problem. The doctors would almost always respond to us as well as fix the problem.

(Nowadays, QA decides, and QA is often wrong, they think that magic "CMT" gives them some sort of divining power and I shudder sometimes at the changes they take upon themselves to make.)

Plus when the doctor came into medical records, we could ask him (or her) questions about his(her) dictation. And don't forget the very sophisticated and knowledgable transcription clerks available, what a resource they were! These factors, and others I have not mentioned, created high quality trustworthy reports.

What I see now, from the vantage point of having done this work for nearly 40 years is not good. We have a problem, and it isn't just miserable pay and working conditions. While I agree the global economy marches on, I think in this one area, that in the end, the hospitals may decide it is far less costly to take this back in house. What these two law suits do show, is that outsourcing transcription can harm or even kill patients, and that happens just because of the way MTSOs operate, and have to operate. These two lawsuits are not an anomaly, there will be more.

Needs to happen at the patient level... - MT

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Patients need to be educated and understand that their records are being accessed by MTs in different countries. The hospitals are not going to make the change. It will need to come from patient awareness and demand. The patients are the consumers in this case.

Hospitals and physicians are cutting corners to save money, but the consumers (patients) are not seeing the benefits of those cuts. Are insurance prices going down? Is any price the patient pays going down? No. Not only are patients being put at risk more and more with these practices, they are not seeing any cost benefit. The problem is most people have no idea what transcription even is.

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