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15 Nov 2003
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Going overseas won't solve the problem?

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Dear Friends,

As the MTIA International Committee Chair goes about developing the
proposed 2004 business seminars to be held in India and
Philippines; this is the latest from the AAMT Executive Director, I
quote:

"To read the article "As Economy Gains, Outsourcing Surges" (Boston
Globe, Hiawatha Bray, 11/02/03) the reader would believe that
sending medical transcription offshore to the Philippines could
save the U.S. healthcare system millions in labor costs. Not so -
in fact, the elaborate web of transcription subcontractors that vie
for business in the industry are the real culprits in escalating
the costs in this business - not the transcriptionist. Going
overseas for transcription service won't solve the problem.

If healthcare executives would cut out the many layers of middlemen
and pay more directly for transcription services, much of the $20
billion a year industry could be redirected to risk management and
patient safety, thereby driving down the costs of expensive medical
errors and lag times in documentation. Recognizing the role medical
transcriptionists play in documenting healthcare encounters, these
professionals offer great value as medical language specialists in
quality assurance and continuity of care. Driving out U.S.
transcriptionists merely to pay for cheaper labor overseas is
shortsighted and threatens to take another bite out of quality in
the U.S. healthcare system.

Fix the system with the U.S. transcriptionist by maintaining
rigorous educational standards, recognize credentialed
transcriptionists, and reform the workplace to meet the realities
of the electronic medical record and evolving health information
infrastructure. Healthcare in America will get a better return on
that investment."

This gentleman does manage to confuse me - what is trying to say?

1) That offshore transcription doesn't offer a cost advantage?

Then why does he think transcription is going overseas? Because of
a shortage of US MTs?

2) That many layers of middlemen take away the margins?

Now don't we all know that! Removing subcontractors would help the
offshore industry to a great extent, in both costs and
deliverables. I hope he starts an information campaign to that
effect, amongst HMOs.

3) That offshore MT quality can't be at par with that done in the
US?

That's contradictory to all evidence - he should be speaking with
those who get their work done offshore, rather than with those
whose only agenda is to ban offshore outsourcing.

4) Fix the US Healthcare system?

I am extremely surprised to see that he can't appreciate that when
HMOs are forced to invest, they shall do so on long term
technological alternatives to transcription like structured data
entry in electronic patient records and speech recognition; and not
in training or furthering the cause of transcriptionists.

In our last newsletter, I quoted Claudia Tessier, the past and
long-term CEO of the AAMT, where she felt "Transcriptionists will
increasingly fall short of meeting changing demands for health care
information capture , including greater accuracy and point-of-care
documentation."

Here I am seeing the present Executive Director of the AAMT making
statements which fall short of comprehending changing demands - let
alone meeting them!

"A person going nowhere can be sure of reaching his destination"

We invite our members to discuss this further at the forum:
http://www.mtindia.org/Forum/default.cfm

Chio!

Maj (Dr.) Amit Chatterjee, SM
Strategist / Founder ~ mailto:amit@...
MT India ~ www.mtindia.org
"The Community of MT Professionals"

"It takes years to become an overnight success! Inch by inch, it's
a cinch."

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NEWS AND VIEWS :
------------------------

1) Salary hike boom for back-room boys

A Hewitt Associates' survey has shown that IT-enabled professionals
in India had the highest pay hike this year with an average
increase of 14 per cent among employees in all sectors in the
Asia-Pacific region.

This year's increase was, however, 10 percentage points lower than
the industry's average salary increase in 2002.

"IT-enabled services like call centres, transaction processing
centres, medical transcription centres and other business process
outsourcing (BPO) units are showing the highest growth in salary
and the trend will continue," Hewitt's India business consulting
leader Nishchae Suri said.

After India, employees in the Philippines enjoyed the biggest
average salary increases, ranging from 7.1 per cent to 8.6 per cent
across job categories, compared with the respective 2002 figures of
6.4 per cent to almost 10 per cent.

http://www.telegraphindia.com/1031112/asp/business/story_2562528.as
p

2) US divided over outsourcing of jobs

American experts are divided over the issue of outsourcing white
collar jobs from the country with some being of the opinion that it
may slow down the nation's job growth, while others stating that
the phenomenon was healthy for the country as it could create more
sophisticated jobs doing away with less productive ones.

Jobs vulnerable to the new way of outsourcing, they said include
medical transcription services, stock-market research for financial
firms, customer-service call centres, legal online-database
research, and payroll and other 'back office activities'.

They argue that the positions feature vulnerability-producing
attributes such as a lack of face-to-face customer service, work
processes that enable telecommuting and Internet work, high wage
differentials between countries, a high information content, low
social-networking requirements, and low set-up costs.

A coalition of Indian government officials, business groups and
influential Indian Americans has quietly launched an extensive
lobbying campaign here to counter allegations that the country was
taking an unfair number of high-end US jobs.
India is paying several high-priced Washington lobbying and law
firms to craft a campaign extolling the benefits to the US of
closer economic ties with India.

http://www.rediff.com/money/2003/nov/14bpo.htm

3) Who's Reading Your X-Ray?

Anjay Saini was not prepared for the hate mail. A radiologist at
Massachusetts General Hospital, Dr. Saini thought he had found a
clever way to relieve an acute shortage of specialists who could
read X-rays and M.R.I. scans. The hospital would beam images
electronically from some scans to India, to be worked on by
radiologists there.

Since the news got out, Dr. Saini has received a flurry of angry
e-mail messages, most of them anonymous, urging him to stop. The
American College of Radiology, the professional group for the
country's 30,000 radiologists, has set up a task force to look at
the offshore transfer of radiology services. "This teleradiology
thing is another nail in the coffin of the job market," wrote
someone on the Web site who identified himself as a radiologist.
"Who needs to pay us $350,000/yr if they can get a cheap Indian
radiologist for $25,000/yr."

Coding - the assignment of numbers for medical procedures to
bills - is also heading offshore. The American Academy of
Professional Coders now has chapters in India. Companies have
sprung up to offer services like billing and transcription in
India. For example, Ajuba International Inc., based in Novi, Mich.,
does the billing follow-up for Botsford Hospital. And Manor Care
Inc., an operator of nursing homes, owns the majority of Heartland
Information Services of Toledo, Ohio, which does the transcription
in India for the Children's Hospital of Wisconsin.

"People want to protect their turf," Dr. Saini of Massachusetts
General said. "But it's very interesting that that turf battle
stops at 5 p.m. on Friday. How many people say they want to do this
thing on Saturday and Sunday?" Indeed, not every posting on the
radiology Web site has criticized Dr. Saini. Some favored using
foreign radiologists. "If we don't hire them, we'll be working
longer hours for the same pay," one person wrote. "So everyone
please shut up about this."

http://www.nytimes.com/2003/11/16/business/yourmoney/16hosp.html?ex
=1069563600&en=2bdbe240146876a4&ei=5062&partner=GOOGLE

4) MT spectacle to sister being gored to death

Promila Aswal left her house to drop her elder sister, Aruna, at
her medical transcription office in Sector 34. The jaunt took them
to the Sector 23-24 dividing road. A little ahead of the traffic
lights, two bulls were fighting on the road divider.

"The Kinetic hit the bull lightly. In rage, the animal turned
around and attacked my sister," recalls Aruna still in shock.
Thrown down on the road with the impact, Aruna and Sanjay watched
in horror as the bull's horns pierced Promila's stomach. "People
around rushed to help us. They succeeded in shooing away the bull,
but it was too late," adds Aruna, breaking down.

http://cities.expressindia.com/fullstory.php?newsid=68160

5) Is Philippines ready for the ICT revolution?

These technology level indicators are very important because ICT
and knowledge-industry investors will go only to countries where
their requirements not only for manpower but also for these
important infrastructure and facilities will be met. In fact, the
types of businesses that are currently evolving and becoming
dominant in the ICT field are gravitating toward locations where
there is a concentration or critical mass of such high technology
facilities, since this is important for their own competitiveness.
Although we may not have fully tapped yet the potentials of
low-end, manpower-intensive operations like call centers or even
medical transcription centers, which have relatively simple
requirements in terms of technology and facilities, these are
already gradually reaching a saturation point and can no longer be
expected to be major drivers of our ICT competitiveness.

http://www.manilatimes.net/national/2003/nov/12/opinion/20031112opi
2.html

6) Bangladesh rings in all-pleasing net telephony

After years of keeping it on hold, Bangladesh has finally legalised
Internet telephony, ringing in an era of cheap communications that
may help it grab a slice of the rapidly growing telecom business.

Entrepreneurs will now be able to set up commercial call centres
and offer Internet-based services, including medical transcription.

http://www.newkerala.com/news-daily/news/features.php?action=fullne
ws&id=598

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The MTIndia Team
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