This may be the closest I ever get to writing an expose, so pay attention.
And while this may not have much to do with natural beauty recipes, it has a lot to do with your health, and the health of your family.
Imagine you’re at the emergency room. You have severe stomach cramps and you’re throwing up every 10 minutes. While you probably just have the stomach flu, you’re in so much pain and misery, you just want to make sure you’re not dying.
After waiting an hour or two, you’re admitted – checked out by nurses and then ushered into a curtained cubicle to wait for the doctor. She comes in. There are labs and x-rays involved, and she notices, as you throw up, that there’s a little blood tinge. She admits you for more observation.
While you’re waiting to find out the results of your labs, other things are happening in the background. You have no idea about these things. But they’re all about you, all about your health, and all about the treatment and medication you’re about to be prescribed.
The doctor is dictating into a little recording device, which will be hooked up to her computer, your medical history, your symptoms, your lab results, and how she’s going to treat you.
This recording, it’s sent to a medical transcription company to be transcribed. It contains a lot of really big words (like ileojejunostomy or pantoprazole), and the doctor was eating a sandwich while she was dictating it, so it’s pretty hard to understand. She also mumbles. Stutters a few times. It’s not an easy recording to listen to, much less decipher.
The accuracy of this report, though, it’s of the utmost importance. These are documents that will be referred to again and again while you’re staying in the hospital, and for years afterward when you visit your physician.
You need someone who knows what they’re doing, right? Knows the language inside and out. Knows that 50 mg of your diabetes medication is good, but 500 mg could kill you. Someone who knows the difference between your ileum and your ilium. Someone who doesn’t just understand English, but understands medicalese English spoken by a doctor with a heavy Louisiana accent (who still happens to be eating that dang sandwich).
Instead, my dear readers, this sound file, after it reaches the medical transcription company, is likely being sent over to India.
Why Outsourcing Medical Transcription to India is a Bad Thing
Off and on for the last 15 years, I’ve done a bit of medical transcription – either as my sole source of income or to supplement when I didn’t have the motivation to write. It’s not a glamorous job, but it used to have its perks. Not so much these days. The pay is going down tremendously, the expectations for independent contractors rivals or exceeds that of employees (who get benefits), and the majority of work available to U.S. transcriptionists is the worst of the worst. When you’re paid on production, the worst of the worst isn’t going to put food on the table.
One of the things that’s lead the transcription industry down this road is the offshoring of work to India. There, transcriptionists will work for less than half the amount that U.S. transcriptionists will work for, so it’s much more cost effective for hospitals and medical professionals.
But it comes at a price to us.
Not only is revenue exiting this country and going to India, but it’s on the back of a trade that’s so personal, so confidential, and so imperative that the English and medical language not only be understood (in any dialect), but known intimately.
I’ve seen, with my own eyes, reports come back from India – sent to the hospitals – with grave medical errors in them. Sound-alike words that could easily be mistaken by someone who isn’t familiar with a Texas accent. Dosages WAY off – either far too high or far too low. Surgical terms just completely botched in a way that makes you think they hit their head on the keyboard and hoped something legible came out.
While it may be funny to see a medical report saying, “The patient has flea bite his last leg” instead of “The patient has phlebitis in his leg,” it’s not so funny when the errors pertain to treatments and dosages that will be referred to repeatedly – and sometimes urgently.
I’ve been an editor (and have even run an entire transcription department) for several companies – some of which outsourced to India, some of which were strictly US-based. This may be subjective, but I can assure you that in no uncertain terms, the Indian transcriptionists were far worse than even the newest of the U.S. transcriptionists when it came to accuracy.
So what I’m saying here is: It’s dangerous for Indians to transcribe our medical records.
However, it’s far less expensive for a hospital to pay for a dozen potentially lethal mistakes caused by medical records errors than it is for them to pay for U.S. based transcription.
This is why it will not change.
And What About Privacy?
The other thing that’s always really bothered me about our medical records being sent to India is the privacy issue.
Here, in the U.S., HIPAA (Health Insurance Portability and Accountability Act) laws are STRICTLY adhered to. They’re no joking matter. There are entire committees and positions dedicated to making very sure that HIPAA privacy laws are being enforced to their fullest. The punishment for breaking a HIPAA law is very high.
Over in India, though, they’re not bound by the same laws.
And over in India, they have something else. Have you watched Outsourced yet? (It’s funny. You should.)
They have call centers. They have call centers for companies of all types, not the least of which are insurance companies, credit card companies, and other companies that have a big impact on your life.
With your medical records goes things like your social security number, your address, and your full name. This information could be very valuable to certain companies, when combined with medical information. This information could be shared with these call centers – to your detriment.
Now, I don’t want to be an alarmist here. That’s not my point. I have no proof that anything untoward is happening. I’m just saying it could. And that it wouldn’t be hard to do.
In fact, take a look at this article about a transcriptionist in Pakistan who threatened, in 2003, to release medical records to the public unless she received extra money for the work she did.
Your medical records – all over the internet.
But, more importantly, take a look at the important sentence in that article that states “U.S. laws maintain strict standards to protect patients’ medical data. But those laws are virtually unenforceable overseas, where much of the labor- intensive transcribing of dictated medical notes to written form is being exported.”
While my fears may be based on paranoia, they’re certainly not without merit.
What You Can Do About Offshoring of Your Private Medical Records
Okay. Let’s face it, in the long list of things to champion or get worked up about or fight for, worrying about your medical records in India probably isn’t going to take top priority. I understand.
It’s why this issue hasn’t made headlines. It’s why it’s not talked about. Heck, it’s why most doctors don’t even know it’s being done with their dictation.
You could write to your Congresspeople, you could even call them. That would be fantastic.
But you could also take a more personal approach.
When you’re in the hospital, for any reason, ask where your medical records are being transcribed. Ask if they have a strict no-offshore policy. Ask, ask, ask. And then demand that they do whatever they can to keep your medical records within the borders of this country.
Talk to your physician, when you’re in his or her office. Ask them what they know about the offshoring of medical information. Ask them what company they use for their transcription services.
Ask, ask, ask.
Again, I’m a realist and know that not much is going to be done about this issue. But I believe, with all my heart, we all have the right to know where our sensitive medical information is going, how it’s handled, and whether it’s accurate enough to help us get better – or to make us a whole lot worse.
Did you know a huge percentage of medical records were being sent to India, or is this news to you?
Does it make you a little angry, or do you think it’s just good business sense?
Moreover, do you think you’ll have a little chat with the medical professionals you encounter from now on?