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Passage

May I Mambo Dogface to the Banana Patch?

Published June 9, 2009 2:53 PM by Jeanne Johnston

That line from Steve Martin's book, Cruel Shoes--where he thought it would be clever, if he ever had a child, to teach him the wrong words to everything so that when he went to school, no one would understand what he was talking about--used to be hysterical to me. . . but that was before speech "recognition." I have now had my first-hand exposure to this boondoggle and no longer have to qualify my rants with the fact that I'm merely repeating what my peers are saying. It really IS that bad.

In the latest comedy of errors, I was inadvertently sent SR reports before I was trained for them, and what I found was jaw-droppingly bad. It didn't seem to matter if the reports were from a facility that was as new to the platform as I was or another one that had been using it for almost a year (supposedly "training" the system to recognize the various dictators' routines). They were all astoundingly, horrifically bad, and the platform itself was so riddled with bugs that it was impossible to use as intended. It even breaks other applications that I need to be able to use in conjunction, most notably Shorthand. After spending twice as long trying to edit the mistakes, I opted--like many MTs--to simply erase the whole mess and transcribe it from scratch. Bad enough I should get paid half for doing that than getting paid a tenth as much because it took me five times longer to simply fight the whole setup. I still had a production quota to meet, after all.

I tried to describe this to my son, who has a degree in digital media and has written no small amount of application and web code himself. He recognized it immediately as he has been a victim of it from the other side: Someone with more money than know-how gets a brainstorm to create an application that will make him millions. He hires guys like my son to write it--often building off someone else's application, to boot, which means you're not saving time as much as simply adopting bugs that someone's already cultivated. The code monkeys quickly get sick of the project, meaning there is massive turnover in the course of getting the application to potential clients. The code is a mess, the guy with the money keeps demanding new tweaks and additions, which only compound the problems, and in the end, it's all such a bloated mess that no one knows how to really make it work right. Unfortunately, it works well enough to do a demo and sell a bunch of suckers on the concept with lofty promises of money and time saved, lower payroll expense, and burgeoning profit margins. If the idea guy is really lucky, he will do such a bang-up sales job that another development company will swoop in and offer to buy the application, meaning his fortune is made AND he's spared the ugly whiplash when clients learn the thing doesn't really work. At that point, the suckers left holding the bag have no choice but to whistle in the dark, as it were, and pretend they didn't make the worst investment of the decade. Why, with enough cheerleading about how terrific this is, they should be able to buy enough time to get their own geeks on the case and fix everything wrong with it, right? Of course, from its inception, no one has even bothered to ask the actual end users and investigate what would be needed to use said application in terms of features and functionality, until the mess is complete and they're ready to roll out the beta and see how it works.

Meanwhile, who is left to pay the dearest price when they're forced to utilize this glorified trash heap? In our case, it's the transcriptionists--the very people who are the backbone of every MTSO because they're doing the actual production of the product being sold. The clients probably don't care so much because they are being charged less. The MTSO doesn't really care because their payroll is also lower, and jobs are more and more scarce so that a majority of MTs do not have the luxury of walking off the job. If we do, there are always MTs in India and wherever else the Crappy Schools are training them today (not only the Philippines, but google your way to see who's training MTs in Jamaica next). Indeed, we've had our pay and benefits whittled away so often, we're pretty much the equivalent of an abused spouse. . . hack away at our self esteem, beat us down, then placate us with soothing words about how you really, really care and are thinking hard about how fair those latest wage cuts were, and we're just too stinkin' tired to pack up our bags and head for the women's shelter like we ought to.

Two weeks ago, my computer died as I was composing a lengthy reply to Rebecca, who asked, "Why stick with a company that burdens you with such a horrible platform?" Why, indeed. I should have hand-written my reply again instead of just pining away for my internet all the time my baby was in the shop because I'm sure I've forgotten my best points by now. I'm afraid part of it hearkens to my history of staying in a lousy marriage for 20 years "for the sake of the kids," despite an emotionally abusive jerk who was a horrible excuse for a father figure. In retrospect, I can kick myself for taking two decades to scrape up enough anger to muster my courage and just bail on him, but at the time, even though I knew I deserved better, you get into this helpless rut where you just don't feel like you can make it. I don't like change. I don't like risking what little I have for an unknown that may turn out to be worse (even when I know it couldn't possibly be). The same seems to apply here. I've told myself that it doesn't make sense to go through the stress of changing jobs/account specs/platforms in a field I hope to get out of in the foreseeable future. I am abused, taken for granted, and more stressed and miserable than I've ever been in this job, but until they've gutted my paycheck to the point where I suddenly can't pay all my bills, I'm having a hard time mustering my Libra temper and heading for greener pastures.

It's a sickness, I know. If I were a believer in 12-step programs, I would probably look for one. I can say that the night these SR reports suddenly appeared in my queue, I came as close as I ever have in my life to walking off a job. If my computer hadn't been in the shop, preventing me from surfing the 'net to find a new one, I may well have done just that. Once SR becomes an irreversible part of my life, I may finally reach that point of no return. I am desperately trying to recapture that feeling of glee when I finally made the jump across that divorce chasm and realized it had actually been just an easy hop to freedom and the promise of self-fulfillment. For now, however, the worrywart on my shoulder is talking louder than the cheerleader on the other and it's still looking like another big jump from here. I still need to pace the track and feel like I've got a running start.

If you remember the lovely essay I quoted a couple months back from another MT in the same position, you will remember how funny it first seemed. That, however, could be shrugged off by MTSOs as fiction. I'd like to know how they can continue to shrug off the real thing, knowing that it is taking MTs as long--or longer--to fix this kind of mess and that they are paying us a fraction of our already-low wages to do so because they've convinced themselves that SR is SUPPOSED to make our jobs so much easier. Do they even care how long it would take to transcribe this normally versus how long it would take to merely edit "a few" SR mistakes, or are they laughing all the way to the bank because they've found the ultimate way to oppress the peons for their own financial gain? Do they realize that fully half of these reports are complete gibberish and routinely make hash out of critical medical information? I can't even imagine how SR can botch the best of dictators, turning, "This is Dr. Potter, dictating on med record 12345, Jane Doe. Date of admission is May 25, 2009," into an abortion like this: "Dr. prostatism axes of the T5-T6-0 range on a calculated indications Ms. 20/50 2009."

And this was the least nonsensical part of the whole report. May I mambo dogface to the banana patch, indeed. . .

2 comments

I completely understand -- I have always said I wouldn't mind losing my job to another qualified person (or machine) who could do it cheaper, if they could maintain the quality...that's just business... but that is not the case...Twice my company has been displaced by "geniuses" (translate -- no transcription insight or experience) who sold the hospital a bill of goods.  The first time the CIO realized what a disaster it was right at the start and called us back -- he then got fired for not having the foresight to realize what a crock those guys were selling.  Well guess what - the next Med Rec director got on the bandwagon and tried to find someone else who could deliver on the "transcription for nothing and reports for free" promise -- and she was promptly fired when they experienced the same crap!  Someone had to pay.  God forbid the hospital administrators admit they made the same mistake again...basically swallowing hook, line and sinker the same sales pitch and trying to replace our 30 years of experience (15 at this facility!) with SR with off-shore editors... you can just imagine what a mess they are getting,  in addition to the fact that they are over a week behind within a month, and they haven't even taken on the entire account yet.  They are only doing office notes only so far --- not critical care.  I hate to think of the botch job they will do with that.  My company still has a year on our contract with the critical care component, and we are all hoping that SOMEONE has the guts to stand up before that to say that a report full of errors is WORSE THAN NO REPORT AT ALL, and that whatever the price, it is money down the drain, leaving the hospital with no credible records, and lawsuits they could have prevented or won with good, complete, accurate reports looming in the distance.  I can only say it couldn't happen to a more deserving organization.  

I realize this is just my individual experience, but I fear it is being repeated across the nation.  

If anyone out there still values experienced, quality-oriented medical transcription, please let me know -- I have 35 people who will be out of a job soon, even tho we have met or exceeded every criteria they have set up for us, including receiving every performance bonus (for quality and turn-around time compliance) we were eligible for.  

Hard to believe they can't see the forest for the trees...again.  Thanks, Jeanne, for giving me a nudge and a place to vent.

Sherri, transcriptionist June 18, 2009 11:41 AM
Stuart FL

How sad is it that I should wake up in a panic because I realized the Steve Martin story wasn't from Cruel Shoes at all, but from his actual stage routine? (Saw him on the Let's Get Small tour--before his hair turned--just for a clue how old and decrepit I really am.)

Clearly, even my unconscious "down time" is not as relaxing as it should be. :)

Jeanne Johnston June 11, 2009 3:31 PM
FL

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