Welcome to Health Care POV | sign in | join
The XY Files in an MT World

The End of Capitalism?

Published April 13, 2009 1:25 PM by Jay Vance
Our Constitution was made only for a moral and religious people. It is wholly inadequate to the government of any other. - John Adams

This has always been one of my favorite quotes from the Founding Fathers, and it seems to me to be more apropos than ever recently.  These days I find myself contemplating a future that until now was unimaginable to me, a future in which the American people abandon the principles of freedom which have been the foundation of our nation since its inception, in favor of what can only be described as a "nanny state."  Our banking system is on the brink of being nationalized.  The government is dictating who can and cannot lead public corporations.  The country is going trillions of dollars into debt in order to expand the reach of government into seemingly every aspect of our lives.  What the heck is going on?

And what does any of this have to do with medical transcription?

My wife and I play a little game sometimes where she abruptly changes the topic of a conversation and I try to figure out how in the world she got from point A to point B.  Clearly this game is a losing proposition for me, being handicapped with a Y chromosome and all. Almost always she has to backtrack and explain step by step the rapid progression of her thoughts from one subject to another.  Having spent a great deal of time perusing the various online MT forums over the course of the last 10 years or so, I can attest to the truly mind-boggling ability of women to hijack a discussion on any given subject and end up light years away from the original topic.  I guess some of that has rubbed off on me, so allow me to explain how a conversation about speech recognition led to a blog post about the end of capitalism as we know it.

A few days ago I posted to my Twitter and Facebook accounts a link to a story about how Nuance is marketing its front-end speech recognition technology by encouraging its integration into EHR platforms.  The article mentioned a survey completed by 1,255 physicians who have adopted Nuance's Dragon Medical software.  According to the survey results, 83 percent said that it improved the quality of their electronic patient notes; 81 percent said that it significantly reduced transcription spending; and, 69 percent said it made their EHR faster and easier to use.

A couple of friends and colleagues in the MT community saw the link on Facebook and offered some input on the story.  One commented that she was suspicious of the survey results.  She wondered how it was that MTs had to train for hours, weeks, months to edit SR drafts, yet we're supposed to believe that doctors can pick up a microphone and produce accurate and timely reports in no time at all.  What about all the lousy grammar, run-on sentences, no punctuation and poor proofreading skills we MTs hear from doctors all the time?

My response was that perhaps it all comes down to the level of quality and accuracy an institution is willing to accept, and that I suspected many are satisfied with an encounter record that vaguely resembles what actually happened, as long as it's cheap.  That thought led me to another, which was that perhaps the healthcare sector will have to suffer a major liability catastrophe due to substandard documentation, on par with the banking meltdown, before they finally understand that the bottom line isn't the bottom line, it should be taking care of people.  I wondered if greed has so totally blinded us to what's important that America is no longer qualified to have a capitalistic economy any more.  My final comment was that if we end up with socialism, it'll be because we couldn't be trusted with capitalism.

Isn't THAT a lovely thought to get your week started!

Am I being overly pessimistic?  Perhaps.  Do I believe speech recognition will lead to a collapse of our economic system?  Of course not.  But I keep going back to what John Adams said about the revolutionary new form of government he and the other Founding Fathers left in our care.  He was right, you know.  The freedoms our system of governance has historically offered us are unsustainable in an environment where morality-simply doing the right thing-has been abandoned in favor of higher profits no matter what they cost.  I don't think we have appreciated how fragile a thing our brand of liberty really is when it's not nourished and nurtured and protected by a shield of morality and self-sacrifice.  Without those protections, freedom such as we take for granted cannot long endure, and authoritarian control will inevitably follow.

Only a virtuous people are capable of freedom. As nations become corrupt and vicious, they have more need of masters. - Benjamin Franklin

Please don't hear what I'm not saying.  I am a capitalist through and through, and big government is anathema to me.  But the harsh reality is that we haven't been willing to regulate ourselves, we haven't been willing to place the welfare of people above the profit margin, and we've all fallen into the trap of greed.  We love to point fingers at Wall Street bigwigs-or MTSOs in suits-but how many of US had to have a newer car, a bigger house, more toys, more clothes, more trips?  And what corners were WE willing to cut, what good deeds did WE leave undone, what charity did WE leave ungiven, in order to satisfy our wants?  Corruption and lack of character at the highest levels of government and commerce are, I believe, simply reflections of a broader collective covetousness that has infected us all.  I fear there is a price to be paid for our national transgressions.

But I am not without hope.  I'm not giving up on the combination of independence and interdependence that has made our nation great.  I think we've lost our way, but journey is not yet over.  Perhaps nowhere else but America do we the people have the opportunity to influence how the next chapter of our story will read.

"Well, Doctor, what have we got-a Republic or a Monarchy?"  "A Republic, if you can keep it." - Benjamin Franklin

4 comments

Jay - What is your opinion on whether or not EMR will be the final nail in the MT profession coffin?  (after voice rec, overseas, template systems, etc.)  Or have you already written an article on it?  From what I've read so far that you've written, I would really value your opinion on this topic.  I've been hopeful all these years that "they" would finally realize just how valuable a good MT is - I know I do - but I'm not holding my breath any more, as this seems to me to be the final push.   Please feel free to e-mail your response too.  Thanks.

Meg Jordan, Vital Lines - Owner May 6, 2009 8:53 PM
Athens GA

Wow Jay, well said.  You're right, too, when you suggest we all have some responsibility in the way things have gone in this country.  We Americans just got too lazy and sure of ourselves....sure that we'd never fall from grace and yet we're doing just that.  The scripture that says "your sins shall find you out" comes to mind!

On the transcription front, I sat in my own doctor's office not too long ago and watched the doctor himself input info into his laptop.  No real capitalization, no punctuation, just words here and there to document the current situation.  Does nobody care anymore about well documented records?  Then, you're told just leave most of the speech recognition input as is, except for absolute obvious mistakes.  It used to be a transcriptionist's job to edit and to make that document the best it could be (not changing meanings, etc., of course), but a document that was professional.  New people are told to "just type what you hear" basically and move on.  Why is transcription starting to "dumb down" as I call it?  I hate that.  I have been transcribing for nearly 31 years and I see changes that I do not particularly like.  I guess it's just produce, produce!  If I could retire right now, I would, but that just isn't possible.  

Patricia Godbey, Transcriptionist April 22, 2009 8:08 PM
OH

Bravo and well-said. Sometimes I wonder if we're in a dying profession... but this old beach is too old and cranky and stubborn to learn new tricks, and at the rate things are going, they will probably have to carry me out feet-first at the age of 90....

Carolyn, Medical Transcriptionist April 15, 2009 10:55 AM
CA

Jay, you hit the nail on the head with this one. Brother, my thinking has gone down nearly the same lines. Of course my examples and my thoughts are tied to my job just as yours are to the work you do. Did you know that I am contemplating, heavily, walking away at the end of my enlistment in 2010? That is 18 years... 2 shy of retirement. But it means that much to me.

God bless you, Jay. You are in our prayers, keep us in yours.

SF~

Mike

MIke Anderson, MILITARY - UNITED STATES, (USMC) April 13, 2009 4:11 PM
Havelock NC

leave a comment



To prevent comment spam, please type the code you see below into the code field before submitting your comment. If you cannot read the numbers in the image, reload the page to generate a new one.

Captcha
Enter the security code below:
 

Search

About this Blog


    Jay Vance, CMT
    Occupation: Medical Transcription Industry Consultant
    Setting: Yuma, AZ
  • About Blog and Author

Keep Me Updated