Friday, July 21, 2006

Bye-Bye American Jobs

After reading the article in the above link, I thought back and remember quite clearly riding in the back seat of my uncle's Hillman fifty years ago. It was a small bit of a car and it hardly used any gasoline at all. Of course, it was from Japan, kind of a rarity at the time. There were mostly big American cars and trucks back then, many sporting bumper stickers that said, "Buy American." Snicker, snicker.

I don't pretend to understand the global market much better now than I did then, but I do understand one thing. We are getting screwed. Corporate America is raking in the bucks and we are paying for it dearly. Oh if only we had all paid more attention to those bumper stickers.

This situation came painfully home to roost for me in the last few years. I had returned to work after my son's death in 1996 and found myself becoming more and more unable to cope with the job and my grief. I quit my long-time job with Boeing in 1999. Five years later, after living on my retirement and also losing much of it in the stock market fiasco of Bush's regime, I needed to return to work. I wanted to work from home as I still did not feel able to cope with the commute and dealing with lots of people around me, so I chose a *profession* that I felt would interest me a great deal, as well as take advantage of my typing and language skills. The added benefit was that I could do it at home. The profession was medical transcription. This course is offered at Everett Community College and can be taken entirely on line and paid for by a student loan from the government. I did ask the school if a person of my age could hope to obtain a job after completion of the course and was assured that oh yes, there are lots of jobs out there.

I took the class, enjoyed it tremendously and did very well. I also became indebted to the tune of several thousand dollars.

It turns out I asked the wrong question. The right question would have been, "will I be able to support myself on the lower-than-minimum-wage money that I would be making?" Of course, I didn't realize at the time it would be less than minimum wage, but they don't tell you that at school. You think you may have to cope with some ESL docs (English as a second language, accents ranging from light to heavy), but that, surprisingly, was not the biggest problem. They don't tell you that you will be competing with a growing monster in India and the Philippines. These people are being trained (although you are never told that your work is helping train them), likewise, you are never told that they get the *normals* the docs who can be understood, the docs who enunciate and do not speed talk, slur, exercise while dictating, drink, drive, drug, all while dictating YOUR medical records. Then you find out that medical transcription is being offshored just as fast as they can do it. Your doctors, your clinics, your hospitals are all pushing for this. They don't care about your records and who sees them. HIPAA? What crap. The bottom line is the only thing that counts. Your medical records are shipped overseas, seen by people over whom there is little, if any, control of privacy, and sucking American jobs right "off shore."

Everett Community College, as well as a plethora of other medical transcription schools are still graduating students by the thousands. Why? Because they can. Yes, there are jobs, but since you are a newbie, you will get bottom dollar for at least three years. Will someone else support you that long? Good for you. You will be required to produce thousands of lines a week in order to retain your job. Most of the time, you will be hired as a independent contractor. Why? Because then the employer does not have to pay ANY taxes. You do. That is 15% and you had better get that saved first. Also, you will never qualify for unemployment or workman's compensation. Of course, any benefits will be paid for by you. Let's say you are making 6 cents a line. Do the math honey. Then there is voice recognition, for which, if you are lucky, you will make 3 cents a line. This is doable if only you have a decent connection - I'm talking about your employer's ability to deliver static-free transmissions every day with no *server down* errors. If only you didn't have to fight carpal tunnel, back pain, knee pain, no vacation, no sick leave, no employment security, and no help from any union ever. The unions have no interest in you, neither do you qualify for the same protections other employees have in your state. You are not an employee and you will be extremely lucky to ever be hired with that designation. If you are hired as an "employee," you will be required to perform at an nearly unachievable level to maintain that designation. You are only paid when your fingers are on the keyboard. You will be expected to provide either DSL or cable, hundreds of dollars worth of resources, headphones, wav pedals, various software, and your computer must be maintained at your expense. Remember, every moment you are not typing, you are not making any money. Need to go to the bathroom? Not getting paid. Need a cup of coffee? Not getting paid. Have to get up and stretch? Not getting paid. Forget ergonomics, forget moving your eyes from the screen to protect your vision, forget getting off your ass to protect yourself from deep vein thrombosis, forget resting your hands, arms, shoulders, back. You are not getting paid when you are not typing. That doesn't sound all that bad until you start figuring out exactly what it means. These points are never touched on by any schools.

So, on top of all that, enter offshore workers primarily from India and the Philippines, and you have competition that you cannot beat. They will press you more and more to do voice recognition work, which is basically editing the mess that either voice recognition software has produced, or one of the thousands of non-English-speaking *medical transcriptionists*. They will want to pay you half to less-than-half of what you get for straight dictation and voice recognition work is very difficult. Many transcriptionists think it is even more difficult than straight transcription. Why? Because you have to pay extremely close attention to both the voice and the printed word so as not to miss any error, particularly in dosages, medications, or diagnoses. The offshore workers are earning so little money (compared to what they would have to pay you - big salaries though for THEIR countries) that the companies are making huge profits from medical transcription, even though they must also hire American transcriptionists to clean up the mess of this offshore work.

I worked for three companies in a year and a half. Focus Infomatics (a company owned and operated from India with connections in the states that never hint as to their ownership) - the company I hired on with had an entirely different name (Rider and Associates operating out of Oregon) who never once explained that they were owned by Focus and that we would be working for an Indian company whose main concern was training people in India to take over our jobs. Then I went to MedQuist. On the MT boards, easily one of the most talked about and despised medical transcription companys in America for their underhanded and dishonest treatment of their workers. Medware, the company I last worked for, is exactly the same, even while being touted as "Employer of the Year" by AAMT. AAMT professes to be for transcriptionists. Most transcriptionists understand that AAMT is for transcription companies. Furthermore, they advocate off shoring medical dictation. Medware's ads state "consistent work." From Thanksgiving 2005 until after New Year's 2006, there was virtually no work, or their server would go down many times a day, sometimes for hours (remember, not getting paid when fingers not moving, even when it's the company's fault). One time, they said, don't worry, we will pay for this downtime. Uh huh. I got $8.75 for being down all day long. I have the paperwork to prove it. I have the paperwork to prove how they misreported time so that it looked like they were at least paying minimum wage. I finally threw in the towel when after being *requested* to work the two days I would normally have had off, and then reporting in for my normal shift after working those two days, there was no work. "Oh, the Indians must have taken it all. They aren't suppose to do that." Right. That really helps pay the rent. I lost my temper and was fired for "insubordination and lack of respect." I thought insubordination was NOT doing something you were requested to do, and I wonder, who disrespects who? I worked very hard and very long hours for them, did everything they asked, suffered through two months (over Christmas no less) with virtually no paycheck, and they demonstrated a total disregard for me or my work and a very cavalier attitude when I would nearly beg them for work. My transcription has never been less than 98% accurate, usually over 99% accurate; I can produce 1000 lines a day given even minimally decent dictators and server connections, and I have a very strong work ethic.

Offshoring. Bush says it's good for America. I wish someone would explain that to me and the thousands of other American workers who have spent their lives paying taxes, working hard for "the American Dream." What a joke. It's good for American big business, not good for America. Now I am out of work again, in debt to the tune of thousands of dollars, finding it difficult to get another job or even some kind of training that I don't have to pay for.

Offshoring. Illegal aliens. I believe everyone has the right to a job, but that also includes my own right to work, my own right to not have my survival eroded by other countries and my government's need to curry favor in the eyes of other governments at my expense.

Sunday, July 16, 2006

Wake up to these words

My breasts aren't as important to me as they used to be now that I'm no longer breast feeding or in competition for the attention of sexual partners. However, they are mine - ALL mine - and when they misbehave, it attracts my attention. Any female who has ever had a period, a child,or entered menopause understands that occasionally our breasts will be a source of discomfort. It's usually a hormone thing and although it sometimes lasts for several days, it is part of life and so we adjust and accept.

On Thursday last, that would be July 13, 2006, I noticed some slight discomfort in my right breast. It piqued my curiousity because normally this discomfort would be felt in both breasts, not just one. It was a lovely summer day and I am an avid gardener so I ignored it and continued with my weeding. On Friday, the breast was bothering me a bit more. I noticed pain in my nipple when my arm brushed my breast or when my shirt rubbed against my nipple. This was annoying, but there was also something in the back of my mind trying to work its way to the front. Something I had heard about a kind of cancer that is often overlooked, but which can be deadly. I looked for information at http://www.breastcancer.org/ , http://www.nationalbreastcancer.org/ , http://www.komen.org/, and http://www.ibcresearch.org/.

It turns out, the kind of breast cancer I was trying to think of is inflammatory breast cancer. A very scary prospect. By the time I had read until my eyes felt like two white onions in a martini, and my mind was stuffed with images of some very unfortunate looking breasts, it was late Friday night.

Saturday morning I appeared at the local walk-in clinic the moment it opened (it appeared there were other folks with the same idea - they must have camped out overnight). In any event, I only had to wait about an hour and a half before seeing the doc. Let me interject something here; the doctor was young and drop-dead gorgeous. When he walked into the exam room, I nearly got up and walked out. His manner was very professional however; which went a long way towards overcoming my reticence (and AWE!) about exposing my, let's just call them *mature* breasts. Besides, I was scared.

The doctor examined me very carefully; I have a lump beneath the aureole of my right breast and it is inflamed. Inflammatory breast cancer has symptoms that mimic mastitis. The doctor gave me a prescription for an antibiotic and asked me to make an immediate appointment with my regular doctor for follow up. Today is Sunday. It is another beautiful day and I have enjoyed it tremendously. An added treat; the little mobile home I rent is on 20 acres of woods and across from my front window is a large meadow. Into that meadow this morning came a doe and her fawn, a sight that is quickly vanishing from this once rural environment. The peacefullness of a doe grazing in a meadow is a fine gift for me. The lesson is not lost.

It was a moment of happiness descending without notice. I thought of the many times someone I knew had to go in for a biopsy and my response was, "don't worry, most of the time there is nothing there." I will never give that response again, for even though true, that moment is not lightened by reassurance, it needs only an arm around the shoulders and silence.