If a medical transcription agency charges on a per-character basis, a hospital administrator might say "We don't pay for spaces or hard returns."The transcription agency might then ask the client to sign a contract to that effect. When the agency then delivers documents in which all the words run together (see example below) it will have fulfilled its contractual obligation by not including any spaces or hard returns in the transcribed document. The final product might look like this:
The client might then discover the true cost of replacing thoses paces and hard returns in each report, or be forced -- after having established an adversarial working relationship -- to swallow its pride and negotiate a higher rate in order to have the final product look like this:"Thepatientcomestotheemergencyroomcomplainingofnausea,vomiting,diarrhea,fever,andchills.Thepatientisonnomedications,hasnohistoryofchronicobstructivepulmonarydisease,adultonsetdiabetesmellitus,orcongestiveheartfailure."
"The patient comes to the emergency room complaining of nausea, vomiting, diarrhea, fever, and chills. The patient is on no medications, has no history of chronic obstructive pulmonary disease, adult onset diabetes mellitus, or congestive heart failure."
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