Dictation Therapy For Doctors: Sending Work Overseas

Many corporations have recently invested in technology which allows them to send electronically-recorded dictation overseas where English-speaking workers can transcribe the work. Taking advantage of a global economy as a means of cutting labor costs may increase profit margins for a medical transcription agency's owners and/or shareholders. But what does it do for protecting patient confidentiality? What kind of quality assurance can it offer?

In foreign markets with lower labor costs (India, Ireland, Bangladesh, Barbados, the Philippines), English-speaking workers are thinking in textbook English rather than the American vernacular. A lack of familiarity with American culture can easily cause these workers to misinterpret a doctor's careless use of the English language.

Although the confidentiality of the physician/patient relationship is protected by law in the United States, those same laws may not apply in other lands.

Many foreign countries have thriving black markets. How can you be sure that patient information is not being sold overseas to generate a secondary source of income?

These issues may seem ridiculous to a hospital administrator or Chief Financial Officer who wants to cut labor costs. But they represent serious ethical concerns for medical transcriptionists, medical record directors, risk managers and -- one would hope -- the physicians who are responsible for maintaining the confidentiality of a patient's medical record. The risk of sending work overseas was highlighted when a Pakistani subcontractor -- who was several steps down the ladder of subcontractors working on an account from the University of California Medical Center -- threatened to release confidential patient information online unless she was paid funds was owed to her by the medical transcription agency for which she was a subcontractor.

Another risk is that the offshore company contracted to do your work can have a heavy turnover in personnel -- or might be underbid by another company with workers who are not used to your account. In other words, the reliability of the transcription services you are contracting can easily be undermined by economic pressures in the global marketplace.