Spam and Scam Alert

Although the lifespan of an individual cockroach is relatively short, cockroaches have plagued apartment dwellers for many years. For the tenant who maintains a clean home, the first sighting of a cockroach may be accompanied by shrieks of horror and an anguished sense of violation. However, as repeat sightings warn of an invasion of epidemic proportions, shock often turns to anger. Many New Yorkers will confess that, during the hot andsticky summer months, the battle against cockroaches is like witnessing tribal warfare in one’s own apartment.

Various powders and sprays can be used to attack the invaders. In some cases, the services of professional roach exterminators may be employed. But cockroaches have no respect for boundaries. They are merely animals in search of food and, like other unwelcome insects (ants, gnats, fleas, and mosquitos), they come with the territory. Instead of letting these annoying pests spark volatile bursts of anger, it is better to deal with them as clinically as possible. Whether one’s money is spent on bug strips, insecticides, contractors, or a fleet of roach motels, dealing with cockroaches is the cost of living in a large city. If one is smart, one’s personal rage against cockroaches diminishes and is replaced by a sadder albeit wiser outlook on life. You may never get rid of the problem. But, as Martha Stewart would say, the sound of a juicy bug being stepped on can truly be“a good thing.”

In recent months, Pakistan and India have come dangerously close to nuclear war (a phenomenon which should send shudders down the spine of any healthcare organization outsourcing work to offshore transcription vendors in those countries). Meanwhile, the volume of spam from medical transcription entrepreneurs on the subcontinent has risen to a fever pitch. Medical transcription websites, newsgroups, and e-mail lists – as well as the membership rosters for professional organizations like the Medical Transcription Industry Alliance (MTIA) and the American Association for Medical Transcription (AAMT) -- have proven to be fertile grounds for Third World spammers trying to get a piece of the action.

“There isn't much we can do about unscrupulous people who weed through the forums pruning e-mail addresses,” warns Annie, a volunteer administrator at www.mtdesk.com who is also the owner-moderator of who is also the owner-moderator of www.mtbookclub.com “The best way to deal with unsolicited e-mails from people is to just ignore them. Do yourself a favor -- don't engage in any type of communication. If they really bother you, you can make your e-mail unavailable to the public or set up a separate e-mail at one of the freebie e-mail services.”

Three years ago, when I first started receiving spam from offshore transcription vendors, I tried to answer each email with a polite but firm boilerplate message explaining that our company had no intentions of sending work overseas. That only resulted in more spam. When I asked my business partner how he was handling the onslaught, he told me that he treated it like the junk mail it really was. He deleted it the same way he would throw regular junk mail into the garbage -- without reading it. “Face it, if you respond to them, you’re doing the electronic equivalent of confirming an active address or phone number to telemarketers,” he warned.

After several discussions, we decided it was in our best interest to clearly articulate a company policy and post it on our website. That policy reads as follows:

“In his 1999 State of the Union address to the United States Congress,President Bill Clinton made specific mention of the fact that, with so many medical records being stored in electronic format, protecting the privacy of every American's medical records is a matter of utmost urgency. The management team of Alert & Oriented Medical Transcription Services is vehemently opposed to outsourcing transcription beyond America's geographic borders -- where neither the privacy nor confidentiality of a patient's medical record can be protected by American law. As a result, we have a strict policy that all transcription done on behalf of our clients must be performed within the United States. We are not interested in receiving any solicitations from offshore transcription services in nations like Pakistan, India, Bangladesh, Ireland, the Philippines, etc. Do not contact us in hopes of establishing any kind of working relationship.”

I’d like to think that message is clear but, apparently, some people just don’t get it. On more than one occasion I have received e-mails from India insisting that we remove our policy statement because it is “discriminatory.” I recently received the following pathetic piece of e-mail:

Dear Mr. George Heymont. We are transcription from India. I have gone through your site, where it's has been clearly mentioned, that your are not interested in any solicitations from offshore transcription services in nations like India and other countries. But I could like to request you to check us at least once, and you won't find any compalint regarding the same. There are many US based companies like Heartland, Health Scribe, GE who are very happy with Indian performance I am sending you my company profile, pls. go through the same, and at least mail me, and send me some test files so that I can prove the same to you. For TRANS MEDI SCRIBE LTD. SHEETHAL.KARUNAKAR.

A quick look at Mr. Karunakar’s e-mail should send danger signals to any MTSO indicating that you don’t want to do business with someone whose sales letters contain more spelling and grammatical errors than you would ever tolerate from a medical transcriptionist! Unfortunately, such e-mails are not the exception. They are the norm from people who are determined to assure you that their work will be 98.5% accurate. Consider this other sample:

Dear George Heymont I read your article "KEEPING ABREAST OF MEDICAL TRANSCRIPTION" from "http://www.wwma.com/kamt/dumber.html" and I like It. I am Atif Nazar from Hi-Tech Quality Solutions LLC Mississippi. We are a well-diversified Medical Transcription/IT Services oriented organization. Our focus is not just Enter a piece of data, but to ensure that the solution we provide fulfils the Quality. We stick to customer's Deadlines. That's why we have a team of professionals to help you throughout the technology lifecycle. As we are an end-to-end company, we work with our clients from concept right through to launch. I am Looking forward to establish an alliance / Affiliation with your company to share your over volume of work. We have three divisions right now 1) Transcription (Medical & Insurance) 2) General Data Entry (Mails, Presentations, Web Pages, Databases, Articles, Adds, Books Etc) 3) Web Application Development So If you have the projects to give to Off-Shore Development House. We have the ability to do it. Our rates are 8c/line for transcription with dial in dictation server and 6c/line without dial in dictation service. Our Major Clients are

MACON PRIMARY CARE INC

NEPHOROGY ASSOCIATES

COLUMBUS NEROLOGY

GEORGE E. WILKERSON NEURODIAGNOSTICS

TONGUE & QUILL MEDICAL TRANSCRIPTION SERVICES,

LLCGLOBAL PHARMASUITICLES

GEORGE TOWN TOBBACO INC

And Many More....We Offer you FREE TEST WORK. Reply this message today to start. I will be looking forward to have a positive reply from you."

Read that list of clients very carefully and ask yourself if what you see represents the kind of accuracy you want to be responsible for placing in a patient’s chart. I sincerely doubt that it does. And yet, the daunting combination of bone-headed stupidity and an unyielding determination to develop new accounts is truly a force to be reckoned with. Describing her volunteer chores on www.mtdesk.com, Annie notes that “No overseas ads are allowed. Even though that's clearly stated at the top of the classifieds, there are still dozens in there every few days. You need to delete them all. Don't be surprised when you find yourself deleting the same ad repeatedly -- some people just don't get the message.”

And then there are the cold calls from hyperaggressive salesmen who are more annoying than AT&T’s telemarketers. Some are merely jerks who refuse to take no for an answer. Several months ago I received one such call from a TASP whose corporate name is a homonym for a popular frozen dessert. When I politely explained that I had no interest in working with his company – and stressed that I had said this to numerous sales reps before him – this salesman did not get the message. Instead, he simply ranted on, insisting that they weren’t just outsourcing work overseas anymore, but that his company was all about new ways to manage human resources. Once again, I told him that I was not interested in outsourcing work to his company. When he started to inquire about the kind of equipment my company uses, I told him that was none of his business. But he just wouldn’t give up. Finally, I interrupted him and asked “What part of the word NO don’t you understand?” He didn’t even hear me. He just kept barreling on with his spiel.

At that point I said, “Stop right now. You’re obviously not the slightest bit interested in listening to what a potential client might have to say to you. This conversation is officially over.” And I hung up the phone.

I don’t care how much venture capital a TASP has going for it. If potential clients must be subjected to the rude and unprofessional behavior of overly aggressive sales reps -- who think like some kind of rapist who hears the word “no” but thinks it means “yes” – then that company’s sales prospects are severely limited.So far we’ve examined pestilence (e-mail spam), arrogance (obnoxious sales reps), and stupidity (impaired language skills) as major reasons why I would not outsource work to offshore vendors. Now let’s talk about deceptive business practices.

One of the most common approaches for offshore entrepreneurs has been to find American MTSOs they can partner with. My hat goes off to Jeri Steenwerth for finally unmasking one of these charades. She writes: “Many Indian MT companies have tried to hire me, but not one has been willing to put their money where their mouth is. Shane Eakin in Tampa, Florida, is running a company called The Back Suite, and offered me a QA job at 2 cpl. When I spoke with him on the phone, he was vague about the terms of my employment. A couple of things really set off my bullshit detector. On contracts: ‘You can write a contract if you want to, but we usually don't use them. We do everything verbally. Contracts are really unenforceable anyway.’ Then he wanted me to start work the next day (this was in the beginning of December) but said I wouldn't get paid till the end of the month! So I traced the company and discovered that The Back Suite is actually an Indian MT company. I know so many QA people who've worked for these companies and wound up not getting paid.”

Feeling that a transoceanic contract was entirely unenforceable, Steenworth requested verifiable proof of The Back Suite’s corporate existence in this country, demanding:

• A certified copy of the company’s articles of incorporation as well as its U.S. attorney's name, firm, and phone number and permission to discuss matters with him/her.

• Proof that all checks were drawn on a U.S. bank.

• Up-front payment of a certain percentage of expected earnings and biweekly payment of the remainder.

• Payment by certified check, cashier's check, or money order.

• A minimum rate of 3 cpl with advances to follow, assuming everything was satisfactory.

Eakin’s email reply stated that: "The Back Suite Corporation is NOT an Indian company. There is an Indian company named "Back Suite, Ltd.", but that is not us. We are and have always been an American company, incorporated in the State of Florida. I have been in this business for over 14 years, and have never had a potential employee dictate terms like yours. Even if we were an Indian company, I would not agree to those terms. No company would. I responded to your MT Daily post because it struck a cord, not because I was desperate. We are a rapidly growing company and I hire MTs all the time. I have had no problem finding people "with brains". These days there are many more MTs looking for work than there are jobs for them, as you apparently well know. I wish you well in your search for employment.”

What Eaken failed to anticipate was a professional medical transcriptionist’s nasty penchant for looking things up. When Steenworth traced the ownership of the domain name "thebacksuite.com" through Network Solutions, she discovered the following information:

Registrant:
Backsuite Pvt. Ltd.
40, Manisha Society, Karve Nagar
Pune, Maharashtra 411052
IN
Domain Name: THEBACKSUITE.COM
Sponsoring Reseller; for Technical Support
with respect to this domain contact:
Direct Information Pvt. Ltd.,
Manisha Nagar

In her reply to Eakin, Steenworth stated "If the backsuite.com website does not belong to your company (although it says it's in the Tampa area, serves customers in Florida, and lists you as the contact person), then I apologize. Direct me to the correct website for your company and I'll take back everything I said. Otherwise, I'm afraid I can't take the risk of doing work that I won't get paid for till the end of the month, if at all.”

Another subscriber to the KAMT-list suffered a far more unnerving experience.

“I thought you should all know who you're dealing with (sara_samsara), both the people who denounced him/her for the ill-worded e-mail spam for work and those who took the denouncements as a personal insult to samsara and labeled them as verbal assault,” writes Erin. “Samsara has impersonated K.W. and myself 5 times on this list, for which he/she has been reported to the proper department of both Yahoo andhis/her FTP provider, whose service was used to do so, since it is a violation of the TOS for both services. Also, rather than argue the merits of his/hervalue as an MT, this person chose to act out in a most childish way by submitting my "url" to an FFA blaster, thereby filling my inbox with 419, and counting, confirmation e-mails. More spam for me, yum yum. To me, this equates to e-mail terrorism. What a wonderful quality to display as an MT looking for work as well as representing your country, sara. Those of you who were considering hiring samsara (if there were any of you out there) are probably now rethinking this, wondering: What if it didn't work out and I actually had to "fire" him/her for lacking acceptable quality of work? Would I be barraged by spam, too? Probably.”

Just like the proprietor of a bar or restaurant, I reserve the right to refuse to do business with anyone. I don’t care if that person is an obnoxious surgeon, an arrogant sales rep for an offshore transcription vendor, or a dysfunctional medical transcriptionist. When I say no, that’s exactly what I mean. If foreign entrepreneurs (who are high on the potential of globalization) don’t want to hear that message, that’s their problem. I refuse to put my clients and their patients at risk because of substandard transcription work and/or shady business practices.

The bottom line is simple. No healthcare organization or MTSO is obligated to outsource transcription to offshore vendors. If the spammers and scammers in the medical transcription industry don’t understand that, they are operating in a severe state of denial.