Wednesday, March 30, 2016

Truth's about being an at-home transcriptionist.

There are so many misconceptions people have about not only what being a transcriptionist really means, but also what it means to be an at-home transcriptionist. This is a lengthy post, to educate those who are looking at transcription as a potential career choice, to those who just don't understand what it is we really do, and the stresses that goes along with it.

1. "You are so lucky to be able to work at home." I hear this all the time. It's not "lucky." When people say this, they seem to assume that I don't actually work, or that my job is somehow easier than theirs. I have set hours that I have to work. I have to adhere to a work schedule like everyone else. I also have production requirements. Being a production employee sucks. I can't have a slow day, or a day where I can sit and talk to co-workers at their desk and shoot the breeze for 20 minutes and still get paid for it. I have to constantly be typing. Yes, I don't have a supervisor looking over my shoulder, or have the annoying co-worker I can't stand to be around, that is a plus. But I have to be accountable 100% of the time. It takes a great amount of self-discipline to work when you are at home, where distraction is so easy.

2. People think you have a ton of free time. Friends, neighbors, even family think that you are always available to do things like watching people's kids for them, run errands, or talk on the phone. Can you do these things at an office job? Well, neither can I. It's a real job people. Just because I work from home doesn't mean I have a ton of free time.

3. People don't understand that you have to concentrate. The job is to listen. I don't know how many times I will be typing and someone decides they want to have a conversation with me right in the middle of a report. Not only does this eat into my production time, by making it look like it takes me longer to complete a report than it really takes me, but when you're in the rhythm of typing, and someone decides to ask you a question, you lose that flow of where you were, have to rewind the recording and start again. It's frustrating.

4. People say, "It must be wonderful to be at home with your child and work from home." Yes...and no. She doesn't understand that I'm working. To her I am staring at a computer screen all day and playing on a keyboard, and ignoring her. Sometimes she comes in and stands next to my chair and screams, or sings, or asks a million questions, or throws a dozen requests at me of "I need something to eat/drink, a toy, where's my daddy," and much like number three, I can't hear what the person on my recording is saying. Employers are not sensitive to the fact that I'm a mother. I have had more than one employer say, if your child is bothering you at work, put them in daycare.

Are you shitting me? First you don't pay me anywhere close to enough to afford daycare, and if I had to put them in daycare, what would be the purpose of working at home? I would get an out of the home job that offers me actual benefits, and insurance, and paid days off, versus the slave wages I get paid now. I make 6 cpl (cents per line) with a 1400 line a day requirement. That means I make $84 dollars a day. That is if I can actually hit 1400, which many times I can't and barely get 1000 lines, which means I make $60 or less a day. During low volume periods at work which happens several times a year, sometimes for weeks at a time, particularly summer months, spring break, and holidays, the company runs out of work all together and I make zero dollars per day.

5. Production jobs suck. When you're an hourly paid employee at a company, you get paid for idle time. I don't. The people I type for waste a lot of my time and I don't get paid for it. Sometimes you spend 10 minutes typing a report and at the very end they say, oh sorry, I already sent this, please delete this report, and I lose all the lines and all the time spent in it. Some people leave super long gaps in between their talking, which is productive time I don't get paid for.

I have gotten 1 hour long dictations before which in theory should be 600 lines or more, and it ends up being 100 lines because they would let the recording run for minutes at a time between sentences while saying nothing, while you hear them thumbing through paperwork to find something they want to remark on, or you hear them pondering their own thoughts which you can't type.

Sometimes they get a phone call in the middle of dictation, but they don't hang up the recording, so you have to listen to the whole thing, called spot checking, to be sure that you don't miss if they start recording something again that you do need to type. Again, this is time spent idle, that doesn't go towards your line count or your pay, and is just wasted time. Sometimes you type a paragraph and they say, no delete that let me start again, and you lose all that work, and sometimes they do this four or five times in a row and you're consistently deleting all the work you just did.

 I have also had more than one lengthy report that was a "butt dial" where somehow they connected to the voice platform and didn't know it. I have to scan the entire length of the recording whether it was only a minute, to something that recorded three hours of nothing, waste all that time and send it as a no dictation, and get zero lines and zero pay for it.

6. People think it's an easy job. I just sit and type what I hear. It's not simple. There are dozens of rules from the employer itself. There's client specifics and for a company that has 300 or more clients, and each client has their own specifics, you have to memorize 300 client profiles. One client might want double spacing, others don't. One client wants comma's for four digit numbers (ex: 1,000 versus 1000), others only want commas in five digit numbers. Some have specifics on if they want numbered bullets versus a dot bullet. Some have abbreviations that were created and used only by them and you have to learn them. Then there's competing noise. Sometimes they dictate while in the car and you have to listen to all the traffic or listen to their really loud GPS talking at the same time they are. Sometimes they cough, sneeze, belch, swear and it blows your eardrum out. Some shout into the recording making you cringe. Some whisper and you can barely make out anything they're saying. Some slur, some mumble, some use really poor grammar or mix up details like interchanging her and his or give you erroneous information that you have to correct for them. If I miss a mistake they make, they're not held responsible, I am. Because I am the editor. I am paid to catch any and all errors that they make.

They think all you do is type. How hard can that be? People think it's a sit down job, it's easy. It's not like manual labor jobs. The job is rough on the hands and the body in general. It is a true sit down job. This means sore, stiff legs, back pain, neck pain, carpal tunnel, wrist pain, finger numbness, eye fatigue, headaches. People don't understand ear fatigue. Have you ever sat through an hour long lecture and gotten sleepy? Try an 8 hour long lecture, where you have to listen to every single utterance? When I'm listening to someone talking, I can't fade out or lose focus. I get paid to type everything I hear. Imagine if you had to listen to 40 different people every day, every single word they say, 8 hours a day, five days a week. It all wears on you. Burn out is very easy. Physically, after sitting for several hours typing, when I stand up, my knees ache so bad. Yes, I can get up and move around, and I have to, but the longer in takes me to get in my lines for the day, the longer I have to sit at the desk overall.

8. Consistency of work. There is no consistency. I can have a day where I get several really long reports and my day flies by quick. Other days, and most days, I'll get 50 reports less than 30 seconds each, and the actual demographics that I have to do, that I don't get paid for, takes longer to complete than the actual typing of the report. Some days I get really good speakers. Some days I get one lousy speaker after another which grates on every single nerve you have. Some days I get one problematic report after another.

9. QA or quality assurance. These people can make or break you. Every single day you will have a report and sometimes half of your reports where you can't make out what the person is saying. For every word you can't hear you have to put a blank (usually five underline spaces) and send it to QA, for a second listen. QA is paid for their incredible scope of word knowledge and super attuned ears. They make out stuff that sounds like gibberish to another person. They are paid considerably more than an MT, sometimes two to three times as much, just to fill in blanks.

QA people. Can be the greatest asset or your worst enemy. They feel superior. I have had some that are so insulting to you, and they used to be MTs too. Unfortunately 90% of the QA people I have worked with are demeaning. I've had some email me in all caps and end a sentence with 20 exclamation points, no exaggeration. I had one QA person call me at home and start yelling at me, and saying I have told you over and over again, why can't you get this right, and we may have to let you go because you're not grasping the material quick enough, only to discover that they called me in error, and it was another MT they meant to call. I've been brought to tears by QA people. I've gotten such shitty emails from QA that I literally stopped working for the entire day and had to make up my missed lines on another day, because the urge to quit is so strong.

QA also do your audits, and audits are done monthly. Most jobs require at least 98% accuracy on your reports, but some require 99% to 99.5%. You're on a scale, where punctuation errors might be .25 point error, to the worst which is typing the wrong word completely which can sometimes be a 3 point error, which means you fail your audit. I got marked as an error for a run-on sentence that the dictator was doing, where an entire paragraph was full of and's. I made the election to stop the run on sentence and create a new sentence. This is not unheard of. In fact, it's a requirement to edit run on sentences. However, QA didn't like where I put my comma, and actually gave me 0.25 point deduction for this. This is QA abuse.

I had one that marked me a half point deduction because I typed the number 1 instead of spelling it out as one. Companies have very specific rules regarding numbers. However, any other QA department would have listed this as an FYI and not as an error, because it wasn't a wrong response. I didn't change the meaning of what the person was saying. Wrong means he said her and I typed he, where I literally changed not only what he said which is illegal, but that I changed the gender of the person, or if he says $20 and I type $200, these are serious errors. What we type can, and has been, used in legal proceedings. Typing the number 1 instead of spelling it out does not alter the meaning of the word which is an error. It was simply an oversight. That should not warrant any point deductions. You cannot argue with QA. If you do, they will make life miserable for you every day. As an MT you are never, ever right. The QA person is always right.

If your QA person doesn't like you, they will nitpick on every possible thing and cause you to fail your audits. More than one has been vindictive and malicious. Try to bring it up to management? They basically call you and asshole and say they agree with the QA assessment and then you put a target on yourself.

This is a daily occurrence; the damned if you do, damned if you don't scenario. If you don't know the answer, don't guess. That's what they will tell you. Send it to QA. That's what they tell you. But when you don't know the answer and send it to QA, they respond with, "Well, I could understand it, why couldn't you?" Then you're anxious every time you send something to QA, which sometimes means you decide to take a chance that you're right on a word, only you were wrong and you get hammered with criticism. You get penalized for not sending it to QA, and for sending it to QA. Double edge sword, every single day. One company I worked for in the past actually started to dock us money for the percentage of reports sent to QA. They would put you on an account with ESL speakers (English as a second language) so they have thick accents and you can barely understand anything they're saying. Your report is full of blanks. Report after report like this, and they actually deduct money from your check for sending it to QA. So you're working and losing money.

QA in the same department are not all consistent. One QA person might tell you something you did was incorrect, and quite literally, another QA person will tell you what you did was correct. This happens a lot. It means you never know what to do sometimes. It means luck of the draw. Maybe you get the great QA person, maybe you don't. A rude QA person can ruin your entire day. I have quit jobs over their QA department. That's how bad it can be.

10. Short on lines. It's easy to fall behind on work. It is a real feat to hit 1400 lines a day. Many MTs fall short. So if you only get 1000 lines one day, now you have to make up 400 lines, on top of the fact that it's already hard to hit your minimum. It only takes a few short days; internet outage, power outage from storms, illness, family issues, low productivity days where you sit at the computer and type all day and everything you get is just worthless and you barely accumulate lines, all this adds up to a deficit that has you drowning in missed lines. It's easy to sink.

11. VR/SR or voice recognition, speech recognition software. Don't even get me started. Typing used to be straight transcription. About 8 years ago, some asshole company somewhere said let's transition to voice recognition to increase productivity. You often have people with different dialects, poor speaking habits, the constant corrections they ask you to make, VR doesn't understand that. VR would type sentences so full of errors and you have to go in and sometimes have to retype nearly the entire report because of all the errors, constantly deleting, revising, correcting everything some machine did, but the industry says VR means you actually type less (you don't) and that VR makes your job easier (it doesn't).

The industry did two things when they introduced VR. First what used to be 10 cpl (cents per line), 15 cpl in the distant past, got pushed down to 2 cpl and 3 cpl for VR. That means I'm doing all the same work, even more in most cases because I'm having to correct a machine and do constant editing, but I'm making less than ever before. 3 cpl at 1400 lines a day is $42 a day. At 8 hours of work, that means $5.50 an hour. Below minimum wage. Because it's production based, they can get away with paying you below minimum wage, but because that's not entirely legal, they did something.

They raised the lines per hour requirement from a standard 100 lines per hour, to 250 lines per hour. 250 line per hour means typing 4 lines per minute. A line is considered 65 character spaces. That's 260 characters a minute. That's 4 characters a second. It's a lot people. Trust me. They raised what used to be a typical 1000-1200 lines a day minimum to 2000 plus lines a day, but still require that you get this done in an 8 hour work day. It's impossible for most. It was impossible for me. Sometimes it takes you 12 plus hours a day to complete this, but you have to report 8 hours. You can't get paid overtime.

If you don't agree to saying you did this in 8 hours, then you get fired for not being able to meet the "minimum production requirements."

12. "It must be nice to not have a supervisor or co-workers watching over your shoulder." People think we have complete freedom from overseeing because we work at home. We don't. They monitor our computer. They monitor our keystrokes remotely. They can tell when you've been idle and will pop up an instant message of why aren't you working. Some can tell if you're not using hot keys on the keyboard and using your mouse instead to which they'll tell you hot keys are faster (not always) and you get reprimanded. Some monitor how often you use expansions and if they feel you're not utilizing expansions enough, you get reprimanded.

A description of "expansions." Expansions are shortcuts. If you type the word "approximately" a lot, you make an expansion like "apx" and every time you type "apx" it automatically spells out approximately for you. The key with expansions is that you have to memorize thousands of expansions you create yourself. Sometimes expansions have the same letters and you have to get super creative and this means sometimes you forget your expansions or waste time typing the wrong one, deleting it, getting it wrong again, getting frustrated with not being able to remember it, and end up typing the whole thing out. This is all lost time in production and reduction of overall speed. However, I would fall apart without expansions. Expansions or a time and life saver.

13. Emotional. Medical is not easy. Especially emergency department transcription. I have had doctors break down crying in the middle of dictating because of a lost patient. I have had doctors go on a tirade (which you can't type) about how shitty Medicare is, or HMO's, and how they want and need to do tests that the insurance company won't approve. I've had doctors who had homeless people who were so hungry, that they faked a medical problem, just so they could get into a room where they could get out of the cold, or sometimes they use it as a way to get a hospital meal, and because they're homeless, the doctor won't get paid, the hospital won't get paid and it drains on social programs. I've had doctors who have given their own lunches, paid for cab fares or bus fares so people in poverty could go somewhere, and you hear it in their voice.

I typed reports on babies born stillborn. I've typed reports on a drive by shooting that killed a 3-year-old child on their front porch. I've typed a report on people who have been run over by cars and died, people who were beaten by their partners, people who were stabbed and mugged, people who were raped, child abuse cases, freak accidents like the child who tossed his sandal up into the air and as it came down, the buckle caught him in the eye, and his eye had to be removed.

I've had the 5-year-old diagnosed with terminal cancer. I've actually typed for a doctor, but in the background I could hear a different doctor telling someone their loved one passed away in the emergency room, and I can hear screaming and sobbing on top of having to listen to the person I'm typing for.

I have had to type things that made me cry. I have had to type things that haunted me for days. I have typed things that make you look into the lives of strangers and you know everything about them; what diseases they have, did they contract an STD from a prostitute, are these using drugs. Things that this person may not know that somewhere out there, is a woman who is typing all their intimate personal details, someone who doesn't work for the hospital, but who works for a transcription company in some other state and I know something they probably wish I didn't know. I know their name. I know where they live. I know what kind of insurance they have. There is an emotional toll to being a transcriptionist.

And a legal responsibility to protect their information or be fined thousands up to millions of dollars and threatened with legal action and jail time for even an accidental breach of patient information. Tell me, if you mess up at your office job by making a data entry error, are you threatened with jail time?

And lastly, people are very critical of what I type casually. If I make a typo on Facebook, I get slammed from people who are like "Don't you type for a living?" I'm sorry if I slack off or make mistakes, and typos, or phonetically spell a word accidentally. Sorry, that I'm not on the ball all the time when I'm off the clock, and don't have QA breathing down my neck, and where I'm not getting audited on Facebook or in a personal email for quality control. I have to be on all the time at my job for errors and mistakes. Forgive me for thinking it would be possible to get by with the occasional error when not working. Maybe I was very tired. Maybe my eyes are blurry from a days worth of typing. Maybe my fingers are sore and tired and they slipped. Maybe I just didn't give a fuck after a shitty day at work.

So yes, it is nice to be able to work from home as a transcriptionist. But it is not easy, and it is not lucky.


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