A. Letter to Congressman About Reducing Medical Costs


Dear Representative Burgess:

I was watching C-SPAN recently and saw your HealthCaucus.Org discussion about medical costs. I thought it was remarkable that besides working in the health care field, I am a resident of Texas, although not your district, and could give you some insight into the: high cost of medical care. I have been working in the health care field for over 20 years as a medical transcriptionist. When I started, in the early 1980s, medical transcription was done in the hospitals. Then it began being outsourced to large nationwide medical transcription services, done by individual transcriptionists working for the agencies. The internet made this possible, by receiving dictation remotely (even in other countries) and sending the typed report back via the internet.

Interestingly several days after I saw your forum, I went to a small hospital in the Texas Panhandle, inquiring about my letter offer several weeks earlier to do medical transcription directly for the hospital. I was told there was no medical transcription done by the hospital, it all was outsourced to a large medical transcription service out of Dallas. The explanation used by the Human Resources Department was that when they did their own work the hospital had to juggle coverage for weekends and evenings and giving it all to an agency was much more convenient.

But as we all know, there is an increased cost for convenience, which involves paying a middle man (transcription service). During the unlimited medical growth of the 1990s and early  2000s, this expense may have seemed unimportant, as it could easily be added to the hospital’s bottom line.  However, now that there are so many uninsured, as well as reduced government revenues available for programs like Medicare, it seems wasteful for hospitals to pay an unnecessary middleman to do their medical transcription.  Hospitals could take control of the process, deal directly with medical transcriptionists, working remotely, and still have the savings of not having to provide space in the hospital or equipment for the transcription.

Even though it is out of your district, surprisingly, one of the largest medical facilities in the Texas Panhandle in Amarillo still outsources all of their medical transcription.  I have contacted them and offered to do transcription for a lower cost than their current agency, but have not received any response; ostensibly because it is a government bureaucracy slow to respond, but they also have not responded to my offer to expedite the transcription process, even when I point out the transcription services ALREADY do this.

I note that a lot of people blame the doctors for the high cost of medical care, but from my perspective, doctors nowadays are no longer self-employed, with their own office, but are having to work for a HMO or hospital-based group, making less money. I believe the hospitals have become too accustomed to incurring costs for convenience, like outsourcing of medical transcription, and simply passing that on in their hospital charges.  Medical transcription does not generate revenue, but is a necessary expense of running a hospital.  It does not justify outsourcing or spending more than necessary on the process.

You are aware of how much this country spends on medical costs and how poorly our country ranks in comparison with other developed countries’ medical systems.  I wanted you to know that I can help reduce hospital costs for medical transcription and simultaneously improve turnaround time for the dictated reports, by eliminating outsourcing, which would also benefit the local economy and increase local jobs.


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