Monday, October 27, 2008
Friday, October 24, 2008
Wednesday, October 15, 2008
First... I am not one to go around hunting for omens, portents or "signs from God" under every rock, but if this doesn't qualify, I don't know what does.
Last Friday my new supervisor called me. Long story a whole lot shorter... she used to work for the husband of a woman I met online through some of the most unbelievable circumstances you could imagine. (For those in the know, that woman is also known as Mrs. ex-Perp. The rest of you... don't sweat it.) No six degrees of separation going on here! And we're talking about opposite coasts... my new employer is headquartered in North Carolina.
Yesterday was my first full day on the job (and my head is still spinning, but that's to be expected). You know how "those in the know" talk about how you must be very, very circumspect and professional when using company e-mail? Well... yesterday morning, a whole series of e-mails started popping up, beginning with some concerns surrounding the fact that many of us (a) are new to the company and (b) are working on a brand-new account to boot, so there are some definite issues to iron out. In the midst of this, one woman made a reference to a "crabby old lady."
Well... y'all know me. I jumped in with "Crabby old lady? Did someone call my name?"
And after that it turned into a free-for-all--in which the supervisors were giving just as much fun to the party as us worker bees. Apparently, and I haven't learned otherwise yet, the corporate mentality is that we all need a sanity (insanity?) break once in a while, and group laughter (in the form of e-mails, anyway, since we're all working remotely) is to be encouraged.
And then, this morning, someone wrote in that now she knows why all the QA (quality assurance) people at her last job were grumpy... all of the ones who have a sense of humor work for OUR company!
Meanwhile... I am still getting used to their system, and there are some really, really difficult-to-understand ESL doctors whose dictation I have been unlucky enough to draw. But I cranked out marginally more work today than yesterday, so perhaps I am speeding up just a little. We shall see. I am meeting my first-week daily production quota so far, and hopefully will have sped up enough by week 2 to meet that quota, and so forth. I am still well under the normal production quota, though.... Oh well, this is what the training period is for!
Is it time for my nap yet?
Wednesday, October 8, 2008
That is an order. CrankyBeach hath spoken.
(Hat tip: Baldilocks)
The first time I heard this song on local radio I was driving home, pulled up at a stoplight, and the person in the next car looked over at me and quickly looked away again because I was laughing my pinkytoe off and the tears were rolling down my face.
In the next day or two I managed to tape-record the song from the radio; but at this point I have no idea where that tape might be hiding.
It had to be 1986, because unless my brain is completely gone (instead of just mostly gone) that was the year Clint ran for mayor and put Carmel on the map.
Brings back some crazy memories, that's for sure....
(Edited to add: That was a popular local band called The Medflys.)
Friday, October 3, 2008
I have not mentioned this on the blog until now because I really don't enjoy bleeding all over the folks who come here hoping for a little entertainment and enlightenment.
But I've known since the middle of June, right after I got home from visiting Kerry in Wisconsin (and seeing the Moody Blues in Waukegan) that big changes were coming.
(This has turned into a very long post, so I am putting the rest of it below the fold.)
JR, the doctor who has been my employer, my doctor, my other adopted big brother and truly a member of my extended family for nearly 28 years decided, for various reasons, that it was time to close his practice and spend his remaining working years practicing medicine in the employ of someone else.
I have always known, in the back of my mind, that this day would come. After all, the man is 11 years older than I am, and it stood to reason he would retire long before I would be ready to pack it in, and I'd have to go to work for someone else. That was one of the major reasons I went back to college 10 years ago and finally finished my degree. (And JR gave the toast at my graduation party.)
I guess it's human nature that even when you know something will happen eventually... you are still stunned, gob-smacked, reeling from the two-by-four upside the head, when it actually happens. You just didn't expect it to happen NOW.
JR is not retiring just yet; he and his daughter NR who joined the practice about 4 years ago are going to work for another medical group. In July I sent my resume and a very polite and professional cover letter to the other medical group, more or less applying to keep my job.
But it was not to be; the other medical group has other solutions in mind to cover the medical transcription department (voice recognition among them, which I want to watch, because I have never actually seen a computer melt down in self-defense). JR went to bat for me, but he was not able to persuade them to bring me on board.
So I've been looking around, and asking around; but there's nothing local to be found. There is one job that's been advertised for at least a month and a half on the state employment site--but it would be an 80-mile round trip daily commute, plus the pay rate offered--well, I haven't worked for that low a rate since the Reagan administration, so I was not even tempted to apply. I'd have eaten up half my paycheck in gas alone.
Interestingly enough, the office where JR and NR will practice was advertising for a medical biller. In addition to being a transcriptionist, I am a recovering biller--but I have said I will clean toilets for a living before I will go back to being a biller. The entire medical reimbursement racket has turned into such a headache these days. When I started, all those years ago, it was so simple. The doctor saw a patient, you billed their insurance, you got paid. End of story. Nowadays, you have to call the insurance company practically every time the patient is seen, because what was true the last time you called very often is not true the following week. You call, you verify that they have coverage, you verify that the service you want to perform on the patient is a covered service under their plan, you request authorization to perform the service, you perform the service and you bill for it--and then you wait and wait and wait to be paid. The insurance company requests medical records and justification for performing a covered service that is the standard of care, because they've got some medical director sitting up there who probably hasn't actually had his hands on a real live patient since 1969, whose job it is to deny or stonewall.
I got tired of pushing that boulder uphill (seriously burned out is actually a better description) and left the billing department a year ago last July to come home and transcribe full time. And now my job has gone away.
With the technology these days, medical transcription can be done from anywhere (anywhere with an internet connection, that is) for a client located anywhere (also with an internet connection). There's no commute, no professional wardrobe to maintain, and no office politics. The downside is that with all the cost savings on both ends, the pay scales have dropped. Part of this is because there has been a lot of outsourcing overseas, and those folks overseas will work for a tiny fraction of American wages. But we're starting to see a trend for the jobs to come back onshore, because even if the initial wage is lower, when you have to proofread everything that comes back with a magnifying glass, where's the savings? Best to pay a bit more and have it done right in the first place. Plus... there's really no way to enforce the privacy laws when you're sending work overseas. There's a true story floating around about how a transcriptionist overseas sent an e-mail to a major hospital threatening to put their patients' medical records on the web, for all the world to see, if she did not get paid for her work. She attached some medical records to the e-mail to prove she actually had them, and could make good on her threat. This led the hospital to rewrite all their contracts with medical transcription services, prohibiting the services from subcontracting any of their work offshore.
I started job-hunting seriously about a month ago. And discovered that even with 36 years of experience under my belt, I am not qualified for at least half of the available jobs. Why? Because I have worked strictly in the doctor's office (clinical) setting, and never for a hospital (acute care), and no one would even let me try out for acute care. The only people eligible for those jobs are (a) those with at least 2 years of recent experience in it, and (b) recent graduates of the top medical transcription schools.
I even called one school, explained my dilemma, and asked if they had a crash course in acute care for someone like me. The recruiter sympathized, but said no they didn't, and did I want to enroll in their complete course (at least half of which I could teach in my sleep). I said no, thank you, and went on with my search.
Finally, in the last couple of weeks, I began to receive job offers; but these employers required me to commit to a 40-hour week in order to be eligible for benefits. Interestingly, within that 40-hour week, they require a per-day line quota, usually 1200 lines, and the pay is by the line, not by the hour. When I am doing familiar work, I can knock out 1200 lines in 4 or 5 hours--and my hands (and brain) can't go on much longer than that. So I needed to find a job where the quota was the thing, and not the hours.
A week ago I applied for one such job (1200 lines a day and they don't care what time you do it, or how long it does or does not take you, as long as it's done and back by midnight) and waited for the recruiter to call me back. And waited. Meanwhile, I kept applying.
And meanwhile, I did the last of NR's dictation (she moved over to the new place on the 19th) and I did not handle it well at all. Friday the 25th a bunch of the staff went out for unhappy hour, something we never did before, realizing this might be the only farewell party we would get. Monday the 29th was JR's last day of seeing patients in the old office. M, the manager who had been there even longer than me, told me to come over at lunch time. We had ourselves a little farewell pity party that involved bagels and doughnuts. Tuesday the 30th I did the last of JR's work--and handled that even less well.
Wednesday, I spent most of the day just scanning medical transcription bulletin boards, looking for names of companies that people were happy working for, hunting down websites, and sending in online applications. I also took several tests, at the sites that had tests available. In all, I applied for 13 jobs that day alone.
By the time I turned in my last test (and resume) of the day, it was about 4:30 in the afternoon, and I was really, really tired. I went off for a couple of hours to see some friends--and when I got home, I had a sizzling hot e-mail from the recruiter for the very last company I had applied to. She had marked up my test and sent it back to me (THAT was a first!) and really, really wanted to talk to me ASAP.
So I called her first thing in the morning. She said I had scored 98.6 percent on the test, and the bits that I missed, everyone misses. (She even missed them herself when she took the very same test.) She had three more positions to fill for a large hospital/clinic system that is coming online as a new client for their transcription company, she had already filled two of them, and when she saw my test and resume, she knew she had found her third person, if only I would agree. After learning all the particulars, I asked her if I could have a little time, since I had a couple more phone interviews actually scheduled for that morning. She said okay but that she really needed an answer ASAP because it was getting down to the wire. I told her I would let her know by the end of the day.
So I took the other two interviews--and in addition finally got a call back from that "dream job" I had applied for, the one that was strictly production-based and not hourly. Unfortunately, the "dream job" recruiter said she had several other interviews to conduct, and would not be able to make a hiring decision until next week, and of course there was no guarantee I would be chosen. I did get an immediate offer from one of the other interviews. After I ran the numbers and considered all the particulars, I decided to go with the first one. I called the recruiter back and accepted the job. I spent half of yesterday filling out and faxing back employment paperwork.
The new job actually starts at a slightly lower pay rate than the other offer--but there are production incentives, which I will have no trouble meeting, plus my share of cost for the health insurance premium is far less than for the other company. That alone was almost enough to make up for the pay differential.
But... there are other compensations. As soon as I have worked for them for 3 months, I will sit for the first certification exam--and they will reimburse me the cost of taking the exam. They offer free study groups for exam prep, and passing the exam bumps up the pay rate. I am, the recruiter said, over-qualified to take that first exam, because it is designed for newbies right out of school. The second certification (and second salary bump) has a prerequisite of 2 1/2 years of acute care experience.
Here's the thing that sealed the deal for me. Since I scored so high on the test, I am eligible for up-training into acute care. Yes, acute care, the discipline in which I haven't even been able to get arrested, the don't-call-us-and-we-won't-call-you thing. They'll start me, of course, on clinical work (what doctors and what specialties, I don't know yet) but as soon as I am eligible for that up-training, you can bet I will be right there. Acute care of course pays better than clinical.
None of the other companies that offered me jobs offered me up-training, or reimbursement for taking certification exams, or even study groups for exam prep. With all of those things to consider, it turned into a no-brainer.
The company supplies all the hardware. They're shipping me a Dell tower, a KVM switch, a network cable, a headset and a foot pedal first thing next week. Thursday morning, I will get a training call from the IT department, and they will walk me through setting up the computer. Later in the morning I will get another training call, for training on the online interface and transcription platform. (Somebody remind me to dig out that old hands-free headset telephone....)
Monday morning, October 13, the account goes live, and we will have work.
I may actually not start real work until Tuesday, because I have signed up for a Tuesday-Saturday, 6 a.m. to noon California time, work schedule. Yes, they do require at least 30 hours a week of seat time for benefits eligibility--but again, the entire pay scale is based on the production quota. So I will have 6 hours a day in which to get in a minimum of 1000 lines, or 10,000 lines per 2-week pay period. At 12,001 lines, there's a production incentive pay bump, in which not just the lines over 12,000 but the entire production for that pay period gets paid at the higher rate. There's another bump at 15,001 and on upwards. I shall have to see how well my hands (and my brain) hold up; but I know I can do the 1200 a day with no problems.
There are also bonuses for working holidays; if a holiday falls on one of your regular workdays, you get your regular pay but you also get PTO (paid time off) hours put into your bank. I don't know yet exactly which days are considered holidays in this company--but Thanksgiving, Christmas and New Year's Day all come on a Thursday this time around, and that is one of my regular work days, so I will rack up some PTO fairly quickly. Routine PTO does not start to be earned until after the first full year of employment. The health insurance kicks in after 90 days, and there is also a 401k available.
So... the whole proposition will constitute a rather substantial pay cut, but since no one local was hiring, I really didn't have much of a choice. And the compensations of working at home (the commute is a few feet down the hall, the professional wardrobe is pajamas, and there are no office politics) do count for a lot.
If you're still reading... thanks for listening! It's been quite a ride. I have a lot of training to get through, and the learning curve on the new platform alone will be steep; but hopefully, once I get used to it, my life will settle back down into its usual dull roar.
At least I won't be bored.
Wednesday, October 1, 2008
That's the percentage my entire portfolio (retirement, savings, etc.) lost in the last one month.
How did you do?