After 30 years as a medical transcriptionist, documenting patient records for doctors, Welch was laid off in September when her employer transferred much of her workload to an office in India.

Shocked, she began contacting former employers and co-workers for job leads, but found only part-time work at less than half her previous pay.

“Here I was, a middle-income health-care worker with a good work record and all the right credentials competing with someone in India for a job that paid at best $50 per day,” Welch said. “No benefits either. I said forget it. How can I compete with that?”

Recent federal and industry surveys show an increasing amount of work is being shifted to low-wage earners in India and the Philippines, where transcribers are paid about 3 cents per line of text to document doctors’ notes about a patient’s visit.

Cutting Costs

A U.S. Bureau of Labor Statistics report from 2008 noted that hospitals looking to cut costs will increase the amount of work outsourced abroad in coming years, though it says much work will remain for U.S.-based transcribers - even if it’s only to edit transcribed notes made overseas.

“Reports transcribed by overseas medical transcription services usually require editing for accuracy by domestic medical transcriptionists before they meet U.S. quality standards,” the report noted.

However, the report also states that many hospitals will maintain in-house staff for quality control.

Outsourcing transcription work abroad - to countries such as India, Pakistan, Philippines and the Caribbean - has grown more popular as transmitting confidential health information over the Internet has become more secure, the the bureau report states. “However, the demand for overseas transcription services is expected only to supplement the demand for well-trained domestic medical transcriptionists.”

Indeed, the government of the tiny Caribbean nation of Barbados announced in January that it was opening a medical transcription school to train the growing number of local workers being hired by U.S. firms.

Another study, commissioned by the Medical Transcription Industry Association, found that “hospitals are increasing the pressure for cheaper and faster (transcription), looking to stem the tide of their own rising costs by increasing savings on health-care documentation production.

This practice, the report notes, “is based on a general devaluation of the work that (medical transcriptionists) do.”

Statements like that may ring true with workers like Welch, but it isn’t helping generate jobs in the meantime.

For Welch, the prospects in her dedicated line of work appear grim enough for her to begin exploring other job opportunities.

She’s applying for positions in medical billing and coding and helping hospitals transfer their medical records from paper to digital files - an effort the federal government has dedicated more than $20billion to help accomplish in coming years.

Welch is also looking to teach her deep knowledge of medical paperwork - and its importance to the health-care industry - to local students, an endeavor she’s been hired to perform on occasion in the past.

But she still longs for the freedom and flexibility provided by medical transcription, which the Labor Bureau estimates employs some 100,000 people in the U.S.

“I’m weighing my options and looking for something with long-term prospects,” Welch said. “Stability would be great right now, but it’s a bad economy and people aren’t hiring, so I’m not being unrealistic.”

Local hospitals vary

Still, she wishes American companies would invest more in their workers.

“At the end of the day, these records are critical to a patient’s medication, care and well-being,” Welch said. “If you screw one of those up, it could cost somebody their life. Protecting people’s health is worth paying a few extra dollars.”

A survey of area hospitals revealed many contract outside agencies to transcribe patient records, though Long Beach Memorial Medical Center has a staff of 38 transcribers on site.

The Veterans Affairs Medical Center hospital on Seventh Street doesn’t use any transcribers - in-hour or off-site - and instead requires physicians to directly input medical files, said VA spokesman Richard Beam.