The new reality when STEGH outsources transcription services


“We’re in financial devastation.”

That’s the stark assessment of a medical records transcriptionist who, last year, lost her job at a London hospital when it was out-sourced to Ottawa-based Accentus.

It’s the same firm hired by St. Thomas-Elgin General Hospital to handle its transcription services, resulting in the loss of four full-time and an equal number of part-time jobs effective May 22.

With 12 years medical records experience in various capacities, the London transcriptionist, who wished to remain anonymous for fear of reprisals, has been an independent contractor for Accentus since last November, when nearly 50 transcribing jobs were axed at two hospitals.

She works out of home, earns about $400 every two weeks and receives no benefits or sick time.

“My biggest thing is the quality of the work. We took great pride in our work when we worked at the hospital. The doctors really appreciated us. Now there are huge, blatant errors that come through in emails where we’re told ‘someone did this, don’t do it again.’

“It’s just ridiculous. It casts a bad shadow over the whole industry when there are people out there who are completely capable of doing this.”

Her comments echo those of dozens of disgruntled Accentus independent contractors posted on several blog sites, including

Typical is this from ‘nyclim’:

“If you enjoy being paid less than minimum wage, stressing over finances, having no social life, being chained to your computer, computer problems, dealing with useless and mean-spirited supervisors and long hours, Accentus is just your thing.”

At the start of the year, Accentus was absorbed by an American firm, Nuance.

“Since Christmas they have brought on American transcriptionists to our accounts,” she advised. “Which, as far as we knew, was against our contract regulations. These American transcriptionists are guaranteed a certain number of minutes per week whereas the Canadians aren’t guaranteed anything.”

She raised concern about the quality of work being produced by some of the work-at-home contractors.

“They don’t just take on experienced transcriptionists. They will hire anyone who is straight out of school, so some of the things that come out are just atrocious.

“Once you are in full-time production there is a certain percentage of your work that gets checked every week. Usually with me, because I do so much, it’s about 5%. For someone doing a smaller amount of work it would be higher.”

She said she is paid 57.5 cents per minute of transcription.

“It doesn’t matter if it’s 30 seconds or 40 minutes long, it takes me two minutes to set up. A lot of the notes, because of the nature of the job we do, are very short. Like, a minute or less. They are a complete and total waste of my time.

“We are paid so little, the onus on perfection and the onus on quality is not there anymore. At the hospital, we were paid by the hour and I would re-read a note if I had to. We had quotas but they were not difficult to meet. I wouldn’t re-read now.

“If I had a word I couldn’t figure out I would look it up on the internet, talk to other people, phone the physician if I had to. I would go to any length necessary to find out something and make sure I had the appropriate content.

“I’m not paid well enough to do that now. We have team leaders and I would leave a blank and tell them to deal with it. Team leaders are paid by the hour and have a little more onus to do that.”

The lack of communication with account managers is also a problem area.

“As far as the account managers in Ottawa, I find it very challenging to get them on the phone. I find it very challenging to get any email answers. Anything important I need to talk about it, seems a real battle to get any information. There’s emails that I’ve sent about various things that I haven’t heard back on.”

Accentus has not responded to an interview request from the Times-Journal.

Citing confidentiality, Cathy Fox, STEGH’s communications/public relations specialist, would not disclose the annual cost of providing the transcription service through Accentus, but did say the hospital expects “a cost savings range of approximately $100,000 to $150,000 in 2013, with expected higher savings range in 2014 of approximately $200,000 to $250,000.”

4 thoughts on “The new reality when STEGH outsources transcription services

  1. Leadership has no clue about how department processes are run, the legal requirements, the stakeholder expectations, the interrelated tasks between other services. This lack of understanding causes unrealistic pressures of management who are scapegoats to the executives who don’t know how to operationalize what they read or learned in theory. How is a site chief qualified to run health records or IT or anything corporate services for that matter? Did the job posting for Vp ask for a vag doctor? Really?


  2. The entire restructure at the Hospital is ridiculous. I have heard nothing but horror stories about the way employees have been treated. The decisions that have been made to outcast intelligent, creative employees and promote others with financial backgrounds is a testimony to the fact that this is all about reallocation of money into Execs pockets. The vibe at the Hospital has changed to one of disrespect and disdain for others. The executives make decisions based on old school thinking and promote those they can control, who are the kind of people who do what they are told and are not very strong or people oriented and will not stand up for their staff. It is a dog eat dog world and the best are leaving or kicked to the curb – perhaps they are a threat. As a patient there recently I noticed an immense change in staff as though they are abused and scared and hate being there, scared to do their jobs and angry about the way they are treated and it comes out in the “excellent patient health care experience” as “worst patient experience in terms of relationships and energy and heart in the hospital”. It is like trying to heal in hell.


  3. I can attest to the lack of quality control at Accentus and the poor quality of the work coming from the at-home typists who are not hospital trained. A doctor called our transcription department when I was still employed at a London hospital. He was angry because the operative note he had dictated did not contain the information that he had found cancer in his patient’s colon and that his patient needed to immediately see a surgeon. We checked the his dictation and compared it to the typed note. Most of the note was disjointed gibberish. The main flaw was that the physician had stated he had found cancer but that information was not in the note typed by an Accentus typist. I can only conclude that the Accentus transcriptionist had trouble understanding the physician’s Eastern accent. We, the in-hospital employees, had no trouble understanding his accent and we deleted the bad note and re-typed it correctly. This happens a lot with the Accentus contractors who have no in-hospital experience and training. These notes are sometimes useless and unreliable and are what hospital executives feel is okay to provide to the public. I do not.


  4. Unfortunately, the hospitals value $$$ over patient care. As a London transcriptionist that has over 12 years of experience, I find it insulting to make under minimum wage. I also find it insulting that our tax money is being spent to employ other countries! This is so wrong in many ways!


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