An Open Letter to the St. Thomas-Elgin General Hospital Board of Governors Regarding the Outsourcing of Medical Transcription

The following letter is from Stratford-area health care advocate Frances Simone regarding the hospital’s decision to out-source its medical transcription services. She has also created a petition urging the hospital to re-consider the decision . . .

On May 22, 2013, STEGH plans to lay off all of its in-house Medical Transcriptionists and outsource their jobs to Accentus. STEGH is making a poor decision that will harm staff and put patient care at risk.

I have contacted Mr. Paul Collins, CEO to discuss this matter and have received no response. As a result, this letter is directed to the Board of Governors and the community of St. Thomas.

The community of St. Thomas deserves to know the facts rather than the public relations spin. Accentus is not an Ottawa company, it was owned by New York based High Road Capital Partners, a private equity firm, and BMO Capital Corporation since 2009. In a merger and acquisition deal closing in November 2012, Accentus was sold to Nuance Communications. Nuance Communications is a multinational corporation headquartered in Massachusetts, whose CEO earned $37,077,679 million total calculated compensation in 2012.

Medical Transcriptionists who have been outsourced to these for-profit companies have filed numerous complaints related to lack of quality standards. Transcriptionists are forced into compensation arrangements that are often below minimum wage in order to make the for-profit corporations and their shareholders rich.

The Hospital should not tamper with such a vital component of our health care system. It was wrong of London Health Sciences Centre and St. Joseph’s Health Care London to choose this path and it is wrong for St. Thomas Elgin General Hospital to follow their lead.

At no time in London or in St. Thomas were staff ever consulted about issues regarding Medical Transcription and the risks associated with outsourcing.

Promises of savings are overstated because lack of quality puts the entire health care system at financial risk for litigation and wastes taxpayer healthcare dollars. The for-profit model also adds unnecessary layers to the system which introduces opportunities for error. Quality is not the focus with piece rate work and over time, the experienced Medical Transcriptionists will be replaced with cheaper inexperienced labour. This industry has a revolving door once people realize that they cannot make a living wage.

Recently, a judgement of $140 million was awarded in the U.S. in a wrongful death lawsuit over a prescription error caused by the outsourcing of medical transcription. It is irresponsible for St. Thomas Elgin General Hospital to proceed with the outsourcing and we are demanding that the Board of Governors reverse this decision.

I would be willing to meet with the board to further discuss these concerns on behalf of the Medical Transcriptionists and the citizens of Ontario.

Frances Simone MHA
Health Care Advocate

cc: St.Thomas Elgin General Hospital Board of Governors
Paul Collins, President and CEO

5 thoughts on “An Open Letter to the St. Thomas-Elgin General Hospital Board of Governors Regarding the Outsourcing of Medical Transcription

  1. awesome letter, scary that the boss gets $37 million


  2. Do you really need to wait and be told “I told you so” by staff, regarding this and half the cheap and ignorant decisions you keep making?


  3. Seriously! All of the LOCAL fundraising and so many other (large $$$ from the local community), and this happens? Really????

    Jason H. McComb


  4. Any American working on Canadian accounts is a HIPAA VIOLATION! Another HIPAA violation with Accentus is their Editor EditScript a household can have 3 or 4 computers logged into the same account. Another words MTs can have several other people in their household working on different computers through EditScript on the same account doing their work for them this is a HIPAA violation.


  5. Working at Accentus/Nuance is a SCAM. For EScript when you produce 3000 lines you are actually getting paid three pennies and a 1/2 cent per line in reality. For speech recognition those 3000 lines are divided in half so you are actually getting paid for 1/2 the work you lines you produced. For example once you produce 3000 lines by the word lines, divide that by half then it is only 1500 lines at a rate of 7 cents so for total lines you would need to divide 7 cents in half and times that by the total lines. This company is a total SCAM. Basically you work half of your lines for free. Competing transcription companies pay by the total line count they do not half the line count or they pay by the minutes. This company needs to be brought under the labour board or have some time of government involvement to stop them from exploiting home workers like this. The average transcription job in a doctors office or hospital pays over 15 an hour.


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