Nothing like watching old movies . . . .

Watched again the other day an old movie, “Independence Day.” Okay, it’s not THAT old, but it has been around for a while. Anyway, there is one scene in it where the president of the United States gets locked into an alien’s mind and sees what the aliens have in mind for the human population of the planet. “Extermination,” he says, when he is finally freed from the alien’s telepathic grip.

Upon revisiting that movie scene, it dawned on me why listening to my company’s quarterly report the other day had so shaken me.

Our “bosses” have in mind for us, the American medical transcriptionists and editors who do the work the company sells and greatly profits from, exactly the same plan that the aliens in “Independence Day” had for human beings: Extermination.

That is not isolation paranoia-borne hyperbole or exaggeration, it is simply fact.

The more work they can send overseas, the better their profit margin. They were positively gleeful over the fact that they’ve managed to offshore 46%--up from 44%!--of transcription in the last quarter, and the picture only gets brighter (for them)!

They were equally happy that 77% of dictation now goes through speech-recognition programs before it gets to a transcriptionist. This makes them happy because they pay us much less, and in fact, unfairly less, for lines we edit than for those we transcribe. Anything that makes us, the workers, poorer, makes them richer--of COURSE they’re happy about that.

There was also some mention of a 19-million-dollar tax windfall of some sort or another, no specifics were provided although I suppose they are all still bowing and praying to Mr. Bush for that. Astonishingly, they didn’t use that tax windfall to enhance or create American jobs. Go figure.

I will never name the company for which I work, for a variety of reasons, some of them pretty obvious, and also because it doesn’t matter. The same scenario has been playing out in a lot of companies, a lot of industries, over a whole lot of years. If it hadn’t been, there would be no “Occupy Wall Street” movement--there wouldn’t have to be.

What I still have not figured out is what the corporate and political honchos, the 1%, think the result of all this will be. To me, it looks like, at some point, the misery will have to begin to trickle UP. Our economy is about 75% consumer-driven, last time I heard. What happens when you eliminate consumers by eliminating anything above a subsistence wage? What happens to the healthcare system (10% of the economy, I think I’ve heard), for instance, when only 1% of the people can afford healthcare?
I don’t know, I honestly don’t.

When I figure out some way to prevent what looks increasingly to me like the impending destruction of America, and not just economically, I’ll happily post it. Unfortunately, I’m just not that smart, so I suspect I’ll never have to write such a post.

Cheers!

Cognitive Dissonance and Other Stuff

Experienced a bit of cognitive dissonance today when wandering into Google to research work-at-home jobs. The reason I was doing such research was that, from where I sit as a medical transcriptionist (MT) for a large transcription company, it looks like technological advances such as speech recognition software and “point-and-click” electronic medical records are going to render us obsolete, probably within a very few short years (one private-practice doctor to whom one of my colleagues spoke said that it would be less than 2 years, and it doesn’t sound like he was a “gloom-and-doomer.” Basically he said that doctors, whether they liked change or not, were going to be forced to adopt point-and-click medical records technology).

You won't hear/see any gloom-and-doom about the future of the transcription industry on Google, however, at least on the first two pages or so of search results.  Everything I looked at painted a rosy future for us, a growth industry.

Of course, most of what you run into on a cursory search comes from companies trying to sell you a foothold into this rosy-futured industry.  We always must consider the source.

But I'm in the trenches, and the proverbial writing is on the wall. Speech recognition alone has vanished a lot of transcription jobs; point-and-click will disappear the rest.

There's a little "cognitive dissonance" for you.

For me, of course, the probable disappearance of my livelihood is a bad thing, but part of me also feels that, well, this was a long time coming, and probably is the right way to go. It will suck being out on that unemployment line, though.

More packratting, actually kind of related, from a July 27, 1994 journal entry:

I’m going to try to summarize briefly a conversation held in the hallway by my desk yesterday afternoon among Joanne, Mary and Ken. Part of it I only heard pieces of, and I came in after it started, but apparently they were talking about the future of medicine. In some places this is already happening. Doctors as we know them are being replaced by a combination of standardized protocols for the diagnosis and treatment of all kinds of illnesses ranging from urinary tract or ear infections to, presumably, appendicitis, etc., and highly trained technicians who apply the protocols.

“What happened to the ART of medicine?” Mary wailed a time or two. Joanne sounded as though she had had her legs knocked out from under her when she cried in sad desperation about investing so much time in becoming a physician, only to see her job apparently vanish. “Welcome to the club,” I thought, having been troubled for a couple of months, ever since the advent of voice recognition software, by visions of my own impending obsolescence. There was much desperate discussion about doctors’ own failure to protect their profession: “We brought it on ourselves,” Ken said. “People go into specialties so they don’t have to be responsible for the whole patient.” Jean used to say much the same thing--doctors specialize so they don’t have to care about the whole kid, don’t have to worry about the kid’s home life, family substance abuse and its toll, etc. “Specialization is for ants,” Thoreau or somebody said, and that is what has happened or is in the process of happening to medicine. Take specialization to its logical conclusion, and a specialist becomes a technician. Why send a medical student or resident through all the various rotations, if you can take the same person straight out of college, or even high school, and train him to do, say, appendectomies or bilateral myringotomies and tubes? Why would he even need to know about the pancreas or the penis if all he is ever going to do is stick tubes through tympanic membranes, all day, every day, throughout his professional life?

When we were talking about the probable disappearance of my job with the advent of voice recognition software and computers that can transcribe dictation, Mary asked, “But who would edit us?” “Who edited your article in ‘Pediatrics’?” I reminded her. Answer: A computer program. “I still can’t believe it,” I admitted. “I mean, I can see how a computer program could proofread something--that’s what spell checker does, sort of. But I don’t know how it could actually edit,” which, of course, is very different from mere proofreading, looking for spelling and typographical errors. “Program it to write in different styles,” Ken said. “Then you can tell it to write in D H Lawrence’s style, or Hemingway’s.” “What you would do, I suppose, is feed into it every book that has ever been written,” I said. “That’s really how writers learn to write--by reading.” (IS it that simple, I wondered? How could a machine that cannot see, hear, smell, taste or feel--physically or emotionally--learn to write? It could create clear sentences, but could it describe a pastel sunrise or the smell of sizzling bacon on a clear, cool summer morning at your grandparents’ house and all the memories that smell will forever evoke in you? Would it have to be able to? In a society that doesn’t read particularly well, isn’t great writing obsolete, too?).

To say that our world is wobbling would be to understate the case. We’re losing our all-important sense of place in this brave new world of health care and technology. Referring to computer doctors, etc., I told Ken, “Once that particular cat is let out of that particular bag, we’ll never get it stuffed back inside.” He agreed, surprisingly.

Which leaves us where? Beats the hell out of me. I told Mary that, given the rapid approach of the new century and new millennium, if I were religious I would probably be one of those people walking around carrying a sign proclaiming “the end is nigh” or whatever, and start looking around for the Antichrist. “Bill Clinton would do in a pinch,” I said. She laughed.

I’ve cut a lot of this out, mostly on account of being too lazy to type so much after having typed so much already over the past few hours. Obviously I didn’t become obsolete as quickly as I had feared, 17 years ago, and, obviously, doctors haven’t become obsolete. All our lives have changed, though, in some cases very dramatically.

It was an interesting conversation, at least for me. Revisiting it made me think of those coal-mine canaries, again, and how we all sensed that something was going badly wrong. The thread I see now is that we were all sensing the slow but inexorable loss of our humanity. We were/are all being reduced to numbers.

On reflection it strikes me that maybe “reality TV” is just one more, well, reflection of that. We’re all screaming to be seen as individuals. We all want to be recognized as human beings with genuine worth and all that psychobabble stuff.

And we all want to be heard, if only for one brief, life-affirming moment.

We're all riders on this train . . . .

A long time ago I worked briefly (2 days, or maybe 3 or 4 days if you count the orientation--I've managed to forget how interminably long that orientation seemed to last) for a "big box store."  I was going to be a night stocker (not stalker)/cashier, which sounded like a good fit for me at the time, for a variety of reasons I may or may not enumerate here.  The job paid minimum wage or thereabouts, so you would think the expectations of its performers would be, um, minimal.

"Minimal" has been redefined over the years, obviously.

Minimum-wage me was expected to average somewhere north of 100 "swipes" across the scanner per minute, for instance--again, don't remember exact numbers, but more than one swipe per second.  Probably that is possible if someone trundles up a cart full of, say, canned mushrooms; if instead the trundled cart is full of kids' clothing, well, it gets a bit more complicated.  Or impossible.  Plus, as a night stocker/cashier, you were expected to be at restocking the department at the far northwest corner of the store while at the same time keeping an eye on the cash register at the southeast corner--and woe be unto you should you make the customer wait more than 22 seconds for you to arrive.

There ARE people who can do this.  I wasn't one of them.

Sometime before that I worked as an office coordinator (glorified secretary) in the general pediatrics section at a children's hospital.  I happened upon that job at a time when that particular section was being "studied" by some sort of "efficiency expert."  The efficiency expert basically wandered around, probably with some sort of design or purpose although it was impossible to see from the "outside," taking notes and making checkmarks on a clipboard.  After a few weeks I asked him how I was doing, checkmark-wise.  "You actually come out pretty well," he said.  Too-long conversations with physicians I worked with/for were marked as "work discussion," whether they were or weren't, for instance.  A lot of what I considered "time wasters" were, in the statistician's view, necessary and valuable and, whatever.  And I suppose there was a case to be made for that, from a purely human standpoint--I would have been able to "produce" more without the human interaction, but the human interaction, the time I spent talking to, or, more often, listening to the human beings with whom I worked probably made for a better workplace environment for all of us--and that in itself probably increased our "productivity."

It has been close to 20 years since that experience, and I no longer remember what, if any, recommendations the efficiency expert made.  He was a consultant--a pigeon who flies in from more than 20 miles away, craps on stuff, then flies back on out, or something like that.

In my current job--medical transcription--we get these reports every week or two telling us how many "gross" lines per hour (and a lot of the operative notes really are gross) we've produced, compared to "net" lines per hour--that is, the lines we produced while actually typing/editing, not counting time we spent researching stuff or going to the bathroom or letting cats/dogs in/out the door, etc.  The reports are essentially meaningless to us, because they never provide benchmarks to which we can compare ourselves (and if the company for which I work DID provide such benchmarks, I would automatically doubt them, would assume that their numbers were just pulled out of the air or the head of a corporate suit).

We've all become so "quantified."  Any humanity to which we once clung has been "bean-counted" out of the workplace.

I understand the "need" or craving or whatever it is we seem to have for statistics, for numbers--but if we rely only on numbers, how can we quantify or qualify the human element, the "Human Touch" (my subject line is a line from the Bruce Springsteen song of that name, by the way)?  The talking/listening I did with/for my co-workers/bosses at that children's hospital may not have shown up in the "bottom line" for the hospital or even for our particular clinic, but I think it mattered.  That I can produce 250 lines an hour or whatever in my current job may also matter to someone's bottom line--but maybe I could do 300 if I didn't spend so much time researching/googling terms, or trying to catch an ESL ("English as a second language," you know, foreign) dictator's accent and trying to figure out what he MEANT to say, as opposed to what he actually DID say.  Maybe the time I spent chatting about the day's heavy snow and the horrendous heating prices, mostly to fill time (not KILL time), with the elderly lady who was fishing with trembling hands and painstaking slowness for the few items in her cart killed my productivity stats for the two days I worked at that box store (in fact I know it did), but how much of "me" would it have killed NOT to spend the time with her?

At some point, doesn't humanity have to count for more than numbers?