E 93 Transcription Services Behind The Scenes with Ben Walker

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Benjamin Walker talks to Dr Trosclair on A Doctors Perspective Podcast.

A faster way to take patient notes is by talking and Benjamin Walker of Transcription Outsourcing gives us behind the scenes of the different types, EMR integrations, why they expanded to lawyers, and how hospitals are changing the game. He likes SEO too.

How does a mortgage broker pivot to medical transcription services after talking to a family friend at an airport for a few hours?

What is and why would a doctor, lawyer, law enforcement etc use a Transcription Service?

If you dictate 60 seconds of patient notes, that stops you from having to write it, even in EMR / HER programs. That saves you 10 minutes and if you tried to transcribe it yourself, well you can probably triple that time.

Since EMR are all somewhat different in the layout, his transcribers typically have to custom tailor each doctor to a certain template.

If you ever tried to transcribe more than 2 people having a conversation, you know just how difficult that is. How do they overcome the 2-5 person lawyer deposition hurdles? Remember, they have to be 99% accurate.

What are text expanders and how is that the secret sauce (plus a few other tricks) to typing so fast?

What does Ben Walker find as the pitfalls to using these cheap outsourced transcription services?

Dictation software seems like the next best thing, but you still run into the problem of being outsourced to foreign countries doing less than perfect work.

Hospitals have taken over many private MD offices. Hospitals tend to have their own EMR and potentially their own transcription accounts… how does Mr. Walker market to overcome this obstacle? What can the individual doctors do if they aren’t satisfied with the transcription services the hospital is set up with already?

Ben is nice enough to even give us the standard rates for transcription services for medical doctors. Now you can know if you are under or over paying.

YouTube and Facebook can do automatic transcription for captions. The problem with only being 70% accurate is that you have to listen to the entire length to find and correct the mistakes.

If you have a 1 hour recording with 4 people on that file, it could take up to 3-4 hours to transcribe the whole thing including who said what.

How does someone become a transcriptionist and what are some of the ways to booster your skills?

When he is not busy playing tennis 8 hours a week, you can find him volunteering at his friends charity organizations.

Jim Collins Books: Good to Great, Great By Choice, How the Mighty Fall; Tim Grover – Relentless; Simon Sinek- Find Your Why; Malcolm Gladwell’s Books, Ryan Holiday- Ego is the Enemy

Google Analytics and SEO trackers he likes to learn about. Audible for books.

Podcasts: Neil Patel’s Marketing School, Noah Kagan

His biggest tip for a doctors’ office… own your zip code organically online. 3 Tools: Moz.com, Whitespark.ca, Jerry Sexton in Denver for onpage seo help sextonandcompany.com , ahrefs.com

For more information on Benjamin Walker and the Transcription Services Visit: www.transcriptionoutsourcing.net

Show notes can be found at www.adoctorsperspective.net/93 here you can also find links to things mentioned.

Full Transcript by his company <strong>Transcription Outsourcing</strong>. Just Click to expand

INTRO: Episode 93: Transcription Services behind the scenes. I’m your host, Dr. Justin Trosclair, and today we hear Benjamin Walker’s perspective. Join 2017 podcast awards nominated host, Dr. Justin Trosclair, as he gets a rarely seen look into the specialties of all types of doctors and guests, plus marketing, travel tips, struggles, goals, and relationship advice. Let’s hear A Doctor’s Perspective.

JUSTIN: Okay, now, some doctors may not know that some offices, some doctors, especially in hospital settings, use transcription services. That means instead of taking your notes on paper, you voice them, and they get sent off, put on paper, you review them, sign it, and you’re done. It’s a time-saver. So we’re going to go to a guy who started out doing this in just the medical profession, and then we’ll talk about, like, how the landscape has change and how they have had to broaden their service to, like, lawyers and depositions and law enforcement agencies, and things like that. We’re going to go behind the scenes on, like, what that was all about; how does it integrate with EMR systems; why use them versus, say, like, a dictation software, and, like, how some of that stuff goes all the way to foreign countries and how that does affect the way it’s actually transcribed. Do they miss things?

We even talk about the future of his business, like: can computers do this for you better; what if there’s three or four people talking; and near the end of the interview, very end, we find out that he is really excited about SEO and Google Analytics for his business, so he’s learned a lot, so he gives us some great resources not only as books and podcasts, but also three different websites that you can use to try to dominate your on-site SEO local Google search, so definitely stay tuned ‘til the end of the episode for that.

He’s a nice guy. I think you’re really going to enjoy this episode. Enjoy your workout. Enjoy your commute. Be safe. All the show notes can be found at adoctorsperspective.net/93. Let’s go #behindthecurtan.

Live from China, and Denver, Colorado, today’s guest is something that some doctor’s offices use all the time; others don’t realize the power of it. It’s called transcription.

Yes, the guy today, he has served on the board of the Colorado Medical Group Management Association and the Colorado Association of Healthcare Executives. He does transcription services not just for doctors but legal, law, financial people, and just people who need it. So that’s pretty awesome in my opinion. Please welcome Ben Walker.

BEN: Thanks, Justin, for having me. I’m looking forward to it.

JUSTIN: Oh, yeah. Well, I gotta be honest with you. Just out the jump, I gotta know a little bit of your backstory, because I was reading you were in, like, mortgages and things, and I don’t think people really wake up one day and say, “You know I wanna sit down and just type for eight hours a day and transcribe,” and something tells me you probably weren’t that person who said, “I’m going to be the one transcribing and I could probably hire this out,” so of all the career paths, how’d you find this and what’s the backstory?

BEN: Well, the backstory’s kind of funny. I just happened to be at dinner with my parents about 10-and-a-half years ago, and they were talking about a new friend of theirs that was starting a medical transcription company, and I immediately said, “I want in!”

And they said, “What are you talking about?”

And I said, “I want to work for whoever the guy you’re talking about is, because I don’t like doing mortgages, anymore. This isn’t what I thought it would be, and I want to get into the healthcare industry because of the Baby Boom generation and the boom that was about to happen in the healthcare industry.”

Since they’re Baby Boomers, I don’t know if they took that very well, but they said, “Okay, we’ll introduce you to this guy and see how it goes, and if you guys get along and strike something up, then go for it,”

So – I don’t know – two months later I met him at Denver International Airport when he was coming back from an international trip, and he had, like, a six-hour layover, so he came out of the security and we talked for a couple hours, and then two months after that we were signing articles of incorporation.

JUSTIN: Woah. And you started out doing medical transcription. That’s correct?

BEN: Yeah, we were a medical transcription services company exclusively when we started a little over 10 years ago.

JUSTIN: And just briefly: what is that and why would people use your services in general? Not just you, but that whole industry. Why do doctors use that?

BEN: Well, medical transcription is kind of a hidden thing that not a lot of people talk about, because doctors don’t dictate in front of their patients. They’ll usually go into their office, maybe in a hallway or at a workstation after they see a patient, and they’ll dictate what happened during the visit, so if it was a standard visit and they do a history and physical, the doctor will dictate an H&P, or if it’s a pre-op for a shoulder surgery, a rotator cuff, he’ll do the preoperative report, “Justin injured his shoulder playing baseball sliding into second base,” you know, and he’ll go through all that. “We’re ordering an MRI and x-rays that should be done soon. Once we get those results back we’ll have a follow-up with Justin.” They do that behind the scenes where you don’t really see it or hear it happening, and doctors do that because they can dictate a 60 second report in 60 seconds. That same report that they were to type themselves would take 8-9 minutes – to sit down at a computer; to type it all out like we do for them – it takes 8-9 times longer for them to do it.

JUSTIN: Is that something that all the EHR – does that make it more complicated? Because you know there’s a lot of checkboxes typically that this has to go there, or do the doctors just, like, make an amendment and here we just save it into the computer into their chart, and then somebody else inputs? Or just add an extra paper?

BEN: If they were to enter it into an EMR, like you just asked – or an EHR, whatever they want to call it – it’s going to take 8-9 minutes, regardless if it’s in an EHR or if they were to type a Word document, it’s still going to take eight or nine minutes. If we do it for them, their portion will still last 60, maybe 90 seconds, because we can log into their EHR for them and fill out everything. They’ll use a template, and we’ll follow a template, and we’ll fill in the boxes for them.

JUSTIN: Okay, cool. Cool. So it’s not just, like, 1,000 words as a Word document, boom, and then it’s attached like an MRI report; it actually goes where it’s supposed to in the EHR. I didn’t realize y’all had back-access to it. That’s pretty cool.

BEN: It’s both. We’ve done both. It just depends on what they want.

JUSTIN: And probably on their system, maybe? How fancy their system is?

BEN: Exactly, yep. Some are really sophisticated. Others are very easy to navigate and don’t take long to learn at all.

JUSTIN: And do doctors get upset? I’m guessing human error happens, but if they find that y’all don’t do something, do they just call and say, “Hey, can y’all format it in a special way for me?” Is that something that can be offered?

BEN: Yes, it is; because every doctor has their own preferences and requirements, so it’s almost like that now, anyway, because of, you know, everybody likes it a little different. One guy might do a SOAP note differently than the next guy or gal, and we kind of go along with it. We create files for each of our clients so we know when we’re typing for each client: Dr. Smith likes it like this and Dr. Thompson likes it like this. We accommodate their preferences.

JUSTIN: I’ve already prepped you a little bit. I’m going to ask you a question I think that’s going to be on everybody’s mind. Like, okay, cost is important and everything, but before I do that: I was reading a little bit about you, and you transitioned to a lot of other fields, and I’m curious: what was that about? Was medical not enough niche? Lawyers, law enforcement, is that just something that they’re doing now? Is it a bigger market, bigger fish?

BEN: Well, because of the changes in technology in the medical industry that you alluded to, electronic medical records and electronic health records, doctors are dictating less, so we were losing clients because doctors were pointing and clicking, and I wanted to diversify so we weren’t tied to just one niche. Now we have five or six pretty big ones and three main: medical, legal, and law enforcement. It gives us a little room if something goes sideways and we lose a larger client, we’re not totally hosed when that happens.

JUSTIN: I would assume, like, for lawyers, my goodness, that’s their job, typing and writing. It’s got to be easy just to talk it out.

BEN: Yeah, you’d think so. A lot of lawyers have in-house paralegals that do that kind of stuff for them – letters. Where we help lawyers a lot are depositions and court hearings, because there’s multiple people involved, it could be a four-hour hearing, their paralegals aren’t really trained for that. We have trained people that have good ears and they can differentiate between your voice and my voice and the judge and the other attorney, and maybe a clerk or something, that all speak during the same recording.

JUSTIN: Okay, so that can get pretty complicated pretty quick.

BEN: Yes.

JUSTIN: I was switching gears. My brain just kind of goes somewhere. Doctors, especially orthopedics, neurologists, they can use some really big words; stuff that I wouldn’t even know how to pronounce, like the drugs and everything. How do they figure it out on your end?

BEN: Fortunately, there are add-ons to word that you can pay for on a monthly subscription basis that add in the new medical terms and pharmacological terms, so they can keep up-to-date. The doctors that have been dictating for a while or were trained well, they know to spell it, also, so when mesothelioma comes up – well, that’s kind of an easy one, at least for transcriptionists – they’ll spell it out. A new drug name, they’ll spell it out, or they’ll say who the manufacturer is so we can Google it really quick and find it.

JUSTIN: That’s pretty cool. Okay.

BEN: Yeah, and if there is any question, we’ll put it in parenthesis, or highlight it, or timestamp it, whatever that doctor wants, so they can jump to that part of the recording themselves or have one of their assistants do it, and make sure it’s right.

JUSTIN: Right, because you’re supposed to review them anyway, as the doctor, before you hit sign and okay.

BEN: Yes.

JUSTIN: Okay. All right. So when we’re talking about fees – we don’t have to talk about exactly what your fees are – but is it per minute? Is it per page, or how does that play out?

BEN: In the medical industry, it’s per 65 character line, and our pricing goes between $0.10 and $0.14, maybe $0.15 a line, depending on a few things. Yeah, it depends. It’s usually 24 hour turnaround time Monday through Friday. One of our clients, if they work over the weekend and they want it over the weekend, we just ask that they tell us so that we have somebody ready. Otherwise it’s Monday through Friday. And it’s pretty standard, a 65-character line if the doctor or the doctor’s office knows what they’re talking about, because some don’t and they may call someone who isn’t following the same industry standards, and they might do a 60-character line, but not tell them it’s 60 characters, when it’s a standard of 65.

JUSTIN: That adds up.

BEN: Oh, yeah, it does. It’s almost a 10% difference. Yeah, we’ve been doing the same pricing for eight years.

JUSTIN: Oh, wow! I just was curious on that one because it’s one thing to not do it and be a busy clinic. A lot of our audience isn’t really medical doctors, it’s going to be the chiropractors, the physical therapy, the dentists, those types of docs who generally maybe I have seen a lot of dictation, but like you said, it could be behind-the-scenes and I’ve never really asked that question before, like, “Hey, how do you do your documentation?” So that’s why I was asking, because I know people complain they get really busy, and then we see on the Facebook groups, “Oh, man, I just spent a couple of hours doing all this paperwork and stuff,” and I’m like why didn’t you do it right after the patient whether your clicking boxes or doing dictations? I don’t know, maybe I’ve never been busy enough to where I didn’t even have time to click a couple buttons.

BEN: Yeah, it depends, too, like, what their documenting standards are requirements are. Chiropractors, a lot of them use some version of an EHR that is much more universal, and they just click, click, click, and they don’t really individualize a report because they don’t have to. Their requirements don’t require that to get paid.

JUSTIN: Two times in a treatment plan do they really have to, like, the history and all that kind of stuff. Typically it’s, “What’d you do today?” “I did these different exercises,” and yeah.

BEN: Exactly.

JUSTIN: A full-time PT would have a lot to say, I would think, because they might have done 10 different exercises in an hour.

BEN: Yes, because we’ve worked with some, and I think we are right now. I’m not positive. I’d have to go ask one of the ladies down the hall. It all depends on requirements and what level of billing they want to get reimbursed for, and some of them will use the same report over and over for different patients, which is obviously in the gray area. It depends on their level of –

JUSTIN: Because if you’re lazy you can be lazy in dictation, too.

BEN: Yes. Yes, we’ve seen it many times where we’ve gotten calls from doctors and they’ve asked us to help catch them up for the last nine months. Nine months? What?

JUSTIN: Just can I copy and paste, please?

BEN: Yeah. Some of them, I think, may do that; but if they get audited they will get into a world of hurt.

JUSTIN: I love the hesitation in your voice. You’re like, “This is not how I wanted to run my business! You’re going to get in trouble! I’m going to get in trouble! This is not going to work!”

BEN: Yeah, we don’t want to help them do that. If they can individualize the reports, we’re more than happy to help.

JUSTIN: Yeah, that’s perfect.

So, this is the question that I was alluding to earlier: we have marketing on the show. We always kind of talk about it. There’s companies out there, it’s a dollar per minute. Now, typically those we use for I recorded a video, I need to do YouTube captions or Facebook captions. Why wouldn’t I just use a company like that versus using something like yourself?

BEN: Well, it’s the old adage that you get what you pay for. Those services are different than ours. A lot of their people are overseas. English is their 2nd, 3rd, 4th language. They miss context. They will get homonyms wrong, and sound-alikes, you know, the “there”, their”, and “there”; they’ll mix them up or spell them wrong. Whereas our people don’t, because they’re US-based and English is their first language. We understand the slang because we’re here. It’s not that the foreign transcriptionists are bad, they just don’t know because they don’t live it, eat it, breathe it every day like our transcriptionists do.

JUSTIN: I’ve never tried it with medical terms.

BEN: It depends on the context, because there are some highly trained people in India and the Philippines that are really good at medical transcription. Doctors dictate the same things over and over, and they’re very regimented. It’s when you have a free-flowing dictation, like let’s say for mental health or psychiatry, they don’t say the same things over and over, so that’s where it gets more complicated; and going back to the YouTube example, if we were recording this right now and you wanted to put it up on YouTube, that voice recognition system YouTube uses is about 70% accurate, so you’re going to need at least 30% changed, but you’re going to have to listen to the whole thing because you don’t know where the errors are, you or me or someone else editing, and it’s going to take you a really long time to go through it and edit it. A considerable amount.

Or let’s say you send it to one of my competitors that’s a dollar a minute, and you get a four-hour hearing back, and it doesn’t matter if it’s a schoolboard hearing or a court hearing, it’s going to take you three times longer than the recording to do the editing, so if it’s a four-hour hearing it’s going to take you 12 hours to go through the whole thing to make sure it’s accurate, if you need it that accurate.

Our clients are different, where they need 99% accuracy. The people that don’t need that, they go to the dollar-a-minute place, because maybe they don’t need it that accurate for some reason or another. I don’t know why you wouldn’t want something accurate, but that’s why people go there and not come to us. Because those places are like a Walmart: extremely high volume, extremely low prices. We’re more like Nordstrom. We’re not the most expensive. We’re expensive and we guarantee it. If you don’t like it, we give it to you for free. Those companies, they don’t. And you can’t get them on the phone, either.

JUSTIN: Right. You know, if I’m talking about a five-minute sales video about three steps to get rid of your headaches without having to go to the doctor. Yeah, I mean, even if it takes me 10 minutes to read through what they did, that’s a whole different ballgame versus my license is on the line because Bob down the street thinks I caused his headaches that he’s never had before.

BEN: Exactly.

JUSTIN: And that was more for the listeners to understand. You’re paying more for your services, but there’s a reason why you’re not a dollar a minute.

BEN: Yes.

JUSTIN: Okay. Cool. What are some of the misconceptions that you find, that you’re always maybe having to answer new clients or people who’ve just started with your services for, like, the last month? What do you find is a big issue?

BEN: A lot of them think if it’s a one-hour file, they think it can be done in one hour. Because it’s an hour, and they’re like, “Well, why would it take you longer than an hour to type an hour?” If there’s two, three, four, five, eight people, it takes longer because we have to keep rewinding to make sure we’re attributing the right thing to the right person, and that we heard them correctly. If they speak over each other, or someone has a heavy accent, or there’s a bad connection, there’s music in the background, it takes longer, so we rewind repeatedly to make sure we get it right. A normal one-hour file with, let’s say, four people on it, and we have to identify all four, we have to know who’s speaking each time, it’s going to take us between three and four times longer, so it’ll take three to four hours to complete, assuming good audio quality, not a lot of cross-talk, things like that.

The other big one is, “Why can’t I just do it myself? I know how to type.” And then they try it and they’re like, “Oh, man, this does take a long time.

JUSTIN: No, I did. I tried that before. I was like, “Nope.” I’m sure I’m not going to be doing that.

BEN: You’d be surprised at the tips and tricks that our transcriptionists do to go faster and just as accurate. You know, they have foot pedals and really good software, and really good headphones to knock out background noise. Some of them have software where they can isolate different channels if there are different channels on the recording so you can hone in on one person, to make it more accurate and to go faster. Lots of text-expanders, if you’re familiar with those, and they memorize them; we’ve got transcriptionists that have hundreds if not thousands of text-expanders saved on their computer so they can fly through.

JUSTIN: Which means “patient presents with” and all they have to do is type “PWI” and a whole sentence is now populated from a short code?

BEN: Yes.

JUSTIN: Wow. That’s pretty awesome.

BEN: Yeah, it helps them. Transcription was somewhat commoditized when the internet became so accessible and fast, so there was a lot of foreign competition driving down prices, so to combat that, transcriptionists got faster so they could make more money in less time, because prices were going down. Does that make sense?


BEN: So a lot of them have learned how to use text expanders, and they do it really well.

JUSTIN: Because that’s kind of like at a court, the person that’s typing up everything that’s said, they’re just doing it on the fly.

BEN: Yes, a court reporter is doing it in code – or shorthand, whatever you want to call it – and they go home and re-listen, and type it all out again.

JUSTIN: Oh, they do?

BEN: Yes.

JUSTIN: Let’s think about this: you have to hire people. Maybe somebody’s listening to this and they’ve got a niece of a nephew that, I don’t know, likes to type or something, and who needs a job, wants a career. What is some of the qualifications that you look for when you’re hiring someone to do this?

BEN: They can’t be a felon because we run background checks on everybody. They’ve got to be in the US because of the background check thing. We’ve had some people from Canada, the UK, Australia, South Africa; they want to work for us, but I don’t know how to run background checks in those countries. I’ve found places that could do the background checks; they cost like $1,000, so that’s why we don’t. Yeah, so we stick with US-based people because the background checks here are, like, $100, so it’s not bad. And then we test them. If they score a 95 or above on the three tests we give, we let them move onto the next stage where we start sending them short jobs, and then we check their jobs every time, so we don’t really need 10 years of experience, we want perfection, and if they score 95 or above on these tests, it’s close to perfection. I know it doesn’t sound like it, but the tests are really difficult, and they’re difficult on purpose.

JUSTIN: Do they go to school? These short codes, what you call them, text blocks – do you learn that? Is it something that you can go to trade school for? Is it something you just have to kind of figure out on your own?

BEN: There are online classes that will teach you how to do different kinds of transcription: legal; medical. You know, we don’t mind if people haven’t gone to those, because let’s say you worked in a sheriff’s office for 10 years and you typed law enforcement reports for the patrolmen and then you did some of their interviews that investigators were conducting, and you did that over 10 years; you’ve got pretty good experience. Or maybe you worked at a University doing closed captioning for the hearing impaired, or something. You know, you’ve got the experience, you just don’t have the certificate that says you went to some school. We don’t mind. Again, it’s all about the tests, because we’ve had people – we’ve hired them as independent contractors – that have had no experience, but they got 98% on the test. That tells us something. If they’re willing to do these tests and spend the time and score high, that they want the job.

JUSTIN: Okay. So really, if there is somebody listening that’d be interested in something like this, they could just start transcribing YouTube videos for practice or taking online classes to figure out how to do it faster, and then they’re like, “Oh, yeah! This is amazing to me! I just love doing this,” then they can contact a company like yours, and that’s how they can get a job.

BEN: That’s exactly right, and that’s what we’ll tell them when they fill out our online inquiry form for employment or independent contractor work, if they don’t pass our tests will tell them, “Hey, go to Amazon Turks, go to this company; they hire people with no experience. Get your feet wet, do maybe 750 hours’ or 1,000 –

JUSTIN: That’s a lot!

BEN: It is, but that’s how you get good at something. You know, you’ve gotta do 10,000, according to Malcolm Blackwell, to become an expert. So around 750 hours, you start to get pretty good at it, and then you start adding in more text expanders as you keep going, and then it starts building in your brain, and pretty soon you’re going pretty fast and pretty accurate.

JUSTIN: Okay. So the practice helps. You start figuring out shortcuts, and you just – really, it’s about practice and you’ll get better at it.

BEN: Yes, and I would tell people to specialize, too. If you want to do legal, do legal; or legal and law enforcement. They’re really close, but medical is very different from legal transcription or law enforcement, because medical is almost always single-person narrative, which is much different than throwing in another two or three voices in a court setting.

JUSTIN: But who’s then they’re going to work faster, because I assume they get paid by the project, and if it takes you three times longer than the average person, like, man, you’re just not making as much money as the next person, either.

BEN: Exactly.

JUSTIN: That was good! I like that!

When we’re discussing marketing, I always say if people listen to the show and what the guests say, there’s a good chance they can integrate it into their own practice some way. Maybe it’s an internal referral, maybe even external, so as a company, what kind of marketing do y’all do that is successful?

BEN: We do a lot of public relations and PR work – tons – to drive people to our website. We get traffic that way, and then we get inquiries from all over the country coming in through our website. The public relations we do is on LinkedIn, a little on Facebook, and a little on Twitter, but LinkedIn mostly for us, because we’re B-to-B, or from a physician’s point of view, I would think they’re more Facebook – at least the physicians I know that use Facebook say it works really well for them, and that’s a form of public relations, because if people don’t know about you, they can’t use you, or they can’t go to your office. It’s almost all outreach of some kind to get in front of the decision-maker or the person that’s going to use our services. It’s public relations all day long. I wish I’d have known that five years ago, because for the first three or four years I didn’t even know what public relations was. I would go to the Colorado Medical Group Management Association conferences and meetings and meet people, and I guess that’s a form of public relations, but we weren’t getting mentioned in magazine articles, we weren’t doing magazine articles. Now I do a lot of that.

JUSTIN: You were in Forbes.

BEN: Yeah. Forbes, Entrepreneur, Inc. To get the name out. Not necessarily my name, because I don’t care if people know who I am. I want them to know who Transcription Outsourcing is, though.

JUSTIN: Right. Somebody’s gotta be behind it.

BEN: Yeah. That’s why it’s me. Yes, exactly.

JUSTIN: Yeah, you’re right; because LinkedIn, you know, when I’m finding guests, sometimes I’ll go on Instagram, or if I see somebody that’s interesting with their stuff, I’ll be like, “Hey! You want to be on the show?” And lately I’ve been kind of going on LinkedIn, because they’ve got all these suggestion people; and then you look at your Rolodex that you’ve become “friends” with, and if they’re a bunch of doctors, you’ve just got send it all, “Hey! Saw your LinkedIn, saw your website. Looks like you’re the CEO, potentially, of x-y-z hospital. Maybe we could have lunch or have a conversation about using me exclusively for your entire hospital,” or something.

BEN: Yeah, no. That’s right. And it works. It won’t work every time, but no sales or marketing works every time. There’s a percentage, and then when you find what works, you pile on and keep going with it.

JUSTIN: I’m assuming once you get the foot in the door, you get the right doctor in an organization to try you, because we’re probably not happy, always, with who we’re using. We just don’t know what to do and we’re not – it’s easier just to stick with something that doesn’t work than to figure out how to make it work better sometimes. Like, it kind of works good enough.

BEN: Oh, yeah, you’re exactly right. That happens all the time. I even do that in my business, where I’m just like, “Uh, it works. It’s not working as well as I’d like, but it’s a pain in the butt to change it, so we’re just going to deal with it until it totally blows up.”

JUSTIN: Then you finally change it and you’re like, “Oh, my gosh. That was so dumb.”

BEN: Yes.

JUSTIN: Wasted time, wasted money. Where do you see the profession, and I guess specifically yourself – where are y’all going in the next five years, but also as the profession?

BEN: That’s a tough one. Voice recognition has gotten better, for sure. Don’t think it’s as good as they want us to think. The big one, the Dragons of the world, they have 20,000 people in India editing for them. It’s not even close to as accurate as they may give off, and that service costs extra in addition to if you have the yearly license, you want to have them edit it, it costs more.

JUSTIN: And that license ain’t cheap!

BEN: Oh, no. $1,200 or $1,500 a year. It usually ties in with an EMR, and then through the EMR company they partner back with the folks in India, so then it all is done online and it’s seamless, but it’s not nearly as accurate. That doesn’t worry me too much. It’s the voice recognition for multiple person files. If that gets better, then I’m in trouble. At this point, I think we’re okay, because they can’t tell a man’s voice from a woman’s voice, literally. They can’t differentiate between that yet.


BEN: I don’t know that that will happen. I guess I’m not into that kind of stuff enough to know.

JUSTIN: I need you to do some more research on this, and then send me an email so that we can invest into this company, and then we can just have a nice nest egg from something that might take over an entire industry.

BEN: If that does happen, yeah, I’m going to invest, too. I do keep an eye on it. I get Google alerts every day. Yeah.

JUSTIN: Let me ask you this. I was going to go a different direction. Dragon software, or whatever other companies are doing that, $1,200’s not that bad. I thought it was, like, $10,000 a year, so $1,200, that’s not that bad. So they’re still – you’re still dictating, there’s still a lag time, someone still is in the background checking everything, and then it gets inputted, so is that a major competitor compared to, like, Rev.com?

BEN: For medical transcription it is, because they’ve signed agreements with all the EHR companies; so if you have a specific EHR like Epic or Allscripts, you can funnel it that way toward the voice recognition piece, then to the editing, then back to your EHR, and it usually takes anywhere between four and 24 hours, but again, you’re dealing with people whose first language is not English, so there are still way more mistakes.

JUSTIN: That’s your main competitors right now.

BEN: Yes.

JUSTIN: Okay. All right. So that’s where we come in with, “Yeah, you’re using it. Yeah, it ties in. But ask your doctors, they may not be that satisfied with it. They really would switch over and pay a little extra, even, if they had to, to get a better service and a better outcome.

BEN: Yeah, but a lot of them are not allowed to. Like you mentioned in the beginning, we’re in Denver, and the University of Colorado Health System is the biggest in the state now, and they’ve been buying up practices like crazy. They migrated them all onto their EHR with their voice recognition piece, and I still talk to some of my old clients and they say, “It’s not even close,” but they can’t do anything about it.

JUSTIN: Their hands are tied.

BEN: Yeah.

JUSTIN: Ayeee.

BEN: Yeah.

JUSTIN: Okay. No wonder you had to transition into other fields.

BEN: Yes. I really enjoyed being in the medical healthcare industry, too, and being on those boards and going to all the conference, because I thought it was fun.

JUSTIN: I need to have an episode about that, because I’ve kind of been hearing doctors, you know, they get bought out by the system, and it was supposed to be this big, fancy, awesome thing; but it sounds like the drawbacks are there but now it’s gotten to the point where it’s like, “Well, I really can’t get out of it,” or, like, to start over, I don’t know if they can do it or not. I guess there’s a lot of political stuff in there, maybe, that you don’t want to talk about that on the show; but I think it’s a problem, kind of. It was cool at one point, but then it turned into a problem.

BEN: Yes, it’s very different, because at one point – and I know this because I have a lot of clients that are now part of those systems, and friends in Denver – they were their own business owners and they got to make their own decisions, and now someone else is telling them, “Oh, you’re on call this weekend.” “Oh, you only get three weeks’ vacation.” Things like that. “Here’s your salary, and you can’t make more even if you see more patients. Here’s your salary.”

JUSTIN: Oh, wow.

BEN: Yeah, so it’s much different. I mean, you’re part of a giant corporation.

JUSTIN: Wow. But they did get bought out at one point.

BEN: Yeah. They made a lot of money on a buy-out, for sure.

JUSTIN: Per year, now. You’re averaging it out.

BEN: Yes.


BEN: And I don’t know. They would talk about it; because I’m thinking of a couple of buddies that are doctors that have been bought out. I don’t know, they might. They probably wouldn’t, at least, on the record talk about it.

JUSTIN: Yeah, that sounds like whiskey in Boulder, but not on the podcast.

BEN: Yeah.

JUSTIN: Oh, man. I had a clinic out in Westminster, Colorado.

BEN: Yeah, it’s about 20 minutes from our office.

JUSTIN: Yeah, not too bad little area.

I want to transition just a little bit on the personal side. Sounds like you probably have a busy life. Any kind of volunteering, hobbies, or anything to help create that work/life balance?

BEN: Yeah, a few things here and there. I play a lot of tennis; probably between eight and 12 hours a week, probably four, five, six times a week. Sometimes it’s seven or eight, just depending on what’s going on. I play on a lot of different teams, and it can get busy sometimes. And I volunteer usually for friends who have already started a foundation or a fundraiser. I’ve not started my own. I’ve given some thought; I haven’t gotten into it yet. I will eventually, but right now I’m helping friends with cystic fibrosis and cancer research, things like that. When they ask me to help, I help.

JUSTIN: I always wondered, you know, all these people – especially, like, celebrities – they always start their own organization. Like, aren’t there 100 organizations already that do whatever it is that you’re interested? Why don’t you just give time and money and just be their spokesman or something? I don’t know.

BEN: That’s what I’m doing. You’re right.

JUSTIN: How do you stay injury-free? Because that’s a lot of tennis. I don’t know what pros do, but you know, as a chiropractor, we treat a lot of elbows and wrists and shoulders, so what are you doing?

BEN: It’s a lot of foam rollers, stretching, massage. I do Pilates. I do have elbow problems. I have golfer’s elbow and tennis elbow. It’s gone away for now. I have a pinched nerve in my neck that I have to get acupuncture for every two or three months, and I have bad sciatic nerve problems, so the proper stretches for sciatic nerve. So I don’t. I don’t stay injury-free. It’s managing them.

JUSTIN: Okay. That’s pretty funny. I go “injury-free,” you’re like, “Actually, I just play through it! I figure it out!” But I applaud you for actually doing what you need to, because some people would just give up and either quit playing or just deal with the pain and not actually spend the cash and the time to fix it.

JUSTIN: What kind of racket is a good racquet these days?

BEN: Oh, man. There’s a bunch of good Wilson racquets right now, and Babolat, and Head.

JUSTIN: What kind of range are we talking for a good racquet price-wise?

BEN: $150-250, depending on what you’re looking for. Yeah.

JUSTIN: Okay. All right. I don’t play tennis, so I don’t – I mean, in my little town, the one thing we do have is basketball, and they have, like, six tennis courts, and I was supposed to play with this little guy. I was like, “Why? I don’t own anything. I really don’t want to buy the gear to play, like, six lessons and never do it again.” We tried that with badminton. I don’t want to do it for tennis, too.

BEN: If you send me your address, I can probably mail you some racquets.

JUSTIN: Wow! There we go!

When we’re talking about books, podcasts, even your favorite phone app, anything that you secretly love and something that you should definitely check out?

BEN: Man, books. I really like Jim Collins’s books: Good to Great; Great by Choice; How the Mighty Fall. Recently I read a book called Relentless I thought was pretty good. The guy was no-nonsense; at least, I thought he was no-nonsense. Tim Grover wrote it. It’s fairly new and it’s pretty good. Start with Why by Simon Sinek is also a really good book, and it’s pretty popular; you probably get that answer a lot.

JUSTIN: Never had that answer, but I have heard of the book, personally.

BEN: It’s a good book and he’s a very good storyteller, so it’s easy to follow. It’s not complicated.

JUSTIN: Start with Why?

BEN: Yes.

JUSTIN: Did you like the Malcolm Gladwell?

BEN: Oh! I’ve read all of his, yes. Malcolm Gladwell, his books are awesome. I like the way he puts things together, too. He’s a good storyteller, also. Ego Is The Enemy. It helps you understand the perspective of you really should take a step back and understand not everyone’s talking about you, and perspective. There’s almost 8,000,000,000 people on the planet. Relax, buddy, you’re not number one.

JUSTIN: Have you noticed – talking about celebrities again – but it’s like if you can survive those 48 hours, people just don’t care anymore. Maybe your inner circle cares and you hear about it because you’re surrounded by it, but the average Joe, we’re done. “Oh! There was a mass shooting the other day!” A week later you’re like, “I don’t know. Okay. What city was that in again?” I’m mean, that’s horrible, but that’s kind of true. That’s how it is, it seems.

BEN: Yes. Oh, yeah, you’re right. It’s sad, but yeah.

JUSTIN: Any fun phone apps for yourself?

BEN: I follow Google Analytics probably a little too much. I could probably go to some type of rehab for that. I pay attention to search engine optimization a lot, so I use the Google Analytics app quite a bit.

JUSTIN: That’s the crux of your proof in the pudding of marketing?

BEN: Yeah. Other than that, I use audible a lot to listen to books when I’m driving, or when I’m visiting clients and things like that. And podcasts. I listen to a bunch of different podcasts, and it’s not the same. I like to switch it up. Marketing School is a good one. I don’t know if you’re familiar with that.

JUSTIN: I’ll look it up.

BEN: Neil Patel and Eric Siu. They’re five-minute episodes of actionable items that can be used immediately.

JUSTIN: Five minutes with Neil Patel; that’s pretty good.

BEN: Yeah. They do a new one Monday through Friday, every day.

JUSTIN: Okay. I need to look that up. You know Noah Kagan?

BEN: Yes.

JUSTIN: Yeah, I listen to his a little bit, and Digital Marketer. That’s a pretty good one. I find Digital Marketer, if someone’s interested in this stuff, they’ve got really good programs. The podcast is really good; and I guess that’s the point. They found the price point that people are like, “Eh. $37. I’ll buy it. If I end up not even implementing anything from it, it was still only $37.” They’ve got a lot of good stuff out there.

BEN: Oh, there totally is; but I don’t know if there’s a shortcut for search engine optimization. There’s on-page, there’s off-page, there’s backlinks. There’s all kinds of stuff going on. There are so many different moving parts and piecing. I have a really good on-page search engine optimization, and then I’ve got a couple of other pieces that I tie together, and these guys all specialize in different things to bring them all into one. I would think that almost any doctor could benefit from that, because if they don’t own their zip code where they’re at when someone types in Google, there’s something wrong. I would really emphasize that if I were giving a doctor or a dentist, chiropractor, podiatrist, orthopedic surgeon; if they’re new, starting a new practice, search engine optimization. Get your town or your zip code under control.

JUSTIN: That’s good advice. When I searched you I was like, “I don’t know what his business name is called, but I know his name.” The easiest way to find you was back-linked articles, and then I found your website from one your articles. And I was like, “Wow!” That’s kind of like a dream, I would think, for a company like yourself, where you obviously want your website first, but then those backlinks from, like, Forbes pop up quick.

BEN: Yeah.

JUSTIN: That’s a good thing. Social proof, immediately. Like who’s this guy? Woah!

BEN: Well, exactly. I hired a PR firm to help get me into those publications and things like that, and I submitted applications to write for different places, which doctors can do, too, because they’re experts in their field. Yeah.

JUSTIN: There we go. I think you just put some lightbulbs up for a lot of people right now. The last five minutes, if you were still listening to the show, you got some good information just now that should be able to get you excited Monday morning to research more on how to get this PR and how to get the SEO on your page just a little bit better than it probably is right now.

BEN: I could easily give them three tools in a heartbeat that would blow their minds and help them immediately.

JUSTIN: Come on, give ‘em.

BEN: I would use moz.com for local. You can use – oh, what it is – BrightLocal? Bright – oh, man, now I’ve forgotten it. Whitespark, Bright-something; BrightLocal? Bright Search? Bright? Moz. They’re local so you can make sure your listing is the same on every local citation, so your Google business page, your Bing, your Yahoo, Yellow Pages. You pay those things, those services I just mentioned. Moz, for example, Moz Local, you pay them, like, $20 a month, and they make sure that your address, phone number, and everything is the same on all those things, which then Google likes because it sees it’s the same on, let’s say, 25 different directories. Google goes, “Oh! That must be the right address and the right phone number.”

JUSTIN: Places you’ve never even heard of are now accurate.

BEN: Yes, and they do it for you. That’s the whole point of having them.

JUSTIN: Oh, nice. Okay.

BEN: They make sure it’s the same on every single place – or directory, sorry.

JUSTIN: Perfect.

BEN: On-page SEO, I don’t know that – he’s just a guy I found in Denver that’s really good at his job. If someone contacts me after the show, I’ll be more than happy to give you his name and number. Well, I could –

JUSTIN: If you just gave his website, we could find it.

BEN: What is his website? His name is Jerry Sexton. He’s in Denver. I can tell you in a second. Sextonandcompany.com. He knows his stuff. On-page SEO, he’s really good. Oh! Ahrefs! A-h-r-e-f-s is really good. You’ll get more information about your website than you ever thought possible.

JUSTIN: What do you do with it?

BEN: You can see your competitors.

JUSTIN: For things that are broken?

BEN: That. You can see what your competitors are doing. Keyword search suggestions. So if you wanted to start a carwash company in Dallas, you would type in carwash Dallas and then it would tell you “carwash Ft. Worth; carwash Plano; carwash South Dallas,” and say “these are other terms people are searching for in your area,” so then you can start to build out your website with those search terms, as well.

JUSTIN: And if you’re doing Google AdWords, now you have keywords to pay for.

BEN: Exactly, so for a plastic surgeon that wants to do more – I don’t know – facelifts, it will give them ideas on other iterations of facelifts, which I don’t know of any, but I’m sure there are some.

JUSTIN: Dude, that’s hilarious. Two doctors before you are both about facelifts and hair restoration, just randomly.

BEN: Yeah. I mean, it would help them.

JUSTIN: Awesome. That’s great. You never know what somebody’s into; so SEO optimization, Google Analytics. We’ve got Ben on, the expert, the mini-expert, if you will.

BEN: I bring the experts together; I learn a little from all of them.

JUSTIN: Dangerous.

BEN: Yes. Exactly.

JUSTIN: I was like, you know, I would listen to certain podcasts or read certain things and I’d bring it to my internet guy, and he’s like, “Yeah, you’re the only person that’s asked about that, so let me do some research. Where are you getting your information from, Justin?” I was like, “I’m trying to be cutting edge!” I don’t know if it’s working, but I’m trying sometimes.

Where can people contact you? What’s your website, all that jazz?

BEN: Our website is www.transcriptionoutsourcing.net, and on Twitter it’s @BenjaminKWalker. LinkedIn it’s Ben Walker. They can find information on the different kinds of transcription services we offer at transcriptionoutsourcing.net, and there’s a form on there if they want to contact us; our phone number’s obviously there. We’re in Denver, we’re here from 7 AM to 5 PM.

JUSTIN: Very good! Thank you so much for bringing so much knowledge and information today.

BEN: My pleasure, Justin. That was fun.

SIGN-OFF: I’d like to tell you about a special deal we’re doing right now. If you’re listening to this months or years from right now, just contact me, maybe we can still off this for you; but what it is: the acupuncture no needle book. We’re doing some bonuses. For the same cost of the book, not only do you get a one-hour, one-on-one coaching session, but I will actually throw in the probe and the Ear Seeds, which I already like to do, but the big thing is you’re going to get the electric acupuncture pen for no extra cost. The electric acupuncture pen actually helps you find the acupuncture points that you need to stimulate, and because it’s kind of like a muscle stim, but with a special tip, you’re going to get far superior results. Definitely go to needlelessacupuncture.net and check that out. Also, the first book: Today’s Choices, Tomorrow’s Health, you know, we’re talking tips from China. We’re talking 10+ years’ experience as a chiropractor, answering patient’s questions day in and day out, blueprints that I’ve personally used to lose weight, not eat so much, and also keep my finances in order. It’s something that I’m passionate about. That’s why I wrote the book. It’s over 200 pages, 40-something chapters. Again, offering a bonus for this one, as well: a one-on-one coaching call for one hour at no extra cost. We’ve got t-shirts, some different state pride and some chiropractic t-shirts. If you’ve got any ideas, let me know; I can maybe design up something and make it available for everybody. Follow us on social media, because there are a lot of sales that go on with these shirts.

Letting you know, if you write a review, iTunes, Stitcher, Google Podcast, Spotify, wherever; let me know, send me an email, and every month I can raffle off one prize. Prizes to be determined, but we can do that.

Also, if you check underneath the resources page on adoctorsperspective.net, you’ll see all our affiliate links, which we get a little kickback for; and then, of course, on every show note page we have Amazon links for the books that people have mentioned, and any other types of products, so if you click that, Amazon pays us a little bit.

As always, thank you so much for listening. You can buy the host a cup of coffee on the PayPal button the website, and remember: listen, critically think about it, and implement it into your practice.

We just went #behindthecurtain, and this episode has come to an end. I hope you got the right dose for your optimal life. Please, spread the word about this podcast by telling two friends, sharing on social media, and visit the show notes on adoctorsperspective.net to see all the references from today’s guest. A sincere thank you in advance. You’ve been listening to Dr. Justin Trosclair, giving you A Doctor’s Perspective.

About the Author
Dr. Justin Trosclair, D.C., an expert in Chiropractic Care, has been focusing on back and neck pain relief for over 12 years and has delivered treatment to more than 6000 patients. With advanced training in treating disc derangement conditions, you can count on him to keep up to date with the latest research in physical medicine for spinal pain. He has 5 years of hospital experience in China, is currently working in Germany, and had a private practice in Colorado for 6 years. Dr. Trosclair hosts a doctor to doctor interview podcast called ‘A Doctor’s Perspective‘ with over 220 episodes. During his free time he wrote 3 books. Today’s Choices Tomorrow’s Health (rebooting health in 4 categories), a Do-It- Yourself acupressure book for 40 common conditions called Needle-less Acupuncture, and a step by step guide to look like a local for Chinese dinner culture called Chinese Business Dinner Culture. If you have kids, you may be interested in his 6 series tri-lingual animal coloring book series (english, spanish and chinese).