We asked him to share his perceptions on how continuous speech recognition and formatted electronic records might have an impact on this industry. ''The medical transcription industry should not consider technological advances as a threat,'' Mr Khalsa said. Instead, they should be considered as an opportunity for growth of the industry. At present, voice recognition software has not been developed to the extent that is in wide usage in any industry. As this technology further matures, transcriptionists will be able to use it to increase their personal productivity. It is unlikely that many doctors in the United States will be willing to take the time that would be required to personalize word processing software for their own vocabulary and their own voice. Large hospitals may not be willing to devote huge amounts of computer memory space for each and every author. However, he conceded that once voice recognition software has been developed to a high degree of sophistication, medical transcription companies would have to incorporate its use by the transcriptionists in order to enhance productivity.

While on technology, we asked if the need to keep abreast of and harness technological advances, meant that the 'work at home' MTs had a bleak future? Mr Khalsa viewed that in order to compete in this industry; MT businesses will need to incorporate the latest advances in technology into their business operations. He pointed out that in the United States, HealthScribe, Inc. employed hundreds of 'work at home' MTs. This was rendered possible by using very sophisticated technology. The most significant aspect of HealthScribe's proprietary software was its ability to keep track of all jobs being transcribed anywhere in HealthScribe's network. '' All HealthScribe MTs must be logged into our database in order to transcribe. This allows us to keep real time track of jobs. Amongst other things, this is very significant in terms of customer service.'' he clarified.

We touched on the issue of resentment amongst MTs in USA about jobs going abroad. Seeing the magnitude of work available and considering scalability of this industry in India, we queried if the outsourcing model would ever be a threat to MTs in US. '' This may be more of an emotional issue rather than a real issue. At present, the demand for medical transcription in the United States greatly exceeds the supply of medical transcriptionists available to do the work. Any qualified medical transcriptionist in the United States who wants a job will find one.'' Mr Khalsa firmly stated.

Our discussion turned to confidentiality issues over the Internet. New regulations in the future would make it mandatory for 128-bit encryption of patient records being transmitted over the Internet to uphold security. We asked Mr. Khalsa for his opinion on whether transcribing in India did pose a greater threat to maintaining privacy than the same being done within the boundaries of the USA. Mr Khalsa pointed out that in his recent State of the Union address to the United States Congress, President Bill Clinton did talk about the need to guarantee the confidentiality of medical records. ''It doesn't matter to where medical records are out-sourced,'' was his considered opinion. ''Once they are out-sourced anywhere in the world, there is an increased risk that confidentiality can be breached. Legislation will soon be passed in the United States that will require state-of-the-art security be in place for all transmissions of medical records. This would require investment by every medical transcription company in expensive software and equipment. Smaller companies might have to close if they cannot afford this sort of additional investment. Before purchasing anything, though, companies will need to 100% sure that what they are using is fully compatible with what is being used by their provider.'' he advised.

As a parting shot we addressed the problem of unsavory characters having jumped into this business as 'consultants', who were giving it a bad name. What steps did he suggest to new entrants and American clients to identify and avoid such entities? ''The best way to avoid being misled in this industry is to take the time to learn all you can about it on your own,'' opined Mr Khalsa. ''The less you are dependent on persons outside your own organization, the less vulnerable you are. I would advise that before anyone retains a consultant or enters into any agreement with any other person or company, you should demand a list of references and then carefully check on every one of those references before making any decision. I'd want to know if the references feel that money spent on a consultant was considered to be money well spent. I'd want to know if the references have consistently received the volume and quality of work they were promised by brokers or others claiming to provide work.'' he suggested.

And savoring an enlightening interaction we bid adieu, promising to return in the near future.