I think Sky might be right on outsourcing reaching it's peak, or at least I hope so. The quality of the work is right up there with the lower rates they're paid. I QA'd for a year, cleaning up the mess of the offshore transcriptionists. An experienced English-speaking transcriptionist could take care of it for 8 cents a line, but by the time it had to go through QA it cost 12 cents a line and often missed turn-around time because of the extra time sitting in the QA queue. If it missed turn-around time, the clinics and hospitals didn't have to pay for that job, but the office still had to pay the transcriptionist and QAer.

Financially, it's not the greatest situation.

Just because you can two-finger type, have headphones and a keyboard does NOT mean you can be a transcriptionist.