The Doctor is in: And, Suresh Nair, Managing Director, HealthScribe India, has every reason to smile

Syed Shafiq, Dr Syed Shafiq holds an MBBS degree from Karnataka's Devraj Urs Medical College. That's one reason it is difficult to believe the prematurely balding six-footer works at a business process outsourcing (BPO) firm. In a previous life, 28-year-old Shafiq was a GP who used to work at the casualty ward of Bangalore's Lakeside Medical Hospital. Today, he is a medical transcriptionist. It is still an unusual sight to come across a doctor in India's booming BPO space, although there are enough of the species around. Sashi Natesh, a 27-year-old dentist, worked for three years at Bangalore's Airforce Command Hospital before he decided to make a move to, you guessed it, medical transcription (MT).

MT was to the early 1990s what call centres were to the late 1990s, and BPOs, to the 2000s. Newspapers were filled with projections of how much of the first world's medical documentation work would move to India (sound familiar?). At its peak, which, unfortunately, coincided with the acme of the dotcom wave, some 2,000 companies claimed to be in the MT space in India. Most were founded by entrepreneurs out to make a quick buck and boasted little else apart from a few pcs and a hole-in-the-wall office. The inevitable bust followed. ''All and sundry entered the market,'' says Suresh Nair, Managing Director, HealthScribe India, the country's largest extant MT company, making no effort to hide his disgust. ''Most people had the misconception that MT was data entry work; a shakeout had to happen.''

Circa 2004, the industry seems in better shape. There are less than 50 MT companies, with the field being dominated by the big three, HealthScribe, Heartland Information Services, and CBay Systems. Groups like Khoday, Manipal, and TVS that entered the space have either exited it altogether or converted their operations into call centres. As for smaller companies such as Ajax.com, Infomedkey Systems, and Indiamedico Systems, they have disappeared without a trace. And the big trend-this had already started happening when the industry was seemingly flourishing, although in a much smaller scale-is the growing number of medical professionals making a beeline for the industry. HealthScribe's workforce of 1,200 includes 75 doctors. That's a bit.

Lure Of The Big Bucks

Why would qualified physicians become medical transcriptionists? Simple, the love of lucre. ''Three years after becoming a doctor I was being paid Rs 5,000 a month,'' says Shafiq. ''The prospects for an average GP in India are not very exciting; today, as a medical transcriptionist, I get paid five times what I was earning as a doctor.'' Natesh couldn't agree more (both the good doctors work for HealthScribe). ''Unless one goes for a post-graduate qualification and specialises, the earning potential of a doctor is limited,'' he says. ''In India it is expensive to do a post graduation and the number of seats is limited; and it takes several years for a GP to establish himself.'' For the record, salaries for doctors who choose to be medical transcriptionists are around Rs 20,000 a month in the first year, Rs 45,000 in the third, and Rs 80,000 in the fifth, depending on productivity.

Better still, some doctors-turned-medical transcriptionists manage to have the best of both worlds by putting in an eight-hour shift at the BPO and managing a private practice. Dr L. Suresh is a practicing physician who plans to become a medical transcriptionist. ''Not only is a career in an MT firm financially rewarding, it helps one get a grip on pharmacopia (the drugs being prescribed for various ailments). Anytime I want to return to practice I will do so with knowledge of the latest drugs being prescribed abroad.''

Although the MT business isn't as people-intensive as other BPOs-over years, the productivity of employees increases; in the US, medical transcriptionists do around 1,000 lines a day while in India, they do 400; ergo, as Nair of HealthScribe points out, companies can grow their revenues by 2.5 times without any increase in manpower-it provides an ideal employment opportunity for some of the 250,000 doctors India produces every year. The companies themselves benefit in terms of employee-profile. ''India used to be known as a cheap, but poor quality MT destination,'' explains Sanjay Vinayak Urs, Managing Director, Plakon Consulting, a company that specialises in catering to the manpower needs of BPOs. Now, he adds, with some firms attracting doctors, that should change.

Most doctors, however, see MT as a stepping-stone to greater things. Nair points to the fact that the turnover rate of doctors is much higher than that of others. Shafiq, for instance, is preparing to go to London for a post-graduate qualification. ''Most of my fellow doctors in MT companies will look at higher studies after enriching themselves financially and in terms of knowledge for four to five years,'' he says. Plakon's Urs believes this is a win-win. ''For doctors it is good money and the ability to know the latest drugs in the marketplace; for the MT industry the supply of skilled manpower is a huge bonus; and India has adequate supply of doctors coming out of its colleges.'' He can say that again.

"Smart" Campaigning
The two main political parties go hi-tech in their battle for electoral votes.

Congress control room: It didn't seem as hi-tech as BJP's monitoring cell, but computers, printers, and faxes were ubiquitous

From the outside, Pramod Mahajan's house on Safdarjung Road in Delhi looks as peaceful or quiet as you would expect any politico's house to be on a sultry summer afternoon. That is, till you come to the outhouse tucked away behind the garden. There is an array of flat-screened computers lined up in the rooms here, sleek black beauties with CD-writers, speakers or ear phones. These computers, one learns, have TV-tuner cards that let you monitor TV-channels on an hourly basis, and software that can capture and replay critical footage.

Welcome to the poll monitoring cell of the Bhartiya Janata Party. If Elections 2004 is the mother of all political battles, then high technology is the weapon of choice. Except that BJP isn't the only one to have gone hi-tech.

Congress party member Salman Khurshid's office at 99 South Avenue in Delhi is packed with computers, laser printers, and swanky cabinets (but nothing close to BJP's show). One can also catch a glimpse of Jairam Ramesh taking stock of the party activities elsewhere in the country from his D-series LifeBook notebook, connected to the Net through his Reliance mobile. There is an hp Deskjet 450 mobile printer right next to a nonchalant Treo PDA. Congress, which plans to use laptops and satellites to wire up crucial booths during polling, is working on an intranet that will connect its party workers across the length and breadth of the country and has launched an interactive portal, www.congress.org.in.

BJP control room: Broadband connections, GPS-based maps, and sophisticated software all form part of the party's hi-tech armoury

Back in Mahajan's election monitoring cell, the computers have databases of voters in Excel spreadsheets, allowing data to be sorted according to age, locality, or any other demographic parameter one deems fit. The other things one can do: Photoshop, capture video images, and send bulk SMS-es (30,000 to 1 lakh at one go). The computers in BJP's party office can even manage tour schedules of top party leaders using elaborate spreadsheets and transmit them to the party offices across the country. The office walls are adorned with maps of the country, colour coded to reveal, at a glance, the total number of seats in a given constituency, and the number of seats the BJP is contesting in. "It was done using GPs layering technology," informs a party official. Adds Mahajan: "Technology is not the monopoly of business houses."

The Congress party office, in contrast, looks tame. Sure, there are computers churning out thousands of SMS-es a day and printers spewing out campaign literature, but the cutting-edge feel is missing. Still, there's no doubt as to the pay-off. "The periodicity with which you can coordinate with party workers at the district level is amazing," says Khurshid. As always, Jairam Ramesh sums up Election 2004's technology-intensive battle aptly: "Earlier they had Ram Mandir, and now it's ram mandir." Let's just hope that the zeal for technology outlives this year's elections.

-Sudarshana Banerjee