The Real Future of Work

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In 2013, Diana Borland and 129 of her colleagues filed into an auditorium at the University of Pittsburgh Medical Center. Borland had worked there for the past 13 years as a medical transcriptionist, typing up doctors’ audio recordings into written reports. The hospital occasionally held meetings in the auditorium, so it seemed like any other morning.

The news she heard came as a shock: A UPMC representative stood in front of the group and told them their jobs were being outsourced to a contractor in Massachusetts. The representative told them it wouldn’t be a big change, since the contractor, Nuance Communications, would rehire them all for the exact same position and the same hourly pay. There would just be a different name on their paychecks.

Borland soon learned that this wasn’t quite true. Nuance would pay her the same hourly rate—but for only the first three months. After that, she’d be paid according to her production, 6 cents for each line she transcribed. If she and her co-workers passed up the new offer, they couldn’t collect unemployment insurance, so Borland took the deal. But after the three-month transition period, her pay fell off a cliff. As a UPMC employee, she had earned $19 per hour, enough to support a solidly middle-class life. Her first paycheck at the per-line rate worked out to just $6.36 per hour—below the minimum wage.

“I thought they made a mistake,” she said. “But when I asked the company, they said, ‘That’s your paycheck.’”

Borland quit not long after. At the time, she was 48, with four kids ranging in age from 9 to 24. She referred to herself as retired and didn’t hold a job for the next two years. Her husband, a medical technician, told her that “you need to be well for your kids and me.” But early retirement didn’t work out. The family struggled financially. Two years ago, when the rival Allegheny General Hospital recruited her for a transcriptionist position, she took the job. To this day, she remains furious about UPMC’s treatment of her and her colleagues.

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