Do you value confidentiality of your medical records?
For a change I listened and watched the local PBS news and it was most interesting! It seems that UCSF outsourced its medical transcription to a company in Sausalito contracted for this work (it used to be done by hospital employees) who subcontracted to someone in Florida, who subcontracted to someone in Texas, who outsourced to Pakistan. This is called "a food chain".
Your medical records are protected by law in the United States but not by International law. If you think this is not important then you are indeed an optimistic person.
http://www.oocenter.com/t124.htmlThe complexity of outsourcing is of great interest. It involves more than “customer service”.