Career

Medical Transcription A Brief Overview

If you’ve been thinking about working at home as an MT, here is some basic info you need to know.

by Cynthia Ann Lewis, The Entrepreneurial Parent

What is involved in Medical Transcription?

Medical transcription, as you may know, is transcribing audio cassette or digital dictation by physicians into hard copy or computer files for printing. In other words, physicians recount the patient’s medical history, clinical findings and health care services on a tape recorder or digital recording system, which in turn is interpreted by the medical transcriptionist and generated into a written record regarding the patient.

Medical terminology is a mix of Latin and Greek word parts (roots, prefixes and suffixes), using English and a smattering of foreign terms. A working knowledge of biology, human anatomy and physiology is necessary to understand the dictation. Grammar, spelling and punctuation are necessary to create a document that is correct, professional-looking, and interpretable by others
(lawyers, health care professionals, etc.).

Is there a market for medical transcriptionists?

Most definitely, there is a market for skilled medical transcriptionists.

Training

Just having a computer at home and knowing how to type is definitely not enough to become a working, successful medical transcriptionist. Technical training is a necessity for the novice medical transcriptionist, usually in the form of a correspondence course or an apprenticeship. Experience in the field of transcription is invaluable to broaden your abilities and become familiar with the different medical specialties. Working for a transcription service, physician’s office, clinic or hospital is a good way to start building your career.

Working On Site VS. Working at Home

With your sharpened skills, the next decision is, should you work on-site or become an independent? This is best answered by a self-evaluation test. Calculate your transcription productivity. How many lines can you transcribe in an hour or day? Calculate that by the price rate in your area. Would you make enough as a self-employed transcriptionist to pay for overhead and have a profit? If you are an average to low producer, employee status is probably best. The job offers a steady income and benefits, but there are ceiling wages and an uncontrollable work environment. If you are an above average or high producer, consider self-employment. Becoming an independent medical transcriptionist offers awesome benefits for some people. It affords the opportunity to increase your income, control your work environment, learn more and varied business skills, and grow. It requires self-discipline, organization, continuing education and reinvestment in your equipment and yourself. A successful transition into independent transcription can also build self-esteem and the skills and motivation to tackle larger projects.

There are many different working environments available to a trained, experienced MT, including hospitals, clinics, individual and group medical, chiropractic, radiology, physical therapy practices, national transcription services that hire or contract home-based MT’s, local transcription services who may also hire or contract MT’s, and owner-operator MT’s (who may also subcontract work out).

STRICTLY FOR NEWBIES

by Cynthia Ann Lewis

You’ve finished your classes, you’re eager to get started-but you’re stumped: How do you really make the transition from “wannabe” to successful home-based transcriptionist? Without question, the best way to start your career is in an environment where you will have on-site transcriptionists to guide you. But-if you are committed (as I was) to begin your career at home without this interim step-I’m here to tell you it can be done as long as you have the necessary transcription skills and determination.

I landed my first client the week I finished my home-study course. Four months and four additional clients later, I met the financial goals I had set for myself the previous year (when the whole venture seemed an unattainable dream). I don’t pretend to have all the answers about this profession, but I can share my successful methods with you.

BE PREPARED. Don’t kid yourself about this most important step. You must be able to transcribe, with confidence and speed, the most difficult work your class offers. Researching new terms must be one of your top skills, and typing 75+ words per minute will only help your productivity-and income. Don’t expect to know every medical term ever coined but be honest in assessing your readiness. Accurate transcription is the foundation of your success.

PURCHASE a medical spell checker, online dictionary, word-expansion utility, and as many reference books as you can afford. Home-based medical transcription is one of the leaner businesses in startup costs, but you must expect to spend a few hundred dollars in this area. You won’t have Helpful Henrietta sitting by your side at home coaching you on those obscure terms; you need as many resources as possible. You already have your computer, ink jet or laser printer, transcriber, and fax machine. Don’t skimp on the tools that will make you accurate and efficient.

PERUSE online services such as CompuServe, America Online, Prodigy, and the Internet for lively groups of medical transcriptionists who can be an incredible support system. You’re reading one of the best newsletters available, and there are others through associations dedicated to your growth and success. Local contacts are invaluable (even if they are hard to find).

Choose the VALUE PROPOSITION you will offer your potential clients. What makes YOUR transcription service unique? Why should the doctor or office manager choose YOU? What are you offering that is exactly what your clients need and want, and better than your competition? Don’t guess-take a lesson from marketing experts and research. Do you really know what the going rates are for your area, or are you guessing? Do you know what is important to your clients, or have you decided what they should want? Whether it is 24-hour turnaround, call-in dictation service, free page reprints, free archival and retrieval service, free pickup and delivery, full-time, vacation or emergency coverage, something must set you apart from other transcriptionists. And that “something” must be valuable to your clients. Be creative. There are imaginative ways to find out exactly what your clients need-and for which they will pay.

A PROFESSIONAL PRESENTATION is a necessity, once you know what you will offer your medical community. Your material does not have to be expensive, but it should be the best you can afford. Business cards, flyers, brochures, cover letters and rolodex cards should all be 100% accurate and as attractive and attention-getting as you can make them. This is another “startup cost” that you must plan for but one that will bring your reward of….. clients!

BE PERSNICKETY as you market your new service through direct mail. If you are skilled with one, use a database to build a file of physicians and medical offices and clinics for your area. This will allow you to eliminate duplicate mailings by cross-referencing by phone number, to mail by specialty or by zip code, track follow-up contacts, etc. Verify and re-verify the spelling of names. Get a list of physicians from your local medical society or hospital. If office managers are your target, call each office and get their names. A personalized letter is much more effective, and you will also have a name for your follow-up calls.

FOLLOW UP each mailing with phone call. This was, by far, the hardest step for me, but well worth the trouble. Medical office personnel are almost always friendly and courteous-they will be considerate and sincerely interested in your service. You will at least establish personal contact and attach a voice to your anonymous letter, plus you may get other leads from your conversations. If you get nervous about making these phone calls, prepare a script with all pertinent information about yourself and your service. Practice the calls with a friend or by yourself until you are calm and confident.

PRACTICE, PRACTICE, PRACTICE. While you wait for that first magical call, practice your terminology, transcription, research and word processing skills. Learn how to use the add-on tools you have installed. The more familiar you are with your word processor’s features, the more efficient and versatile your work will be. Experiment with macros, tables, horizontal and vertical lines, formatting documents, and printing envelopes. Plan how you will store your clients’ data, how you will backup for security, how you will bill your clients, and how you will manage the “business” part of your business. Experiment with your office area until it is efficient and pleasing to you. If you have children, be sure you have arranged for their care while you are working. You will never have this amount of free time after you start transcribing-make good use of it now.

PROMOTE YOURSELF AND YOUR SKILLS when you get that first terrifying call from a potential client. Don’t fib about your lack of transcription experience, but don’t be afraid to point out your other excellent qualities and work experience, either. Provide a course description of your training and a few sample reports, along with your resume and references. Offer to transcribe a test tape for free to prove you have the ability to do their work. If a client “wonders” if you could reproduce a particular format or transcribe a technical report, offer to try, based on an example. You might spend some development time that you are not getting paid for — but you be will gaining experience and perhaps a client!

Above all, BE PERSISTENT. You’ve already invested money, time, and a great deal of effort in the successful completion of your transcription class. Put that same effort into marketing yourself and your services and keep trying. The medical community needs your skills, and you will be working soon.

When that miracle happens and you have your first client, PRIDE YOURSELF on doing the absolute best job you can-every time, every tape, every report. For my first four months, I proofed my work by re-listening to each tape. It was definitely time-consuming, but I built a reputation for good work very quickly and boosted my own confidence. Be meticulous about the quality and appearance of each day’s work, and meet every deadline. Do all that you have promised your client and more. In a business that thrives on referrals, you will want to be friendly with the office staff-including a mug of flowers from your garden, home-baked cookies, a note to acknowledge special help-anything to say, “Thanks for the work. I appreciate it!”

You will find that the rewards of working at home in your own business are greater than you ever imagined. With determination, persistence and professionalism, success can be yours. Good luck!

Understanding the Profession of Medical Transcription

Medical Transcription has existed since the beginning of medical care and research. Ancient cave writings attest to the earliest forms of healthcare documentation. While the medium changed from metal plates to clay tablets, to hieroglyphs on temple walls, to papyrus, to parchment, to paper, and most recently to electronic files, the reasons for maintaining records have always been the same-to record an individual’s health care and the achievements in medical science.

Until the twentieth century, physicians served as both providers of medical care and scribes for the medical community. After 1900, when standardization of medical data became critical to research, medical stenographers replaced physicians as scribes, taking their dictation in shorthand. The advent of dictating equipment made it unnecessary for physician and scribe to work face-to-face, and the career of medical transcription began. As physicians came to rely on the judgment and reasoning of experienced medical transcriptionists to safeguard the accuracy and integrity of medical dictation, medical transcription evolved into a medical language specialty. Now, at the dawn of the twenty-first century, medical transcriptionists are using speech recognition technology to help them create even more documents in a shorter time. Medical transcription is one of the most sophisticated of the allied health professions, creating an important partnership between healthcare providers and those who document patient care.

Medical Transcriptionists as Professionals
The industry is moving toward electronic health records, allowing storage of an individual’s health history so that it can be accessed by physicians and healthcare providers anywhere.
Physicians and other healthcare providers employ state-of-the-art electronic technology to dictate and transmit highly technical and confidential information for their patients. These medical professionals rely on skilled medical transcriptionists to transform spoken words into comprehensive records that accurately communicate medical information. Sometimes speech recognition systems are used as an intermediary to translate the medical professional’s dictation into rough draft. The medical transcriptionist then further refines it into a finished document.
Keyboarding and transcription should not be confused. The primary skills necessary for performance of quality medical transcription are extensive medical knowledge and understanding, sound judgment, deductive reasoning, and the ability to detect medical inconsistencies in dictation. For example, a diagnosis inconsistent with the patient’s history and symptoms may be mistakenly dictated. The medical transcriptionist questions, seeks clarification, verifies the information, and enters it into the report.

What does a medical transcriptionist need to know?
Medical understanding is critical for the professional medical transcriptionist. The complex terms used in medicine are unlike the language of any other profession.Medical transcription requires a practical knowledge of medical language, anatomy, physiology, disease processes, pharmacology, laboratory medicine, and the internal organization of medical reports. A medical transcriptionist is truly a medical language specialist who must be aware of standards and requirements that apply to the health record, as well as the legal significance of medical transcripts.
Reports of patient care take many forms, including histories and physical examinations, progress reports, emergency room notes, consultations, operative reports, discharge summaries, clinic notes, referral letters, radiology reports, pathology reports, and an array of documentation spanning more than 60 medical specialties and subspecialties! Thus, the medical transcriptionist, or medical language specialist, must be well versed in the language of medicine.

To prepare for this profession, medical transcriptionists study medical language, including Greek and Latin suffixes, prefixes, and roots biological science, including anatomy and physiology of all body systems and various disease processes, medical science, medical and surgical procedures, involving thousands of instruments, supplies, appliances, and prosthetic devices, pharmacology, laboratory values, correlating laboratory test results with a patient’s diagnosis and treatment, use of medical reference materials and research techniques.

Quality medical transcription also requires above-average knowledge of English punctuation and grammar, excellent auditory skills, allowing the transcriptionist to interpret sounds almost simultaneously with keyboarding, advanced proofreading and editing skills, ensuring accuracy of transcribed material, versatility in use of transcription equipment and computers, since transcriptionists may work in a variety of settings, highly developed analytical skills, employing deductive reasoning to convert sounds into meaningful form.

Why haven’t I heard about medical transcription before?
While medical transcription is among the most fascinating of allied health professions, the general public knows little about those who practice this skill. It was not until 1999 that the US Department of Labor assigned a separate job classification (Standard Occupational Classification #31-9094) so that statistics could be gathered on medical transcriptionists. Before that, transcriptionists were misclassified as typists, word processors, medical secretaries, and dictating machine operators.

Medical transcriptionists work in settings that are usually far removed from the examining rooms, clinics, and hospital floors where health care is provided. Patients rarely have the opportunity to hear about those who transcribe their medical reports, and medical transcriptionists rarely meet the subjects of their work. All healthcare providers rely to some extent on the skills of the medical transcriptionist to provide written documentation of health care. The reports produced by medical transcriptionists are the repository of information concerning medical practice. These reports function as legal documentation and fulfill requirements for insurance reimbursement. They also serve as reference for scientific research.

Where are medical transcriptionists employed?
Medical transcriptionists use their talents in a variety of healthcare settings, including doctors’ offices, public and private hospitals, teaching hospitals, medical transcription businesses, clinics, laboratories, radiology and pathology departments, insurance companies, medical libraries, government medical facilities, rehabilitation centers, legal offices, research centers, veterinary medical facilities, and associations representing the healthcare industry.

Medical transcriptionists work with physicians and surgeons in multiple specialties. They work with pharmacists, therapists, technicians, nurses, dieticians, social workers, psychologists, and other medical personnel. All of these healthcare providers rely on information that is received, documented, and disseminated by the medical transcriptionist. Some transcriptionists choose to work at home as employees of transcription businesses or hospitals. Still others provide services as independent contractors.Qualified medical transcriptionists who wish to expand their professional responsibilities may become quality assurance specialists, supervisors, managers, department heads, or owners of medical transcription businesses. Experienced medical transcriptionists may become teachers, working in schools and colleges to educate future medical transcriptionists.

Is medical transcription a good home-based business?
The transcriptionist working from home must make a significant investment in equipment and reference materials and be willing to make frequent updates to both in order to keep up with rapidly changing technology and terminology. Careful planning and the advice of legal and financial experts are essential to the success of a home-based business.

Medical transcription provides unlimited intellectual challenge and the opportunity to make a unique contribution to quality health care and service. Health care is a rapidly growing industry, and the demand for quality documentation is increasing. The profession provides a high level of job security, and skilled medical transcriptionists may receive a premium for their services. Because their services are in demand, transcriptionists are often able to arrange convenient and flexible work schedules.

Medical transcription is a portable skill that allows for professional and geographic mobility. Age restrictions are seldom found, with great value being placed on the experience and knowledge of the well-seasoned transcriptionist. Medical transcription can be a lifelong, satisfying career, providing the constant challenge of an expanding and advancing technology. The changes occurring in the healthcare industry promise to provide even more challenges to the forward-looking medical transcriptionist.

What are the characteristics of a medical transcriptionist?
Medical transcription professionals are; word specialists, self-starters, perfectionists, independent by nature, and self-disciplined. Medical transcriptionists are also interested in medicine, committed to learning, known to have inquiring minds, able to concentrate for long periods, willing to assist others, able to work with minimal supervision, and dedicated to professional development and achievement.

©2002 American Association for Medical Transcription