Medical Transcriptionists

• Job opportunities will be good.

• Employers prefer medical transcriptionists who have completed a postsecondary training program at a vocational school or community college.

• Many medical transcriptionists telecommute from home-based offices as employees or subcontractors for hospitals and transcription services or as self-employed, independent contractors.

• About 4 out of 10 worked in hospitals and another 3 out of 10 worked in offices of physicians.

Medical transcriptionists listen to dictated recordings made by physicians and other health care professionals and transcribe them into medical reports, correspondence, and other administrative material. They generally listen to recordings on a headset, using a foot pedal to pause the recording when necessary, and key the text into a personal computer or word processor, editing as necessary for grammar and clarity. The documents they produce include discharge summaries, history and physical examination reports, operative reports, consultation reports, autopsy reports, diagnostic imaging studies, progress notes, and referral letters. Medical transcriptionists return transcribed documents to the physicians or other health care professionals who dictated them for review and signature, or correction. These documents eventually become part of patients’ permanent files.

To understand and accurately transcribe dictated reports into a format that is clear and comprehensible for the reader, medical transcriptionists must understand medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and treatment assessments. They also must be able to translate medical jargon and abbreviations into their expanded forms. To help identify terms appropriately, transcriptionists refer to standard medical reference materials—both printed and electronic; some of these are available over the Internet. Medical transcriptionists must comply with specific standards that apply to the style of medical records, in addition to the legal and ethical requirements involved with keeping patient information confidential.

Experienced transcriptionists spot mistakes or inconsistencies in a medical report and check to correct the information. Their ability to understand and correctly transcribe patient assessments and treatments reduces the chance of patients receiving ineffective or even harmful treatments and ensures high-quality patient care.

Currently, most health care providers transmit dictation to medical transcriptionists using either digital or analog dictating equipment. The Internet has grown to be a popular mode for transmitting documentation. Many transcriptionists receive dictation over the Internet and are able to quickly return transcribed documents to clients for approval. Another increasingly popular method utilizes speech recognition technology, which electronically translates sound into text and creates drafts of reports. Reports are then formatted; edited for mistakes in translation, punctuation, or grammar; and checked for consistency and any possible medical errors. Transcriptionists working in areas with standardized terminology, such as radiology or pathology, are more likely to encounter speech recognition technology. However, use of speech recognition technology will become more widespread as the technology becomes more sophisticated.

Medical transcriptionists who work in physicians’ offices may have other office duties, such as receiving patients, scheduling appointments, answering the telephone, and handling incoming and outgoing mail. Medical secretaries, discussed in the statement on secretaries and administrative assistants elsewhere in the Handbook, also may transcribe as part of their jobs. Court reporters, also discussed elsewhere in the Handbook, have similar duties, but with a different focus. They take verbatim reports of speeches, conversations, legal proceedings, meetings, and other events when written accounts of spoken words are necessary for correspondence, records, or legal proof.

The majority of these workers are employed in comfortable settings, such as hospitals, physicians’ offices, transcription service offices, clinics, laboratories, medical libraries, government medical facilities, or their own homes. Many medical transcriptionists telecommute from home-based offices as employees or subcontractors for hospitals and transcription services or as self-employed, independent contractors.

Work in this occupation presents hazards from sitting in the same position for long periods. Workers can suffer wrist, back, neck, or eye problems due to strain and risk repetitive motion injuries such as carpal tunnel syndrome. The constant pressure to be accurate and productive also can be stressful.

Many medical transcriptionists work a standard 40-hour week. Self-employed medical transcriptionists are more likely to work irregular hours—including part time, evenings, weekends, or on call at any time.

Employers prefer to hire transcriptionists who have completed postsecondary training in medical transcription, offered by many vocational schools, community colleges, and distance-learning programs. Completion of a 2-year associate degree or 1-year certificate program—including coursework in anatomy, medical terminology, legal issues relating to health care documentation, and English grammar and punctuation—is highly recommended, but not always required. Many of these programs include supervised on-the-job experience. Some transcriptionists, especially those already familiar with medical terminology from previous experience as a nurse or medical secretary, become proficient through refresher courses and training.

The American Association for Medical Transcription (AAMT) awards the voluntary designation Certified Medical Transcriptionist (CMT), to those who earn a passing score on a certification examination. As in many other fields, certification is recognized as a sign of competence. Because medicine is constantly evolving, medical transcriptionists are encouraged to update their skills regularly. Every 3 years, CMTs must earn continuing education credits to be recertified.

In addition to understanding medical terminology, transcriptionists must have good English grammar and punctuation skills, as well as proficiency with personal computers and word processing software. Normal hearing acuity and good listening skills also are necessary. Employers require applicants to take pre-employment tests and usually prefer individuals with experience.

With experience, medical transcriptionists can advance to supervisory positions, home-based work, editing, consulting, or teaching. With additional education or training, some become medical records and health information technicians, medical coders, or medical records and health information administrators.

Medical transcriptionists held about 105,000 jobs in 2004. About 4 out of 10 worked in hospitals and another 3 out of 10 worked in offices of physicians. Others worked for business support services; medical and diagnostic laboratories; outpatient care centers; and offices of physical, occupational and speech therapists, and audiologists.

Job opportunities will be good. Employment of medical transcriptionists is projected to grow faster than average for all occupations through 2014. Demand for medical transcription services will be spurred by a growing and aging population. Older age groups receive proportionately greater numbers of medical tests, treatments, and procedures that require documentation. A high level of demand for transcription services also will be sustained by the continued need for electronic documentation that can easily be shared among providers, third-party payers, regulators, consumers, and health information systems. Growing numbers of medical transcriptionists will be needed to amend patients’ records, edit documents from speech recognition systems, and identify discrepancies in medical reports.

Contracting out transcription work overseas and advancements in speech recognition technology are not expected to significantly reduce the need for well-trained medical transcriptionists. Outsourcing transcription work abroad—to countries such as India, Pakistan, Philippines, and the Caribbean—has grown more popular as transmitting confidential health information over the Internet has become more secure; however, the demand for overseas transcription services is expected only to supplement the demand for well-trained domestic medical transcriptionists. In addition, reports transcribed by overseas medical transcription services usually require editing for accuracy by domestic medical transcriptionists before they meet domestic quality standards. Speech-recognition technology allows physicians and other health professionals to dictate medical reports to a computer that immediately creates an electronic document. In spite of the advances in this technology, the software has been slow to grasp and analyze the human voice and the English language, and the medical vernacular with all its diversity. As a result, there will continue to be a need for skilled medical transcriptionists to identify and appropriately edit the inevitable errors created by speech recognition systems, and to create a final document.

Hospitals will continue to employ a large percentage of medical transcriptionists, but job growth there will not be as fast as in other industries. An increasing demand for standardized records should result in rapid employment growth in physicians’ offices, especially in large group practices.

Medical transcriptionists had median hourly earnings of $13.64 in May 2004. The middle 50 percent earned between $11.50 and $16.32. The lowest 10 percent earned less than $9.67, and the highest 10 percent earned more than $19.11. Median hourly earnings in the industries employing the largest numbers of medical transcriptionists in May 2004 were:

Compensation methods for medical transcriptionists vary. Some are paid based on the number of hours they work or on the number of lines they transcribe. Others receive a base pay per hour with incentives for extra production. Employees of transcription services and independent contractors almost always receive production-based pay. Independent contractors earn more than do transcriptionists who work for others, but independent contractors have higher expenses than their corporate counterparts, receive no benefits, and may face higher risk of termination than do employed transcriptionists.

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