What is Medical Transcription?
Medical transcription is the process of converting voice-recorded reports as dictated by physicians and/or other healthcare professionals into text format. India has become the hub of the global MT industry. It is the transcribing (typing) of doctor's reports from dictated audio files. Each time a physician or other medical provider sees a patient, a record is kept -- the medical record.
Insurance companies have now made typed notes mandatory, which means the need for medical transcription has nearly tripled in the last decade. Add to that the baby boomers who are reaching their senior years, and you have a wonderful career opportunity and a bigger demand than there is supply for the correctly trained personnel to transcribe these records.
What makes a medical transcriptionist qualified?
What most people don't realize is that the qualified medical transcriptionist is worth every dime she makes (and more!) However it's not just the typing speed that decides your success -- it's far more. Things like working SMARTER instead of HARDER. Things like being trained in ALL aspects of the transcription business instead of just a few medical specialties. Things like knowing your computer inside and out and knowing little tips and shortcuts that take the job from an average one to an extremely profitable one.
Don't get us wrong -- we're not saying you are going to make big money your first year. Maybe not even your second year. But if you were to learn transcription and work at home, wouldn't you want to learn it from the very best? Wouldn't you want your training to come from people who have successfully already DONE what you want to do? What if those experienced individuals got together and created a program so thorough and so intense that you could cut months off your learning curve? Wouldn't that be worth looking into?
Well that's exactly what has happened here. In our FREE e-book (see link above) you'll get in-depth reports and stories from a number of successful transcriptionists around the country -- each one telling you what worked for them and the mistakes they made first starting out.
What better way to make your decisions than by getting advice from the people who have been there before you? People who have learned the ropes the hard way. Now you can benefit from this knowledge!
For a good example, if you wanted to learn oil painting, would you rather learn from your next door neighbor who dabbles in weekend art, or from a renowned artist who has many years of experience in both painting and the business of selling their painting? This is how an investment in yourself at the beginning of your career can make the difference between you earning an average or below-average income and one that is well above-average. The payoff over even just a few years (many times only a few months!) is well worth the difference in cost!
Skills needed for a Medical Transcriptionist/ What are the requirement to become an Medical Transcriptionist?
- Good Typing Skill
- Basic computer skill (Introduction, Windows XP, MS-Office 2003/2007/2010 and other MT-related software tools)
- Good English skill (Grammar, Comprehension, Spelling, Communication, Verbal and Written knowledge)
- Knowledge of medical terminology (Language of Medicine)
Topics covered in Medical Transcription Training
- Medical transcription theory – According to the AAMT (American Association for Medical Transcription) standards.
- Language of Medicine – Human anatomy, physiology and medical terminology pertaining to each system in the human body.
- Transcription – Practice to transcribe all the system-related voice files (With feedback from QA's)
- Live Transcription
Medical Transcription Documentation Process
- Patient sees doctor
- Doctor dictates into microphone
- Voice captured on servers
- Medical transcriptionist will access the file
- File is transcribed
- Uploaded to second level
- Files are sent to hospital/filed
- Coder codes the document from the transcribed report
- Completed documents are filed for patient
Curricular requirements, skills and abilities experience that is directly related to the duties and responsibilities specified, and dependent on the employer (working directly for a physician or in hospital facility).
It is very important to have a properly formatted, edited, and reviewed medical transcription document. If a medical transcriptionist accidentally typed a wrong medication or the wrong diagnosis, the patient could be at risk if the doctor (or his designee) did not review the document for accuracy. Both the doctor and the medical transcriptionist play an important role to make sure the transcribed dictation is correct and accurate. The doctor should speak slowly and concisely, especially when dictating medications or details of diseases and conditions. The medical transcriptionist must possess hearing acuity, medical knowledge, and good reading comprehension in addition to checking references when in doubt.
However, some doctors do not review their transcribed reports for accuracy, and the computer attaches an electronic signature with the disclaimer that a report is "dictated but not read". This electronic signature is readily acceptable in a legal sense. The transcriptionist is bound to transcribe verbatim (exactly what is said) and make no changes, but has the option to flag any report inconsistencies. On some occasions, the doctors do not speak clearly, or voice files are garbled. Some doctors are, unfortunately, time-challenged and need to dictate their reports quickly (as in ER Reports). In addition, there are many regional or national accents and (mis)pronunciations of words the MT must contend with. It is imperative and a large part of the job of the Transcriptionist to look up the correct spelling of complex medical terms, medications, obvious dosage or dictation errors, and when in doubt should "flag" a report. A "flag" on a report requires the dictator (or his designee) to fill in a blank on a finished report, which has been returned to him, before it is considered complete. Transcriptionists are never, ever permitted to guess, or 'just put in anything' in a report transcription. Furthermore, medicine is constantly changing. New equipment, new medical devices, and new medications come on the market on a daily basis, and the Medical Transcriptionist needs to be creative and to tenaciously research (quickly) to find these new words. An MT needs to have access to, or keep on memory, an up-to-date library to quickly facilitate the insertion of a correctly spelled device,
Outsourcing of medical transcription Due to the increasing demand to document medical records, countries have started to outsource the services of medical transcription. In the United States, the medical transcription business is estimated to be worth US$10 to $25 billion annually and growing 15 percent each year.[4] The main reason for outsourcing is stated to be the cost advantage due to cheap labor in developing countries, and their currency rates as compared to the U.S. dollar.
There is a volatile controversy on whether medical transcription work should be outsourced, mainly due to three reasons:
- Knowledge of medical terminology.
- Above-average spelling, grammar, communication and memory skills.
- Ability to sort, check, count, and verify numbers with accuracy.
- Skill in the use and operation of basic office equipment/computer; eye/hand/foot coordination.
- Ability to follow verbal and written instructions.
- Records maintenance skills or ability.
- Above-average to excellent typing skills.
- Knowledge of basic to advanced medical terminology is essential.
- Knowledge of anatomy and physiology.
- Knowledge of disease processes.
- Knowledge of medical style and grammar.
- Average verbal communication skills.
- Above-average memory skills.
- Ability to sort, check, count, and verify numbers with accuracy.
- Demonstrated skill in the use and operation of basic office equipment/computer.
- Ability to follow verbal and written instructions.
- Records maintenance skills or ability.
- Above-average typing skills.
- Knowledge and experience transcribing (from training or real report work) in the Basic Four work types: History and Physical Exam, Consultation, Operative Report, and Discharge Summary.
- Knowledge of and proper application of grammar.
- Knowledge of and use of correct punctuation and capitalization rules.
- Demonstrated MT proficiency in multiple report types and multiple specialties.
- Accurately transcribes the patient-identifying information such as name and Medical Record or Social Security Number.
- Transcribes accurately, utilizing correct punctuation, grammar and spelling, and edits for inconsistencies.
- Maintains/consults references for medical procedures and terminology.
- Keeps a transcription log.
- In some countries, MTs may sort, copy, prepare, assemble, and file records and charts (though in the United States (US) the filing of charts and records are most often assigned to Medical Records Techs in Hospitals or Secretaries in Doctor offices).
- Distributes transcribed reports and collects dictation tapes.
- Follows up on physicians' missing and/or late dictation, returns printed or electronic report in a timely fashion (in US Hospital, MT Supervisor performs).
- Performs quality assurance check.
- May maintain disk and disk backup system (in US Hospital, MT Supervisor performs).
- May order supplies and report equipment operational problems (In US, this task is most often done by Unit Secretaries, Office Secretaries, or Tech Support personnel).
- May collect, tabulate, and generate reports on statistical data, as appropriate (in US, generally performed by MT Supervisor).
It is very important to have a properly formatted, edited, and reviewed medical transcription document. If a medical transcriptionist accidentally typed a wrong medication or the wrong diagnosis, the patient could be at risk if the doctor (or his designee) did not review the document for accuracy. Both the doctor and the medical transcriptionist play an important role to make sure the transcribed dictation is correct and accurate. The doctor should speak slowly and concisely, especially when dictating medications or details of diseases and conditions. The medical transcriptionist must possess hearing acuity, medical knowledge, and good reading comprehension in addition to checking references when in doubt.
However, some doctors do not review their transcribed reports for accuracy, and the computer attaches an electronic signature with the disclaimer that a report is "dictated but not read". This electronic signature is readily acceptable in a legal sense. The transcriptionist is bound to transcribe verbatim (exactly what is said) and make no changes, but has the option to flag any report inconsistencies. On some occasions, the doctors do not speak clearly, or voice files are garbled. Some doctors are, unfortunately, time-challenged and need to dictate their reports quickly (as in ER Reports). In addition, there are many regional or national accents and (mis)pronunciations of words the MT must contend with. It is imperative and a large part of the job of the Transcriptionist to look up the correct spelling of complex medical terms, medications, obvious dosage or dictation errors, and when in doubt should "flag" a report. A "flag" on a report requires the dictator (or his designee) to fill in a blank on a finished report, which has been returned to him, before it is considered complete. Transcriptionists are never, ever permitted to guess, or 'just put in anything' in a report transcription. Furthermore, medicine is constantly changing. New equipment, new medical devices, and new medications come on the market on a daily basis, and the Medical Transcriptionist needs to be creative and to tenaciously research (quickly) to find these new words. An MT needs to have access to, or keep on memory, an up-to-date library to quickly facilitate the insertion of a correctly spelled device,
Outsourcing of medical transcription Due to the increasing demand to document medical records, countries have started to outsource the services of medical transcription. In the United States, the medical transcription business is estimated to be worth US$10 to $25 billion annually and growing 15 percent each year.[4] The main reason for outsourcing is stated to be the cost advantage due to cheap labor in developing countries, and their currency rates as compared to the U.S. dollar.
There is a volatile controversy on whether medical transcription work should be outsourced, mainly due to three reasons:
- The greater majority of MTs presently work from home offices rather than in hospitals, working off-site for "national" transcription services. It is predominantly those nationals located in the United States who are striving to outsource work to other-than-US-based transcriptionists. In outsourcing work to sometimes lesser-qualified and lower-paid non-US MTs, the nationals unfortunately can force US transcriptionists to accept lower rates, at the risk of losing business altogether to the cheaper outsourcing providers. In addition to the low line rates forced on US transcriptionists, US MTs are often paid as ICs (independent contractors); thus, the nationals save on employee insurance and benefits offered, etc. Unfortunately for the state of healthcare-related administrative costs in the United States, in outsourcing, the nationals still charge the hospitals the same rate as they did in the past for highly qualified US transcriptionists but subcontract the work to non-US MTs, keeping the difference as profit.
- There are concerns about patient privacy, with confidential reports going from the country where the patient is located (i.e. the US) to a country where the laws about privacy and patient confidentiality may not even exist, which was overcome as the Health Insurance Portability and Accountability Act (HIPAA) became mandatory for all the providers from the outsourced countries. Some of the countries that now outsource transcription work are the United States and Britain, with work outsourced to Philippines, India, SriLanka, Canada, Australia and Barbados.
- The quality of the finished transcriptions is a concern. Many outsourced transcriptionists simply do not have the requisite basic education to do the job with reasonable accuracy, as well as additional, occupation-specific training in medical transcription. Many foreign MTs who can speak English are not familiar with American expressions and/or the slang doctors often use, and can be unfamiliar with American names and places. An MT editor, certainly, is then responsible for all work transcribed from these countries and under these conditions. These outsourced transcriptionists often work for a fraction of what transcriptionists are paid in the United States, even with the US MTs daily accepting lower and lower rates. However, some firms choose to employ American transcriptionists as they believe the quality of work is better.