With keen listening skills and fast typing ability, these transcriptionists use their training to document medical histories.

“The patient had discomfort anterior to the lateral malleolus. Talar tilt negative. Drawer sign negative.”

What does that mean? Medical transcriptionists know. And because of transcriptionists’ work, the fact that the patient’s sore ankle passed two tests for stability becomes part of his or her recorded medical history.

Medical transcriptionists are experts in the language of medicine. They turn healthcare providers’ spoken notes into well-edited, typed reports. They can recognize–and spell–the names of bones, muscles, procedures, and prescriptions. Their efforts ensure that doctors and other healthcare workers have accurate information about patients.

The chance to learn about medicine is one reason some people are attracted to this occupation. Ample job openings, flexible schedules, relatively short education requirements, and opportunities for home-based work are other draws. On the following pages, you’ll learn what medical transcriptionists do and what their working conditions, earnings, employment prospects, and training requirements are.

Dictation into document

Medical transcriptionists type voice recordings made by physicians or other healthcare professionals into medical reports and correspondence. The documents that transcriptionists produce include discharge summaries, physical examination reports, patients’ history reports, operating room reports, consultation notes, diagnostic imaging studies, autopsy reports, and referral letters.

Transcriptionists usually listen to recordings on a special headset, using a foot pedal to pause the recording when desired. As they listen, they type the text using word processing software. Then, they organize the material into a set format and return transcribed documents to the dictator for review and signature or correction. Finished documents become part of patients’ permanent medical files.

It takes more than careful listening and fast typing to transcribe medical records, though. Medical transcriptionists use their understanding of medical terminology, anatomy and physiology, diagnostic procedures, and treatment to create accurate reports. For example, the medical terms “ilium” and “ileum” sound the same on a recording, but a transcriptionist knows which is correct in a given context: “ilium” refers to a bone in the hip, and “ileum” is part of the small intestine.

Some people confuse the work of medical transcriptionists with that of another transcribing occupation, court reporter. Both occupations listen to speech and type it on a word processor. But while court reporters use a special typewriter to record verbatim reports of legal proceedings, medical transcriptionists are more concerned with the speaker’s meaning than with his or her exact words.

As they work, transcriptionists translate medical abbreviations and jargon into their expanded forms so that records are easy to understand. They check the spelling and meaning of these terms by consulting standard medical reference materials, both printed and electronic.

Experienced medical transcriptionists spot inconsistencies or mistakes, such as misspoken prescriptions, in a medical report and verify the correct information with the dictator. Transcriptionists’ ability to understand and correctly transcribe patient assessments and treatments reduces the chance that patients will receive ineffective or harmful care.

The emergence of speech recognition technology, which translates sound into text automatically and creates draft reports, has allowed some medical transcriptionists to spend less time typing and more time editing for accuracy and clarity. Transcriptionists format draft reports; edit them for mistakes in translation, punctuation, and grammar; and check for possible errors by the speaker. In specialized areas with more common terminology, such as radiology or pathology, transcriptionists are more likely to encounter speech recognition systems. However, use of these systems will become increasingly widespread as the technology becomes more sophisticated.

Medical transcriptionists are careful when transmitting storing the medical records they create. They keep records confidential by following strict legal and ethical guidelines. As more transcriptionists use the Internet and intranets to transmit records, new security procedures are being implemented. Using the Internet to send records will become widespread only when the technology becomes more secure.

Medical transcriptionists who work in physicians’ offices and clinics may have nonrecordmaking duties, such as scheduling appointments, answering the telephone, and handling mail.

Worklife at the keyboard

Most medical transcriptionists work in comfortable office settings. About 40 percent worked in hospitals in 1999 and another 40 percent in physicians’ offices and clinics. Others worked in laboratories, colleges and universities, transcription service offices, and personnel supply services agencies. An increasing number of medical transcriptionists work from home, either as subcontractors for hospitals and transcription services or as independent contractors.

Many medical transcriptionists work a conventional 40-hour week. But many others work irregular schedules, including part-time, weekend, evening, or on-call hours. Self-employed and home-based workers are most likely to have irregular hours and flexible schedules. However, self-employed transcriptionists usually receive no benefits and face a higher risk of job loss than other transcriptionists do.

Working in this occupation presents few hazards. But sitting in the same position for long periods can be tiring, and workers can suffer strains resulting in wrist, back, neck, or eye problems. Transcriptionists also risk repetitive motion injuries, such as carpal tunnel syndrome.

Transcriptionists must meet tight deadlines. And sometimes, their earnings depend on how fast they transcribe. This pressure to work accurately and quickly can be stressful and wearing. But for some, working fast is a job benefit: transcriptionists often say they enjoy the quick, steady pace of their work.

Medical transcriptionists also like seeing tangible results of their efforts. And inquisitive transcriptionists enjoy satisfying their curiosity as they track down the meanings and spellings of the latest treatments.

Earnings for recordmakers

Medical transcriptionists had median hourly wages of $11.67 in 1999. The middle 50 percent earned between $9.70 and $13.54, the lowest paid 10 percent earned less than $8.38, and the highest paid 10 percent earned more than $16.17.

Compensation for medical transcriptionists varies. Some are paid by the hour for their work. Others are paid based on the number of standardized, 65-character lines they transcribe. Large hospitals and healthcare organizations usually prefer to pay transcriptionists by the hour. Most independent contractors and employees of transcription services receive line-based pay. Employers sometimes combine the two methods, paying a base hourly fee and giving bonuses for extra production.

According to a 1999 study conducted by Hay Management Consultants for the American Association for Medical Transcription, entry-level medical transcriptionists had median hourly earnings of $10.32. The most experienced transcriptionists had median hourly earnings of $13. Earnings were highest in organizations employing 1,000 or more workers. Transcriptionists receiving production-based pay earned about 7 to 9 cents per standardized line. Independent contractors, who have higher expenses than their corporate counterparts, typically charge about 12 to 13 cents per standardized line.

Transcription prediction: Job growth

Medical transcriptionists held about 97,260 wage and salary jobs in 1999. Many others were self employed. And employment of medical transcriptionists is projected to grow rapidly through 2008, with demand 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 demand for transcription services also will be sustained by the continued need for the electronic documentation that transcriptionists provide. This documentation is shared easily among providers, third-party payors, regulators, and patients.

Because medical transcriptionists will still be needed to review and edit drafts for accuracy, advancements in speech recognition technology are not expected to significantly reduce the need for these workers. Despite advances in this technology, the software is not yet sophisticated enough to grasp and analyze the complexities of voice and the English language. Skilled medical transcriptionists still will be needed to identify and fix errors created by speech recognition systems and to create final documents.