Frequently
Asked Questions
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What is Medical Transcription?
By it's simplest definition, Medical
Transcription is the process whereby voice dictation is converted
to a typewritten (hard copy or electronic) format. Of course,
to truly understand the nature of Medical Transcription, a
more detailed explanation is in order.
Consider that each day in hospitals
all over the country, thousands of patients are admitted and
discharged. Examinations are conducted, procedures are performed
and recommendations are made. It is not uncommon for multiple
physicians to be involved in a simple procedure for a single
patient. Radiologists, Pathologists, Anesthesiologists, Surgeons,
and a host of other medical specialists must all coordinate
their efforts to ensure that patient care is both adequate
and appropriate.
Underpinning all of these activities
is a complex web of medical and patient information. Each
patient-related activity and procedure must be meticulously
documented and then added to the patient's permanent record.
Over time, all of this information accumulates in a centralized
medical records repository where it serves as a critical resource
for patient care - facilitating accurate diagnoses and appropriate
treatments. Indeed, timely patient care often hinges on the
ability of Radiology, Pathology, and other specialty departments
to quickly conduct their examinations and report their findings.
Verbal dictation is by far the most
common method for documenting and reporting the results of
examinations and procedures. Physicians generally use either
a cassette based voice dictation system or a digital voice
dictation system to record their findings. Dictating reports
verbally not only allows physicians to be more thorough in
their reporting, it also saves them a great deal of time.
The process of converting this voice
dictation to a typewritten format is known as transcription.
What skills and experience
are required for success in this field?
Medical Transcriptionists must complete
advanced training in medical terminology and have a thorough
understanding of policies, procedures and documentation protocols
required for the production of medical records.
In addition, the following skills
and attributes should be considered important for success
in the field of Medical Transcription:
Advanced knowledge of anatomy,
physiology, pharmacology, systems, diagnoses, and a familiarity
with terminology specific to a variety of medical specialties.
Excellent command of the
English language and solid grammar and spelling skills.
Access to, familiarity
with, and ability to use appropriate medical reference material
efficiently.
Proficiency with appropriate
word-processing hardware and software and transcription equipment.
Solid typing skills.
Good judgement.
Ability to concentrate
and decipher marginally intelligible dictation and interpret
varied dialects, accents and speech patterns.
Ability to work independently
with minimal supervision.
Are there other skills,
training and experience which would also prove helpful?
Associates or Bachelors
degree in a life science or liberal arts discipline.
Certified Medical Transcriptionist
(CMT) designation.
How can I gain these skills?
Most competent Medical Transcriptionists
possess inherent aptitudes in spelling, language and grammar.
However, nearly all of the other necessary skills can be acquired
through experience and training.
The quickest way to gain the requisite
anatomy, medical terminology and pharmacology skills is through
training. There are a number of excellent training courses
available on the market. There are also numerous programs
of study available through local community colleges and other
training organizations.
Once a basic level of competence
has been achieved, skills must be refined through practice
and repetition. Because of the complex nature of medical transcription,
learning retention requires continuous effort. The most effective
way to internalize formal training and gain depth in skills
is through practical application. The best Medical Transcriptionists
are continually updating their skills through a combination
of ongoing training and experience. Rapid advances in technology
and medicine virtually guarantee that continuous improvement
will be essential to success in this field in the future.
What drives the demand
for Medical Transcription?
Demographic data indicates that
our population is rapidly aging at the same time we are achieving
significant improvements in average lifespan. These demographic
patterns along with technological and legal trends suggest
that the need for accurate medical transcription will accelerate
dramatically in coming years.
How long does it take
to become productive and competent?
This depends very much on your personal
motivation level. There is no point in mincing words here.
Medical transcription has a relatively steep learning curve.
True proficiency across a variety of medical specialties can
take years to achieve. However, a basic level of competency
can be achieved in a matter of months. The two primary educational
phases are:
1. Learning the basics of
terminology, anatomy, physiology, pharmacology, etc.
2. Practice, practice, practice.
Both phases are important. The first
phase can be accomplished in several different ways. There
are several quality online medical transcription courses designed
to teach the basics of Medical Transcription.
The most important learning will
occur through practice. Therefore, you should look for a course
of instruction that provides ample opportunities for hands-on
learning. To maximize results, it is necessary to churn through
as much dictation as possible in a short period of time. Doing
a little bit "now and then" as the mood strikes you is not
an efficient method of learning. If you are serious enough
to spend money on a course then you need to make a commitment
to diligence and excellence.
Learning transcription is very much
like learning a second language. You can learn the basics
in school, but until you apply it extensively in conversation
you will never become fluent. There is another similarity
as well. It can be referred to as the "aha" effect. After
about three or four months of consistent and grueling effort,
one day a light just seems to come on and you say to yourself
"Aha! I see how it works! Hey, I can do this!" Up until that
time no amount of convincing could make you believe that you
have what it takes to succeed.
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Experience has shown that the people
who ultimately succeed in this field are those who can successfully
get over that hump in a short period of time - 6 months or
less. Too many individuals languish for months or years coming
back to their studies intermittently and avoiding the often
excruciating practice sessions. They never truly internalize
the learning and as a consequence, most of the small progress
they make is lost between sessions. It is a poor way of learning.
Ultimately it is self-defeating.
The better approach is to adopt
the Nike slogan and "Just do it!" Set some specific short
term goals and then stick to them until they become habit.
If you can do this for a two week period then you will be
well on your way.
Do I need to be certified
to work as a Medical Transcriptionist?
The most important consideration
in finding successful employment in this industry is your
skill set. Certification is helpful but not necessary to advance
a career. When people speak of certification in the Medical
Transcription field, they are typically referring to certification
with AHDI (Association for Healthcare Documentation Integrity)
formerly AAMT (American Association of Medical Transcriptionists).
The official designation of this organization is CMT - Certified
Medical Transcriptionist.
While the CMT is certainly highly
regarded, it is by no means a prerequisite to entry into,
or advancement within the field of medical transcription.
Many competent trancriptionists do not have the designation.
However, if your time and resources permit, it is something
that should be seriously considered.
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In addition to the CMT designation,
there are a variety of certifications available through schools
and home study courses. These certifications are typically
awarded upon successful completion of a course of study in
Medical Transcription. And while they are not equivalent to
the CMT designation, they do provide evidence of a level of
formal training.
Ultimately the value of these certifications
depends very much on the placement assistance provided with
the course and the reputation of the school or course providor.
Medical transcription is an occupation
that is ideally suited for home based employment. Because
many transcriptionists are paid on the basis of production,
employers have been quick to embrace flexible employment arrangements
allowing transcriptionists to work from home.
Because of recent advances in technology
enabling seamless flows of information, the concept of home
based employment has gained in popularity over the past several
years. Skilled Transcriptionists wishing to work from home
should have no problem finding home based work opportunities.
What is the outlook for
the Medical Transcription profession?
The healthcare industry represents
the world's first trillion-dollar industry. Healthcare expenditures
as a percentage of our nation's Gross Domestic Product dwarf
all other non-governmental expenditures. And demand for services
has never been greater. Demographic changes such as an increased
average life span and a rapidly aging population ensure that
demand will remain strong well into the 21st century.
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The timing is excellent for anyone
interested in entering this exciting and lucrative field.
Like any technology-intensive career, success will require
patience and perseverance, but the opportunity to enter the
medical transcription industry has never been greater than
it is today.
What impact will voice
recognition technology have on the industry?
Voice recognition technology has
been threatening for some time to replace human transcriptionists.
It turns out that there are a number of problems with this.
For starters, the fluctuating speech patterns, accents and
non-verbal noise common to one degree or another in the dictation
process render voice recognition cumbersome at best and seriously
flawed at worst.
Voice recognition is far from a
panacea. In its current state, the technology is unwieldy
and inefficient. Even as the technology evolves, there will
always be a need for expert oversight and rigid quality control
to ensure that the content of transcribed reports is accurate
and devoid of unintended material.
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It is also not reasonable to expect
highly paid physicians to assume responsibility for the editing,
formatting and processing of large quantities of medical documents.
Even if physicians were interested in assuming these duties
- which most clearly are not - cost considerations would cry
out against it. Basic economic theory suggests that a division
of labor is the best course of action in an instance like
this. Ultimately, it makes sense for a group of skilled medical
transcription specialists to continue to manage the editing
and processing functions of the medical records production
process.
It seems likely that there will
always be a need for qualified medical transcriptionists.
This is not to say that more sophisticated technology will
not ultimately become capable of replacing or at least augmenting
certain subsets of the transcription process. It seems unlikely,
however, that computer software will depose traditional transcriptionists
in the near term future.
What role will Government
and Business play in the future of Medical Transcription?
The healthcare industry is, by its
nature, very bureaucratic. Even though our healthcare delivery
system is a private one, you can rest assured that the government
will continue to play a key role in shaping its future. As
a consequence, red tape and bureacracy will remain a part
of the landscape for the forseeable future.
At the same time, however, large
corporations and other consumer organizations are beginning
to step up and aggressively challenge traditional healthcare
assumptions. They are streamlining processes and forcing a
new level of economic efficiency into an industry that has
historically enjoyed complete freedom in its pricing and delivery
practices. Look for a continuation of the positive reforms
that have been transforming the industry over the past decade.
Skilled Medical Transcriptionists
generally have little trouble finding work. Most Medical Transcription
operations are continually seeking new employees or contractors.
The growth in the scope and complexity of medical records
has been significant over the past several years and the demand
for qualified help currently outstrips supply.
Unfortunately, recent graduates
of Vocational Schools and Medical Transcription training courses
often have a more difficult time finding an employer who is
willing to take a chance on them. This is largely due to the
fact that it takes a number of years of consistent effort
to become truly proficient in Medical Transcription. Most
Hospitals and Transcription Companies insist on two to three
years of experience as a minimum requirement of employment.
It is a time consuming and expensive proposition to train
a new employee. Many companies have trained employees only
to watch them leave for better pay upon gaining the requisite
experience.
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There are few substitutes for hands-on
experience. That is why the training programs which emphasize
hands-on experience by requiring their students to work through
a wide variety of actual dictation and related coursework
tend to produce graduates who are more prepared for the real
world.
Some of the better training programs
will also offer placement assistance to their graduates. If
you are short on experience, this can be a real plus.
Ultimately however, the burden of
finding employment or contract work must rest on the individual.
If used properly, the directories and resource materials in
this Career Guide will open up a world of options for individuals
willing to be proactive in their employment search.
What other career advice
can you offer?
If you are serious about your career
it is important that you manage it aggressively. This implies
that you do not necessarily settle for the first thing that
comes along. If you are currently working as a Medical Transcriptionist
and are dissatisfied with your current situation, you should
take special care not to jump at the first opportunity that
presents itself - simply as a means of getting out of an unpleasant
situation.
Any move you make should be well
calculated and meaningful. It should clearly move you in a
positive direction. Be mindful of the fact that once you have
made a move, you will typically be there for a while. That
is why it is so important to make every move count. Make sure
that every job change propels you to your next career plateau.
You want to avoid making strictly lateral moves unless the
new position will clearly provide an opportunity to gain a
significant amount of valuable experience.
It is important to set stretch goals.
Set your sights high and then work aggressively to sell yourself
to employers. Think about getting the specialty training you
need if that is standing in the way of your progress.
If you have not clearly thought
through your career objectives then this is a good time to
do so. Consider your objectives in the context of family,
lifestyle, personal growth and income requirements.
Individuals who are most successful
in their careers are typically those who are proactive. Waiting
for opportunities to come to you is not the best way to manage
your career. Think about where you want to be and then go
after it.
How much money can I
earn as a Medical Transcriptionist?
This will be depend on a number
of factors. Wage rates tend to vary considerably from one
area of the country to another. Also, the method of payment
will vary from company to company. Increasingly, transcription
companies are paying on a production basis. This means that
ultimately, the amount of money you make will be determined
by your speed and proficiency.
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An inexperienced Medical Transcriptionist
will typically be better off with a compensation structure
that guarantees an hourly wage. Securing a job with an hourly
wage rate allows the new transcriptionist to earn a minumum
amount of income during the least productive period of her
career. Experienced transcriptionists are almost always better
off being paid on production - provided they have the motivation
to produce consistently.
Annual income for full-time entry-level
transcriptionists typing hospital reports averages between
$24,000 - $35,000 - depending on location and proficiency.
More experienced transcriptionists can expect to make double
or even triple that amount on the basis of production - particularly
if they are willing to develop their own customer base. Unfortunately,
the pay differential between experienced and non-experienced
transcriptionists is not typically as large in hospital settings
where transcriptionists are often paid by the hour. This is
one of the primary reasons that experienced transcriptionists
tend to seek out positions as independent or sub-contractors
where the opportunity exists to leverage their earnings potential.
Are there opportunities
to start my own business?
In recent years, traditional hospitals
have come under competitive attack by more efficient managed
care organizations. In an effort to remain competitive, many
hospitals have turned to outsourcing as a means of cutting
costs. Many of the processes that were previously performed
internally are now being contracted out to third parties.
Medical transcription is no exception. The outsourcing of
transcription and other functions relieves hospitals of the
administrative headaches and overhead burdens associated with
internal production and allows them to focus their attention
on improving service and lowering costs.
There is considerable evidence to
suggest that contracting out medical transcription is a much
less costly alternative to producing reports internally. Most
savvy healthcare providers today understand this and are responding
appropriately. The significant cost-cutting pressures which
continue to drive the industry toward consolidation, managed
care and capitation virtually guarantee that the outsourcing
trend will not only continue but accelerate in coming years.
This proliferation of outsourcing
agreements has spawned a new generation of small medical transcription
companies intent on carving out a piece of the pie. Interestingly,
in spite of its rapid growth, the medical transcription industry
is still considered a cottage industry. While there are a
few truly national players, the industry is at this point
still dominated by the hundreds of small local transcription
companies located wherever hospitals are found.
Am I better off working
for a Hospital or a Medical Transcription Company?
This depends on a number of factors.
Some of these factors include:
Level of Experience and
Proficiency
Income Requirements
Benefit Requirements
Importance of Freedom and
Flexibility
Personal Motivation
Risk Tolerance
Hospitals tend to be more rigid
and bureaucratic in their approach to human resources. They
also tend to pay by the hour - which makes it difficult for
experienced and productive transcriptionists to maximize their
earnings potential.
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On the other hand, large hospitals
can offer benefits which far outweigh those provided by most
medical transcription companies. These benefits may include
guaranteed salaries, overtime pay, flex-time, sick leave,
paid vacation, and perhaps most importantly - generous health
care benefits. Also, if you are interested in pursuing a long
term career as a Medical Records Director or Hospital Administrator,
a large hospital system will typically provide more opportunities
for upward mobility.
Medical transcription contracting
companies tend to appeal to individuals seeking to maximize
personal income and flexibility. Many transcription companies
pay on a production basis - which means that proficiency is
rewarded. Also, many transcription companies allow their employees
to tele-commute. Working from home can be a big draw for many
individuals.
Of course, working from home also
has its drawbacks. A transcriptionist must be personally motivated
in order to meet her production goals without continuous supervision.
Also, distractions often abound - making it difficult to achieve
a consistent level of production.
Ultimately, both avenues provide
tremendous opportunities for motivated individuals. Many transcriptionists
migrate back and forth periodically as changes occur in their
life. In any case, it is always a good idea to evaluate specific
opportunities in depth before making final judgements.
What is the difference
between an independent contractor and a subcontractor?
Independent Contractors
Independent contractors essentially
operate as small business entities. These individuals contract
directly with hospitals and other healthcare providors to
manage all or part of their medical transcription needs. This
type of arrangement requires that the independent contractor
assume total responsibility for the production and completion
of the final product. This includes pick-up and delivery of
work, distribution of work to one or more transcriptionists,
ensuring turnaround requirements are met, and supervising
quality control efforts. In addition, there are other administrative
burdens such as billing, payroll, and taxes.
Under these conditions, flexibility
can be a double-edged sword. An independent contractor cannot
simply take off on a vacation without making detailed arrangements
for the continuation of workflows in her absence. On the other
hand, an independent contractor is her own boss. Many of the
most tedious activities can be delegated to administrative
help; and noone is looking over her shoulder to tell her she
cannot slip away for a ballgame or take an extended lunch
break.
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As an independent contractor, income
is typically maximized. By definition, an independent contractor
generates and keeps all the profit from each of her contracts.
This can be significant for a skilled transcriptionist - particularly
if she is willing to assume some or all of the transcription
duties herself.
Subcontractors
The subcontractor also works independently.
She is responsible for her own taxes, equipment, reference
materials and office space (typically a home office). She
also sets her own hours. The difference between a subcontractor
and an independent contractor is that the subcontractor does
not contract directly with the healthcare providor. She subcontracts
from a medical transcription company.
The medical transcription company
has ultimate responsibility for the fulfillment of the contract.
It assumes the logistical and administrative burdens of the
contract. The subcontractor provides transcription services
to the medical transcription company on a contract basis.
That is to say there is no employment relationship.
The primary benefit of being a subcontractor
vs. an employee is flexibility. The subcontractor relationship
is based solely on production. If a subcontractor completes
her work early, she is free to do something else with her
time.
Another benefit is that many of
the typical expenses related to producing the product will
be tax deductible. This can be an important element of the
subcontracting equation. In certain instances, it may also
be possible to negotiate a higher rate of pay as a subcontractor.
One of the primary drawbacks of
the subcontracting relationship are that there are typically
no guarantees. For this reason, most subcontractors establish
relationships with a number of medical transcription companies
to ensure that adequate work is always available to them.
Another drawback to subcontracting
is that the subcontractor must assume a number of administrative
burdens - including managing the payroll and income tax reporting
and payment processes.
Be aware that working from your
home does not automatically qualify you for subcontract status.
There has been a movement in recent years by the IRS to challenge
many so called "subcontract" relationships. There is a fine
line between a home-based employment arrangement and a true
subcontracting arrangement. You want to make sure that you
understand the distinctions. To avoid potential problems,
it is adviseable to seek professional advice before establishing
yourself as an independent contractor or subcontractor.
Are there associations
that I can join?
Yes. The Asssociation for Healthcare
Documentation Integrity (AHDI) formerly the American Association
of Medical Transcriptionists (AAMT) has been formed to advance
the profession of Medical Transcription. The best way to explore
the resources available from AHDI is to visit it's web site
at www.ahdionline.org.
You can also contact the AHDI directly
at:
AHDI
4230 Kiernan Avenue Suite 130
Modesto, CA 95356
800-982-2182
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