Should I Start a Career as a Medical Transcriptionist?

What is Medical Transcription?

First, let me say I am an experienced medical transcriptionist who has changed careers due to inability to find work that paid a decent amount and didn’t demand my every waking moment in order to earn pocket change. Having said that, lets carry on shall we?

After you see a doctor, any kind of doctor, he makes notes on his visit with you. He usually dictates his notes into a recorder or will call into a recording system. He will go over your visit in detail describing what you and he talked about, the physical examination, pre-existing conditions, new diagnosis/diagnoses, medications and any other details he feels are necessary to be recorded. Sometimes the doctor will even include non-medical details. I heard one dictation where the doctor related a conversation with a patient regarding the patients’ new boat; where he bought it, how much he paid for it, what features it had and his love of fishing. It’s possible the doctor thought this might have future bearing on this patients care or the doctor simply shared this interest and thought it worth mentioning for his own memory later. The next time he saw this patient, he could ask about the boat or fishing and the patient would feel like his doctor takes a personal interest in him. Whatever the doctor dictates, for whatever reason, goes into the patients’ medical record and must be typed. This is medical transcription.
What skills does a medical transcriptionist require?

In most cases you do need medical transcription training before you will be hired as a medical transcriptionist. This means you must have certain knowledge and skills. Certainly typing is primary! You MUST have excellent English spelling and grammar skills. Good listening skills and the ability to stay focused for long periods of time. You must also have a solid working knowledge of medical procedures, medications, diagnoses and medical terminology. This is a high stress and demanding job and it will only be worse if you don’t have the necessary skills/knowledge.
Who can do medical transcription?

Anyone can do medical transcription if you have the necessary knowledge and training. That’s not to say it’s easy to get started though! Most, though not all, medical transcriptionists work through an agency that is contracted with the physician’s office or hospital network. This agency sets up the contract to handle the transcription for that particular network of doctors and then hires medical transcriptionists to do the actual transcription work. More and more medical transcription work is outsourced outside of the US. There are a good many US based transcriptionists who work for these agencies also. Some examples of these agencies are M*Modal, MedTech and Nuance.
What is the medical transcription salary?

The amount transcriptionists make varies wildly. You can expect entry level medical transcription jobs to pay about 5 cents per line. According to the most recent Bureau of Labor statistics for 2010, mt’s make (on average) $32,000 per year; which is about $15.00 per hour. Honestly, I find that hard to believe. What that Bureau of Labor research doesn’t take into account is the experience required to make that money and the time involved daily to do that work. Americans look at that figure and see it as the result of a 40 hour work week. Let me tell you straight up and honestly, that figure does NOT reflect 40 hours a week, 8 hours a day. It’s more like 10-12 hours a day, 60+ hours per week of intense focus and determined work. If you have a dictator who is plain spoken and easy to understand, you might make that much money with less than 60 hours per week.
What is the outlook for medical transcription in the US?

The Bureau of Labor website said in 2010 the outlook for medical transcriptionists was looking up. It says that 5,600 new jobs should be expected within the next 10 years. That is not much growth but, it might happen because so many US medical transcriptionists are giving up the career. I don’t know where they get their information, but most medical transcriptionists are struggling to get enough work or flat out changing careers. The work is disappearing or pay is going so far down you can’t make a living. One website states medical transcription is being outsourced oversees because of a shortage of US based medical transcriptionists. That is not true. US transcription is being outsourced overseas because it is cheaper. The hospital network/physician can pay less for overseas transcriptionists than it can for US based mt’s. The quality of the work coming from overseas is sub par in every way. These overseas mt’s may speak English but they are not familiar with American expressions or slang that the dictator may use. They also do not have the specific training needed to produce quality transcription.

Overall, the transcription industry suffers, as physicians and hospitals adjust to and accept this poor quality of work, US based mt’s lose the ability to support themselves and the patient ends up with incorrect and false information in their medical records. It is astounding how the medical field, over all, is willing to accept these poor quality results and not do anything to change it. If the physicians would put their collective foot down and demand their dictations be handled by US mt’s only, things might change. Until the economy picks up and it doesn’t boil down to ‘save a penny in order to stay afloat’, that isn’t going to happen. And with things going the direction of electronic medical records, it will never happen.

One more point to consider is the influx of foreign language with English as a second language physicians coming to the US. There are still plenty of English speaking physicians. The problem is that new mt’s don’t get the cream of the crop to transcribe. Those go to long experienced mt’s, the new, young foreign physicians are the dictators you will get as a new mt or even an mt with a few years of experience.

In my work as an mt I mostly transcribed for foreign physicians in the US. I did get the occasional native English physician but these were few and far between. I spent countless hours listening and rewinding dictation trying to understand what that physician was saying. It was the most frustrating thing I have ever experienced. If you work on the same physician’s account long enough you learn their particular accent and it gets better. More often, you are switched around from account to account and never have time to get good at any one physician so it’s constantly a struggle to understand.
Electronic Medical Records and how this change will affect medical transcriptionists

President Obama has mandated that by the end of 2014 all medical records must be transferred to electronic medical record systems. Okay, you think, the physician will dictate and the mt will type it and it will be transmitted directly into the EMR. Some networks are doing this already, I worked for one. One month before I was laid off, the hospital network I was working for officially converted one region of its network to Epic. Epic is a very popular EMR. By the end of 2014 the entire network will be on Epic. That network is anticipating no longer needing transcription at all. Why? Because with this change to Epic, the physician is required (absolutely, no passing the buck, it must be done) to go in to each dictated document and fix all errors before they can sign off on it. Okay, so no big deal you think, mt’s will still type it and then the physician can double check it. Nope. With just that one region switching we saw a huge drop off in dictation. The physicians found that it was easier to just enter their notes in the system while they were in the room with the patient. They all carry around laptops or tablets and would simply sit and make all their notes, diagnoses, write prescriptions, order tests and submit them, all while the patient was right there with them. No need to dictate, no need for transcription. One visit to the EMR and that patients’ visit was recorded and signed off on. All wrapped up in a nice little bow.

I realize that this was one small region amongst the entire country but, it stands to reason that more and more physicians will find this is easier than having to take time after seeing a patient or at the end of the day, to dictate their notes and then follow up to see if they are done yet and what mistakes/blanks need to be corrected.

I know, you are thinking that I am talking about big networks. Certainly smaller networks or independent physicians will still need transcription done. For awhile, yes, they will. But Obamacare requires ALL medical records to be made electronic for sharing across networks and tracking patients. That means the smaller physician networks and the independent doctors too. It means that the outlook for medical transcription as a field does not have a bright future. In time, and not too long either, it will be gone all together.

Don’t even get me started on voice recognition taking the place of transcriptionists. Our level of technology is so far behind what would be needed for transcription to become strictly voice recognition, it isn’t even funny. The voice recognition system would have to be capable of distinguishing what the physician is meaning to say not what the words actually sound like. Many dictators flub up words and mumble or stammer and backup to correct themselves. It takes a thinking being to understand that he just re-stated the last part of the sentence and worded it differently. Voice recognition is in no way capable of taking over the job of a medical transcriptionist. Someone will always have to listen to the recording and read along with the voice recognized script and make corrections.

So, here I am at the end of my rant. After all that information, do you think medical transcription is something you want to invest your time and money into at this point? Would I recommend this as a career choice? No, I would not. Just in case you were in any doubt after reading this entire article. The good jobs are going to mt’s with years and years of experience. The newbies are stuck with having to slave themselves out to an agency that does most of its hiring from overseas so they won’t pay a decent living income. Why should they, they can get all the workers they need for a fraction of the cost from outside of the US. If you happen to have a line on a good transcription position, then it may possibly work out for you. Be prepared though for the future of electronic medical records.

Another ObamaCare Pipe Dream: Electronic Medical Records :: Independent Women’s Voice
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Medical Transcriptionists : Occupational Outlook Handbook : U.S. Bureau of Labor Statistics
Medical transcriptionists listen to voice recordings that physicians and other health professionals make and convert them into written reports. They interpret medical terminology and abbreviations in preparing patients’ medical histories, discharge s