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Medical Transcriptionists
Nature of the Work
Medical transcriptionists listen to dictated recordings made by physicians and other healthcare 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 healthcare 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 healthcare 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 emerging trend is the implementation of 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 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 and clinics 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, may also 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.

Working Conditions
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 at home. 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, and workers can suffer wrist, back, neck, or eye problems due to strain and risk repetitive motion injuries such as carpal tunnel syndrome. The 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.

Medical transcriptionists held about 101,000 jobs in 2002. 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, offices of other health practitioners, medical and diagnostic laboratories, outpatient care centers, and home healthcare services.

Training, Other Qualifications, and Advancement
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 healthcare 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 due to previous experience as a nurse or medical secretary, become proficient through on-the-job training.

The American Association for Medical Transcription (AAMT) awards the voluntary designation, Certified Medical Transcriptionist (CMT), to those who earn passing scores on written and practical examinations. As in many other fields, certification is recognized as a sign of competence. Because medical terminology is constantly evolving, medical transcriptionists are encouraged to regularly update their skills. 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 often require applicants to take pre-employment tests.

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.

Job Outlook
Job opportunities will be good. Employment of medical transcriptionists is projected to grow faster than the average for all occupations through 2012. 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 be easily shared among providers, third-party payers, regulators, and consumers. Growing numbers of medical transcriptionists will be needed to amend patients' records, edit for grammar, and identify discrepancies in medical records.

Contracting out transcription work overseas and advancements in speech recognition technology are not expected to significantly reduce the need for well-trained medical transcriptionists domestically. Contracting out transcription work abroad -- to countries such as India -- 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 to supplement the demand for well-trained domestic medical transcriptionists. 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, it has been difficult for the software to grasp and analyze the human voice and the English language 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 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. Increasing demand for standardized records should result in rapid employment growth in offices of physicians or other health practitioners, especially in large group practices.

Medical transcriptionists had median hourly earnings of $13.05 in 2002. The middle 50 percent earned between $10.87 and $15.63. The lowest 10 percent earned less than $9.27, and the highest 10 percent earned more than $17.97. Median hourly earnings in the industries employing the largest numbers of medical transcriptionists in 2002 were as follows:

General medical and surgical hospitals
Offices of physicians
Business support services

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 transcriptionists who work for others but have higher expenses than their corporate counterparts, receive no benefits, and may face higher risk of termination than employed transcriptionists.

Related Occupations
A number of other workers type, record information, and process paperwork. Among these are Court reporters; human resources assistants, except payroll and timekeeping; receptionists and information clerks; and secretaries and administrative assistants. Other workers who provide medical support include medical assistants and medical records and health information technicians.

The above artilce was from the Bureau of Labor Statistics.


Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2004-05 Edition, Medical Transcriptionists, on the Internet at (visited May 10, 2004).
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