Since I have made the transition from the teaching career to the field of medical transcription, many people have asked me about this occupation. Several have been interested themselves about potentially entering this field, with the main advantage of being able to work from home. Others have questioned the viability of the industry as a growing trend seems to be outsourcing the work to other countries or even the doctors using speech recognition software themselves to complete the reports.
After composing my thoughts on some of the questions I have
been asked and the interest different people have shown in this job, I decided
to create this blog post in a question and answer format to give an overview of
my perspective and experience in the medical transcription field.
How did you make the decision to switch from teaching to
transcription?
The original idea came to me from a former student's mom who
was just starting on this career path herself.
At the time, I had been considering a career change from my teaching
position but wasn't exactly sure which path I would take. I had always wanted to be a teacher, and my
fifth grade teaching position in a small Catholic school was the ideal position
for me when I first started. I truly
feel teaching was my vocation at that point in my life. However, I knew we wanted to start a family,
and the idea of working from home was very appealing, and after extensive
research to find out more what this position would entail, I found it to be
something I would be potentially interested in.
Did you take any classes or training before starting this
position?
I researched online, looking for online classes I could take
while still teaching (and planning our wedding at the time). I wanted to be sure before I decided not to
sign my teaching contract that this change in careers would be a good fit for
me, both financially and as something I would enjoy doing. I came across a well-respected and recognized
online school specializing in medical transcription, The Andrews School, which
was designed to be a self-paced program you could start any time. It took me about 9 months to complete the
course. The coursework consisted of
medical terminology and medical abbreviations, formatting of medical reports, a
grammar component, along with actual dictations that were transcribed as practice
reports. At the completion of the
coursework, I utilized an extensive list from the Andrews School
of potential companies to apply to in hopes of being accepted for a
position.
Which company do you work for?
I accepted a position with Alpha Transcription based out of Ohio. This company has government contracts with
the VA Hospitals across the country.
They seem to be rapidly expanding and continually acquiring more
accounts. I was hired as an independent
contractor, which means I have a self-employed status versus being hired as an
employee, which other companies do. As
an independent contractor, I have complete flexibility in my schedule, being
able to log on and work when I want.
Companies that hire on an employee status will typically require a
stricter schedule that must be followed.
How is the pay determined?
This industry offers production-based pay. We are paid based on the number of characters
in the reports that are submitted.
Therefore, the more productive you become, the more you can earn. Since I have started, I have greatly
increased the amount of reports I am able to complete, so now I only work an
average of about 20 hours per week.
How would you describe your typical day?
I like to start early.
I usually try to get logged on by 5:30 in the morning so I can get at
least a good hour in before Eli wakes up for the day. On Mondays and Wednesdays when he is at
daycare, I do more typing so I have less to do on Tuesdays and Thursdays when
he is with me all day. On those days, I
can usually get some typing done before he wakes up in the morning and then
finish during his afternoon nap. My mom
still comes on Fridays, so she is able to watch him during the day so I can
finish up my typing for the week while she is there.
How do you receive the dictations?
The dictations come through the company's software platform
that is installed on my computer. There is a foot pedal that is used to play the
dictation. I also use a word expander
program that has allowed me to become much more productive. When I first started, all of the jobs that
came through were straight transcription, meaning a blank document came up and
they were all typed beginning to end.
Now, only about 10% of the jobs that come through are straight
transcription while 90% of them come through the speech editor, which uses
speech recognition software as the doctor is dictating to create the
report. When it comes through on my end,
the report itself comes up and needs to be edited instead of entirely
typed. Some reports need a lot of
corrections while others need only a few; it depends on how clearly the doctor
speaks and whether they have a heavy accent or not. The speech editor does not pick up on
grammatically correct usage of words either, so that needs to be watched for
along with any medical discrepancies, such as medication dosages and the format
of the report so it includes the correct headings, numbering, etc. The company I work for has many accounts, and
each of those is made up of a different group of VA Hospitals. The account specifics vary from one to the
next, which means there is quite a learning curve when first starting to keep
all the rules straight for each facility that must be followed. Even particular doctors within a certain
hospital may want their reports formatted a different way.
What about all those foreign doctors?
The ESL doctors make up about 40% of the reports I do, while
the rest are native English speakers, even though some of those are hard to
understand too since they insist on mumbling, dictating where there is a ton of
background noise, or garble words together.
As for the doctors with the thick accents, it takes a lot of time and
practice to get used to them, but I have found they are usually repetitive in
their style and use a lot of the same phrases over and over again, making it
easier to decipher. I am always amazed at
their ability to not only learn a second language but then to learn all the
medical terms and procedures in that new language as well.
What types of reports do you transcribe?
I type a variety of reports.
These include regular doctors' visits/progress notes, consultations,
hospital discharge summaries, operative reports, pathology, and radiology
reports. All the patients are veterans,
mostly of retirement age and older, since the accounts I work on are all part
of the VA Hospitals.
What happens if you can't understand what they are saying?
This happens at times, although not as often as when I first
started. If I just cannot figure out a
word or phrase that is being said, I use a "blank" symbol in that
spot in the report. These symbols vary
by facility but usually consist of 3 symbols used together like @@@. Then, this report is sent to QA so they can
take a second look at it to try to determine the unknown word before it gets
sent back to the doctor. When first
starting, they require 100% of reports go to QA until they decide you can be
released once the quality of the reports meets their expectations. I can also look back at reports that have
gone through QA to learn what the missing word was, but sometimes they can't
figure it out either. I also use context
clues within the report to try to determine what they are saying.
What about outsourcing transcription jobs overseas?
It seems this is a growing trend in this industry since it
is a cost saving measure for the companies to do this. The company I work for, however, is required by
the government to hire only US citizens in the continental United States.
With the use of speech recognition software, are doctors
going to be editing the reports themselves?
Some hospitals have implemented software that allows the
doctors themselves to input patient data, such as vital signs, medications,
diagnoses, etc. There is always a
narrative component to a medical record as well, which is dictated and must be
edited. Many doctors are resistant to
having to edit this portion of the report themselves since it takes a lot of
their time and cuts back on the time they are able to see more patients. Plus, it would take much more advanced
technology to be able to allow for the strong accents of the ESL doctors in
order to be used accurately.
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