Medical Transcriptionists

Medical transcriptionists, also called medical transcribers and medical stenographers, listen to dictated  recordings made by physicians and other healthcare professionals and transcribe them into medical reports,  correspondence, and other administrative material. 

Employment of medical transcriptionists is projected to grow faster than the average for all occupations through  2010.

Additional Information | Earnings | Employment | Job Outlook | Nature of the Work | Related Occupations | Significant Points | Training & Advancement | Working Conditions

Significant Points

* Employers prefer medical transcriptionists who have completed a vocational school or community college program.

* Employment is projected to grow faster than average due to increasing demand for medical 
transcription services.

* Some medical transcriptionists enjoy the flexibility of working at home, especially those with 
previous experience in a hospital or clinic setting.

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Nature of the Work

Medical transcriptionists, also called medical transcribers and medical stenographers, 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 special 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, operating room reports, consultation reports, autopsy reports, diagnostic imaging studies, and referral letters. Medical transcriptionists return transcribed documents to 
the dictator 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, and treatment. 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 records confidential.

Experienced transcriptionists spot mistakes or inconsistencies in a medical report and check back with the dictator 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. With the emergence of the Internet, some transcriptionists receive dictation over the Internet and are able to quickly return transcribed documents to clients for approval. As confidentiality concerns are resolved, this practice will become more prevalent. 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 specialized areas with more standard 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 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.

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Working Conditions

The majority of these workers are employed in comfortable settings, such as hospitals, physicians' offices, clinics, laboratories, medical libraries, government medical facilities, or at home. An increasing number of 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 few hazards, although sitting in the same position for long periods can be tiring, 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 fast 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 an on-call basis.

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Medical transcriptionists held about 102,000 jobs in 2000. About 2 out of 5 worked in hospitals and about another 2 out of 5 in physicians' offices and clinics. Others worked for laboratories, colleges and universities, transcription services, and temporary help agencies.

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Training 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, medicolegal issues, 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 familiarity 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, 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.

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Job Outlook

Employment of medical transcriptionists is projected to grow faster than the average for all occupations through 2010. 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 discover discrepancies in medical records.

Advancements in speech recognition technology are not projected to significantly reduce the need for medical transcriptionists because these workers will continue to be needed to review and edit drafts for accuracy. 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. 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 will not be as fast as in other areas. Increasing demand for standardized records in offices and clinics of physicians should result in rapid employment growth, especially in large group practices. Job opportunities should be the best for those who earn an associate degree or certification from the American Association for Medical Transcription.

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Medical transcriptionists had median hourly earnings of $12.15 in 2000. The middle 50 percent earned between $10.07 and $14.41. The lowest 10 percent earned less than $8.66, and the highest 10 percent earned more than $16.70. Median hourly earnings in the industries employing the largest numbers of medical transcriptionists in 2000 were as follows:

Offices and clinics of medical doctors $12.25
Hospitals 12.14
Mailing, reproduction, and stenographic services 11.47

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. Large hospitals and healthcare organizations usually prefer to pay for the time an employee works. Independent contractors and employees of transcription services almost always receive production-based pay.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 and the most 
experienced transcriptionists had median hourly earnings of $13.00. Earnings were highest in organizations employing 1,000 or more workers. Transcriptionists receiving production-based pay earned about 7 to 8.5 cents per Standardized Line (based on a 65-character line, counting all keystrokes). However, independent contractors-who have higher expenses than their corporate counterparts, receive no benefits, and face higher risk of termination than employed transcriptionists-typically charge about 12 to 13 cents per Standardized Line.

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Related Occupations

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

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Additional Information

For information on a career as a medical transcriptionist, send a self-addressed, stamped envelope to:

* American Association for Medical Transcription, 3460 Oakdale Rd., Suite M, Modesto, CA 95355-9690. Internet:

State employment service offices can provide information about job openings for medical transcriptionists.

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