Medical Transcriptionists

Summary

What Medical Transcriptionists Do About this section

Medical transcriptionists review medical reports for accuracy.

Medical transcriptionists, sometimes referred to as healthcare documentation specialists, listen to voice recordings that physicians and other healthcare workers make and convert them into written reports. They also may review and edit medical documents created using speech recognition technology. Transcriptionists interpret medical terminology and abbreviations in preparing patients’ medical histories, discharge summaries, and other documents.

Duties

Medical transcriptionists typically do the following:

• Listen to the recorded dictation of a doctor or other healthcare worker
• Interpret and transcribe the dictation into patient history, exam notes, operative reports, referral letters, discharge summaries, and other documents
• Review and edit drafts prepared by speech recognition software, making sure that the transcription is correct, complete, and consistent in style
• Translate medical abbreviations and jargon into the appropriate long form
• Identify inconsistencies, errors, and missing information within a report that could compromise patient care
• Follow up with the healthcare provider to ensure that reports are accurate
• Submit health records for physicians to approve
• Follow patient confidentiality guidelines and legal documentation requirements
• Enter medical reports into electronic health records (EHR) systems
• Perform quality improvement audits

Traditionally, medical transcriptionists used audio playback equipment to listen to an entire dictation in order to produce a transcribed report, and some transcription is still done this way. It has become more common for medical documents to be prepared using speech recognition technology, in which specialized software automatically prepares an initial draft of a report. The transcriptionist then listens to the voice file and reviews the draft for accuracy, identifying any errors and editing the report, when necessary. Transcriptionists use word-processing and other specialized software to prepare the transcripts, as well as medical reference materials when needed.

Medical transcriptionists must be familiar with medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and treatment assessments. Their ability to understand what the healthcare worker has recorded, correctly transcribe that information, and identify any inaccuracies in the transcript is critical to reducing the chance that patients will get ineffective or even harmful treatments. Medical transcriptionists also may need to be familiar with EHR systems.

Medical transcriptionists who work in doctors’ offices may have other duties, such as answering phones and greeting patients.

Work Environment About this section

Medical transcriptions must understand what the healthcare worker has recorded and correctly transcribe that information.

Administrative and support services includes companies that provide transcription services.

Medical transcriptionists may work from home, receiving dictation and submitting drafts electronically.

Work Schedules

Most medical transcriptionists work full time. Medical transcriptionists who work from home may work outside typical business hours and/or may have some flexibility in determining their schedules. Their work can be stressful because they need to ensure that reports are accurate within a quick turnaround time.

How to Become a Medical Transcriptionist About this section

Transcriptionists listen to dictated recordings made by physicians and other healthcare professionals and transcribe them into medical reports, correspondence, and other administrative material.

Medical transcriptionists typically need postsecondary education. Some choose to become certified.

Education

Employers prefer to hire transcriptionists who have completed postsecondary education in medical transcription, which is offered by vocational schools, community colleges, and distance-learning programs. Medical transcription programs are typically 1-year certificate programs, although there are also associate’s degree programs.

Programs normally include coursework in anatomy, medical terminology, risk management, legal issues relating to healthcare documentation, and English grammar and punctuation. Many of these programs include supervised on-the-job experience. Some transcriptionists, especially those already familiar with medical terminology from previous experience as a nursing assistant or medical secretary, become proficient through refresher courses and training.

Licenses, Certifications, and Registrations

Although certification is not required, some medical transcriptionists choose to become certified. The Association for Healthcare Documentation Integrity offers the Registered Healthcare Documentation Specialist (RHDS) and the Certified Healthcare Documentation Specialist (CHDS) certifications. Both certifications require passing an exam and periodic retesting or continuing education.

The RHDS certification, formerly known as the Registered Medical Transcriptionist (RMT), is for recent graduates with less than 2 years of experience and who work in a single specialty environment, such as a clinic or a doctor’s office.

The CHDS certification, formerly known as the Certified Medical Transcriptionist (CMT), is for transcriptionists who hold the RHDS designation. In addition, CHDS candidates must have at least 2 years of acute care experience, including experience handling dictation in various medical specialties.

To maintain certification, medical transcriptionists must complete continuing education requirements every 3 years.

Important Qualities

Computer skills. Medical transcriptionists must be comfortable using computers and word-processing software, because those tools are an essential part of their jobs. They also may need to know how to operate electronic health records (EHR) systems.

Critical-thinking skills. Medical transcriptionists must assess medical reports and spot any inaccuracies and inconsistencies in finished drafts. They must also think critically when doing research to find the information that they need and to ensure that sources are both accurate and reliable.

Listening skills. Medical transcriptionists must listen carefully to dictation from physicians. They need to hear and interpret the intended meaning of the medical report.

Time-management skills. Because dictation must be done quickly, medical transcriptionists should be comfortable working under short deadlines.

Writing skills. Medical transcriptionists need a good understanding of the English language and grammar.

Pay About this section

Some medical transcriptionists are paid based on the volume of transcription they produce. Others are paid an hourly rate or an annual salary.

Most medical transcriptionists work full time. Medical transcriptionists who work from home may work outside typical business hours and/or have some flexibility in determining their schedules. Their work can be stressful because they need to ensure that reports are accurate within a quick turnaround time. 

Job Outlook About this section

Overall employment of medical transcriptionists is projected to grow $pc.toString().replaceAll("^\-","") percent from 2020 to 2030, $gra.

About $tools.number.format('#,###',$op) openings for medical transcriptionists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force, such as to retire.

Employment

Employment of medical transcriptionists is projected to decline 3 percent from 2018 to 2028. Technological advances have changed the way medical transcription is done. Speech recognition and electronic health records (EHR) software advances often allow physicians to create some of this documentation in the moment, reducing the need for transcriptionists.

The aging population and growing rates of chronic conditions will continue to increase demand for healthcare services. This will result in a growing number of medical tests and procedures, all of which will require transcription. However, technological advances, such as speech recognition software, allow transcriptions to be prepared by fewer medical transcriptionists. 

As healthcare providers seek to cut costs, some will contract out transcription services and not do transcription in-house. Some of this work may be outsourced to other countries, which would reduce domestic employment.

State & Area Data About this section

Occupational Employment and Wage Statistics (OEWS)

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Projections Central

Occupational employment projections are developed for all states by Labor Market Information (LMI) or individual state Employment Projections offices. All state projections data are available at www.projectionscentral.com. Information on this site allows projected employment growth for an occupation to be compared among states or to be compared within one state. In addition, states may produce projections for areas; there are links to each state’s websites where these data may be retrieved.

CareerOneStop

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Contacts for More Information About this section

For more information about medical transcriptionists and for a list of accredited medical transcription programs, visit

Association for Healthcare Documentation Integrity