Career Guide for Medical Transcriptionists

Medical transcriptionists listen to recordings from healthcare professional and transcribe them into reports and correspondence. A medical transcriptionist is trained to understand medical terms and concepts so the recordings can be edited for grammar and be medically correct before being returned to a physician for signature and placement into a patient’s file.

In this free career guide, you will learn how to become a successful medical transcriptionist.

Medical Transcriptionist Summary

• Job opportunities will be good, especially for those who are certified.
• Employers prefer medical transcriptionists who have completed a postsecondary training program.
• Many medical transcriptionists telecommute from home-based offices.
• About 36 percent worked in hospitals, and another 23 percent worked in offices of physicians.

Working as a Medical Transcriptionist

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, medical 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, 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 and to the legal and ethical requirements for 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 use either digital or analog dictating equipment to transmit dictation to medical transcriptionists. 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. Also, because of the popularity of using the Internet to transmit documentation, many medical transcription departments are beginning to work closely with programmers and information systems staff to stream in voice communication that provides seamless data transfers through network interfaces. This practice allows medical transcriptionists the convenience of having hand-held personal computers or personal data assistants (PDAs) that utilize software for dictation.

Another increasingly popular method uses speech recognition technology, which electronically translates sound into text and creates drafts of reports. Transcriptionists then format the reports; edit them for mistakes in translation, punctuation, or grammar; and check for consistency and any wording that doesn’t make sense medically. Transcriptionists working in specialties such as radiology or pathology, which have standardized terminology, are more likely to use speech recognition technology, a medium that will become more widespread in all specialties as it becomes more sophisticated and is better able to recognize and more accurately transcribe diverse modes of speech.

Medical transcriptionists who work in physicians’ offices 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, also may perform transcription as part of their jobs.

Work environment. 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 their own homes. Many medical transcriptionists telecommute from home-based offices.

Workers usually sit in the same position for long periods. They can suffer wrist, back, neck, or eye problems caused by strain and risk repetitive motion injuries such as carpal tunnel syndrome. The constant 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, and weekends. Some may be on call at any time.

Training, Other Qualifications, and Advancement

Postsecondary training in medical transcription is preferred by employers; writing and computer skills also are important.

Education and training. 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’s 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 from previous experience as a nurse or medical secretary, become proficient through refresher courses and training.

Formal accreditation is not required for medical transcription programs. However, the Approval Committee for Certificate Programs (ACCP)—established by the Association for Healthcare Documentation Integrity (AHDI) and the American Health Information Management Association—offers voluntary accreditation for medical transcription programs. Although voluntary, the completion of an ACCP-approved program may be required for transcriptionists seeking certification.

Certification and other qualifications. The AHDI awards two voluntary designations: Registered Medical Transcriptionist (RMT) and Certified Medical Transcriptionist (CMT). Medical transcriptionists who are recent graduates of medical transcription educational programs or who have fewer than 2 years’ experience in acute care may become a registered RMT. The credential is awarded upon successfully passing the AHDI level-1 registered medical transcription exam. The CMT designation requires at least 2 years of acute care experience using different format, report, and dictation types in multiple-specialty surgery areas. Candidates also must earn a passing score on a certification examination. Because medicine is constantly evolving, medical transcriptionists are encouraged to update their skills regularly. In order to be recertified, RMTs and CMTs must pay a recertification fee. In addition to the fee, RMTs must earn a minimum of 30 continuing education credits in required categories during their 3-year cycle. CMTs must successfully complete an online course and final exam during the 3-year cycle. As in many other fields, certification is recognized as a sign of competence.

Graduates of an ACCP-approved program who earn the RMT credential are eligible to participate in the Registered Apprenticeship Program sponsored by the Medical Transcription Industry Association through the U.S. Department of Labor. The program offers structured on-the-job learning and related technical instruction for qualified medical transcriptionists entering the profession.

In addition to understanding medical terminology, transcriptionists must have good English grammar and punctuation skills and proficiency with personal computers and word-processing software. Normal hearing acuity and good listening skills also are necessary. Employers usually require applicants to take preemployment tests.

Advancement. With experience, medical transcriptionists can advance to supervisory positions, home-based work, editing, consulting, or teaching. Some become owners of medical transcription businesses. With additional education or training, some become medical records and health information technicians, medical coders, or medical records and health information administrators.

Employment as a Medical Transcriptionist

Medical transcriptionists held about 105,200 jobs in 2008. About 36 percent worked in hospitals and another 23 percent worked in offices of physicians. Others worked for business support services; medical and diagnostic laboratories; outpatient care centers; offices of physical, occupational, and speech therapists; and offices of audiologists.

Job Outlook

Employment of medical transcriptionists is projected to grow about as fast as the average; job opportunities should be good, especially for those who are certified.

Employment change. Employment of medical transcriptionists is projected to grow by 11 percent from 2008 to 2018, about as fast as the average for all occupations. Demand for medical transcription services will continue to be spurred by a growing and aging population. Older age groups receive proportionally 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 shared easily among providers, third-party payers, regulators, consumers, and health information systems. Growing numbers of medical transcriptionists will be needed to amend patients’ records, edit documents from speech recognition systems, and identify discrepancies in medical reports.

Contracting out transcription work overseas and advancements in speech recognition technology are not expected to significantly reduce the need for well-trained medical transcriptionists. Outsourcing transcription work abroad—to countries such as India, Pakistan, Philippines, Barbados, and Canada—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 only to supplement the demand for well-trained domestic medical transcriptionists. In addition, reports transcribed by overseas medical transcription services usually require editing for accuracy by domestic medical transcriptionists before they meet U.S. quality standards.

Speech recognition technology allows physicians and other health professionals to dictate medical reports to a computer, which immediately creates an electronic document. In spite of the advances in this technology, the software has been slow to grasp and analyze the human voice, the English language, and the medical vernacular 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 to create a final document.

Job prospects. Job opportunities will be good, especially for those who are certified. Hospitals will continue to employ a large percentage of medical transcriptionists, but job growth will be in other industries. An increasing demand for standardized records should result in rapid employment growth in physicians’ offices, especially in large group practices.

Projections Data

Projections data from the National Employment Matrix

Occupational Title	SOC Code	Employment, 2008	Projected Employment, 2018	Change, 2008-18
				Number	Percent
Medical transcriptionists	31-9094	105,200	116,900	11,700	11
NOTE: Data in this table are rounded.

Earnings for Medical Transcriptionists

Wage-and-salary medical transcriptionists had median hourly wages of $15.41 in May 2008. The middle 50 percent earned between $13.02 and $18.55. The lowest 10 percent earned less than $10.76, and the highest 10 percent earned more than $21.81. Median hourly wages in the industries employing the largest numbers of medical transcriptionists were as follows:

Compensation arrangements for medical transcriptionists vary. Some are paid on the basis of the number of hours they work or 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 do transcriptionists who work for others, but independent contractors have higher expenses than their corporate counterparts, receive no benefits, and may face a higher risk of termination than do wage-and-salary transcriptionists.