What do you do for a living?

I currently own MT Desk, a reference and style guide for medical transcriptionists. I also have a blog, MT Exchange, about medical transcription and the medical transcription industry. I have been a medical transcriptionist and medical transcription service owner for over 20 years but now work full time on MT Desk.

Since the focus of this interview is on medical transcription, I’ll describe what I did when I worked full time as a medical transcriptionist.

How would you describe what you do?

I listen to doctors all day! Every time a patient is seen by a doctor for any reason, the doctor has to detail what took place. Over 50% of physicians in America do that by dictating into a recorder. A medical transcriptionist listens to the dictation and transcribes it to a written (now electronic) document that is then sent back to the doctor’s office, clinic or hospital for placement in the patient’s medical records.

What does your work entail?

I have primarily worked independently, transcribing for local doctors. Before digital dictation, I would go to the doctor’s office, pick up the tape recorded dictation, take it home and transcribe it, then print the reports and deliver them back to the office the next day – when more tapes were available for me to pick up. When digital dictation became possible, I no longer had to go to the doctor’s office and files were transferred securely to the office. Boy, was that a step forward! A lot of time is lost when you have to drive around to pick up and deliver work, time when you can’t be transcribing. Many times, it isn’t even an issue that you don’t get paid if you aren’t transcribing; there was so much work that had to be done and returned within very strict time parameters that spending an hour driving around could translate into staying up late and working to get it all done. Almost all medical transcription is paid on a production basis; i.e., per character, line, page, or minutes of dictation. If a transcriptionist isn’t producing, s/he isn’t getting paid.

What’s a typical work week like?

When I worked on my own accounts, a typical week would be getting the work as early as possible so I could start transcribing. Depending on how much work didn’t get done the day before, I might start as early as 6 a.m. so I could get a start on it before I had to stop and get my children to school. I would then spend the day transcribing as much as I could, as fast as I could. I’d take a break when my children came home, then work some more after they went to bed. That was a typical weekday. Weekends, I would spend catching up – getting the dictation from Friday done and clearing up anything else that was leftover. For many years, I transcribed radiology reports for a local hospital, covering weekends. I’d pick up the dictation after the radiologists were done on Saturday, then work all night to get it transcribed because radiology reports have an overnight turnaround requirement. I’d take the completed reports back to the hospital on Sunday morning, then go back Sunday night and pick up more to be done and delivered back on Monday morning. I preferred transcribing for clinics – they close for the weekends! Doing hospital transcription is more stressful because there are no breaks – there are patients in the hospital 24/7 and doctors seeing them and doing dictation 24/7.

How did you get started?

Funny you should ask! I’d been a secretary since I graduated from high school. After I married and had my first child, I worked a few jobs but child care seemed to always be an issue and I wanted to do something from home. I started transcribing for local insurance companies, attorneys and investigators, doing general transcription. Because a lot of the insurance reports included medical language, I decided to take a medical terminology class so I wouldn’t have to look those words up all the time. I realized while I was taking that class that the flow of work from the medical community was much more voluminous and steady than general transcription. When I finished, I got a part-time job as a medical transcriptionist at a very small local hospital, where I received some excellent training from an experienced transcriptionist. I also started contracting work from the service that did the overflow work for the hospital. Eventually, the hospital closed and I worked full time for the service, as they had other accounts. A few years later, I started to get my own contracts.

What do you like about what you do?

I had the good fortune to work during what I think are the best years of medical transcription. I was able to work from home and as long as the work was done on time, my schedule was flexible. I didn’t have to clock in or out or tell anyone that I wouldn’t be working for a couple of hours.

What do you dislike?

When you work at home, you never leave the office. There were many times I thought I would have worked fewer hours if I’d just found a 40-hour-a-week job. My schedule was flexible, but I still had to get the work done. I didn’t get paid if I didn’t work and the work didn’t get done if I wasn’t there to do it. When I had my own clients, it was a struggle to make arrangements to take even one day off; if I did, I’d end up working twice as hard for a couple of days or through the weekend to make up for it. Taking an entire week off was unthinkable.

How do you make money/or how are you compensated?

Most medical transcriptionist who work in-house at a clinic or hospital still get paid hourly with minimum production requirements. However, those jobs are few and far between any more. The majority of medical transcriptionists are paid by the line or character produced – and that’s the final product, not actual keystrokes. If you type a sentence and the doctor changes his or her mind and asks you to delete it, you don’t get paid for typing that sentence.

How much money do you make?

An experienced full-time medical transcriptionist can make as much as $20 an hour. A new transcriptionist just breaking in will be lucky to make minimum wage. Since the job pays on production, the faster you can produce, the more you will make. Being very familiar with medical terminology and clinical records, as well as fast keyboarding skills and productivity-enhancing software tools will help. Inexperienced transcriptionists are slow because they’re unfamiliar with the dictators and the terminology. It also depends on the quality of the recording and the quality of the dictator; doctors with accents can be very challenging and deeply impact a transcriptionist’s productivity. When I had my own accounts and nobody working for me, I could make between $25 and $35 per hour. Most medical transcriptionists working for another transcription service can expect to make between $9 an hour up to about $18 an hour.

How much money do you make starting out?

My first job at the hospital paid minimum wage; at that time, it was somewhere around $7 an hour. I only got the job because I was the fastest typist who applied. If I’d been paid by the line, as many medical transcriptionists are today, I calculated I would’ve made around $3 an hour at the rate being paid per line at that time! I transcribed for over a year before I felt competent and it took a couple more years before every new dictator didn’t throw my production off.

What education or skills are needed to do this?

When I started over 24 years ago, there weren’t many formal programs. Like many others, I took medical terminology classes at the local vo-tech, then got on-the-job training. That scenario would be a real exception in today’s medical transcription job market. It would be extremely difficult for someone to get a job unless they complete one of the top formal medical transcription education programs. Even then, many graduates cannot get hired because most employers want people with experience. I hear from many, many people who complete programs from lesser-known schools and still haven’t been able to get hired after years of trying. Medical transcription is a very difficult field to break into.

Fast and accurate typing is essential. A transcriptionist has to have a good ear – doctors are usually in a hurry, frequently dictating in noisy hospitals, emergency rooms, clinics, while eating, talking and otherwise doing things that make it difficult to understand what they’re saying. A transcriptionist is supposed to be able to hear through all that and figure out what the doctor is saying and interpret what the doctor means to say. The job requires knowing enough about anatomy, physiology, pharmaceuticals, diagnostic studies and laboratory values to know whether or not the dictation is accurate.

What is most challenging about what you do?

For me, the most challenging was doctors who are terrible dictators. I met with one prospective client and thought the guy would be a dream to transcribe for – he had a great voice and was very articulate. However, something happened when he turned on a recorder and he became Elmer Fudd. Another challenging dictator was a Chinese acupuncturist. His accent was very difficult to decipher and my production dropped to half. I finally had to drop the client altogether because I just couldn’t make any money.

What is most rewarding?

I made very good money for many years while being able to work from home. I’d like to say I felt like I was contributing to patient care, but that was really not my motivator – I work for money and not much else.

What advice would you offer someone considering this career?

Pick your school carefully or you may find you’ve spent a lot of time and money on an education and you can’t get a job. Understand that you won’t make much money to start. Make sure you get your information from a reputable source. There are many medical transcription schools with affiliate programs and websites promoting them to get their affiliate fee. They don’t care whether or not the school is a good one or whether or not you can get a job when you graduate from that school. I am, of course, going to say that the information you’ll get from MT Desk is reliable and honest. There are also many medical transcription groups at Facebook and LinkedIn and I highly recommend networking with experienced transcriptionists to find out where they went to school, how helpful the school was in placing them in a job, how long it took them to get a job and how much they’re making.

How much time off do you get/take?

What’s time off? As an independent contractor, I haven’t had a paid day off in over 20 years. Most medical transcription jobs have some paid time off, but not much. I have never worked for a transcription service as an employee, so I don’t know what’s currently being offered; don’t expect two weeks of paid time off. Medical transcription is a 24/7 business and most employees are required to work at least one weekend day, as well as holidays, without any differential in pay.

What is a common misconception people have about what you do?

That we just type what we hear and what’s so hard about that?

What are your goals/dreams for the future?

My goal is to continue to build MT Desk into the #1 reference and resource for medical transcriptionists.

What else would you like people to know about what you do?

I have to be honest – I don’t recommend medical transcription as a career any longer. Someone just starting will spend 12 to 24 months and $3,000 or more on school and still not be able to get a job. When they do get a job, they will make minimum wage or less and no company will pay the difference. If there’s no work available, the computer or internet connection goes down, or any number of other factors that prevent a transcriptionist from working, there is no pay for the down time. The pay rates have been stagnant for the last 12 years. Electronic medical records and speech recognition are impacting the amount of dictation being done and transcribed. There are many experienced medical transcriptionists who can’t get jobs or the jobs they have don’t have enough work available to allow them to make full-time equivalent pay. However, it remains one of the few legitimate jobs that can be done from home. If a person MUST work from home because of health reasons, locale or family reasons, it’s still probably the best work-at-home job option.