Sunday, September 16, 2007

Medical Transcription as a career option

I have seen and read quite a few articles that have come up in various newspapers on Medical Transcription. An interesting factor I was able to notice from all those write-ups is that most of the authors have not actually had firsthand experience in the transcription industry. As a person who has been associated with this industry in India since its inception, I felt it is high time someone from the industry itself shed some light on its various aspects.

For beginners, medical transcription is a slightly complex process that requires a combination of common sense, an aptitude and a willingness to learn new things and being open to suggestions, and also requires a fair bit of education and training. A medical transcriptionist or medical language specialist is required to convert dictations made by medical professionals into formatted electronic patient records. Medical transcription has, over the years, evolved into a medical language specialty. Physicians increasingly rely on the reasoning ability and judgment of experienced medical transcriptionists to safeguard the accuracy and integrity of their dictations. Medical transcription today is among the most sophisticated of the allied health professions that create a vital partnership between healthcare providers and those who document patient care. The primary requirement for this job is a thorough knowledge of the English language, and excellent listening skills. America can be rightly referred to as a nation of Immigrants, with its huge immigrant workforce and the fact that most American families have foreign origins. So it will not be the archetypal 'Yankee' accent alone that a transcriptionist would be needed to tackle. Dictators can come from all nationalities, and that means that for you to decipher what some of them are saying, your listening skills and language should be exceptionally good. Many dictators are not particular about grammar, but the transcriptionist should be good enough to make corrections where necessary and make the report grammatically correct. It is imperative that you develop your medical understanding to become a professional medical transcriptionist. The complex terminology used in medicine is very different from the language used in any other profession. Medical transcription requires a practical knowledge of medical language, anatomy, physiology, disease processes, pharmacology, laboratory medicine, and the internal organization of medical reports. A medical transcriptionist must be aware of the requirements and standards that apply to health records, and also the legal significance and importance of medical transcripts. The medical reports can be any of the following, patient history and physical examinations, progress reports, consultations, discharge summaries, clinic notes, emergency room reports, operative reports, radiology reports, referral letters, pathology reports, etc. It can be any of the above or any other documentation connected with any of the more than 60 medical specialties and subspecialties. I think that should give you a fair idea on why the medical transcriptionist truly needs to be a medical language specialist, he should be thorough with the language of medicine.

In India, medical transcription training has over the years evolved as a business in itself. 2001 and 2002 were the worst years for the Indian medical transcription industry. Transcription companies and training centres mushroomed all over the place. Bangalore, Chennai, Hyderabad, and Coimbatore had a host of companies that promised small-time business aspirants work in return for an upfront payment of a few lakhs. A few others started giving 'consultancy' in return for a few more lakhs. Many of them did not even have the basic reference material or infrastructure. Many people tried to make a fast buck by charging fantastic amounts as fees for training programmes and consultancy, which would, to the horror of those who enrolled for it, later prove to be reprehensibly unprofessional. Even in a small city like Trivandrum, there were nearly 15 or so companies claiming to be doing medical transcription. It took a while for people to understand the fraud involved in such shoddy business practices. The industry went through a very bad phase with many such small timers creating a bad name for transcription from India. But thankfully, the last three years have seen a revival of the Indian medical transcription industry, with most of the small timers who indulged in fraudulent business practices being forced to close shop. A good medical transcription training programme will include:

Medical language, including Latin and Greek prefixes, suffixes, and roots.

Biological science, including anatomy and physiology of all body
systems and various disease processes.

Medical and surgical procedures, involving thousands of instruments,
supplies, appliances, and prosthetic devices.


Laboratory values, correlating laboratory test results with a
patient's diagnosis and treatment.

Use of medical reference materials and research techniques.

English punctuation and grammar.

Auditory skill development, helping the transcriptionist to try and
interpret sounds along with keyboarding.

Editing and proofreading skill development to ensure accuracy of his

Use of transcription equipment and computers.

Analytical skill development that will help the transcriptionist to
employ deductive reasoning to convert sounds into meaningful form

With only less than 10% of the available work in the United States being outsourced to other countries, this industry holds a massive potential for employment in the future. India, with its huge English-speaking educated manpower and a time difference of roughly 12 hours with most US cities, is poised to be the greatest beneficiary. Like in other fields of BPO, most of the major players in the Indian MT industry operate from the southern states of Karnataka, Andhra Pradesh, and Tamilnadu. An interesting statistic is that a huge percentage of staff working in large medical transcription companies across the country comprises Keralites. Unlike in the field of Call Centres, where Kerala is not considered by the larger companies as a major positive destination (mainly because they claim accent neutralization training is most difficult with candidates from Kerala as it is more difficult for the native Keralite to overcome his mother-tongue influence), medical transcription does not require spoken English language skills at all. So, it is definitely an irony that the Kerala does not have many major players working from there. For this only the state's peculiarly abject political situation where political protests of all kinds take precedent over anything else can be put to blame. In an industry that seeks to function 24 x 7, where one day can make you lose a contract, and where quality is of utmost importance, bandhs and the kind of uncouth forms of protests that can be seen in that state almost daily are a strict no-no. One understands that the Kerala Government is engaged in a major image-building exercise to attract more investment in the IT and ITES sector, and maybe in the future we might see some major players operating from that state too.

Medical transcription provides infinite intellectual challenge and a chance to make your own unique contribution in providing quality healthcare and service. Healthcare is among the fastest growing industries in the world, and the demand for quality documentation will only keep increasing. For the good transcriptionist, this profession provides a high level of job security, and with the advent of broadband and Internet connectivity becoming affordably accessible, he will see newer and newer avenues open before him. Medical transcription has truly become a portable skill that allows for professional and geographic mobility. Another great thing about this field is that age restrictions are almost never found. There has always been and there will always be great value placed on the experience and knowledge of a seasoned transcriptionist. It is a wonderful career option that can be lifelong and greatly satisfying to anyone who is prepared to face the constant challenges offered by an expanding and advancing technology. So if you are confident and believe that you have qualities mentioned above, it is definitely the right time to take the plunge, but make sure that you are not taken for a ride by a fraudulent training centre. Enquire about the authenticity of the course offered. If the course is affiliated to or directly connected with reputed hospitals or successfully running medical transcription companies, it adds more credibility. Most training centres charge between Rs. 10,000 and 20,000 for a course that can last anywhere between 4 and 6 months. Make sure that you enquire about the credentials of the people involved. If the training is given by a company that claims to be doing live transcription work, ask your friends and acquaintances and make a thorough enquiry about how the company has been functioning, whether they have been regular in paying their staff, and whether they have a history of fraud. Please understand that once you identify a good training centre and get trained properly, it is most definitely worth every penny you spend as training fees. NASSCOM projects the Healthcare Business Process Outsourcing industry in India to be worth $4.2 billion by 2008, offering employment to nearly 200,000 people. So, clearly medical transcription is here to stay, and it is up to you to decide whether to be a part of this industry with infinite potential and possibilities.