Medical transcription as a career

By Taru Bahl

TRANSCRIPTION, as defined by the dictionary, is an exact copy or reproduction in written, typewritten or printed form. Recorded proceedings and minutes of conferences, board and annual general meetings are transcribed by secretaries or by professional transcribers who listen to the audio cassettes and translate the spoken matter onto reams of paper to facilitate documentation and report making. The charges could range between Rs 400 to Rs 750 for a 90-minute cassette. Medical transcription however is different, in that it is more specialised and therefore more lucrative.

The medical profession in the USA is heavily governed by legal and procedural formalities.Every registered doctor has to maintain his patients’ records systematically and chronologically. Indian hospitals and doctors on the other hand are notorious for their disorganised paper work. Old patients’ records, even if documented, are not easily located.

Forget computerisation and information technology which ensures data at the press of a button, most doctors cannot find updates on their patient’s history, even when it is they who maintain their registers and files. Patients have to lug their reports and cards, even if they have been seeing the same doctor all their lives. There are stray exceptions, especially in the fancy ‘five star’ hospitals and private clinics, where doctors make an extra effort at being organised and efficient.

In the USA, a medical report is a vital document which enables the doctor to claim his fees fairly and squarely. Almost evey body has a medical insurance and no company gives reimbursement unless the medical record is authentic and satisfactorily complete. For which reason there is enormous pressure on the medical community to first create an exhaustive database on each of their patients.

The doctor does this by dictating his diagnosis, observations, recommended medication etc directly into a telephone. This is connected to a computer which digitally records the information and then beams it, via a communication satellite.The dictated matter is received, via satellite, by a team of transcribers who have a command over language, grammar and written skills. They are familiar with medical terminology and up-to-date with developments in the medical field, at least the area in which they are transcribing.

Once transcribed, the reports are bounced back to the client nation, via satellite links, where it is formatted in the form of reports or files before being forwarded to the hospital/ doctor/ practitioner concerned. In the developed world where there is greater transparency, you have medical transcriptionists transmitting the doctors’ reports to both the doctor and the patient.

Since Indian doctors are not bound by regulation, legislation or commitment which stipulates that they embrace this concept in toto, the phenomenal amount of work that pours in is from the USA, Canada and Europe. There are various reasons as to why the Indian subcontinent has emerged as a favourite with the western bloc. One obvious attribute being the availability of a literate, English conversant workforce willing to work at rates much lower than their western counterparts. Thanks to technology and an efficient telecommunication system with faxes, e-mails and the works, information can be received and transmitted at an amazing speed. Another advantage vis-a-vis the USA has been the difference in time zones. The few medical transcription agencies that have come up in Mumbai, Delhi, Bangalore, Calcutta and Chennai maintain 24-hour shifts.

The good news is that you don’t have to be a doctor to be a medical transcriptionist. In fact no formal training or qualification is required. Most companies while recruiting, test applicants on their spoken English, topography skills and comprehension of the spoken language, especially the heavily accented American drawl, since most of the work comes from the States. In the USA, outsourcing has become the most efficient and cost effective tool where an exhaustive range of services relating to medical care are provided under one roof. You have the American Association for Medical Transcription as also certified courses, home study programmes and other workshops of short duration equipping job aspirants for full time, part time and alternate careers. There are organisations which go a step forward, offering trained medical language specialists who charge on an hourly basis for surgeries (especially of well-known personalities). Most medical transcription desks provided weekly updates of medical terms, drugs, devices, medical and surgical glossaries, sample operative reports and maintain message centres.

In India most agencies offer between Rs 6,000 and Rs 10,000 a month for an eight-hour shift, depending on whether you are an on-the-job trainee or are competent and quick enough to handle bulk assignments, stick to time deadlines and maintain quality output. The preference is for those who have a working knowledge of clinical medicine, physiology, surgery, diagnostics, pathology, radiology and pharmacology. You don’t have to be a student of medicine, although it helps if you have studied biology in your plus two and B.Sc. level. The main criterion remains a good command over the language. There are students of alternate medical streams like homoeopathy, ayurveda and Tibetan making forays into medical transcription since there is a steady flow of work.

Medical transcription is not as simple as, say, the proceedings of a conference. Not all doctors are articulate and adept at spoken English. Some may speak a monosyllabic language, expecting the transcriber to understand and read between the lines. They may use abbreviated terms, slangs and incomplete phrases. If you are in this profession, you will have to find sources who can assist you in your search for accuracy and precision. Medical dictionaries, local doctor friends and the Internet can be some of your professional tools. On-line reference on the Web as also chat forums and home pages provide an interactive opportunity if you want to share information and gain insights.

Once you have completed two years in a medical transcription unit, you are eligible to take up certification offered by the American Association for Medical Transcription which gives you recognition and acceptance in the international market. Most companies, which recruit transcribers, are keen they clear the test since this helps them get business. You will have to clear a written objective type examination which tests your basic knowledge of medicine and a practical test where you will have to first transcribe a recorded cassette and then convert it into a complete document. Along with working knowledge of the medical profession, it is important for you to have excellent hand, eye, ear coordination.

Both these exams are spaced out. The student has the choice of taking his practical exam (for which greater proficiency is needed) within three years of his clearing the written test.

With increasing awareness and willingness to spend large chunks of money on medical treatment, the scenario in India too is likely to change in the next millennium. Also doctors are going to be inundated with work, forcing them to outsource their documentation. All of this will create a market for medical transcription agencies.