I am finding more and more how very much I miss my job as a medical transcriber, where questions such as this one were answered every day, sometimes several times daily.
In its broadest sense, I would define medical transcription as the act of translating from oral to printed form the record of a patient’s medical history and treatment.
Physicians and other healthcare providers utilize highly technical information and terminology to summarize medical histories, diagnoses and treatments.
As a medical transcriber, it was my job to transform their spoken words into comprehensive reports that accurately communicated medical information which ultimately became a permanent component of the patient’s legal medical record.
Unfortunately, medical transcribers have been replaced by voice recognition software in almost every major hospital in the area. However, the software is not perfect due to word usage, punctuation and problems with the dictating physician’s dialect or manner of speaking.
Therefore, the only job associated with medical transcription is that of an editor and even those are in short demand as most physicians are required to edit their own reports.
I loved my job because it was interesting and I learned something every day. I kept my trusted medical dictionary at my side because I used it many times a day.
In my profession, the transcriber may hear a word one day and never hear it again or hear a word frequently but not enough to remember how to spell it. It wasn’t the same routine every day and it was challenging and I have always loved a good challenge.
A common misconception about my job was that “any good typist” could do it. While being a good typist is certainly a good foundation, one must meticulously train to transcribe medical information and for no short period of time.
According to one of my old job descriptions, the skills required included extensive medical knowledge and understanding of its terminology; sound judgment; deductive reasoning; extensive knowledge of anatomy and physiology as well as disease processes; and last, but certainly not least, the ability to understand foreign dialects or regional accents.
In addition to these technical requirements, one must also possess an above-average command of grammar and punctuation; excellent auditory skills; advanced proofreading and editing skills; and an excellent working knowledge of computers and transcription equipment. Therefore, one can easily see why medical transcription was a skilled trade which required much training and experience to achieve proficiency.
For me personally, the biggest challenge that I faced on my job was making certain that I had conveyed the intent of the dictator in all aspects of the reports I typed. I did this by using the appropriate punctuation and grammar (a comma incorrectly placed can change the entire meaning of a sentence) and by being ever mindful of the diagnoses and medical history, and ensuring that all information within was consistent with those.
On the lighter side, as technical as the job was, it was not without humorous and enjoyable moments. Over the past 25 years I have heard some pretty funny statements dictated totally in earnest but totally incorrect.
Thank goodness we transcribers were there to type what physicians meant to say instead of what they actually said. Voice recognition, as I understand it, recognizes only the voice and types what the voice dictates whether it makes sense or not; thus, the need for editors.
Following is a list of my favorite funny statements which were actually dictated, but I should note that none of them came from my last job at the former Woods Memorial Hospital in Etowah. They were contained on a list that was given to me many years ago.
1) The patient came to the emergency room alert and oriented with CPR in progress.
2) We had great difficulty advancing the scope and decided to leave it there.
3) She insisted on intravenous medication, therefore we gave her pills by mouth.
4) On his return visit we will discuss the results of his biopsy which he took with him.
5) No further treatment is needed at this time as the patient expired.
6) I have asked him to follow up with his psychiatrist for fear of being robbed.
Of all the things that my job was, it was never boring. Even after all these years I find myself getting excited when I hear about a new medication on TV or when I am prescribed new medicine.
I still have reference books and consult them often, particularly the one containing information about medications. I’ve decided that once you’ve worked in the medical profession there is no point where there is no more to learn.
Overall, I would have to say that, while it carried a great deal of responsibility and therefore could be very stressful, my job was also very rewarding and fulfilling. It was my contribution, albeit indirect, to patient care as it related to the medical record.
By the way, if one has “dysphagia,” he or she is having trouble swallowing. If one has “dysphasia,” he or she is having trouble speaking.
Haroldean Thompson is an Etowah resident and can be reached at firstname.lastname@example.org