Medical Transcription, what is it all about.

Well, I am here waiting for work.  Rob and the kids just left for school so of course the house is too quiet.  Wei-Wei is here but she is just sleeping and the cats just want my room for the heat ;)  haha.  So, I come here to type while enjoying my coffee and waiting for files.

While I was researching for Medical Transcription I never found a personal, honest article about what medical transcription is.  So, that is today's post.  Medical Transcription from the training to the job a year later.  My view and my experiences.  

When I first thought of being an MT, I thought, type what I hear, piece of cake I can do this.  This was my biggest mistake.  I joined Career Step not thinking about the number of foreign speaking doctors out there.  The first part of the course was so much fun.  I loved learning how to spell all these big medical words by simply breaking them down and I loved that I could now watch "House" and understand what Dr. House was actually talking about!  There were some rough spots, (Career Step students know the evil Perfecting the Text and Intro to Transcription modules well) but I got through and was so excited to start the actual dictations.  What is unique about Career Step is that they use authentic doctor-dictated audio files.  They really give you a feel of how it is going to be.  

The first files are not that bad and you are thinking, "wow, this is better than I thought".  Then you hit the ESLs (English as a second language).  This is where it hits you.  How many foreign doctors are there out there.  It is a scary moment when you realize that there are more ESL doctors than straight English speakers (or at least it seems that way to me).  This is the first "panic moment" during training because it really is extremely hard to understand these files.  It is not as hard when you are in the room with the person because you can say "I am sorry, can you repeat that" and they can try harder to pronounce the words.  Well, in MT you CANNOT speak to the doctor most of the time so you are stuck with whatever they sent you.  This is the hardest part about medical transcription, and it is not just ESLs you have to worry about!  You have doctors who transcribe with phones ringing incessantly, kids screaming in the background, dogs barking, eating, exercising, and transcribing in a crowd (I have heard of one dictation recorded while at a basketball game).  You have to deal with all of this and learn to focus on ONE voice and tone out all the other stuff around you.  You can practice this now while you are in a crowd.  Focus on one voice and force yourself to only understand that person, make all the other sounds just fade.  It takes work but if you can learn to do this, your job as an MT is so much easier.  The training I had entailed almost 800 audio files.  It sounds like a lot, and it is, but what are you training to do??  You are training to do reports for 8-10 hours a day as your paying job.  If you will make your training your job for a while then the transition to work will be so much easier.  (I am still working on this even a year later).  

For me, the transition has been hard.  I went from school where I had a year to complete 800 files to the work world where you are required to finish your allotted files in 24 hours or less.  I laughed at myself once when I was going over my old posts in my school forum.  I was bragging about doing 10 reports in a day.  I am doing upwards of 20-40 reports a day at this point!  If I had treated my training as my job and worked for a set number of hours on training instead of just a set number of files, I think the transition would have been easier.  I have major issues focusing and saying "This is work time.  Stay off Facebook and don't browse the internet"  I have actually had Rob block Facebook from my computer so that I could focus on work.  


For me, focus is not my only issue.  I try to concentrate too much on how many reports I do instead of the quality.  This is getting better and I am not a terrible transcriptionist.  I work on some of the most challenging doctors in my company (doctors that the QA people don't even want to work on).  So, I am good at what I do but I try to get too fast and I drop words.  I am still on review after a year because of this.  My focus this past 2 months has been on quality and not quantity and I think I am getting better.  So, remember this!  Focus on your quality.  I think this is from me saying "oh, I know what I MEANT to type so I won't count that off" during school.  For non-Career Step students, we grade our own reports using a grading worksheet.  It is up to us to decide what to deduct.  Well, this has faded into my work world in a bad way.  My proofreading skills are my trouble spot.  


So, the work world...What is it like.


The work world for me is challenging.  Here is a list of why, it is easiest to put this in list form so you can read the ones you want and skip the ones you don't want to.


1.) Time Management - I spent 14 years of my adult life as a stay at home wife/mom.  I didn't have the responsibility of managing my time.  I wasn't one of these super busy moms/wives.  I had a husband who believed my place was at home, therefore I didn't drive (no license even) so I had nothing to do all day but clean house and watch TV and play on the computer.  I had all the time in the world for all of this.  So, I think now that it is okay for me to play around on the computer or whatever because "I have all the time in the world".  Not anymore.  I no longer have all the time in the world for playtime.  I have to force myself to work and still hold out enough time for my kids and my family.  


2.) Responsibility - The files you work on as a medical transcriptionist are REAL PEOPLE.  It is up to you to make sure that their reports are precise and all information is exact.  It is harder than you think!  You have to remind yourself constantly that your files are going into this person's chart forever and that if you have anything wrong then it could hurt this patient in the years to come!  Your files can also be used in a court of law.  Keep that in mind!


3.) Empathy/Sympathy - Oh boy, this has been tough on me.  I am lucky in that I work mostly in podiatry and GI.  The patients I work on aren't chronically ill most of the time.  But I do get unfortunate patients that make me lay awake at night wondering if they are okay.  A little girl with a broken arm who cringes when her mom raises her hand, an overweight man with foot infections because no one will help him with his personal care, a daughter being told she is going to have to put her dad in hospice because his liver is failing, a 40-year-old who is having problems adapting because her husband left her and her kids homeless.  The list can go on and on.  So, you have to remember that you are going to be working on patients who are sometimes going to stick with you and this is hard.  It is not just the patients either.  Occasionally you will have a doctor leave a recorder on accidentally.  I have heard an argument which made me change my mind about one of my least favorite doctors.  I also had my favorite doctor shown in a bad light due to a recorder being left on.  These are things you have to deal with.  


4.) Solitude - You may think "oh, I will be at home, everyone will be around me." Yes, this is true but you will be in your own world, with your headphones on, and in a separate room.  You are not supposed to let anyone see what you are typing.  It is HIPPA rules!  You are bound by confidentiality just as a doctor or nurse is.  My whole family knows that if they come into my room they are not to look at my screen and if I am talking to one of the kids, I will minimize all work windows.  So yes, your family is there.  You hear the kids laughing as they play a game in the living room.  You hear your husband roughhousing with the dog.  You hear life going on around you, and you are separate and listening to a doctor across the country talking about bowel movements or foot warts...  This is so hard for me.  


5.) Weight issues - I touched on this a bit yesterday.  In this job you are moving 2 body parts your hands and a foot.  That is it.  You sit and stare at a screen all day typing.  Yes, typing burns calories, but not as much as getting up and playing with the kids, doing housework, or running errands.  So, be prepared to work harder to keep your weight in check!  


6.)  Body aches - Again, you are sitting at a desk for hours on end.  Your thighs will ache, your foot pedal ankle will cramp, your foot will sometimes cramp, your wrists will ache and cause pain all the way to your elbow if you don't stretch enough, and your back will ache.  This is just another part of this job.  You have to teach yourself to get up once an hour and just walk around and stretch your hands and body!  Research ergonomics and get your work station as ergo as you possibly can to prevent some of this!  I have even heard of chipped tail bones due to the wrong sitting position.  It is very important to learn good posture!  Educate yourself! 


7.) Eyesight - I had perfect vision before my training began.  I now have had 2 different prescriptions for lenses in 2 years.  I went from perfect vision to glasses just while reading to glasses all the time with instructions for yearly checks.  There is nothing you can do for this I don't think.  It is just eye strain.  Resting your eyes helps, but when you are watching the screen for mistakes and such, your eyes are being given a major workout.  This inevitably causes vision changes.   


8.)  Judgement - this is a tough one.  It angers me.  I tell people what I do and they say. "Oh, so you don't have a REAL job, you just work from home." I also hear "so, do you have a real job or do you just sit and type".  People have no idea of what medical transcription is about.  They have no idea that our job is as important as it is.  The stigmata around "work at home" jobs is tainted by all the scams out there.  I have told people what I do and have them respond with a "you mean that is real?" but I have also had the "oh, so you don't really work, you just have an at-home thing".  Also, people think that because you work at home, you can drop whatever you are doing for them.  I had one friend who said a friend of hers called and asked her to babysit since all she was doing was typing.  "sure, its not like it is a job or anything...we just sit and type mindlessly."  You betcha!  This is something that angers me to no end.  I do have a real job.  In some ways it is harder than outside the home jobs.  Also, be truthful, how many people are out there that are thankful for their job in the summer because it gets them away from the kids on summer break??  Well...I work with the kids in the house during summer break.  I don't get to escape from them.  


9.) Work load fluctuations - If you depend on this as your sole income you have to be prepared!  The medical industry is a very random thing.  You can go from having so much work that you have to ask for help to having so little that you have to ask for files from a different doctor.  It is like this in all medical transcription companies.  I do manage to make between $1000 and $1600 a month but that is a big fluctuation if you depend on it.  Money management is another skill you need to research a bit.


Truthfully, these are the things that bother me the most.  No other ones really stick out for me at the moment.  I might make this sound like a horrible profession, and at times it is harder than I ever imagined.  I have wondered a few times what I got myself into but then I hear my kids say "its okay, she works from home so she is always here" or "yea, my mom works from home" and I know that my kids are proud of me.  I know that they are thankful that I am at home with them.  It makes it all worth it.  


It gets fun too.  I have one doctor who will throw in random facts to a report at the most unusual spots.  I have a doctor who I have learned gets very moody if Ole Miss loses a football game (so yes, I keep up with Ole Miss football now haha).  I have one who I feel so sorry for because she sounds so sleepy.  One sounds like Gomer Pyle!  I love him.  I have one who sounds like an authentic Southern Belle (think Gone with the Wind).  I have wanted to call a few of my clinics before and say "thank you" because my doctors, even though I may complain, are really a pleasure to work for.  If I worked in the area where these doctors are, I would use them in a heartbeat. 


Okay...Work has been downloaded and my hours technically start at 9:00 so I am going to end this now and spend 10 minutes making me another cup of coffee and preparing for the day.  So far it is only 10 files but I am sure that won't be all for the day!