Never Assume

A file arrives that seems familiar. The filename and length are the same as a file previously received. Still, it must be investigated.  Is it the same file sent twice? Never assume. 

  It is not uncommon for those providers still dictating with handheld recorders to overwrite old dictation files with new. Occasionally files are not cleared when their usefulness has expired. Sometimes this is by design; other times this is due to neglect or oversight. The result can be confusing at best. At worst, an overwritten file can wreak havoc. 

  A file that is 40 minutes long may be overwritten from the start but only for 30 minutes, as an example. At the 31^st minute, old dictation plays. An alert and careful transcriptionist may realize the problem because the old dictation is recognized as familiar. With knowledge and experience, a search for the existence of the remaining dictation may be revealed and then not transcribed a second time. If that file were transcribed by two different transcriptionists, then the old dictation would not be recognized. In that case (and even in the first case cited), the old dictation may begin at an odd place and therefore show itself to be incomplete and questionable, indicating an old underlying dictation file that should not be transcribed a second time. 

I received a dictation file that was overwritten four times, maybe more! Each time the filename was unchanged and the length remained the same. Yet each file contained different information. The first time, the dictation ran the full length of the file. Each subsequent dictation session ran shorter and shorter. The file was certainly a time-consuming mess to unravel. Determining that the file was in fact new somehow, and then where the latest stopping point actually was, became a project in itself. 

It is important to remind each provider’s office to erase old dictation upon completion. This reminder could possibly be placed on every invoice. Even so, the scenario will play again. 

Never ASS-U-ME! It will make an ASS out of U and ME.

Applying for a Job

I was recently contacted to oversee a transcription project. This is general transcription and not of a technical nature. There will be a few dozen or so hours of interviews to be transcribed over the next few months. It is the kind of transcription work that would be well suited for a newer transcriptionist to gain experience and acquire skills.

Finding suitable candidates is a challenge and very time consuming. I am in search of transcriptionists to assist on this project. I posted details on two Internet sites seeking qualified individuals who might be interested in working with me. The post explained the job and called for interested parties to contact me with details of their experience as well as compensation requirements. Within a few hours I received over 200 responses. (I have since pulled the ads.)

Job applicants can learn from this experience. If you are responding to a job, it is incumbent on you to present yourself in the best possible light.

1.  Reread what you are about to submit before you hit that SEND button. Spelling, grammar, and punctuation must be perfect. These are attributes of every transcription job, so demonstrate your abilities. Typos do not go over well. Everyone makes mistakes, but not in that first contact.

2.  Sell yourself. Be brief, be concise, and address the points in the ad. Avoid rambling and   straying off topic. Provide all information that is requested.

3.    Place your resume in the body of the email. A resume sent as an attachment will likely   not be opened. Sending a blank email with only a resume as an attachment provides no introduction and will likely get no response.

First Peek

Have you considered a career in medical transcription?

To succeed in medical transcription a few basic skills are required.

1. Typing – speed and accuracy make a difference.
2. Writing skills - grammar and punctuation.
3. Research skills – dictionaries, googling, print and online resources.

 Accomplishing a medical transcription job is often like solving a puzzle. Putting on paper what is heard in a recording requires focus and attention to detail. Figuring out new and technical words and phrases can be a challenge. With practice and experience, each new dictation gets easier to transcribe.

Do you wonder just what it would be like?  Here is a sample dictation to download to your computer. Can you transcribe this?

Practice Makes Perfect

If you are looking for dictation files for practice, Super Practice, compiled by MT-Connect, has a collection of over 15 hours of dictation with complete answer keys. These dictation files reflect the real world of medical transcription. Included are a variety of practitioners, specialties, medical environments, dictating styles, accents, and dialects.

Who needs medical transcription practice files?

• Anyone considering a career in medical transcription.
• New medical transcriptionists who need practice.
• Medical transcriptionists who have been away from their work and need to refresh or hone their skills.
• Medical transcriptionists who want to expand their knowledge base.

Super Practice CD - $49.95

Shipping included.

----------------------------------         

Super Practice Download - $39.95

Please allow several hours for processing.
Digital files will be delivered to your email Inbox.
CD will ship within 24 hours.

             

Time Travel

The Day Lincoln Was Shot

Medical transcription has been around for many years. Many of today’s transcriptionists jokingly say they have been transcribing since the beginning of time. What follows is the actual transcribed medical report written by Dr. Charles A. Leale on April 14, 1865.

In searching the records of the Surgeon General in the National Archives in Washington, DC, researcher Helena Iles Papaioannou recently discovered a copy of a 21-page report written by Dr. Charles A. Leale, a 23-year-old army doctor who was the first to attend to President Lincoln in the Ford's Theater on that fateful day in 1865. The record that was found was a handwritten transcript of the hours between the time of the shooting and the time of President Lincoln’s death. This report is the collaborative effort between a treating physician and the medical transcriptionist.

• The complete handwritten transcript can be seen here.
• A typed transcript is also available here.

Can We Talk

Voice recognition applications are becoming more popular. We are seeing speech-to-text in new places. The iPad 3 comes with built-in dictation capabilities. Siri made its debut via the iPhone. Medical offices have become increasingly more dependent on speech-to-text. The software continues to improve.

Although I have dabbled with speech-to-text on occasion, it had not been a rewarding experience. In fact, it was more a source of humor - speak into the microphone and see the ludicrous text that is produced. It is rarely a small error, but rather an error that induces laughter, unless, of course, you need it done right, and you need it right now!

I recently came across an offer to purchase Dragon Naturally Speaking at a very enticing price. It seemed the time has come for me to put forth serious effort. I was not looking forward to the training, which I understood to be time-consuming, but I expected the installation to go smoothly.

Installation on my Windows 7 computer did not go well. The first several attempts failed, producing an error message that a required file was missing. After some Internet research, the missing file was located, downloaded, and installed, and Dragon was finally ready.

Although there are pieces of information available, i.e., some voice commands are listed on the box, in an accompanying brochure, and in the on-screen Tip of the Day, it was made obvious that knowing and learning those commands is critical for success. For example, saying “quote” will not produce a quotation mark; saying “open quote” will. That seems trivial, but it is the difference between accomplishing a task and total frustration.

Help was not available. Investigation into the program’s Help revealed that it was written for Windows XP and earlier operating systems. Windows 7 (and Vista) do not recognize the format that was used. As illustrated, it is critical to know precise commands, and where else to find that information if not in Help!

With the location of user guides on the Internet (which I downloaded and made available here, under Blogroll on the sidebar), required information is now available. I also went through the tutorial. Dragon is now ready to use. I get better with practice and so does Dragon, and I am finding Dragon to be a fun and useful tool.

Some transcriptionists use Dragon to transcribe for them. Careful editing is then required, but transcription time is reduced, as is the stress on hands and wrists. Learning to edit can be an asset in itself as there are transcription jobs for speech-to-text editors. Experience with voice recognition software just might be the tool you need to get a job or land a new account as a medical transcriptionist.

Some Jobs Just Are Not Perfect

For every 60 minutes of audio, transcription time takes about 3-4 hours. This is an average. Some jobs go faster, others slower. Transcription time depends on many factors. Besides unfamiliarity with words and phrases that might require lookups, the recording itself usually poses the most challenges.

Quality of the recording is affected by:

1. Hums and buzzes – sometimes recorded, sometimes it is the player's mechanism.
2. Background noise – talking, cell phone ringing, music, etc.
3. Speaker’s distance from microphone.
4. Multiple speakers – interviews, focus groups, lectures, podcasts, broadcasts.
5. Number of speakers talking at the same time.
6. Faulty equipment – beeps, blips, fading sound, etc.
7. Speakers’ accents and dialects.
8. Mumbles and jumbles – uncorrected misspoken words, slurring, etc.
9. Speed talkers – their goal to get done as quickly as possible.
10. Transcriptionist’s attitude.

Many dictators ruin the otherwise perfect audio by eating, drinking, yawning, sneezing, and burping, as well as other “natural” bodily sounds while they talk. It often seems like the pause button must be broken.

My all-time least favorite audiofiles to transcribe were given to me regularly by a physician who liked to dictate chart notes while he drove home from the office. He preferred driving with the window open. In addition to the road noise captured on audio, the wind did a great job of drowning out his voice. Then there were the sounds of cars honking (undoubtedly at him) and every so often the sound of screeching tires. Besides the dictation being difficult to hear, I was a nervous wreck listening and imagining the nuisance he must have been on the road. I figured that if he got into a car crash (and I expected that to happen at any moment), I would get to hear it as it happened, and I was on edge waiting for that to happen.

Then there was the radiologist who flapped his films as he talked...

Have you had a transcription job that stands out as “the worst”?

Logophilia

As transcriptionists, words are our business. It is generally understood that medical transcriptionists are medical language experts. However, medical transcriptionists must know much more than words pertaining to anatomy, diseases, syndromes, pharmaceuticals, jargon, abbreviations, and acronyms.

Medical transcriptionists must be prepared to type the spoken word in all arenas. The patient is often quoted in the medical record from conversations arising during the physical examination. Questions may be posed during a medical lecture. Even the least likely subject comes into play, often obscure words, sometimes misused, and sometimes the word is not a word at all, and all the dictionaries will not help. 

Along come new words, some so new they have not yet been included in traditional dictionaries, others are completely made up words, some represent jargon specific to a particular group. Enter sync, an informal word used to denote synchronization, a harmonious relationship.

• We sync up two computers so they both contain the same information.
• I will sync up later.
• I am syncing now.
• I sanc yesterday. Sunc?

By the way, logophilia, in the title of this post, is not a word; logophile is – meaning lover of words. Logophilia might then mean love of words, perhaps starting right now.

New vocabulary is food for thought. What do you think?

Do you enjoy solving puzzles? Crossword puzzles, Sudoku, cryptograms, even jigsaw puzzles? Very often, completing a transcription assignment is much like solving a puzzle. There are clues buried in each dictation voice file that will help figure out a word, phrase, or more. 

To solve these puzzles, there are various tools available, many of which are at your fingertips. The dictionary is always a good starting point. For medical transcription, a medical dictionary is essential. Google is always ready to assist and often makes suggestions when you are close but not quite there. There are websites, word lists, and more that can help to produce an error-free transcribed document, one that contains no guesses, and no blanks. 

Onelook.com is an excellent resource. When listening to a dictation file, sometimes a word creates a stumbling block. Perhaps it is a word you never heard before or a word that is spoken so quickly that deciphering it is difficult. Onelook can help. Onelook, you see, accepts wildcards. Search for the letters you believe are included and use an asterisk or two to indicate mystery letters. Onelook will produce a list of all words that meet those specifications. 

In the search box, enter *epithelial.” One look will produce a list of 20 words that end with epithelial. One of them is probably the word you are looking for. Let us try another. In the search box, type p*ceph*. Onelook found 332 words that fit. Too many choices?  Narrow down the choices. Possibly the mystery word begins with “por.” Try it. Type por*ceph*. Now there are 17 choices. Your word just may be there. Listen again to the voice file and see if you can find a perfect fit. 

Onelook can even find simple phrases for you. In addition to wildcards, leave a blank to indicate a space between two words (or more). Type * infection in the search box. Click ENTER and there are 288 choices. Perhaps that infection starts with a T. Try t* infection. Remember the blank tells onelook it is more than one word. In fact, onelook brings up 12 possibilities and hopefully the correct word is now before you. 

Solve some of your transcription puzzles with onelook.com.

Put Your Best Foot Forward

When sending out letters, flyers, postcards, or email to solicit new work, be absolutely certain you have proofread every word, every letter, every punctuation mark. Check over your formatting to ensure that spacing and paragraphs are as they should be. 

 Put your copy aside for a few hours or a day, then proofread anew. The brain has a way of remembering what you think you wrote or meant to write, and proofreading soon after creation is not always the best way to ensure quality. You might read everything a second or third time and not even notice a skipped word, a homophone (there instead of their, etc.) or a missed period at the end of a sentence. Putting some time between the initial creation of the printed material and the proofreading will help clear your mind from seeing what was intended as opposed to seeing what is actually there. 

 A second or third pass after some time has elapsed will also give you a chance to better hear how your words actually come across. Perhaps a little rewording would make your intentions more clear. These things are difficult to perceive when everything is fresh and you are still focused on your intentions. 

A checklist for that final proofreading:

1. Spelling. Run your word processor’s spellchecker. Do not assume your spellchecker knows best. Think about its offerings.
2. Capitalization. Does every sentence begin with a capital letter? Proper nouns, brand names, titles with names (President Smith, etc.) require a capital letter.
3. Punctuation. Does every sentence end with appropriate punctuation? A period, comma, question mark, etc., must terminate every sentence.
4. Homophones – words that sound alike but are spelled differently. Are your words the ones you need? Examples: to/too/two, right/write, here/hear.
5. Compound words – two words that are combined to form one word. Examples: anyway, someone, overflow, carsick. Should you be combining or separating words that somehow go together?
6. Contractions. Avoid contractions such as it's, you'll, and don't. Contractions are more appropriate in informal writing.
7. Spacing. Check the spaces between words, between sentences, and between lines.
8. Contact information. Test all hyperlinks. Be sure they are current, free of error, and work as expected.

Once you are 100% certain that every detail is correct, ask someone else to look it over for you. That second pair of eyes will spot things you missed. 

 Demonstrate your proofreading skills. Make a good impression.  

Sneak Peek

Is this your first look at medical transcription? Listen to this audio file to get your first taste of what is involved. If you have good listening skills, enjoy searching the web for answers, and love to learn, medical transcription may be right for you.

Click here for audio file.

Audio files for practice are also available. For more information about dictation practice files, click here.

Day to Day

Working from home or onsite, the medical transcriptionist's day can be intense. How the day actually passes and how others perceive the job can be quite diverse.  Wherever lies the truth, the medical transcriptionist gets the work done and gets it done right.

PDF is an Easy Read

Do you have Adobe Reader software on your computer? Did you know that using Adobe Reader is an easy way to ensure that your document can be read by another computer? Adobe Reader is the “global standard” for document sharing.

If you want to send a document to another computer (a client, a job service agency, a potential client, even a friend or relative) and you do not know what software they have that will read your document, converting your document to a PDF format will work beautifully most of the time. You can convert just about any document to PDF format with just a few simple mouse clicks.

To convert a document to PDF format, you will need to have a PDF writer on your computer. Google can help you find a free PDF write or you can use this link to download* the free Cute PDF writer. The PDF writer will act like another printer connected to your computer but uses no ink or paper. Once installed, it is always ready to serve you. Some examples of files you may want to send as a PDF:

1. Resume.
2. Invoice.
3. Transcribed file.
4. Any picture, diagram, or chart.
5. Manual containing screen shots and step-by-step instructions.

Let us say, for example, that you have an invoice prepared in Excel that you need to send to a new client. You do not know if the client can read an Excel document. Converting that invoice to PDF is simple and easy.

• Open the document you would like to convert.
• Go to FILE, then PRINT.
• Select your PDF writer.

• Click on OK.
• A new window will open asking you where to save the new PDF file.
•  When ready, and your file path shows where the file will be stored, click on SAVE.

That is all there is to it.

_________________________ 

 * Note: Downloading Cute PDF also requires download of a PS2PDF converter such as Ghostscript, which is also available as a free download. Links for both are available at the website link provided.

Your Digital Signature

There are many times when your signature is required on a document that you have received on your computer. There are various ways to handle this. The most common method is to print the document, sign it and either scan it back into the computer and then attach to your email or send the printed document by fax. Another option would be to stick it in an envelope and mail it off the old fashioned way. There is yet another way.


It is possible to affix your signature to the document while it is on your computer – without printing the document, without actually putting pen to paper. Creating and storing your digital signature on your computer is easy. It will save you time and money. Here’s how.

1. Sign your name on any piece of paper.
2.  Scan the paper with your signature into your computer.
3.  Save the signature as a JPG.
4.  Open a Word document.
5.  INSERT the jpg (PICTURE) with your signature into your document.

6.  Highlight your signature. It will be boxed in, as shown above.
7.  Go to AutoCorrect.

8.  Tick the box for formatted text.
9.  In the REPLACE box, type a shortcut that you will remember – like “namesig” (your name as a signature).
10.  Click on OK.
11.  Forevermore, whenever you want your signature to appear in a Word document, just type “namesig” (or whatever you named your shortcut) and your signature will appear.
12.  OPTION: You can create this shortcut for your signature in most      abbreviation expansion applications instead (your choice).

Once it is set up, your signature will appear where you want it with just a few keystrokes.

Spellchecking

Every medical transcription job must be carefully checked for spelling errors. The spellchecker that comes with a word processor is inadequate. For this reason, every medical transcriptionist should have a good medical spellchecker installed on the computer and linked to the word processor. Most companies will  require the availability of a resident medical spellchecker before hiring. The most frequently recommended or suggested spellchecker (and oftentimes it is required) is Stedman’s Medical Spellchecker.

Be aware that no matter how good a spellchecker might be, no spellchecker will find errors in words that otherwise might be correct. Homonyms* are a good example, i.e., there/their, week/weak, dysphasia, dysphagia, etc. The presence of a spellchecker does not preclude proofreading for such errors. Proofreading is still required.

____________________________________________ 

*A comprehensive list of homonyms is available here. .

Get That Job

Testing for medical transcription jobs usually includes some actual transcription. Most companies will provide dictation from their work pool. Others will create dictation material specifically for the test. Sometimes the test material will be very difficult with lots of background noise and low volume, usually reflecting a worst case scenario. In such cases, blanks are expected and best effort with accuracy gets the job. Other tests are clear, simple, and clean. In those cases, the applicant is expected to turn in perfect or close to perfect transcription.

While most companies are looking for experienced transcriptionists who require little or no on-the-job training, some welcome newcomers who demonstrate an aptitude for the work and a willingness to learn. Grammar, spelling, and punctuation are expected to be very good in either case. A good listening ear is essential and the ability to quickly research unfamiliar terms is a must.

Experience with test taking is most helpful. It is beneficial to test for several companies. With each test, the hopeful applicant gains powerful knowledge and experience and brings that information to the next test. With testing comes confidence.

To get that first job, or next job, one rule of thumb prevails: Practice, practice, practice! Practice transcribing from a variety of specialties and sources, and practice applying for those jobs.

I Can't Hear You

A common complaint transcriptionists have is poor audio quality. Dictation is often created with older equipment and even the newest do not have pristine sound like that produced in a sound studio. Audio files are created in an office, sometimes in a room where other workers are carrying out their tasks.

Background noise often includes voices of office workers, telephones, computer sounds, equipment noises, and even electrical lighting hums. Papers are shuffled and drinks are slurped - directly into the recording microphone. Sneezes, coughs, and other bodily sounds are often produced, sometimes louder than the dictation itself. Yawning while dictating is a popular activity. 

Some doctors take their work home with them. I had one doc who liked to dictate during his commute home. Hopefully he was the passenger and not the driver in a car, although I really do not know for sure. What I do know is that the sound of traffic was distinct and I often wanted to shout “roll up the windows” while I struggled to transcribe his windblown words. Another doc whispered his dictation from his bedroom while his wife slept. Another had two dogs nearby that sounded quite large from their deep, loud barks. Then there was the doc who dictated from his living room and on Tuesdays his young daughter had piano lessons in the background. 

With all the noises that are captured on dictation files, it is crucial for transcriptionists to do whatever they can to improve the audio quality. Trying different digital players often helps. Using the audio processing features such as volume control, playback speed, and noise filters can be useful. I have found that the most helpful accessory is headphones. 

Headphones come in a variety of styles. Some wrap around the head, others dangle like a stethoscope. Noise canceling headphones can be essential for the transcriptionist working in a noisy environment. Some transcriptionists prefer wireless headphones, others prefer earbuds. Good quality headphones, whatever the style, will be well worth the extra expense. 

When you are set up with equipment that works best for you, and a loud burp (or worse) comes through your headphones, you just might then be thinking, “I can hear you!”

Eye on Jobs

In today’s economy, there is stiff competition for jobs of any kind. Transcriptionists have an equally tough time finding work. 

On average, an hour of audio dictation requires four hours to transcribe. This does not include an additional 2 hours required for proofreading and processing the document for final submission. Payment for general transcription jobs is generally based on a per-audio-hour rate. The following job was posted on craigslist today. How hungry are you?

There is a Moral Here

Abbreviation expansion software is an essential tool for every transcriptionist. With it, we can reduce the number of typing keystrokes drastically and thus reduce time spent on each job. In addition, use of the expansions reduces errors since each expansion has been carefully screened for accuracy. 

There are many software programs available for this purpose. They range from free to quite expensive. Most work only on specific operating systems, e.g., they may work only on Win 7 or may work on older platforms but only through Win XP or perhaps only on a Mac computer. Word’s AutoCorrect can do the job quite nicely, too. It is important to make sure the abbreviation expansion software is compatible with the operating system on your computer. 

I have used abbreviation expansion software since my first day working as a transcriptionist way back even before Windows was available. Since then, I have tried quite a few and have been happy with most and disappointed in some. A few years ago, I purchased a new upgraded version of the software I had been using for the 10 years prior. This new package is a little quirky to this day. 

Yesterday my expansion software crashed. The menu bar disappeared. I could not add or delete entries. I could not export the file or back it up. According to the company’s Help, my only recourse (and apparently this is a common enough experience that there are step-by-step instructions) is to “reset the program” by running anew the original “exe” file. With most software, reinstalling a program (which is what this really is) means overwriting the program files, but not the database I had created! So I followed instructions and immediately was faced with a blank slate! Every expansion I had entered over the last 10 years was gone as were the settings that I had painfully customized to my preferences. 

The moral of this story is to remember to back up your files – all of your important files – and do so frequently. 

For readers who have not started working with abbreviation expansion software yet, do not be afraid. Once you try it, you will not be able to live without it. For information on setting up your abbreviation expansions, please click on the following link:

eGuide to Abbreviation Expanders

 

Type the shortcut on the left and watch the expansion (on the right) appear on the page.

Practice Makes Perfect

 Click here for ordering information.

Hello Transcriptionists!

I am a medical transcriptionist. I have been a medical transcriptionist since 1990. In addition to transcribing, I have worked as editor and trainer at all levels. Please read My Story. I am a medical transcriptionist.  

I have been a medical transcriptionist since 1990.  In addition to transcribing, I have worked as editor and trainer at all levels.  Please read My Story.

This site was designed to assist new and experienced medical transcriptionists to develop and enhance skills.  It is also a place for potential medical transcriptionists to get acquainted with the field.  There is no question that practice is the key to success in medical transcription.  There are just so many different arenas for medical transcription - hospitals, clinics, physician offices, rehabilitation programs, and more - and so many different specialties - that it is impossible for any transcriptionist to know it all!  Additionally, there are always new drugs, new procedures, new tools, and new words to describe it all.

I have a huge collection of voice files (dictations).  From this collection, I have assembled CD's containing digital files and these CD's are available for practice.  All of the digital files have been transcribed and the transcripts are included on each CD as answer keys.  You will find bonus features on some of the CD's to assist with transcribing the included files.  These voice files come from personal experience.  They reflect the real medical transcription world.  They contain a variety of voices, dialects, accents, and distractions.  Some are easy to understand, others not.  It's the real world of medical transcription.

Also available are digital files that I call ePractice files. These files are available for download today. Each dictation file comes with the answer key.

Specialized ebooks are available for download. These ebooks are designed to assist with setting up the tools required to transcribe with more accuracy and efficiency. Helping medical transcriptionists to be more productive is the goal.