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.