Michele Miller, author of The Step-by-Step Guide to Medical Transcription at Home, shares her knowledge and experience about how to become a medical transcriptionist and advice about medical transcription training. [20 min.]

To learn more about her medical transcription course, click here.

 
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Tell us a little bit about your background, and how you got started in medical transcription.

I’m originally from England. I came to Florida in 1993 and started taking some college classes in the medical field. I’d not heard about medical transcription then, and I happened to meet somebody at college who was taking transcription classes and wanted to work from home. Since my daughter was very young at the time I was very interested in working from home, too, so that I could be with her. That’s really how I got into medical transcription.

Give us a little overview of how the medical transcription business works.

Well, medical transcription is the typing up of medical reports about a patient’s visit. When you visit a doctor, they dictate a complete report about you, what your symptoms are, a treatment plan, and stuff like that, so that when you go back they have accurate medical records to refer to, and also the doctors need those reports for coding purposes so that they can get reimbursed by the insurance companies.

How hard is it to learn how to do medical transcription?

It’s not hard to learn, but you do have to have a good understanding of medical terminology, and you have to learn the proper format of medical reports, and it’s easy, really, with a bit of practice.

What are your thoughts on taking courses? I assume there are different courses available online and maybe even at a local community college or someplace like that? Are they necessary?

Yes. I think it’s better to take a course or some classes because otherwise you’re second-guessing yourself if you didn’t fully understand what you were transcribing. And it would be overwhelming if you didn’t have any education in the subject. Back when I took classes it was a community college, because they didn’t have online courses like they do today, but I think the online courses are great because you can take them in your own time when it’s convenient for you. But yes, it’s definitely better to take some kind of education for it.

Are you familiar with any of the better online courses? Can you recommend any?

Yes, actually there’s a school that I refer to on my website, and in my e-book. You must make sure that they’re accredited places, or that you get a good referral and that you can speak to other students that have taken their courses. But there’s several different ones, and you have to research each one, really.


Is it difficult to learn medical terminology? You talked about that a little earlier. Do you find it hard to figure out what words the doctors are saying, for example?

No, it’s not really difficult to learn at all. I mean it’s a different language, and people think, “oh gosh, I’ll never learn all the medical words,” but it’s really easy once the words are broken down. They’re broken down into three parts: a prefix, a root, and a suffix. And you start to see how the word is put together, and you realize how easy it is once you see how the words are formatted. So, no, it’s not difficult. It’s not like learning a foreign language, it’s just a different kind of language to learn.

Accuracy and sharp hearing must be pretty important in this field. You know, there’s a big difference between Zantac and Xanax. Do you find that it’s hard to be accurate and that accuracy is very important?

Well, it’s absolutely very important to be accurate, especially about medications. You don’t want to make a mistake on somebody’s notes, so you do need to check what the medication is used when you’re transcribing, and know if it’s something you’re not familiar with. But once again, it’s something you get used to, and before long you know loads of medications and what they’re used for. But you always have the options of looking up the medication because there’s special books that you can use to do that.

A lot of medical providers have national certification programs, and that sort of thing. Is there a certification process for medical transcriptionists?

Yeah, you can get certified through the AAMT, that’s the American Association of Medical Transcription. It’s a two-part exam. I’ve never taken it, nor have any of my transcription friends that I work with. It’s a personal achievement if you want to do that, but it’s not necessary to do that.

Talk a little bit about the kind of equipment required to get started.

Well, if you already have a computer and a printer, you’re halfway there. You really only need a transcribing machine, and that’s a machine that plays the tapes. But nowadays a lot of the work is digital, so you play the dictation through a software program like Express Scribe, and that’s free by the way. You can Google that and download it. You just have to get a foot pedal that plugs into your computer and you’re set to go.

How can doctors send you dictations securely? Is it sent over email, or how is that done?

Yeah, through the email, but there’s several types of encryption programs that make sure that the file is securely sent, either way. That really is a necessary factor when you’re emailing work.

Can you recommend some specific machines or software – you’ve mentioned Express Scribe – that you’ve had good luck with?

Well as far as transcribers go, I particularly like Olympus. I find that that brand is more clear, you get a much better sound quality, but there are other brands: Sony, Panasonic and a bunch of other ones. But they tend to be more stereo sounding, and I don’t find those quite as clear. It depends on the person. One person might find those brands the best, but Olympus, I always think, is a great brand.

The Internet has allowed people to work with companies all over the country, and even all over the world. Is it possible to do medical transcription for a company in another state?

Oh yes, that’s quite the norm nowadays, because it’s digital dictation and encryption, and you just have the work emailed to you, the doctor dictates it, it gets uploaded and sent to you, and you transcribe it, and send it back. It’s a good way to do your business cause you can move around and you’re never going to lose your accounts that way.

There are a lot of business scams out there. Are there a lot of medical transcription scams that you’re aware of?

No, I don’t think so. I’ve never run into any scams with transcription, but there’s plenty of medical billing scams around. People say they’ll send you the software, you purchase the software, there’s a lot of scams involved with medical billing, but not with medical transcription, not as far as I’ve ever encountered.

You’ve been transcribing for quite a while. What marketing techniques have you found to be most successful for you, and what techniques have you heard others having success with?

Well, I’ve always sent out a letter about my transcription service and the benefits of using my service, and sometimes you have to send out quite a lot of letters, but once you get the accounts, they generally stay with you for years, so it’s not like you have to keep doing that. And if you want to have your own transcription business and get accounts, you really don’t want to send out a resume. I find that’s a common mistake that people make that are starting a business. They send out a resume as if they are applying for a job, instead of more of a sales letter that talks about the benefits of having that service do the transcriptions for them. So, I think that’s a good way to get accounts. And I think another thing is, if you have the opportunity to actually go to the doctor’s office and drop off the letter, and introduce yourself and give them a business card, that can also help because you never know, you might end up with an account that way. And there’s also the yellow pages but I don’t really recommend that because I think that it’s very expensive when, once you’ve got the amount of accounts that you really need, you’re really paying for advertising, and then you just can’t take on any more accounts, or if that’s the point that you’ve reached. If you’re growing your business, then that’s another way to advertise.

Is this typically a part-time or full-time business for most people?

Well, that’s the beauty of medical transcription. You can work as much or as little as you like. For the most part my friends run full-time businesses, but it’s up to you how many accounts you want to take on. I became full-time in my business very early on, within the first year, and a few years later I decided that I was working too many hours a week, so I cut back, and then gave the accounts to somebody else, and then later on I went back to full-time. So it’s very flexible, and it just depends on your own needs.

Do most people charge by the hour, or by the minutes, or by the typed page?

I think most transcriptionists actually charge by the line. The average rate at the moment is about 14 cents per line, but it does depend where you live. Some people charge by the gross line, which is what I do, and that means whether there’s one word on the line or 12 words on the line. And some people charge by the amount of characters per line, like 65 characters, so every 65 characters would add up to, say, that 14 cents per line.

You write in your book that you can make $25-35 an hour. Is that for someone who’s been in the business forever with lots of experience, or is it possible to make that kind of money just starting out?

Well, it can be slow starting out until you get used to the doctor that you’re typing for, and that’s where people get overwhelmed. But once you get used to their style and you’re more familiar with the specialty that you’re typing, your speed picks up really quickly, and you start making really great money, but also there’s programs that can really double or triple the amount of lines you type, sort of like macros, and also if you prepare yourself ahead of time, you don’t type everything. You don’t type the whole format out each time, you make templates so that it really cuts down on tons of time and you end up really only having to type about a third of what is actually dictated, and that’s definitely how you make more money.

I’m sure if you get used to a certain doctor they end up saying the same things, not through the whole dictation obviously, but in the beginning or the end, and you maybe could set up a macro for that sort of thing?

Absolutely. Once you get used to the specialty and you do see what is repeated every time, you make it so that you really just have to go in and edit certain things like blood pressure or temperature or pulse or different parts of an exam, so yeah, definitely that’s the way you increase your line count.

Is there a lot of competition?

Yes and no. You have to think that most doctors probably already have transcriptionists, so when you’re trying to get accounts, it’s just a matter of timing when that doctor decides he needs somebody else, or that person isn’t working out for them. And that’s why I recommend sending out letters because you’d be surprised that some of the doctors keep that letter on file for ages. I’ve had doctors that have called me about a letter that I sent out two years ago, and I think it’s kind of funny but there’s plenty of work to go around. I think you just have to be motivated about getting those accounts, and like I’ve mentioned before, once you get them, you really don’t have to keep searching. And I’ve always found each time I send out my letters, I’m fortunate enough to get accounts. Competition wise, there’s always competition, but I still think there’s a lot of work to go around.

Do some physicians use more than one transcriptionist?

Some, but not necessarily in that way. I think what happens is if they’re a group of doctors and they contract with a service, that service usually has other subcontractors, so they’re usually able to do the amount of work for that group of physicians, so I don’t think they’re very keen on having several different transcriptionists. They’d rather have one person that overlooks everything that is being transcribed.

Who are your customers in this business? Are they hospitals, or doctor’s offices, or clinics?

My customers are actually solo practictioners, doctors, but I have friends that work for clinics, and one of my friends transcribes for 20 different doctors, and during the weekend there’s a lot of different facilities and ways to do this, but myself personally, yes, I just do solo practitioners.

Should you work independently or through a service that contracts with health providers? Maybe you could talk a little about the advantages and disadvantages of both.

Well, I personally don’t like the thought of working through a national service, mainly because they generally pay poorly, and I prefer to have my own accounts and get paid the full amount. But some people like to work for a service for the health insurance benefits, but it really doesn’t add up in my mind, because if you pay for your own insurance it’s 100% tax deductible anyway, so I don’t think many people realize that. I think it’s good to work for a service particularly if you want to take a vacation, and if it’s a big enough service, they can have somebody else cover for you, whereas when yo work for yourself, you have to do the searching for somebody to do that work for you if you go sick or you’re on vacation. Personally, I wouldn’t recommend working for a service.

Talk a little bit about growing your business by subcontracting work out to other transcriptionists.

Well, the great thing about subcontracting is that you can really expand your business, and make a lot of money by hiring other transcriptionists. It’s a little more time consuming because you have to proofread their work and also you’re responsible still for getting it back to the customer, but once they’re doing the work to your standards you get some of your time back. It can be hard to find good transcriptionists, and you might need to train them for some time before you feel confident not having to proofread their work. I also think you really should pay your subcontractors very fairly, and I’ve always given 2/3 of the rate to them, because they’ve done the bulk of the work, and I think if you are a subcontractor you should probably try and work for a smaller service because I think you’ll get paid more than perhaps the national companies, although some national companies do pay pretty well. But on the whole for growing your business, that’s the way to go if you want to make a big successful business out of it. You definitely need to hire subcontractors.

Are there any magazines or websites or books or other resources that you’d recommend?

Well, there is one magazine that I’ve always subscribed to, and that is the Advance Magazine for Health Information Professionals. It has a lot of information about transcription work in different states, and it also talks about medical billing and stuff like that. You can subscribe to that online. Just search in Google for Advance Magazine. That’s a very informative magazine. It tells you about the latest technology, and a lot of other things that are going on in the field.

I’m sure in writing your book and having experience with people you’ve seen some mistakes that they’ve made when getting started in medical transcription. Maybe you could talk about some of those.

Well, there’s been some really funny typos that I’ve encountered, but I guess the biggest mistake that I think new transcriptionists make is perhaps being a little too confident and not double checking their work to make sure that it’s really accurate, and I think that’s probably one of the biggest things that you must double check your work.

Any other advice for someone considering getting started in medical transcription?

Definitely don’t get overwhelmed, and I think that’s probably the most common factor is people think that they’ll never learn it or that it might be difficult to learn. But if you don’t get overwhelmed and you just take it step by step it does get easier and within a short amount of time you can be typing and you realize you’re thinking about other things like what to cook for dinner or other things that you’ve got to do, and it’s like you go on automatic pilot, and it just takes a short about of time, but I think that would be my advice is don’t get overwhelmed. Realize that you can do it and it’s really not that difficult to do it just takes a little bit of dedication and practice, but it’s so worth it for the flexibility that you have working from home, and you can choose your own hours basically. You know, if I don’t want to type in the morning and I want to go out, I can type in the evening or whenever I like. Just don’t get overwhelmed.

Michelle Miller is the author of The Step-by-Step Guide to Medical Transcription at Home.