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Julianne Weight talks about her career in the Medical Transcription industry.  You can find her at www.mtexchange.com or on her Twitter feed in the sidebar of this interview.

What do you do for a living?

I currently own MT Desk, a reference and style guide for medical transcriptionists. I also have a blog, MT Exchange, about medical transcription and the medical transcription industry. I have been a medical transcriptionist and medical transcription service owner for over 20 years but now work full time on MT Desk.

Since the focus of this interview is on medical transcription, I’ll describe what I did when I worked full time as a medical transcriptionist.

How would you describe what you do?

I listen to doctors all day! Every time a patient is seen by a doctor for any reason, the doctor has to detail what took place. Over 50% of physicians in America do that by dictating into a recorder. A medical transcriptionist listens to the dictation and transcribes it to a written (now electronic) document that is then sent back to the doctor’s office, clinic or hospital for placement in the patient’s medical records.

What does your work entail?

I have primarily worked independently, transcribing for local doctors. Before digital dictation, I would go to the doctor’s office, pick up the tape recorded dictation, take it home and transcribe it, then print the reports and deliver them back to the office the next day – when more tapes were available for me to pick up. When digital dictation became possible, I no longer had to go to the doctor’s office and files were transferred securely to the office. Boy, was that a step forward! A lot of time is lost when you have to drive around to pick up and deliver work, time when you can’t be transcribing. Many times, it isn’t even an issue that you don’t get paid if you aren’t transcribing; there was so much work that had to be done and returned within very strict time parameters that spending an hour driving around could translate into staying up late and working to get it all done. Almost all medical transcription is paid on a production basis; i.e., per character, line, page, or minutes of dictation. If a transcriptionist isn’t producing, s/he isn’t getting paid.

What’s a typical work week like?

When I worked on my own accounts, a typical week would be getting the work as early as possible so I could start transcribing. Depending on how much work didn’t get done the day before, I might start as early as 6 a.m. so I could get a start on it before I had to stop and get my children to school. I would then spend the day transcribing as much as I could, as fast as I could. I’d take a break when my children came home, then work some more after they went to bed. That was a typical weekday. Weekends, I would spend catching up – getting the dictation from Friday done and clearing up anything else that was leftover. For many years, I transcribed radiology reports for a local hospital, covering weekends. I’d pick up the dictation after the radiologists were done on Saturday, then work all night to get it transcribed because radiology reports have an overnight turnaround requirement. I’d take the completed reports back to the hospital on Sunday morning, then go back Sunday night and pick up more to be done and delivered back on Monday morning. I preferred transcribing for clinics – they close for the weekends! Doing hospital transcription is more stressful because there are no breaks – there are patients in the hospital 24/7 and doctors seeing them and doing dictation 24/7.

How did you get started?

Funny you should ask! I’d been a secretary since I graduated from high school. After I married and had my first child, I worked a few jobs but child care seemed to always be an issue and I wanted to do something from home. I started transcribing for local insurance companies, attorneys and investigators, doing general transcription. Because a lot of the insurance reports included medical language, I decided to take a medical terminology class so I wouldn’t have to look those words up all the time. I realized while I was taking that class that the flow of work from the medical community was much more voluminous and steady than general transcription. When I finished, I got a part-time job as a medical transcriptionist at a very small local hospital, where I received some excellent training from an experienced transcriptionist. I also started contracting work from the service that did the overflow work for the hospital. Eventually, the hospital closed and I worked full time for the service, as they had other accounts. A few years later, I started to get my own contracts.

What do you like about what you do?

I had the good fortune to work during what I think are the best years of medical transcription. I was able to work from home and as long as the work was done on time, my schedule was flexible. I didn’t have to clock in or out or tell anyone that I wouldn’t be working for a couple of hours.

What do you dislike?

When you work at home, you never leave the office. There were many times I thought I would have worked fewer hours if I’d just found a 40-hour-a-week job. My schedule was flexible, but I still had to get the work done. I didn’t get paid if I didn’t work and the work didn’t get done if I wasn’t there to do it. When I had my own clients, it was a struggle to make arrangements to take even one day off; if I did, I’d end up working twice as hard for a couple of days or through the weekend to make up for it. Taking an entire week off was unthinkable.

How do you make money/or how are you compensated?

Most medical transcriptionist who work in-house at a clinic or hospital still get paid hourly with minimum production requirements. However, those jobs are few and far between any more. The majority of medical transcriptionists are paid by the line or character produced – and that’s the final product, not actual keystrokes. If you type a sentence and the doctor changes his or her mind and asks you to delete it, you don’t get paid for typing that sentence.

How much money do you make?

An experienced full-time medical transcriptionist can make as much as $20 an hour. A new transcriptionist just breaking in will be lucky to make minimum wage. Since the job pays on production, the faster you can produce, the more you will make. Being very familiar with medical terminology and clinical records, as well as fast keyboarding skills and productivity-enhancing software tools will help. Inexperienced transcriptionists are slow because they’re unfamiliar with the dictators and the terminology. It also depends on the quality of the recording and the quality of the dictator; doctors with accents can be very challenging and deeply impact a transcriptionist’s productivity. When I had my own accounts and nobody working for me, I could make between $25 and $35 per hour. Most medical transcriptionists working for another transcription service can expect to make between $9 an hour up to about $18 an hour.

How much money do you make starting out?

My first job at the hospital paid minimum wage; at that time, it was somewhere around $7 an hour. I only got the job because I was the fastest typist who applied. If I’d been paid by the line, as many medical transcriptionists are today, I calculated I would’ve made around $3 an hour at the rate being paid per line at that time! I transcribed for over a year before I felt competent and it took a couple more years before every new dictator didn’t throw my production off.

What education or skills are needed to do this?

When I started over 24 years ago, there weren’t many formal programs. Like many others, I took medical terminology classes at the local vo-tech, then got on-the-job training. That scenario would be a real exception in today’s medical transcription job market. It would be extremely difficult for someone to get a job unless they complete one of the top formal medical transcription education programs. Even then, many graduates cannot get hired because most employers want people with experience. I hear from many, many people who complete programs from lesser-known schools and still haven’t been able to get hired after years of trying. Medical transcription is a very difficult field to break into.

Fast and accurate typing is essential. A transcriptionist has to have a good ear – doctors are usually in a hurry, frequently dictating in noisy hospitals, emergency rooms, clinics, while eating, talking and otherwise doing things that make it difficult to understand what they’re saying. A transcriptionist is supposed to be able to hear through all that and figure out what the doctor is saying and interpret what the doctor means to say. The job requires knowing enough about anatomy, physiology, pharmaceuticals, diagnostic studies and laboratory values to know whether or not the dictation is accurate.

What is most challenging about what you do?

For me, the most challenging was doctors who are terrible dictators. I met with one prospective client and thought the guy would be a dream to transcribe for – he had a great voice and was very articulate. However, something happened when he turned on a recorder and he became Elmer Fudd. Another challenging dictator was a Chinese acupuncturist. His accent was very difficult to decipher and my production dropped to half. I finally had to drop the client altogether because I just couldn’t make any money.

What is most rewarding?

I made very good money for many years while being able to work from home. I’d like to say I felt like I was contributing to patient care, but that was really not my motivator – I work for money and not much else.

What advice would you offer someone considering this career?

Pick your school carefully or you may find you’ve spent a lot of time and money on an education and you can’t get a job. Understand that you won’t make much money to start. Make sure you get your information from a reputable source. There are many medical transcription schools with affiliate programs and websites promoting them to get their affiliate fee. They don’t care whether or not the school is a good one or whether or not you can get a job when you graduate from that school. I am, of course, going to say that the information you’ll get from MT Desk is reliable and honest. There are also many medical transcription groups at Facebook and LinkedIn and I highly recommend networking with experienced transcriptionists to find out where they went to school, how helpful the school was in placing them in a job, how long it took them to get a job and how much they’re making.

How much time off do you get/take?

What’s time off? As an independent contractor, I haven’t had a paid day off in over 20 years. Most medical transcription jobs have some paid time off, but not much. I have never worked for a transcription service as an employee, so I don’t know what’s currently being offered; don’t expect two weeks of paid time off. Medical transcription is a 24/7 business and most employees are required to work at least one weekend day, as well as holidays, without any differential in pay.

What is a common misconception people have about what you do?

That we just type what we hear and what’s so hard about that?

What are your goals/dreams for the future?

My goal is to continue to build MT Desk into the #1 reference and resource for medical transcriptionists.

What else would you like people to know about what you do?

I have to be honest – I don’t recommend medical transcription as a career any longer. Someone just starting will spend 12 to 24 months and $3,000 or more on school and still not be able to get a job. When they do get a job, they will make minimum wage or less and no company will pay the difference. If there’s no work available, the computer or internet connection goes down, or any number of other factors that prevent a transcriptionist from working, there is no pay for the down time. The pay rates have been stagnant for the last 12 years. Electronic medical records and speech recognition are impacting the amount of dictation being done and transcribed. There are many experienced medical transcriptionists who can’t get jobs or the jobs they have don’t have enough work available to allow them to make full-time equivalent pay. However, it remains one of the few legitimate jobs that can be done from home. If a person MUST work from home because of health reasons, locale or family reasons, it’s still probably the best work-at-home job option.

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{ 2 comments… read them below or add one }

Lisa July 26, 2014 at 11:30 am

Thanks for sharing your experience and for being straightforward. I got duped big time on a pharmacy technician course. I’m going to share my experience because a lot of these fly by night schools who offer pharm tech courses also offer MT, MA and billing/coding courses. The school company was Corinthian Colleges and the campus was Georgia Medical Institute, now known as Everest.

The counselor told me I would start out making about $15 per hour or more upon completing the course. I had a perfect attendance record and maintained a 4.0 GPA throughout the 9 month course. I always had satisfactory evaluations from my instructors and from the pharmacists at the externship site. After graduating with honors, I passed the PTCB exam and earned my Pharm. Tech. certification as well. While in school I also took advantage of extracurricular activities like CPR class, class trips and a disaster management class. Despite all of this, I could not get a pharm tech job to save my life, and ended up working in a bookstore for $8 per hour. I guess the “real” education came after school and this is what I learned:

1) In states that don’t require pharm techs to be certified or licensed, retail pharmacies prefer to hire marginally literate and inexperienced people and train them in house because they can use lack of education/experience as an excuse to pay poverty wages. If you’re certified, educated and competent you have grounds to expect pay hikes that they would rather not give.

2) In states that do require license, background check and certification, the licenses and background checks have to be paid for by the pharm tech and are often not affordable. You may end up shelling out $400 just to stay unemployed or only earn below $10 per hour.

3) Since I did my externship in a nuclear pharmacy, and spent time learning various dosage calculations that were not taught in classroom, and since I had learned to safely handle chemo drugs and had learned to prepare parenteral drugs, I thought might have a chance to get hired in a hospital pharmacy. Not so. Every hospital wants pharm techs with at least 1-3 years experience, but none of them are willing to give you that experience! Catch-22?? One facility in Columbus, Mississippi that did offer me a nuclear pharmacy position only paid $8 per hour, did not offer insurance and would not provide any relocation assistance whatsoever. Handling chemo is a high risk job, so $8 per hour was obscenely low pay for such work, especially considering I was already $10,000 in debt.

4) The school’s career counselors were never available, and when they were it was only for people of a certain ethnicity. I’m white and I was treated like garbage every time I walked into the career center.

5) Race matters but competence does not, in Atlanta, Ga anyway. If you’re white, good luck finding work if you’re not a doctor or a lawyer. There were people in my class who sat in the back of the room sleeping, eating, playing on their mobiles and cheating on exams, who barely made it out of school with a D or C average, but every single one of them got job placements and got lots of support from the career counselors- but of course, none of them were white. I had the highest GPA of my class, and got zero help from career counselors and zero job placement assitance.

So, yeah, be very careful about choosing training courses of any type. Always do a background check of sorts on the school. Visit the career counseling center *before* you enroll to see what kind of people work there, because they do play a part in job placement. I didn’t take these precautions and I paid dearly for it.

Furthermore, it’s ugly that I even have to bring this up, but it’s reality: Do not enroll in a school where you will be a heavily outnumbered ethnic minority unless you really have no other choice. At my school, there was a grand total of 3 white students in the entire campus during the 9 months I attended, and that included me. Racism is alive and well and white people fall victim to it all the time, whether the Political Correctness Police want to admit it or not.

Another thing you must consider is the Welfare to Work program. If you’re trying to get off welfare and become self-sufficient, then you will appreciate this program. However, if you’re not on welfare and are trying to eke out a living through gainful employment, you will actually fall victim to the Welfare to Work program because those people on welfare will always get preferential treatment by both the career counselors and employers because the schools and companies get perks for placing/hiring welfare recipients. Even if your classmate barely passed, and you had an impeccable record, your classmate will get hired before you do if she’s receiving welfare. If you want a regular job with a boss, consider moving to a town with a lower number of welfare recipients, since this might increase the odds of you being rewarded for competence instead of being punished for it.

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Carol July 22, 2013 at 5:40 am

Hit the nail right on the head! You go girl! I had precisely the same experiences as you in my 24 years of medical transcription. What really irks me is the ads that continue to be run advertizing an MT course and make $60,000, $75,000, etc. being an MT. Even back in the good ‘ole days of medical transcription, this was all but impossible to achieve. It’s just so sad to see prospective MT’s pay up for an MT course only to get the reality check that being an MT these days, many struggle to make minimum wage. These folks got into medical transcription in hopes of a better life for themselves and their children. I don’t know how these schools get away with this advertizing. Isn’t there a law written to protect the consumer? Finally, being an MT all those years I ended up retiring on disability.

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