The medical transcriptionist has long been an integral part of the healthcare process. Since typed text first started to find itself commonplace in healthcare, physicians have counted on having a transcriptionist to bear the burden of documentation. As time and technology advance, medical transcriptionists will need to respond to many changes in the healthcare industry.
What is a Medical Transcriptionist?
Often behind the scenes, a medical transcriptionist uses their skills to document healthcare encounters. Physicians use dictation systems to create recordings of their findings and important details from patient visits, and these files are transmitted to the transcriptionist. Widely unparalleled in their typing speed and effortless use of shortcuts and macros, the medical transcriptionist takes a physician’s dictation and returns the spoken description of a patient encounter in the form of a medical document.
Watching a medical transcriptionist does not do justice to all that’s required of them. Sure, you can see someone with a headset, listening closely and typing feverishly with intermittent taps on the pedal below their desk used to control the dictation files. Besides juggling all that, there is much more a medical transcriptionist must do to be successful. They’re often given different abbreviations and protocols that they must expand into useful language. The physicians do not wait as what takes moments for them to say takes a few more moments to type, so composure is required to not get tangled up and frustrated with timing that can sometimes be rapid or erratic.
A medical transcriptionist must have strong working healthcare knowledge for a few reasons. It will be essential for them to understand and properly spell complex medical words very quickly. Not only that, but it’s not uncommon for transcriptionists to receive poor dictation file quality. Sometimes the volume of the file is too low or there’s noise in the background, and other times the native tongues of a transcriptionist and a provider may be a mismatch. These situations can all lead to parts of a dictation that cause confusion or uncertainty, which can be overcome with a strong foundation of basic medical knowledge.
Why Transition from Transcriptionist to Scribe?
Once one of the supreme allied healthcare professional jobs that didn’t involve blood and guts, the medical transcriptionist is now being threatened. While it is still used in several areas of medicine and remains a superior means of documentation for many specialties, the improvements in EMRs, voice recognition, and the emergence of medical scribe jobs have begun to encroach on the territory of the transcriptionist. According to BLS, the job outlook for medical transcription from 2014-2024 is projected to be a 3% decline.
Besides fewer job opportunities, the various options that can be more cost-effective for physicians and facilities may also lead to a decreased stream of available assignments at current positions. Inevitably, the availability of different options can start to have a negative impact on the pay available for medical transcriptionist jobs, too.
Differences between a Transcriptionist and a Medical Scribe
Medical transcription and clinical scribing may seem similar, but they have little in common beyond the product of their work. The most distinguishing characteristic of scribes is their presence with the physician in exam rooms. A transcriptionist is often in another room within the facility, offsite in another facility, or even at home! Obviously, there can be a lot of variation in work style and expectations between the two.
Paramount among these differences is how transcriptionists and scribes obtain the medical information they’re going to document. A transcriptionist is told via dictation what to type, often with the expectation that it is verbatim what the file says. Medical scribes instead must extract the relevant medical information from patient encounters. This can be difficult, as much can be happening during patient visits, and digression from the matter at hand is not uncommon. The transcriptionist is spared the small talk and other conversation that is typical in a patient-physician relationship, which makes the task of transcribing more direct.
Transcription Job Highlights
1. Variety of possible work locations including home
2. Being removed from the action and having a pedal makes the pace more controllable (but not necessarily slower!)
3. Multiple ways to be employed and paid
4. Projected job decline
Being so close to the action can be overwhelming and outright unappealing to many people, especially experienced medical transcriptionists who’ve made a career of being outside the fray. Besides proximity to the action, the pedal used by a medical transcriptionist that allows them to pause, rewind, and fast-forward a dictation file is unavailable for scribes. Although scribes can (and must) ask when something is missed during a visit, this is certainly not done as easily as simply tapping the foot.
There is further variance between medical transcriptionists and scribes besides how they acquire information to document. One way that transcriptionists work so quickly is through heavy use of shortcuts and macros. Unfortunately, these aren’t available in many EHR programs. However, some favorites and forms may be used to save time on repetitive information. Some transcriptionists try countering these obstacles by working in their old platform then copy/pasting it into an EHR program, but this is inefficient and can lead to formatting nightmares.
Clinical Scribe Job Highlights
1. Present with the physician during patient visits
2. Incredible exposure to healthcare
3. Possibly less pay and benefits than transcription
4. Likely to be a fast-paced and high-intensity job
5. Rapidly growing position in healthcare industry
The amounts and ways in which a scribe and a transcriptionist are paid can be different. Medical scribes are often hourly employees who are ineligible for most benefits. There can be a lot more variation in how transcriptionists are paid and their employment statuses. Medical transcriptionists can be paid per line of work, per word, per hour, or salaried. Some of them are independent contractors, others work for companies that provide medical transcription services, and yet others are employed by healthcare facilities themselves. Each of these modes of employment might have different implications on availability of benefits and other job perks.
How to Transition from Transcriptionist to Scribe
While the many differences may cause trepidation for medical transcriptionists considering a switch to scribing, it is important to remember the multitude of advantages a transcriptionist has over most scribes. It is more likely that a transcriptionist will be seeking a career in healthcare documentation, which is different from many scribes who are seeking the position solely for medical experience to transition into other healthcare occupations.
This very search for medical experience by scribes is yet another weakness of them in comparison to a medical transcriptionist. Many transcriptionists already have medical experience, and will bring the benefits of such a background to a healthcare team, while a scribe often presents the variety of challenges presented by having a healthcare neophyte involved in patient activities.
If you currently work as a transcriptionist, the most logical place to seek a scribing position is with the facility for which you currently work. Many facilities are already transforming certain parts of their documentation force to scribes. The appeal of having an established employee in the position over the prospect of a new person who would likely need more training on healthcare fundamentals is likely to work in favor of a medical transcriptionist.
It’s not only the experience buffer that favors the transcriptionist, but also the relief their career-seeking status will provide in the wake of high turnover with medical scribes, which is common. Additionally, a transcriptionist with experience as a healthcare documentation specialist and a long-term commitment in mind can be a wonderful prospect to be a scribe manager!
Before making this transition, it is important to set realistic expectations. Although transcriptionists may possess many advantages, it has not been uncommon for them to quickly develop an aversion to scribing. The pace, expectations, and work environment can be very different from what a transcriptionist may be used to, and it can take some adjustment. This is certainly achievable and provides excellent opportunities for those who can accomplish it, but it is not a transition that has been made with a 100% success rate. A careful consideration of one’s compatibility as a scribe would prove useful before making the jump.
Future of the Medical Transcriptionist
In this transition period, it’s difficult to say what place the transcriptionist will find in a field being taken over by medical scribes and advances in the usability of EMR and voice recognition software. It seems that the medical transcriptionist will endure to some extent for the foreseeable future, but some decline seems to be a certainty. Those working or considering a career as a transcriptionist will have to decide which option will be most suitable for them: trying life out as a medical scribe, roughing the storm potentially ahead as a medical transcriptionist, or leaving the industry altogether.