What Is Medical Transcription?

When a doctor examines a patient's chart, he sees tangible documents that he can hold in his hand. Some of these documents are the result of a work process which begins when the physician starts dictating. That work process ends when the report is placed into the patient's chart.

Dictating is a work process.

Transcribing is a work process.

The finished document is a work product.

The difference between process and product accounts for a great deal of misunderstanding with regard to patient documentation.

As long as we're talking about process, dictating physicians must understand that there is a big difference between copy typing (where someone visually takes information from printed material) and transcribing (where someone receives information aurally). While these two processes have similar goals with regard to patient documentation, the ways in which people perform these tasks differ by the ways in which they take their cues.

One is by eye. The other is by ear.

How do the words you dictate end up in print? They pass through the mind of a medical transcriptionist who makes what you thought you said look much better in print than what you really said.

This process is similar to the work of someone who interprets spoken language into American Sign Language. What goes in that person's ears must come out of that person's hands.

Why are medical transcriptionists so important to dictating doctors? Because MTs are the professional allies who serve as your first line of defense against medical malpractice attorneys. They make critical judgment calls which can save your professional ass every time you make a mistake while dictating reports.

Medical transcriptionists are one of the invisible components of the "patient care team" that you learn about in medical school. These people are not just a bunch of fat, old ladies who sit in the basement, typing away at their keyboards. Nor are they entry-level clerks. They are professional medical language specialists whose knowledge would genuinely astound you.

The average medical transcriptionist requires three minutes to transcribe each minute of recorded dictation. The best of the lot might require only 1.5 minutes to transcribe each minute of recorded dictation.

And yet, no matter how talented a medical transcriptionist is -- no matter how strong that person's skills as a medical language specialist might be -- a medical transcriptionist's work product is totally dependent on the quality of dictation which reaches his ears.

The information technology acronym which perfectly describes this phenomenon is GIGO (Garbage In, Garbage Out).

Next: The Patient Care Team

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