Ladies (and I say this because 99.999% of us are women), the people that wrote these marketing spiels have never sat down and transcribed medical dictation and they are passing you a line of total and complete bull feces. After answering the fifth call today (and Heaven only knows how many calls last week and how many more calls will come in tomorrow and the next day and the next and the days after that) that went pretty much like this:

Caller: “Can you tell me what I need to do to get into medical transcription?”
Me: “Why do you want to become a transcriptionist?”
Caller: “I have small children and I want to work at home.”
Me: “Do you have any medical background?”
Caller: “No. I was reading about a course / went to a seminar / saw a TV commercial (take your pick here) that said transcriptionists could work at home and make lots of money. Can you tell me that it takes to get into this?”

At this point, I close my eyes and curse every idiot who seems to think any twit can sit down and do this job because all you have to do is sit in front of a computer and type what the doc says and work at home with the kiddies playing at your feet, watch your soaps, do the laundry, and make lots and lots of money without any hard work – all of this after you have plunked down $2500.00+ of your hard earned money and taken their course, learned how to spell the words but don’t know the first thing about how these words are used or what they mean, how to construct a proper sentence AND that just anything on paper will do.

WRONG! Wrong! Wrong! If you have a burning desire to learn Medicine from the ground up and inside out, have a real love of, devotion to and an aptitude for the Art of Language, then read on. Otherwise, my best advice to you is either sell Tupperware or Mary Kay or go into Real Estate because if you think MT is anything other than a PROFESSION on the level of Medicine, Law, and/or Teaching you are setting yourself up for disillusionment and disappointment, and you are about to learn a very, very expensive lesson before all is said and done. Here is what it takes to make it in this profession:

Since we are talking about Medicine, let’s take a minute to look at how long it takes to make a doctor: After four years of undergrad and getting that Bachelor’s Degree, our Doc2B goes off to four years of Med School. At the end of those four years she now has her MD. (Yippee! she thinks, I’m finally a real, live DOCTOR!!!) Okay, she has her MD but there is no way she’ll be allowed to touch a patient on her own – no, siree, not yet. Now, she embarks on her FIRST residency. If she is going to be a General Practitioner (i.e. Family Doc), she is going to do a four year residency in General Medicine and probably another two year residency in Family Practice – that’s six more years, folks. It has now been TEN YEARS since she graduated from college with her Bachelor’s Degree and she is only just now ready for private practice and the really BIG MONEY – ri-i-i-ight... As an Intern, she made about 18 to 21 grand a year and worked probably 100 hours a week or more. As a Resident, she might have been lucky to make 25 grand and the hours are no better. Now, just when she is ready to go into private practice, golly gee, she is saddled with probably a 300,000 dollar debt – medical school is NOT cheap! Oh yeah, she now has to set up her private office. You know that otoscope the doc uses to look in your ears and nose? That puppy costs about $600.00 (low end). A low-end pulse oximeter with thermometer for getting your temp, pulse and O2 sat? $900.00. Get the picture? Now, let’s look at the MT that doc is going to contract with to transcribe her dictation....

There isn’t a college curriculum for training an MT – most of the education and training is done on the job. Oh yeah, you can take one of those courses I referred to above, but that is only going to teach you how to spell words like intussusception, incudostapediopexy, esophagogastroduodenoscopy, deoxyribonucleic acid and on and on and on, ad nauseam, in toto, en bloc, et cetera. That same course might just barely begin to tell you what all those words mean and how they apply, but those same courses don’t even scratch the surface because there isn’t a course anywhere that can even begin to prepare you for the real world of MT. Here is a general time line for you.

Provided you have a solid background in English grammar, a really good course (and there are very, very few) in medical transcription will take you AT LEAST two years and should be taught in the classroom by a real, live instructor who has been an MT (not a nurse, not a PA, but a Medical Transcriptionist) for at least 15 years with a well rounded background in hospital, clinic, and research transcription. She should also have a background in Business with a healthy sprinkling in Law. During your coursework, you should read anything and everything you can get your hands on having to do with Medicine. Beg to borrow medical journals. Haunt the medical library at your local hospital. Take the EMT basic course and then try to go on to a Paramedic training course; these courses include a very valuable requirement of in-hospital time. The Learning Channel has a program called Operation and you should get those videos and watch them over and over until you see them in your sleep. (This won’t begin to compare to actually being in the OR, but for liability reasons, you probably will never get the chance to observe an operation at the elbow of a surgeon.) If you are lucky enough to have a medical school close by, enroll in the Medical School for the Layman program. Trust me on this one – these programs are an incredible learning experience and worth every penny, nickel, dime and dollar.

Okay, now you’ve finished your MT course at the top of your class and you’ve read until your eyes are ready to fall out, you are dreaming about those videos, and you are thinking seriously about volunteering with your local rescue squad – and you STILL would do just about anything to work in and be a part of MT. BUT – you can’t get a job. Remember our doc friend? Basically, at this point, you are where she was when she graduated medical school. She had her MD and you have your NGMT (New Graduate Medical Transcriptionist, i.e. Newbie Certification!) Now you are ready for your internship and residency. Does this mean you are ready to transcribe live – maybe but not likely.

Medicine has something that the profession of medical transcription doesn’t – organized internship and residency programs. Now comes the hard part. You are going to have to find a veteran MT to mentor you and show you the ropes. Why, then, is it so darned hard to find anyone willing to teach you those ropes? Keep in mind that you have chosen a profession that pays based on production. When that is the case, anything that slows down the MT’s production rate hits her where it hurts the most – in her pocketbook. If the MT / MTSO has to pay you and edit your work she is basically in the hole when all is said and done. Believe me, none of us is in business and/or working to do anything other than make money. We have families to feed and mortgages to pay. So what’s a Newbie to do?

After you finish your coursework, it is going to take about two years of what is basically the equivalent of an internship before you are trained enough that an MTSO will consider paying you a student line rate or a hospital supervisor will hire you as a Level 1 MT. If you are lucky enough to be brought aboard at either a service, hospital or clinic, at best you will be offered an entry level position. After about two more years of very closely supervised OJT, you might be ready to take on your first account – IF the doc is a clear dictator and is willing to work closely with you; however, most docs don’t have that kind of time, and I wouldn’t recommend trying this until you have garnered at least another couple of years on the regional hospital level and then maybe two intense years in a teaching facility. By now, you have been an MT General Practitioner for six years. If your training is broad-based enough, you should be able to take on any report thrown at you by some of the worst dictators to ever open their mouths and cough, belch, choke, mumble, slur, snore and/or all of the above into a dictation system. At this point, you are a very well trained Level 1 MT and well on your way to becoming a well trained Level 2 MT and it’s six years since you completed your MT course (and all the other research and off-campus learning). At this point, as an MTSO, I would be more than willing to consider bringing you aboard at full contract rates knowing that you and I would be able to make money – after all, that’s what it’s all about – right?

Now, let’s look at what it’s cost you to come this far – besides six very, very intense, pressure filled, unappreciated, underpaid, overworked years.

By the time you take your course (average cost $2500.00), buy your computer (about $1000.00 – remember you are making a living with this puppy so those low end ‘puters just won’t get it believe me), your software (another 800 to 1000 bucks), reference books (depending on how many you decide you need probably another 800 bucks), extra courses, reference materials for those courses, and continuing education, probably another 5 grand – so-o-o-o-o now, you are right at about $11,000.00 of hard earned (and I DO mean HARD earned) money. AND you are just now to the point where you might be able to start paying yourself back...

Why on Earth would anyone in their right mind do this? Why would anyone go through the hell of paying their dues in this profession when the docs don’t appreciate us, the general populace thinks we are little better than glorified, overpaid typists and any idiot can do this work?

Why does a doctor do it? Ever assisted at the delivery of a baby, or held a beating human heart in your hands, or seen the look a patient gives the provider when the pain finally goes away? Believe me, there is no drug on earth that can give a high like that.

Why does a lawyer do it? Ever sat in a courtroom and seen real justice meted out to a criminal and seen the look on the victim’s face when they know the perp is going to face the music? Ever sat in the gallery in the Supreme Court and heard lawyers argue some of the cases there?

Why does a teacher do it? Some day I will find my third grade teacher and tell her what a real difference she made in my life because she believed in me when no one else did.

Why does a transcriptionist do it? When the doc says, “I’m so glad I found you. Now I don’t have to worry about the work getting done right.” When the medical staff sends flowers and says “Thanks for a job well done”. When you ask a doc a question about a new procedure and she explains it to you as though she is speaking with a colleague and not a subordinate. And some day I truly hope that some MT somewhere will sit back in the office of her transcription service and remember me the way I remember my mentors.

Bottom line – we do it because when we go to bed every night we know we have made a real difference – what other reason is there?

So, if you are considering Medical Transcription as a profession and you are ready to do the hard work and pay your dues, you will be welcomed into a profession populated by some of the most dedicated, well educated, hard working, downright decent people it has ever been my pleasure and privilege to work with.

I am a newbie MT (less than a year). I work at home and have a small child. Granted, I have to work when he's asleep or at nursery school, but we manage just fine. I work for a small MTSO typing reports for medical school PROFESSORS (who tend to be perfectionists). I make the same amount of money that I did when I worked a 8-5 job in medical insurance and I work only about 30 hours a week.

That said... Yes, I had a medical background (but insurance and coding are a completely different can of worms than transcription) and yes, I had a solid English background in both high school and college, but COME ON! I may be totally off target here, but I think that with a lot of hard work and dedication being an MT can be achieved in much less time than six years and without nearly the expense that you mentioned.

If I had seen your post when I was still researching schools, I may have changed my mind and that would have been a tragedy as becoming an MT is the best life decision I've ever made.

No, you can't do this and cook and clean at the same time while your toddler plays at your feet, but I think that some of your claims are almost as far fetched as those of the schools that claim that you can do this with minimal trainig and make oodles of money doing it.

I've never "flamed" a post before, and I hope that this message is not condsidered one. I only want people to know that there is a happy medium. MT is NOT easy, but it is not impossible either. I'm glad that I made the decision to learn this, and it has paid off after a year (yes, just one) of VERY hard studing and training.

Good luck to everyone.

Julia

[ 12-05-2002: Message edited by: Julia W ]

quote:

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That said... Yes, I had a medical background (but insurance and coding are a completely different can of worms than transcription) and yes, I had a solid English background in both high school and college, but COME ON! I may be totally off target here, but I think that with a lot of hard work and dedication being an MT can be achieved in much less time than six years and without nearly the expense that you mentioned.

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No flames here, Julia, but your education and work history are a good match for moving in to MT. Many of the wannabes only have children and the desire to be at home with them, with no other qualifications. A person in that situation is not going to be transformed into an MT by AHP. We just want people to know what they are up against.

Just curious, about the statement about "A person in that situation is not going to be transformed into an MT by AHP." What exactly does that mean?

I graduated from AHP and I know, it's nothing to brag about learning everything I know now about AHP. But I realize, it was a stupid mistake that I have done but I have to keep moving forward and not give up.

When I finshed high school all I wanted to do was go on with my eduation and attend college. That didn't exactly happen as planned but I wasn't going to give up. I loved working as a receptionist and all the duties that went with the position. When I decided that I wasted to much time already and I wanted to go to college now before it was to late. I started to look around for something that had to do with receptionist work but I wanted to add to it and that is when I came across MT. I thought, that it was great because not only would I be doing something that I love to do but I would also be advancing myself to the medical field which really interested me. Not because of the possibilty of staying home. That was like a bonus for me.

I just wanted to add to the posts on my outlook. Sorry!!!!!

You are a rare find - that is, someone who understood what it took and had the dedication to make that dream come true. However, when you've been in the profession for about six years and really paid your dues (you said it yourself, you've only been doing this for about a year), please sit down one day and think about what it cost you in time, effort, and money to get where you will (probably) be at that time. Then, when you've been doing this for more than thirty years and have trained more than a few MTs yourself, look again at where you are and what it cost in time, effort and money.

If your previous posts are any indication of where you're headed, I suspect you are going to be one of the truly excellent MTs out there and a credit to this profession. You are definitely well on your way.

Doesn't that sound easier, and a heck of a lot more dignified, than begging the already-overworked local MTSOs to mentor you for several years?

It's not rocket science, but there aren't any shortcuts, either.

As et cetera mentioned, it will be interesting to look back in 6, or even 30, years. I'm sure that the 2002 me will look like a complete idiot -- there's SO much to learn -- but I don't think I'll regret the path I took to get started.

Also, there ARE college curriculums for training an MT. I attended a two-year program that even included a business class. I also took an A&P class (taught by a physician) where I had to cut open fetal pigs, sheep eyes, and even determine what type of cells I was viewing through an electronic microscope.

As for your "organized internship and residency," my college required an externship in the MT department of a local hospital, where I was hired after graduation. Sure, I was hired as a trainee under full review, but it didn't take more than 8 months before I was able to consistently produce acute care reports at a 99+% accuracy rate, and it hasn't taken me any "six years" in order to reach a Level 2.

As for costs, I believe your estimates are waaay overstated. Stedman's has frequent sales. Used book stores have produced some of my most-used references. I've purchased year-old books from other MTs. My 6-year-old computer is quite capable of producing reports for a private physician. I have not expended anywhere close to the $11,000 figure you quote.

If the point of your posting is that an MT has to "work hard" at becoming an MT, then I wholeheartedly agree; however, I think exaggeration for dramatic effect is unnecessary.

There was no "exaggeration for dramatic effect". The training and experience outlined in this post was what I have gone through during my thirty plus years in this profession. As to the expenses, I have the receipts and the dollars were quoted in today's dollars based on the cost of the reference books, equipment and courses cited in the post. The post was also directed at those considering taking courses like that offered by AHP. I'm sorry if you misunderstood.

The analogy of the physician education and training to that of an MT is right on; again, I'm sorry if you don't agree. I consider a medical transcriptionist as much of a professional as any doctor, lawyer, engineer, teacher/professor out there. In fact, when one considers the amount of research that an MT does to become expert in this profession, if in the first six years of her career she has transcribed in clinics, regional and teaching hospitals, asked questions and made it her business to learn all she can about the material she is transcribing, then she has accumulated the equivalent knowledge of at least a Bachelor of Science and, in the case of the MT who really takes this seriously, a Master of Science.

How do I know this is true? I'm the MTSO who tests, evaluates, hires and QAs the MTs coming out of courses like AHP, Andrews, MTec, etc., and takes the phone calls just like those I outlined in my original post. I'm also the MTSO who gets the great feedback (and passes it on) from the physicians/providers who have to sign off on the work done by the MTs who have taken the time and made the effort to expand their knowledge base and keep themselves on top of their profession.

The implied statement in your post seems to be how could I dare to compare an MT to a physician. I can because my colleagues and I are Professionals, no more or less than any physician. Why do I feel this way? Because that is how MTs were treated in this profession when I started out and I will continue to fight to bring that back.

If you have spent $11,000 over a 30-year career span, you've spent $366.66 a year on average. Well, I've probably spent that much also, so you could have stated that there is an ongoing investment of about $400-500/year in order to have a career as a top-notch MT.

I call it a career because by any dictionary definition, medical transcription is not a profession. This discussion has been held on MTChat many times before. Becoming an MT does not require ANY "training in the liberal arts or the sciences and advanced study in a specialized field." The current standard to become an MT is "a high school diploma."

A BA degree requires classes in history, philosophy, economics, math, physical education, social sciences, etc. Given the wide variety of general education that is required to obtain a BA degree, there is no way that an MT can obtain an equivalent by researching for their jobs -- even if they do it for 30 years. People don't know what they don't know until they actually obtain that BA/PhD/MD/JD degree.

I know that I do not have the same education or experience as a physician, and I have 7 academic letters behind my name.

You can continue to "fight for" bringing back what "usta be" as much as you want, but as long as you and others like you continue to hire MTs who have graduated without actual college-level academic degrees, then medical transcription will continue to be a "career."

[ 12-05-2002: Message edited by: Gaile Stevens ]

We could go 'round and 'round about this this until the end of time, and you will continue to argue your point and I could continue to argue mine. Posting my CV won't change a thing, least of all your perceptions about medical transcription and whether it is a "career" or a "profession" - that isn't the point. You have misread and taken out of context several (if not all) of the points I made in my post. If you are offended by the idea that someone out of high school can educate themselves while performing their job to the equivalent of a four to six year college level education, then so be it.

The point of the post - again - was to illustrate that there are no short cuts. The difference between the MT working at home and any other professional who works outside the home is that the MT working at home really does have a shorter commute than POTUS and she can work in her bunny slippers if she chooses to do so. That is where the difference ends unless you want to include that she must be much more disciplined in order to avoid all of the extraneous distractions she will encounter when working at home. MTs who are expert in this profession have become so through years of hard work without the structure and guidance of formal college-sanctioned programs - I recognize that and said so in the post. That they do not have "alphabet soup" after their names means nothing. That they have shown the initiative and determination to know more means more to me when it comes time to hire than any sheepskin ever will.

I'm not offended in the least.

Following your logic, I'm just reassured that the next time my grandson is running a high temperature, vomiting, and screaming in pain, I don't need to call a doctor; the MT sitting next to me with 30 years of experience has the equivalent of a 5 or 6 year college education in science and is qualified to give me advice.

As for your curriculum vitae (CV), I am always interested in reading the publications, education, fellowships, academic credentials, and faculty appointments that fellow MTs have accomplished. For the rest of us, we merely have a resume.

Am I right? Do I get the prize?

I would like to work at home, but wouldn't mind working in an office or a hospital to start out. I don't have any kids to work around. I realize that I can't just jump into being a medical transcriptionist. If I wanted to jump into a job, I would look in the classified section and start applying. I know this will take hard work. I plan to work hard, absorb everything I learn, ask questions. I know I will not make much money at first. I have weighed the pros and cons of becoming an MT, and the pros outweighed the cons for me.

I am excited on the journey that I am about to embark upon, but reading messages like the first post in this thread get me so discouraged.

I guess I just want to hear that if I go into becoming a medical transcriptionist with realistic expectations, the right qualifications, and the right education, that I will succeed. Will I?

Two: I didn't see any typos in your post and I thought it was well-written, which probably means you are already a "natural" with the English language, or at least you know how to proofread well! There were a couple unnecessary commas, but you will learn ALL ABOUT COMMAS in the course! So don't worry - just work hard and you'll be fine.

By the way, I am an Andrews student myself, in the second module. Feel free to e-mail me or post with any other questions. You will truly enjoy the course, I am sure.

Best wishes in your new career!