Medical transcription is the process whereby one accurately and swiftly transcribes medical records dictated by doctors and others, including history and physical reports, clinic notes, office notes, operative reports, consultation notes, discharge summaries, letters, psychiatric evaluations, laboratory reports, x-ray reports and pathology reports. It involves receiving dictation by tape, digital system or voice file, and using earphones, a foot pedal for start-stop control and a word processing program. It sometimes includes the use of a printer and sometimes a modem. A variety of word-processing systems are used. It requires good listening skills, computer skills and knowledge of medical terms.
Several dictionaries are necessary.
Medical definitions, medications, medical terms by specialty, laboratory terms, surgery terms and abbreviations. Specialized word lists are also helpful, and journals and computer networking are helpful for current information about new medications and terms. Transcription is done more efficiently with the use of a medical spellchecker and an abbreviation system. As an employee in an office or hospital, transcriptionists may be paid by the hour. Usually independent transcriptionists charge by the 65-character line, sometimes by the character, word or page, or even by the minute of dictation.