Review of Perspectiveson the Medical Transcription Profession
Review of Perspectives
Published by Health Professions
Institute
By Mary Morken
Winter 1996-97, Vol. 6, No. 4
Kathy Cameron addresses the process of selecting new transcription department equipment from assessing the present system, to having a team assess the needs from the perspective of all departments, to evaluating vendors and making the purchase.
Adrienne Yazijian writes two articles: The first one reports that people are taking less time for rest and recreation in the 90s. The other encourages living a balanced life in order to keep strong.
Bron Taylor shares her biography of entering medical transcription in the early 1970s and learning on the job under the proofreading of Vera Pyle. She mentions the "Homemade Dictionary" the department kept that all the MTs contributed to, with documentation; this was the forerunner of Current Medical Terminology, now in its sixth edition.
Dr. Richard Lederer writes about how the meaning of words change over time, some broadening, others becoming more precise. Examples: straight, gay, doctor, business, and holiday.
Dr. Robert Seal answers practical questions from readers. In response to a letter of concern about overseas MT, he writes that years ago MTs "wanted to keep the medical transcription profession closeted in an exclusive group in order to increase their own employability and ultimately their earnings. This frequently discouraged people from taking up the career. Those unselfish MTs who did recruit other became mentors...They were richly rewarded and formed lifelong...friendships." He encourages American MTs to compete to keep the market here.
Marcy Diehl gives tips for teaching study skills to MT students. Kathy Cameron, Interim Executive Director of MTIA, presents information on it. Seventy-two companies are now members. The President is Ed Samek of the MRC Group. An article on finding a first MT job includes advice to be persistent, ready to take transcription and editing tests, and ready to fill out applications.
Linda Campbell gives some basic instructions about the Internet and outlines several website resources, including "Guide to Oncology Regimens," http://www.meds.com/mol/regimens.html.
Dr. John Dirckx writes five pages on neoplasia (erratic cell growth) explaining terms like carcinogens (chemical toxins) and grading (degree of malignancy) such as Broders classification and the T-N-M (tumor, nodes, metastases) classification. He examines in detail the four most common cancers, lung, breast, prostate, and colon. He ends with a glossary of terms like anaplastic (undifferentiated cells), effusion, hyperplasia (increase in cells), melanoma (tumor of skin pigment cells), and paraneoplastic syndrome.
Donna Avila-Weil and Mary Glaccum write with advice on how to compete with strength in the face of overseas competition. They encourage ongoing education and learning about technology.
Three pages of new terms are listed, including FemPatch, fluasterone, Focustent, Gadolite, MIDCAB (minimally invasive direct coronary artery bypass), Neoral, and OsmoCyte.
Judith Marshall writes about the realities of the global market that are hurting some American MTs and benefiting some MT companies. She welcomes the world competition of Capitalism as creating a healthier environment. Included in this article is her evaluation of online MTs: They are computer literate, they are often ICs, they are critical of AAMT, they don't read MT journals, they discuss issues that AAMT has discussed years ago, and some are weak in ethics, grammar, and MT history. She mentions AAMT's silence on the Internet, and states that "...there is a shift in leadership to the technically savvy, if leadership is the correct term in a profession that employs so many diverse people in so many diverse work situations. A union is out of the question, but from the Net may come more local association groups..."
Finally, there are advertisements for MTIA, Pat Systems, Crescendo Systems, Saunders Dorland's spellchecker, AAMT's CD-ROM Book of Style, MDXpressNT, PC-DART, HPI's books and SUM program, PRD+, and a few others. They announced HPI's new book just out, Psychiatric Words and Phrases.
Business by Sally C. Pitman, p. 2: Pitman reports on the 1997 Medical Transcription Industry Alliance annual conference, stating, "The business of MTIA is business." She notes that transcription business alliances give MT leaders unprecedented access to technology vendors, enabling them to lead the way in technology innovation.
Features
"When it Hurts Too Much: Alternative Careers for Medical Transcriptionists." by Diane S. Heath. p. 4: Heath explores options for those transcriptionists whose physical distress makes it impossible for them to continue typing. She urges MTs to focus on their medical language skills and pursue careers that make use of them, including that of supervisor or manager in a transcription service or department; teacher or trainer at a vocational school or community college; proofreader or editor in a quality assurance program at a hospital or service; researcher or writer for publishers of transcription reference materials; coder for medical records; cancer registrar; business owner; or consultant.
"Enhancing Word Processing in Transcription." by Judy Hinickle. p. 10: A discussion of the tools that augment traditional word processing programs, including productivity tools and management information programs. Hinickle lists those tools (along with company Web sites and phone numbers) which work along side of word processing programs, including medical spellers and dictionaries, management enhancements (which track productivity through line-counting capabilities), productivity enhancement programs (abbreviation expanders for keyboarding shortcuts), and finally, "voice to text" programs which enable transcriptionists to re-dictate reports.
"Frequently Asked Questions in the Medical Transcription Field." by Kathy Cameron. p. 16: Cameron's article provides answers to the questions most often asked by health information managers, supervisors of medical transcription, service owners, and medical transcriptionists. She addresses what constitutes a line and how it is measured; how many lines per hour (or per 8-hour shift) a transcriptionist should be able to do; how to set up a QA program and whether there are national standards for quality; whether transcription should be outsourced; how to find a good service; what is the average pay rate for MTs and how to set up an incentive pay program; whether ICs should be used; whether there will be a continuing need for MTs; the future of voice recognition; what MTSOs should charge for their services. Each question is accompanied by references to entire articles on the topic.
"New Bugs on the Block: Emergent Infections." by John H. Dirckx, M.D. p. 33: Dirckx discusses the field of Infectious Disease and the challenges presented by antibiotic-resistant bacteria, and newly emergent bacteria and viruses. He discusses causes and possible solutions, including more conservative use of antibiotics.
"Where Have All the Operations Managers Gone?" by Judith Marshall. p. 28: Marshall laments the scarcity in transcription departments of the operations manager, whom she describes as the coordinator in the department. The OM makes sure the needs of the MT, the client, and administration are met. The OM is in charge of making the department run smoothly, keeping the work-flow moving, understanding the ins and outs of dictation systems, and acting as a liaison between the transcription work that is available and the large pool of MTs who are waiting to fill vacant positions.
Columns
Working... a Lot More than a Necessary Evil by Adrienne Yazijian, p. 8: Yazijian discusses how our society neglects the importance of work as an important ingredient in the make-up of a psychologically healthy adult. She claims that work is not honored and valued, and is often viewed as a necessary evil or a prison. She suggests people take responsibility for finding fulfillment and happiness in work which enables them to express their gifts and talents.
If I Won the Lottery by Kathryn Rambo, p. 20: Rambo describes the demands she would put on her clients if she had enough money to make her work as a medical transcriptionist an option rather than a necessity. The article serves as a tongue-in-cheek wish list of those things that would make an MT's life easier.
CLooking at Language: Jest for the Health of It by Richard Lederer, p. 21: Lederer gives several examples of amusing medical malapropisms.
MTIA Happenings by Molly Malone, p. 22: A report on the 1997 MTIA Annual Conference in New Orleans. Malone reports that there were 120 conference attendees and 20 vendor companies present. Also noted is that Molly Malone has been hired as MTIA Executive Director beginning May 1, 1997. New MTIA members are welcomed and the election of the new Board of Directors is announced.
The Independent MT: Your Best Defense by Donna Avila-Weil & Mary Glaccum, p. 24: This article discusses how important a business relationship between an attorney and a MTSO can be. The time to establish such a relationship is before there is a legal emergency. A business attorney can assist with advice on matters of business planning, zoning, the use of subcontractors, government regulations, lawsuits and contracts. The authors advise that MTSOs determine their legal needs, and then find an attorney who specializes in home-based businesses. Alternatively, business owners with access to the internet can get legal forms and do their own research at several Web sites, and there are also legal software packages available. Web in the Corner by Linda C. Campbell, p. 26: Campbell describes the MT Desk Web site, "a launch pad to an incredible array of medical information for MTs," as well as three on-line books, International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9 CM), UNC's Online Neurosurgery Resident's Handbook, and The Basics of MRI. Also discussed is a Web site which is a database of laboratory tests from the University of Virginia Clinical Laboratories.
Teaching Tidbits: Tips for Teaching Study Skills, Part 2 by Marcy Diehl, p. 28: To help students prepare for testing, Diehl recommends teaching them through the lecture process which part of the lecture is most important, with emphasis on note-taking. Diehl also recommends teaching students how to read the textbook most effectively, and how to get the most out of routine homework assignments and study groups.
Departments
Networking in MT Cyberspace, p. 14: The author urges caution when entering the world of on-line transcriptionists for networking purposes, and urges balance by establishing and maintaining face-to-face networks in the local community.
What's New in Medicine, p. 30: Three pages of medical terminology with definitions, from "abnormal uterine bleeding (AUB) to "XPS Straightshot."
Education Sally C. Pitman, p. 2: The focus of this issue is education as employers of medical transcriptionsts are finally realizing that the supply of well-trained MTs is inadequate to allow for industry expansion stemming from mergers and acquisitions.
Features
"Editing: Do It with Style." by Diane S. Heath, p. 3: Heath holds that it is the duty of medical transcriptionist to produce grammatically correct, well=A9punctuated, coherent reports for their clients, and encourages MTs to edit dictated reports for style. She advises MTs to have and use proper references materials for grammar and punctuation, as well as at least one of the several style manuals that are available for the medical transcription field.
"Corporate Training: A Solution for MT Staffing." by Kathy Cameron, p. 6: According to Cameron, one solution to the lack of qualified transcriptionsts needed in hospitals and transcription companies is to offer a corporate training program. Benefits include improved staffing, productivity and quality assurance, a pool of well-prepared new MTs, cross=A9training for current employees, career advancement and vocational retraining, and meeting the needs of the larger community. Cameron also lists the requirements for a successful transcription training program, discusses the budget necessary for such a program, provides a corporate training case scenario, and profiles one such successful program.
"Anatomy and Physiology of Teamwork." by Juanita Reames, p. 12: Reames describes the "anatomy" of successful teamwork (the number of people working together, the environment and tools they have, and the tasks to be performed), as well as the "physiology" of such teamwork (how everyone actually works to achieve the common goal). An important factor is not only getting along with team members, but also liking them.
"Recruiting Transcription Students (Urban Version)" by Josephine Gordon and Carolyn K. Grimes, p. 17; The authors discuss the best places to recruit students into the field of medical transcription, a "hidden profession." They suggest women's groups, grocery stores and laundromats. Also, middle schools and high schools are fertile ground for recruitment presentations because the students take home literature to their parents, or may be interested themselves, and frequently, teachers are interested as well.
"Two Years Before the Class (Confessions of a Medical Transcription Instructor)." by Keith A. Drake, p. 24: Drake recounts his experiences when he was unexpectedly approached to take over as instructor of a medical transcription course at a technical college. He found that offering 20-minute lectures on such topics as computers, the internet, dictation technology, reference materials, quality assurances, and managing a home business, enabled him to connect with his students better than simply grading their transcription, and also served to make his class extremely popular.
"Old Foes, New Woes: Resistant and Resurgent Pathogens." by John H. Dirckx, M.D., p. 37: Current developments in the field of infectious disease, includes discussion of well-known pathogens that have re-emerged or become newly virulent. Penicillin-resistant pneumococci, multidrug-resistant tuberculosis, toxin-producing staphylococcus, "flesh-eating" streptococci, and acute rheumatic fever (caused by Group A beta-hemolytic streptococci) are discussed.
Columns
Ask Bob by Robert M. Seale, p. 14: A question and answer column for MTs: what a large facility should look for in a transcription company, how to evaluate claims of MT expertise on the internet, how to handle hospital transcription department politics.
Teaching Tidbits: Obstacles to Success: Planning Time for Homework by Marcy Diehl, p. 18: Diehl has found that focusing on obstacles to success with her students enables them to confront them at the beginning, and heads off any surprises that may arise as students tackle a demanding curriculum. Time constraints and distractions such as paid employment are two of the obstacles Diehl discusses.
MTIA Happenings by Molly Malone, p. 20: Malone reports on the July 28 board of directors meeting in Las Vegas. She also discusses 1998 conference plans, welcomes new MTIA members, discusses membership growth, and announces the opening of a new MTIA office in Seattle. At the upcoming AHIMA National Convention, a day-long tutorial on "Transcription Management Issues" will be held. Speakers will be Malone, Judy Hinickle, and Kathy Cameron.
The Independent MT: The State of a Union by Donna Avila-Weil and Mary Glaccum, p. 22: The issues that have always been important to medical transcriptionists for the past 30 years continue to be important, i.e., adequate compensation for the work they do, improving the quality of dictation through improved dictation technology and physician training, and professional recognition of medical transcription as an allied health care profession. The authors point out that the medical transcription field is essential to meeting quality health care standards. They conclude that unionization to address these issues is worthy of serious consideration.
On Track with New Techniques by Adrienne C. Yazijian, p. 26: A discussion of techniques companies can use for "continuous improvement or betterment." Focus is on employee education and implementing service strategies by engaging the participation and enthusiasm of the employees.
Looking at Language: A Fair Dinkum Guide to Speaking Strine by Richard Lederer: A report on the author's trip to Australia and his fascination of their use of the English language. He notes differences in spelling and word usage, as well as Aussie slang.
On Our Reference Shelf by Diane S. Heath, p. 31: Reviews of Sheila B. Sloane Medical Abbreviations & Eponyms, 2nd edition, W.B. Saunders Company, 1997 and Stedman's Electronic Medical Dictionary, 26th edition, Williams & Wilkins, 1994.
Web in the Corner by Linda C. Campbell, p. 34: A look at Web sites that offer free medical terminology lists, a MT message board, and a new Web site from the Department of Health and Human Services. Web sites that are discussed include MT Daily (www.mtdaily.com), MT Desk (www.mtdesk.com), MT Monthly (www.sound.net/~mtmonth/terms.htm). Current terms from Health Professions Institute can be found at www.hpisum.com/CurTerms.html). The Health and Human Services site is at www.healthfinder.gov.
Flexibility: The Gumby Principle by Adrienne C. Yazijian, p. 36: Flexibility to adapt to change benefits corporations and individuals. Plans and scenarios help to prepare for change in the future.
Refried Beans by Judith Marshall, p. 47: A look at how the English language is warped by dictators, ever anxious to make reports more elaborate and less understandable, and how MTs are needed to straighten things out.
Departments
Self-Assessment Quiz, p. 28: A 50-question quiz to "test your knowledge of spelling and punctuation; grammar, style and format; medical terminology; professional issues; anatomy; laboratory medicine; pharmacology; and general medical knowledge."
What's New in Medicine. p. 44: Three pages of new medical terms, from "Acticoat" to "Xenical".
Information Security, Sally C. Pitman, p. 2: Focus is on health care information security and the joint position statement on "Confidential Health Information and the Internet" by the MTIA and the AHIMA, which is published in this issue of Perspectives and in the Journal of AHIMA.
Features
"Don't Just Toss 'Em a Fish!" by Diane S. Heath, p. 3: Heath advocates "fishing lessons" for all new MTs, i.e., she believes it is important for new MTs to learn where and how to get the information they seek, rather than simply providing answers to questions. Heath is a believer in the indispensability of formal, quality transcription education programs. An MT who has taken "fishing lessons" is one who has completed a quality transcription training program, built a reference library, has sought out mentors, and has done research on transcription business practices.
"Confidential Health Information and the Internet." MTIA and AHIMA, p. 7: The joint position statement of the MTIA and AHIMA on patient record confidentiality as it relates to new technologies, particularly the internet which can be used to transfer text and voice files. Safety concerns and recommendations are outlined.
"Integrated Transcription Delivery." by Kathy Cameron, p. 9: Cameron discusses the important role of the transcription department/service in an HMO, and the challenges faced when a hospital transcription department must become the regional supplier of services to a much larger "integrated delivery system" which can include physician offices, clinics, imaging centers, and freestanding surgery centers. Scenarios and solutions are discussed.
"Tick-Borne Diseases: The Woods Are Full of Them." by John H. Dirckx, M.D., p. 34: Dirckx discusses the viral, bacterial, Rickettsial and protozoal-diseases carried by different kinds of ticks, including tick paralysis, babesiosis, Rocky Mountain Spotted Fever, Lyme disease, and ehrlichiosis. He also discusses symptoms, treatments and precautions.
Columns
Ask Bob by Robert M. Seale, p. 13: A question and answer column for MTs: disparities in company pay rates based upon city, employee relations, dress codes in hospital transcription departments, and assorted office politics are discussed.
Looking at Language: Retro-Active Words by Richard Lederer, p. 16: "Retronyms" are words which are "adjective-noun pairings generated by a change in the meaning of the noun, usually because of advances in technology." Examples include watch/pocket watch, pen/fountain pen, and razor/straight razor.
SuperVISION by Judy Hinickle, p. 17: The column is adapted from Q & A sessions held by Hinickle. She offers advice on formulating a dictation checklist to be used to give providers feedback on their dictations. She also discusses factors to be considered when evaluating at-home transcription courses, productivity, incentive programs, dictation and transcription dates, work-place ergonomics, word processing templates, and confidentiality agreements.
MTIA Happenings by Molly Malone, p. 22: Malone announces the new MTIA Web site, at www.mtia.com. The Web site will offer links to Web sites of member companies, direct e-mail to the MTIA office, a calendar of upcoming events and the agenda for all meetings. She also reports on the semiannual MTIA meeting in Phoenix and announces plans for the 1998 Conference for Medical Transcription Services in San Diego to be held May 7 to 9, 1998.
The Independent MT: So Big by Donna Avila-Weil and Mary Glaccum, p. 27: The issue of controlling growth when an independent contractor's business booms is discussed in this article. Solutions include outsourcing and expansion. The authors also discuss the reasons why businesses fail, including lack of planning, inexperience, insufficient financial records, inadequate cash reserves, excessive overhead, overexpansion and complacency.
Web in the Corner by Linda C. Campbell, p. 30: Campbell lists many Web sites that were previously reviewed, but which have changed their URLs or content significantly. The focus is on Web sites with medical content which the medical transcriptionist may find to be useful resources.
Teaching Tidbits: Obstacles to Success: Part 2 by Marcy Diehl, p. 32: Diehl has found that focusing on obstacles to success with her students enables them to confront them at the beginning, and heads off any surprises that may arise as students tackle a demanding curriculum. In part two of this article, Diehl discusses family pressures, equipment issues (cost and technology challenges), terminology, typing speed, grammar skills, and getting along with the instructor.
Business, Bowling, and White-water Rafting by Adrienne C. Yazijian, p. 40: Yazijian compares the new global way of doing business to white-water rafting, noting that it demands "continual adaptation to the ever-changing environment." She notes that there is no sure-fire, consistent, or reliable way to do business and that flexibility is key to running a successful business.
Departments
What's New in Medicine, p. 24: Three pages of new medical terms, from "accuDEXA" to "Zomig.".
Working from Home, p. 29: An article aimed at students discussing the pros and cons of working at home, the financial and educational investments that need to be made, the supplies and equipment necessary, home office considerations, and the best way to reach this goal.