Why Medical Transcription Jobs are High in Demand

There are many transcription jobs available to job seekers these days and one type of position which gets quite a bit of inquiries is medical transcription. This particular category of transcription jobs entices individuals with its many favorable attributes. The following will highlight some reasons why transcription jobs in the medical field are so high in demand.

One of the main reasons why individuals are interested in obtaining transcription jobs in the medical field is that there are usually plenty of them to go around. If you are well versed in this field you are certain to find many opportunities for transcribing medical documents for healthcare facilities. When you consider the number of hospitals, doctor's offices and any other type of medical facility throughout the world, you can certainly see how many documents are needed to be transcribed and put into a new format. This makes getting involved with medical-related transcription positions a good move for many transcriptionists.

An additional reason why more and more individuals are expressing an interest in medical transcription positions is that these jobs are often well paid ones. If you are a fast typist then you will find making good money is an easy feat in this field. The more time you have to type, the more money you are likely to make. Since most individuals want a well paid job, getting a position as a medical transcriptionist is a good way to go.

Many individuals who work in typing related fields also opt for medical transcriptionist positions as they are often freelance or telecommuting positions. This type of job allows the individual to work from the comfort of his or her own home or any other location in which they have access to the proper transcription equipment. The flexibility which often comes along with this type of work presents a favorable option for those who take care of their children during the day or need to be there when the kids get off the bus in the afternoon. In today's world with the high gas prices, it is also helpful to have a job such as being a medical transcriptionist where you can work from home and forget about any possible commute to and from the office which leads to frequent travel expenses.

Another reason why individuals desire transcription jobs in the medical field is that this type of work is not difficult to complete once you do it for awhile and learn the proper medical terminology along the way. Medical terminology may be difficult to learn at first but once you come across the same words a few times you will find that transcribing these documents can be done quickly and efficiently. Although one will often come across different terms throughout their weekly transcribing work, many medical transcriptionists will work in the same medical field and get to know the terms like the back of their hand. This is an additional reason why individuals express such a desire to get involved with medical transcription and take advantage of all it has to offer them.

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SAMPLE FILE MEDICAL TRANSCRIPTION

HISTORY
1. Breast cancer. Presented in August 1999 with unattended left breast cancer. She underwent a positive biopsy and was also found to be hormone-receptor positive. She received preoperative weekly Taxol with a nice response. Following her response to the Taxol, the patient underwent a radical mastectomy on January 12, 2000. The pathology revealed a poorly-differentiated ductal carcinoma with clear margins, and 4 or 5 positive lymph nodes. A metastatic evaluation remained negative. The patient was placed on postoperative tamoxifen and remains on this agent.
2. Right brain lesion. Presented somewhat confused and disoriented a couple of weeks ago. She was seen in the office on Thursday following an MRI study. This revealed a 3.8 x 3.8 x 3-cm right frontal mass, which was enhancing and associated with edema and subfalcine herniation with a shift to the left. The differential rests between a meningioma or extra-axial metastatic lesion. The patient was placed on Decadron. She saw a doctor, who scheduled her for craniotomy tomorrow.
3. COPD. While receiving the weekly Taxol the patient required hospitalization for respiratory distress. She was seen in consultation and underwent pulmonary function testing. She was treated with nebulizer and bronchodilator treatments at that time. Bronchoscopy was performed which was nondiagnostic. Spirometry was consistent with a moderate restrictive defect.
4. Hypertension. Maintained on Adalat.

REVIEW OF SYSTEMS
Negative for recent fever, chills, or sweats. The patient has noted some difficulty with gait, and her family has noted confusion. Otherwise, she denied ENT, cardiopulmonary, GI, or GU symptomatology.

The past medical history is negative for allergies, accidents, or fractures. The patient underwent left knee replacement in the past, as well as cataract surgery. She takes an aspirin because of the history of carotid bruits.

MEDICATIONS
Adalat, Decadron, and Pepcid. Aspirin was discontinued several days ago.

SOCIAL HISTORY
Negative for recent nicotinism or alcohol ingestion. The patient has a very supportive family.

FAMILY HISTORY
Significant for a brother with lung cancer, and her father had colon cancer.

PHYSICAL EXAMINATION
Reveals a pleasant woman in no acute distress with stable vital signs. HEENT: The sclerae are white, conjunctivae are pink, mucosa is moist. The tongue is well papillated. No cervical, axillary, or inguinal adenopathy was noted. The lung fields were clear. There was a grade 2/6 systolic ejection murmur noted along the left sternal border with radiation to the carotids. The right breast was free of masses. The left chest wall was free disease recurrence. The abdominal exam failed to reveal organomegaly, masses, or tenderness. There was no peripheral edema. Distal pulses were not felt, but the feet were warm. Romberg testing was positive. Motor function and cranial nerves 2 through 12 were intact.

LABORATORY AND X-RAY DATA
WBC 12.9 (on Decadron), hemoglobin 11.1, platelets 216,000, PT 12.3, PTT 33 seconds. CMP testing normal except for glucose 142, BUN 24. Urine analysis unremarkable. EKG revealed left atrial enlargement and borderline first degree block.

In addition to the MRI noted above, the patient has had recent radiographic studies. An MRI of the lumbar spine was performed on January 8, and revealed moderate severe multilevel spondylosis with diffuse bulging and degeneration of disks. There was no evidence of metastatic disease. A bone scan performed in early December revealed increased uptake in the lumbar spine, which was evaluated with the above MRI. There was no evidence that suggests metastatic disease. A CT of the abdomen and pelvis was performed on November 29,, and was notable for the presence of renal cysts, but was otherwise unremarkable.


IMPRESSION
1. Stage III B breast carcinoma. The patient currently is without evidence of active systemic disease.
2. Right brain lesion with mass effect, rule out meningioma versus extra-axial metastatic lesion.
3. History of chronic obstructive pulmonary disease.
4. History of hypertension.

RECOMMENDATIONS
1. We will consult doctor, who has seen the patient in the past, and will be available if issues of pulmonary compromise arise.
2. Further recommendations will depend on the pathology identified at craniotomy tomorrow.

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NUROLOGIC

The examination of the central and peripheral nervous system,
like that of the heart, consists almost exclusively of tests
of function. Many of these tests require the cooperation of the
patient. However, the more urgent the need for a neurologic
exam, the less capable may the patient be to cooperate. The
extreme example is the comatose patient, whose life may depend
on prompt and accurate diagnosis but who cannot cooperate
at all. The basic neurologic examination is augmented
by special procedures as history and findings direct.
Neurologic exam reveals no gross sensory or motor deficits.
brain stem pons midbrain
Most part of the neurologic examination
are carried out on a regional basis and
interspersed with examinations of other
system. In analyzing and recording findings,
however, the physician classifieds
them according to anatomic and functional
divisions of the nervous system.
The central nervous system (CNS) comprises
the brain and spinal cord; the peripheral
nervous system, the cranial and
spinal nerves. Peripheral nerve fibers
are either motor (efferent) fibers carrying
impulses to muscles, or sensory (afferent)
fibers carrying impulses to the
spinal cord or brain stem. Both kinds of
fibers are often combined in a single
nerve trunk.
The physician tests sensory functions by
stimulating appropriate receptors and
noting the subject’ s responses. Motor
functions are tested by observing the
subject’s ability to perform certain actions.
Even in an unconscious patient,
testing the deep tendon reflexes enables
Physical Examination: Neurologic Examination
iTrans H & P 025
the examiner to assess the integrity of the spinal reflex
arcs, which consist of both sensory (stretch receptor)
and motor nerve fibers. But evaluation of
complex voluntary movements and muscle coordination
requires the conscious collaboration of the patient.
Assessment of cerebral functions (memory, orientation,
thinking capacity, mood) is described in the
next chapter.
If the patient is stuporous or unconscious, the physician
tries to determine the degree of central nervous
system depression by noting the size and reactivity
of the pupils, the rate and rhythm of breathing, the
response to noxious stimuli such as loud noises and
firm pressure over bony prominences, and the presence
of certain primitive reflexes such as the corneal and gag reflex. In the doll’s eye
maneuver, the examiner rotates the patient’s head from side to side and notes the
effect on eye position. Normally the eyes to rotate in a direction opposite to that in
which the head is moved, tending to maintain the same direction of gaze (oculocephalic
reflex). Failure of the eyes to rotate around their own vertical axes during this maneuver
indicates brain stem damage.
comatose, unconscious, unresponsive Glasgow coma score
postictal state catalepsy
corneal, gag reflex doll’s eye maneuver
The twelve pairs of cranial nerves emanate from the brain stem and pass to
structures in the head and neck. The first pair of cranial nerves (olfactory) are not
routinely tested but, as noted in chapter 21, the sense of smell can be evaluated by
asking the subject to identify common substances (soap, tobacco) by their odors.
The second pair (optic) are inspected during the
funduscopic examination and their function is
checked through vision testing. The third, fourth,
and sixth pairs (oculomotor, trochlear, and abducens)
control ocular movements. The fifth pair
(trigeminal) supply the face with motor and sensory
branches. They are tested by noting the
strength of jaw clenching and the sensitivity of
the facial skin in various areas to gentle pinprick.
The seventh pair (facial) innervate the muscles
of the face and are tested by having the patient
grimace, purse the lips, wrinkle the forehead, close
the eyes tightly, and so on. The sense of taste on
the anterior two- thirds of the tongue with a drop
of salt or sugar solution or vinegar. The eighth
pair (vestibulocochlear) are the nerves of hearPhysical
Examination: Neurologic Examination
iTrans H & P 025
ing and equilibrium. Testing the pharyngeal (gag) reflex
arc (as well as taste afferents from the posterior third of
the tongue), and the tenth (vagus), which carry the efferent
side. The vagus innervates the muscles of the soft
palate as well as those involved in swallowing and speech.
The eleventh pair (spinal accessory) sends motor fibers to
the sternocleidomastoid muscles at the side of the neck.
These are tested by having the subject rotate the head
against a resisting hand placed along side the chin. The
twelfth pair (hypoglossal) innervates the tongue and are
tested by assessing the patient’s ability to protrude the
tongue.
cranial nerves II through X II are intact.
bulbar, pseudobulbar palsy jaw jerk
Bell palsy Bell phenomenon
Horner syndrome Adie pupil
Argyll Robertson pupil Marcus Gunn pupil
The spinal nerves emerge from the spinal cord in pairs, one right, and one
left, and supply the body from the occiput downward with sensory and motor fibers.
A pair of spinal nerves is named from the vertebra
above which (cervical region) or below which (other
region) it emerges. Thus the L2 pair emerge below
the second lumbar vertebra. Sensory nerve
endings in the skin are distributed in segments
called dermatomes, each corresponding to a pair
of spinal nerves. Sensory and motor fibers to the
limbs pass through complicated systems of branching
and interconnection (branchial and lumbar plexuses)
before forming the main nerve trunks of the
upper and lower extremities. The entire skin surface
can be mapped as to the segmental origin of
its sensory supply, and like wise the spinal segment
or segments innervating each muscle are
known. With this anatomical knowledge in hand,
the physician can localize and characterize lesions of the spinal cord and peripheral
nerves by precise study of sensory and motor deficits. In addition, lesions of the
brain can be localized by their effect on coordination, stereognosis, and other complex
motor and sensory functions.
dermatome, segment peripheral neuropathy neuralgia, neuritis
radiculitis, radiculopathy focalizing, localizing signs
mononeuritis, polyneuritis
Physical Examination: Neurologic Examination
iTrans H & P 025
The examiner obtains some information about the motor system from the first view of
the patient, and gains more as the examination proceeds. Generalized weakness,
hemiparesis, disturbances of gait, posture, or speech, and abnormal movements such
as tics and tremors are readily observed. The orthopedic examination provides data
about muscle mass, strength, tone, and control. Paralyzed or disused muscles eventually
undergo contracture and atrophy. Paralysis due to peripheral (lower motor
neuron) disease is flaccid (muscles soft and limp). Paralysis due to a cerebral (upper
motor neuron) lesion is spastic (muscles tight, with rigid or jerky resistance to movement
by the examiner) because of uninterrupted, but no longer efficacious, postural
and checking signals from the basal ganglia of the brain.
akinesia, bradykinesia, dyskinesia akathisia
dystonia, hypotonia paresis, weakness
paralysis, palsy hemiparesis, hemiplegia
flaccid, spastic paralysis wrist drop, foot drop
decerebrate, decorticate posturing (rigidity)
rigidity: clasp-knife, cogwheel, lead-pipe, ratchet
gait: antalgic, apraxic, festinating. glue-footed, hemiplegic, hysterical,
propulsion, scissors, shuffling, spastic, steppage, Trendelenburg, waddling,
wide- based
Hoover test, sign tripod sign
moves all extremities well
In neurology, the term reflex refers to a muscular contraction in response to some
stimulus, such as tapping the patellar tendon. For a reflex to occur, both sensory and
motor limbs of the reflex arc must be intact. A deep tendon reflex, such as the
familiar knee jerk, is elicited by tapping the tendon smartly with a rubber reflex
hammer. For some tendons, such as that of the biceps brachii, the examiner may
place a thumb firmly over the tendon and then strike the thumb with the hammer.
This doesn’t feel very good but it vastly improves the accuracy of aim. The examiner
testes selected tendons (at a minimum, the biceps and triceps in the arm and the
patellar and calcaneal in the leg) and notes the quality and strength of responses,
comparing right and left. Normally a sudden stretch of a voluntary muscle tendon
elicits a prompt, brisk, transitory contraction of the muscle. In lower motor neuron
lesions the reflexes are reduced or absent. In upper motor neuron lesions the reflexes
are not only unimpaired but exaggerated. Besides deep tendon reflexes, superficial
or cutaneous reflexes yield information about peripheral sensory and motor
nerves. These include the abdominal and cremasteric reflexes. Abdominal reflexes,
elicited by stroking the relaxed abdomen, cause contraction of abdominal wall muscles,
with movement of the umbilicus toward the area stroked. The cremasteric reflexes
causes the testicle to draw up when the physician strokes the skin of the inner thigh.
DTR (deep tendon reflex) areflexia, hyperreflexia, hyporeflexia
reflex: Achilles, biceps, brachioradialis, patellar, quadriceps, triceps
ankle, knee jerk Jendrassik maneuver
abdominal, anal, cremasteric reflex root signs
Physical Examination: Neurologic Examination
iTrans H & P 025
Certain reflexes are seen only with upper motor neuron damage (pathologic reflexes).
These include the Babinski (upward deviation of the great toe on stroking the sole of
the foot), the Hoffman (twitching of the thumb when the middle finger is snapped),
and the palmomental (twitching of the chin on stimulation of the palm of the hand).
corticospinal, pyramidal, long tract signs pathologic reflex
patellar clonus, ankle clonus
Babinski, plantar reflex Babinski’s are downgoing, up going
Wartenberg reflex Hoffman reflex Chaddock reflex Oppenheim
reflex
Gordon reflex glabellar sign Myerson sign grasp reflex
Mayer reflex palmomental reflex
Motor coordination is tested by having the patient perform complex actions such as
touching the nose with the eyes closed, running one heel up and down the opposite
shin while recumbent, and making rapidly altering movements with both hands. In
the Gordon Holmes test, the patient is asked to pull with one fist against the physician’s
resistance in such a way that, if coordination is abnormal, the physician’s sudden
release of resistance will result in the fist striking the patient’s own face. (The physician,
however, prevents this.)
adiadochokinesis, dysdiadochokinesis ataxia, incoordination
heel- to- shin test finger- to- nose test
checking overshooting
decomposition of movement Stewart- (Gordon) Holmes sign
apraxia, dyspraxia dysmetria, dyssynergia
associated movements
Abnormal movements vary from fine, ineffectual twitches of a few muscle fibers (fasciculations)
to violent thrusting or hurling movements of the whole body. Tremors can
be coarse or fine, local or generalized; they may be worse at rest (resting tremor),
with purposeful movement (intention tremor), or with position- holding (postural
tremor). Asterixis is a coarse, flapping tremor that occurs when the patient attempts
to hold the hands steady with palms down. Chorea denotes sudden, brief, involuntary
jerking movements of the face or limbs; athetosis is a slow, continuous writhing.
Often these two occur together.
adventitious movements myoclonus myokymia
tetany carpopedal spasm
hemiballismus tic, twitch, habit spasm
chorea, athetosis fasciculation, fibrillation
Physical Examination: Neurologic Examination
iTrans H & P 025
The physician performs a basic sensory examination by noting the subject’s ability to
detect light touch (as from a soft brush or a wisp of cotton) and superficial pain (from
a gentle pinprick) over various parts of the body surface, always comparing right and
left. Nylon monofilaments of various calibers, which buckle at reproducible pressures,
can be used to quantify cutaneous sensory loss. Their principal application is in
grading diabetic neuropathy of the feet. Sensitivity to temperature can be tested by
applying cool and warm metal discs, or test tubes containing cool and warm water, to
the skin. Vibratory sense is tested by placing the shank of a vibrating tuning fork
against a superficially lying bone, such as a knuckle or shin. Proprioception is a form
of sensation by which the brain monitors the position and degree of stretch of voluntary
muscles in the trunk and limbs. It is important for both balance sense and coordination.
Proprioception can be tested by asking the patient to report the position in which
fingers or toes are placed by the examiner.
tactile, touch pain, temperature, and tactile
anesthesia, hyperesthesia, hyp(o)esthesia
10 g Semmes- Weinstein monofilament
glove, stocking anesthesia kinesthesia
pinprick, pinwheel vibratory sense
proprioception meralgia paresthetica
Other sensory modalities that
are tested in selected cases
are two- point discrimination
(the ability to distinguish two
adjacent, simultaneous
pinpricks), stereognosis (the
ability to identify objects
solely by feeling them), and
graphesthesia (the ability to
recognize letters or numbers
traced on the skin).
two- point discrimination barognosis
topognosis stereognosis graphesthesia
Meningitis (inflammation of the covering membranes of the brain and spinal cord) is
often accompanied by painful spasm of paraspinal and leg muscles.
Marked stiffness of the neck (nuchal rigidity) is a cardinal finding in meningitis. In
addition, two signs are often present. The Kernig sign is inability of the knee to be
extended when the hip is flexed, because of spasm. The Brudzinski sign is involuntary
flexion of the hips and knees when the neck is flexed by the examiner.
nuchal rigidity Kernig sign Brudzinski sign
Tetany, a hyperirritable state of the neuromuscular system, can be induced by various
drugs and metabolic states, particularly hypocalcemia. Signs of tetany are involuntary
muscle twitches and spasms, including carpopedal spasm and risus sardonicus,
and the Trousseau and Chvostek signs. The Chvostek sign is spastic contraction of
facial muscles induced by tapping over the facial nerve in front of the ear. The
Trousseau sign is spastic contraction of wrist and forearm muscles induced by inflation
of a sphygmomanometer cuff placed about the arm above systolic pressure.
neuromuscular irritability tetany
carpopedal spasm risus sardonicus
Chvostek sign Trousseau sign

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Anesthetics

Inhalation Anesthetics: Most modern
general anesthetics involve the use of inhalation
anesthetics. When breathed in adequate
concentrations, these medicines create an
anesthetic sleep. The most commonly used are
desflurane (Suprane) and isoflurane (Forane).
Other inhalation agents which may be used are sevoflurane (Ultane), Enflurane (Ethrane),
and halothane (Fluothane). These anesthetics are liquid at room temperature and are
vaporized in precisely controlled concentrations in a metered stream of oxygen and
nitrous oxide (laughing gas). Virtually all of the inhalation agent is breathed out in a
matter of a few hours; almost none is left behind.
Types of Breathing Devices
1. Face mask.
2. Laryngeal mask airway (LMA)
3. Endotracheal tube (ET Tube)
Breathing Devices: Breathing devices help anesthesiologists
administer inhalational anesthetics. One breathing device is a face
mask. You may be asked to breathe some oxygen from a clear
plastic mask held near your face as you begin to sleep.
Another breathing device is a laryngeal mask airway or LMA. This device is inserted after
a patient has begun to sleep. It is put gently in the mouth, and its soft rubber cuff is
inflated to surround the trachea. An anesthesiologist may chose to use an endotracheal
tube. It is a soft plastic tube that is inserted through the mouth and into the upper part
of the trachea.
A sore throat and/or a little hoarseness is possible after the use of any of these devices,
even if they are gently and skillfully placed. Both the LMA and endotracheal tube are put
in place only after the patient is asleep. They are most often removed before the
patient is awakened.
Rarely after the surgery a patient may need breathing help from a machine called a
ventilator. In this case, the patient will keep the endotracheal tube in place while the
ventilator is being used.

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How to Become a Certified Transcriptionist

The job of a medical transcriptionist is to review audio recordings made by doctors and to turn them into written reports. Examples of records they type include routine office visits, surgery and urgent care/emergency room visits. Transcriptionists use a machine called a dictaphone to listen to recordings and type the information they hear. According to iSeek Jobs, the average wage for medical trancriptionists is $17.59 per hour, and projected employment growth for the next 10 years is 18 percent. This growth is due to the aging population and their need for services that require documentation. Obtaining certification is a wise choice to further yourself in this field.

.Difficulty: Moderately ChallengingInstructions.
Step:1
1Complete your high school education or GED. A high school level education is required to enter the medical transcription field and to obtain certification.

Step:2
2Assess your skills and interests to be sure this field is a good fit for you. Assessments can be completed on websites such as iSeek Jobs. This will help ensure you can be successful as a transcriptionist. As a basic rule of thumb, you should be an organized individual with computer skills who enjoys working independently.

Step:3
3Complete a medical transcriptionist education program. Medical transcriptionists typically complete either a 1-year or 2-year program, depending on the school. Courses will include medical terminology, grammar and word processing. You will also work on basic skills related to the job such as accounting, organizational skills, record keeping and filing. If your desire is to be self-employed, complete courses on business management and entrepreneurship as well. Additional knowledge may be gained through work experience, and most employers keep their transcriptionists abreast of technological changes that affect their job.

Step:4
4Work in the field for 2 years or more before taking the certification exam. The Association for Healthcare Documentation Integrity (AHDI) offers the exam for medical transcriptionists to become voluntarily certified after 2 years of experience. Separately, and prior to certification, medical transcriptionists may become registered with the AHDI by completing level one of the registered medical transcription exam.

Step:5
5Take the certification exam. Visit ahdionline.org for more information. According to their site, the AHDI is currently charging an exam fee of $195 for members and $275 for nonmembers. Further information about attaining AHDI membership is available on their site as well. The exam takes approximately 5 hours and is automated. Results are provided immediately. Once certified, you will need to renew your certification every 3 years by earning continuing education credits related to the field

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Medical Transcription

Work at Home Job Openings


The United States Department of Labor states that Medical Transcription is one of the fastest-growing professions today, and ranks in the Top 5 positions for Work at Home Careers.


Many companies who offer online courses also offer job placement assistance.


If you are wondering if learning MT is for you, visit Work at Home: Medical Transcription for information on Medical Transcription training, education, courses online, supplies and equipment.


But for those who already have training and experience, there are increasing numbers of medical transcription job openings that allow you to work from your home office, and enjoy flexible hours.


In the past, the employee had to pick up the tapes from the office, and would be able to transcribe them at home, then had to drop them back at the office. This limited the home-based transcriptionist to living local to the office.


The Internet has dramatically changed the job front of this profession, and with Digital Transcription, it is possible now to transcribe for a company in another state from which you live.


This means that you are no longer bound to seeking MT at home jobs only in your immediate area, but can obtain and work a contract for someone hundreds of miles away, even across the country.


Due to this technology, tapes are being used less and less for transcription. With digital transcription, a digital transcriber is used instead of the microcassette that has been traditionally used in the past.


More Medical Transcription at Home Resources:


Medical Transcription Work at Home Jobs: Current job openings that are pre-screened and verified for legitimacy.



Independent Contractor: Tax Information for the MT worker at home.



HealthJobsUSA: Post your resume, obtain licensing information, review Health Care salary data, and set up a Job Search Agent.

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MEDICAL TRANSCRIPTION TRAINING

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Our training prepares you in the field of lucrative medical transcription (full time or part-time home-based medical transcription jobs or flexible home MT jobs) which is recession-proof and offers high-paying, flexible, work-at-home jobs after successful completion of MT training at home.

Distance online MT education lets you set your own schedule. You decide when and where you want to study, and with our Innovative and Unique Video-Assisted MT Course, you have as much time as you want to complete your MT course at home at your flexible timings with 24x7 Video Classes and start working as home MT with High Salary of Rs. 12,000 to 45,000 p.m. (with incentives, allowances, etc. )


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