#4 - Acute Care Hospital

New transcriptionists often shy away from seeking work in a hospital. Why? Hospitals are least likely to allow their employees to work from home (although that number is on the rise), but this is the best training ground for the newbie MT. Depending on the size and location of the hospital, multiple specialties will be encountered. In addition, hospitals are required by regulatory bodies to maintain patient documentation, so MTs will also encounter a wide variety of report types.

Hospital settings also allow MTs access to patient records. If a healthcare professional is dictating the name of a drug that can't be deciphered, the MT has access to a chart that probably has the name of the drug written within.

Most importantly, however, the hospital setting allows the new transcription to work among fellow MTs. Stuck on a word? There's always another set of ears ready and willing to give a listen and help out.

#3 - Outpatient Surgery Center

With more and more surgical procedures being done on an outpatient basis, many surgeons are setting up facilities where patients can have procedures without a visit to a hospital. Many of these facilities are state-of-the-art and approved by insurance carriers. Although medical language exposure could again be limited to the specialty of the surgeons (i.e., plastic surgery, genitourinary, orthopedics), working in this setting would better prepare the new transcriptionist to transcribe operative reports. Here is where those anatomy and physiology classes will really pay off!

MTs seem to have a love or hate relationship with ORs. Personally they're my favorite! The content is always interesting - sometimes downright fascinating - and they don't contain a lot of numbers to transcribe, as would other reports containing medicine dosages and lab values. It's certainly a personal preference .... for every MT I know that loves ORs, I know another who won't go near them!

#2 - Multispecialty Clinic

A step up from a priviate physician practice would be a multispecialty clinic. This would be a group of physicians from varying medical specialties in one setting. Sometimes the specialties are complimentary to each other (i.e., obstetrics and gynecology, pulmonary and cardiology), sometimes not. The group could even be an HMO (think Kaiser Permanente) where patients covered by a single insurance type can seek medical care for a variety of conditions. This setting would expose the new medical transcriptionist to a wider medical vocabulary than the single physician practice.

#1 - Physician office

A physician's private practice will probably be the easiest place for a newly trained transcriptionist to find work. Be aware that you may be required to also perform other duties (i.e., telephones, filing, billing, etc.). While this avenue does provide opportunity to gain transcription experience, your exposure to medical language will be limited to the physician's specialty (i.e., orthopedics, OB, urology, etc.). If your goal is to work from home independently, few transcription services would be willing to hire an MT with this type of background. Of course, you could negotiate an arrangement with the physician to transcribe at home ... ;-)

Where to work?

In the subsequent posts, I'll outline some of the places a medical transcriptionist can find work.

What are the education requirements?

At a minimum, a strong background in medical terminology is required of a medical transcriptionist, but a good understanding of anatomy and physiology will prove extremely beneficial to the MT just starting out. Proficiency in English, grammar and punctation is also recommended. Some healthcare providers are great dictators, some not so great. While some institutions demand "verbatim" transcription, meaning you type exactly what is heard, regardless of how incorrect it might be, while others permit - and encourage - grammatical editing.

Not surprisingly, US transcriptionists will frequently encounter foreign dictators, commonly referred to in the transcription world as ESLs (English as a second language). Some are difficult at first, but they can be mastered. The MT with a trained ear for various foreign accents will rarely, if ever, be out of work.

What exactly is medical transcription?

Medical transcription is the process of listening to physicians and other healthcare providers dictate medical reports and then typing what's heard, creating a document that will become a permanent part of a patient's medical record. Have you ever been in a physician's office or hospital and see sometime talking into a small hand-held machine? He/she is probably dictating someone's medical chart.

Accuracy of these documents is absolutely critical. Would you want to get copies of your own medical records 5 years from now and find out you were labeled with the wrong diagnosis? What if someone mistakenly typed the dosage of one of your medications wrong, and you ended up unconscious in a hospital in another city or state? The persons caring for you could obtain your medical records and administer that incorrect dose. Sadly, it happens.

Tax Season Fast Approaching

Working from home does bring some tax advantages. You will be permitted to deduct a percentage of your utilities, rent and insurance for the portion of space used for the home office. The percentage is calculated by either using actual square footage - if known - or number of rooms. If you live in a 2-bedroom apartment with a kitchen, living room and dining room and use one of those bedrooms as an office, you can deduct 20% of heat, electric, rent, etc. (1 room divided by 5 total = 0.20).

I tend to overlook (read: forget) mileage. Sure, if I have to take a lengthy drive somewhere for a special event or meeting, it's easy to remember to jot down the miles. But don't forget those short trips. Going to the post office to mail a work-related package counts, just as those trips to Staples or Office Depot for work-related supplies (also deductible). Everything counts!

Independent Contractor vs Statutory

My last post made mention of statutory employee. In the transcription world, there are typically three categories to choose from:

1) Company employee. This means your employer will provide equipment, and you will typically be entitled to company benefits; however, your employer will determine your schedule, even when working from home. You will probably be held to both an hourly schedule and be expected to maintain a production level.

2) Independent contractor. Here you are self-employed. You can either go out and round up your own clients, or you can work under contract with a service and transcribe for their clients. You will be paid on production, typically a rate for every line transcribed. You may have to submit an invoice to be paid, and no taxes will be withheld, so you'll be responsible for quarterly payments. At the end of the year, you'll receive a 1099 instead of a W-2 and have to complete a schedule C.

3) Statutory employee. This is the same as the independent contractor status with two exceptions. First, your Social Security will be withheld from your check, AND the company you contract with will pay their half (as an independent contractor, you'll pay "self-employment tax" which is essentially double Social Security - your portion as the "employee" and your portion as the "employer"). At the end of the year, you'll receive a W-2 instead of 1099, but the section for Statutory Employee should be checked so you're not hit with the SSI.

What's important to note here is that medical transcriptionists who function as statutory employees are earning a little more than their counterparts paid at the same production level but classified as independent contractors. Not having to pay the "employer" portion of the Social Security tax is really earning an additional 7.65%.

Licks & Wags .... Woofie

To employee or not to employee

I ran into equipment trouble today ... great way to start the week. As a company employee, my equipment is provided at no expense to me. When something breaks, I can pick up the phone or e-mail our support center and request a replacement. Years ago while working as a statutory employee under contract, I had to supply all my own equipment. True, it was a cash layout and I had to replace/repair things as they broke, but I was able to write off those expenses on my taxes and, more importantly, could run out immediately and have what I needed within hours as opposed to waiting.

Writing this reminds of the year a cassette recorder broke, and I had to go to the mall for a replacement ... the day after Thanksgiving ... not pretty.

Off-topic rant ...

Am I the only one who notices that when you visit a designated Web site to check on the status of a rebate, despite checking 2 weeks after the deadline, a record of your rebate cannot be found .... only to have the check coincidentally show up in your mailbox 3-4 days afterwards. I'm sure it's safe to assume that if I didn't check, the rebate would never show up.

That's bad enough, but NOW instead of the normal rebate check, I get a $30 debit card ... a debit card that cannot be used at an ATM to withdraw cash ... and now a debit card, I come to find, that has been denied at two different stores when I tried to use it. Oh ... and did I mention the monthly $3.00 maintenance fee for the debit card that doesn't work?

Woofie is growling and showing teeth ......

What do do?

Have you been searching the web for work-at-home opportunities? Don't be surprised when some carry a cost just to learn more about them. Sometimes we have to spend money in order to make money.

For companies sending you written materials, this isn't uncommmon - provided the price is reasonable and comes with a money-back guarantee. There is a cost involved with creating printed materials, along with packaging and shipping. I would be leery, however, of a company asking $79.95 for a downloadable file.

Always remember - if it sounds too good to be true, it probably is.

My Story

Before discussing the pros and cons of working from home, let me share a little about myself. I have a background in healthcare, and my main at-home profession is in the field of medical transcription. I’m a company employee working in management now, but when I first left my hospital job 16 years ago, I was earning a living soley by transcribing medical reports, being paid on production. I had been in a stressful full-time supervisory position and working part time for a local physician while also trying to complete my degree when I happened upon an advertisement seeking transcriptionists to work from home. I applied and was offered a contract as an independent contractor. I gave up the part-time job but maintained the full-time position while I acclimated myself to the new role.

Within 4-5 months, I was earning almost as much for the part-time transcription, working 15-18 hours per week, as I was at the full-time job (excluding benefits, of course) working 45 hours a per week). It became obvious that if I gave up my hospital job and just transcribed, I could probably double my income and work less hours, allowing me more time for classes.
Note must be made of a few critical points:

• I came into transcription with 5+ years of healthcare background. I did not learn to transcribe through one of the schools advertising in Soap Opera Digest and National Enquirer promising me $40,000 per year if a took their $2,000 18-month training course.
• I had no children and so had a quiet environment to work in.
• I do take pride in a strong work ethic, but as an independent contractor paid on production, if you don’t work, there’s no check.
• Finally, I’m a pretty fast typist.
  

I don’t mean to knock all at-home transcription courses, but some are rip-offs - consider where they’ve elected to advertise! There are a few credit-worthy courses available if you’re willing to put in the time. I’ll try to dig up some links in the near future.

Don’t forget to hug your pet today … Woofie

Greetings and welcome!

Caught up in the excitement and enthusiasm of a group of individuals I have much respect for, I begin my first blog. I didn’t have to go far to choose a topic. There is so much marketing and advertising geared these todays toward working from home - some good, some not so good. More and more companies are even sending their employees home to work from virtual offices - good for some folks, not so good for others.

I’m into my 17th year of working from home, so I think I’ve learned a thing or two along the way. Over the coming weeks and months, I’ll be sharing my experiences with you - some good, some not so good.

Licks and tail wags … Woofie