A New Career Path for Medical Transcriptionists and Other Professionals
By: Sharon B. Allred | Instructor, BlueLedge
Transcription of any type — medical, business, government — requires learning an extensive vocabulary and style standards specific to that industry. Constantly changing vocabulary and style standards necessitates practitioners stay up to date and committed to proficiency and constant learning. If transcription has been your career, I’m sure you’re proud of all you’ve learned and grateful for the opportunities afforded in that career choice.
In recent years, however, career opportunities in those fields have been significantly impacted by global technology changes. Those changes have included ASR (automatic speech recognition), mandatory implementation of the EHR (electronic health record), and use of scribes and offshore labor. Work, once plentiful, has become scarce, with a corresponding decrease in pay and opportunities for advancement.
Alternatively, you may have enjoyed a career as a legal secretary, or even a paralegal, but are considering options allowing you to work remotely at this stage of your life.
Each of these careers will have served as exceptional preparation for learning legal transcription; however, understanding challenges associated with a career change such as this is critical to ensuring a successful transition.
Prior to becoming a BlueLedge instructor, my career took a few twists and turns, resulting in what is now a commitment to working with individuals who desire a career change and improved employability. Those twists and turns included a stint as an intermediate schoolteacher of language arts, then a medical transcriptionist for several years. I then became a community college instructor for medical and business transcription, fulfilling my earlier dream of being a teacher. My career path eventually led to hospital transcription management and then to a national company offering healthcare documentation services.
In each of those roles, I had a number of opportunities to train prospective medical transcriptionists or those simply desiring career advancement. As the medical transcription industry declined, I was grateful for opportunities to fulfill my “calling” as a teacher and work specifically with individuals desiring to learn legal transcription. Many of those trainees have successfully transitioned from similar roles and are now happily settled into a legal transcription or digital court reporting career.
There are common elements between legal transcription and other forms of transcription and/or legal secretary roles that make legal transcription a good choice for a career move. Briefly, they are:
- Above-average typing speed
- Good listening skills and hearing ability
- Ability to concentrate and sit for long periods of time
- Attention to detail
- Ability to work independently
- Commitment to continual learning
- Exceptional command of English grammar, punctuation, and spelling
- Excellent vocabulary
- Proficient in researching and cross-referencing
- Comfortable working in a production-pay environment
As you can see, there are many common elements between these transcription types; however, there are critical differences one needs to understand prior to embarking on legal transcription training. The learning curve can be steep, and I’ve realized there are specific challenges common to students I’ve trained.
The purpose of this article is to inform you of those challenges with the hope of ensuring your ultimate success. Currently, opportunities abound in proofreading, editing, scoping, and court reporting, just to name a few of the roles available in the legal field.
I’ll discuss the differences in legal transcription below, with some explanation as to what one can expect.
STRUCTURED TEXT/DICTATION vs. UNSTRUCTURED/VERBALIZED SPEECH:
There’s a huge difference between dictation from prepared notes and taking down words spoken in conversation or question/answer style. In the dictation process, both attorneys and healthcare providers typically rely on notes. Some content is scripted and very familiar to the professional dictating. On the other hand, listening to a deposition or trial is entirely different. Stutters, stammers, false starts, and interruptions are typical in legal transcription work, and no part of the deposition would be structured other than, perhaps, the initial questions as to name and credentials.
SENTENCE STRUCTURE:
In my experience as an instructor, I’ve found this category and the next to be the two most challenging for those pursuing a move to legal transcription. This challenge is driven by structured vs. nonstructured speech, as discussed above. Almost no one speaks using entirely correct grammar. As we talk, we ramble and add phrases and clauses as we think of what we want to say. At times we back up and change a word we’ve already said.
Instead of short, choppy sentences like those in medical dictation, legal proceedings can include sentences that seem unending, with compound predicates, phrases, and clauses tacked on at the beginning, middle, and end.
One of my favorite references is the book by Margie Wells Wakeman, Court Reporting: Bad Grammar, Good Punctuation. The title says it all!
Our purpose as legal transcriptionists is to translate the spoken word verbatim into a readable, accurate document that captures exactly what was said. Punctuation builds the bridge from bad conversational grammar to a legal transcript that captures what was spoken and makes it readable.
The legal record is just that: a historic legal record. It can be accessed many times over; and accuracy, completeness, and readability are critical. The challenge of translating rambling speech to a readable, understandable sentence, while ensuring a verbatim text, can be quite challenging for the newbie legal transcriptionist.
VERBATIM:
Medical, business, and government transcriptionists, as well as legal secretaries, have an ingrained sense of making the dictator “look good.” Judicious editing is the expectation. We subconsciously substitute grammatically correct parts of speech for “misspeaks” as we transcribe. In other words, we “paraphrase” it as we transcribe.
When transcribing legal proceedings, we often find it necessary to slow down considerably, especially initially, to ensure we’re hearing what we’re hearing. I’ve had students “swear” they heard what they heard, when, in fact, their brain was playing tricks on them, as they were so used to typing what it should be, not what was actually said.
Contractions, abbreviations, and dates are particularly challenging. As long-term medical transcriptionists, we hear “CHF” as “congestive heart failure,” “MI” as “myocardial infarction” — you get the picture. We hear “it’s” as “it is,” “don’t” as “do not,” and “he’s” as “he is.” No matter how the date is spoken, we change it according to the preference of that site/style guide, never giving it another thought as to how it was actually spoken.
VOCABULARY:
Medical language continually changes and grows with new drugs, diagnoses, and procedures. However, medical terminology is a specific subset of the entire English language. Legal terminology is also, in itself, a language all its own; however, the sky’s the limit in some sense, as there are innumerable situations encountered in legal proceedings. Consider working on the testimony of a drywall expert; there are many technical words the expert will discuss that many people have never before heard.
FORMATTING/MS WORD:
Transcriptionists in hospitals and medical practices typically transcribe in a “platform,” with no concern for templates, indexes, title pages, etc. Legal secretaries probably transcribe in MS Word simply using a standard business letter template.
Many legal transcriptionists transcribe in MS Word, and some use CAT software. They are usually provided a template but are responsible for creating indexes, title pages, page numbering, and numerous other formatting functions that require proficiency in their word processor.
PAY:
For as long as I can remember, medical transcriptionists have been paid by the character with a couple of varying scenarios. Legal secretaries are typically paid by the hour, as other duties are required in addition to transcribing when needed.
Providers of legal transcription services may also provide court reporting services. In that case a different pay model may be utilized to compensate employees who perform both roles. Primarily, legal transcriptionists are paid by the page, with a specific number of characters per line and lines per page. The page rate may vary based on specific company requirements, such as quality assurance score, certification, longevity, and level of difficulty of the work assigned.
In recent years, especially with the implementation of ASR, hourly rates for medical transcriptionists have declined to almost minimum wage, as medical facilities attempted to recoup costs for implementation of the EHR. The good news is that those former medical transcriptionists, now legal transcriptionists, make considerably higher wages, with work readily available.
STYLE GUIDE/SITE SPECIFICS:
Transcriptionists of any type are expected to comply with site specifics, which are the particular preferences of a specific client or service provider. The same is true for legal transcriptionists; however, those site specifics may vary by court system (federal, state, county) and by jurisdiction within a state. Following instructions to the letter is the expectation; therefore, the ability to follow these preferences is a critical skill.
OPPORTUNITIES:
I realize the challenges I’ve listed may seem overwhelming. But there’s light at the end of the tunnel! There are currently exceptional opportunities for legal transcriptionists, and the average pay is higher than other types of transcription. So there’s a reward for navigating the learning curve, which is exciting and worth the effort. There are opportunities to learn scoping, editing ASR, proofreading, and court reporting. Employers consistently seek new hires, and some are willing to pay or reimburse training costs upon successful completion.
Here is a quote from Ben Walker, owner of Ditto Transcripts: “You can make more money doing legal transcription than medical transcription in almost every scenario. The medical transcription industry has become so commoditized over the years that it’s hard to make good money doing it anymore.”
Becoming a member of our national organization, AAERT (American Association of Electronic Reporters and Transcribers), will be important early in your career. AAERT is the organization responsible for industry credentialing, which you will want to pursue. Some states require certification before transcribing legal proceedings in that state. Credentialed reporters and transcribers are sought after and paid well. Click here to check out all the benefits of certification.
AAERT also publishes a Best Practices Guide, an invaluable reference tool and is utilized by many employers.
Continue to be a LEARNER, and avail yourself of every opportunity to learn! Read, read, read (even aloud at times, as this aids retention). Invest in yourself and your career to be the BEST at what you do! BlueLedge offers a multitude of online courses to prepare you for a career in legal transcription and/or digital court reporting, passing the national certification exam, and many other topics.
Ben Walker, of Ditto Transcripts, said, “Take a good course and do the practice, and it will probably be half the time or less for medical transcriptionists to learn and be very proficient at legal transcription.”
Is the move to legal transcription an insurmountable challenge? Absolutely not! However, understanding the differences between legal transcription and other types of transcription is critical in preparing for a successful transition.
If you are interested in taking a course to help make it a smooth transition into legal transcription, I recommend the Intro to Legal Transcription curriculum. We also have other legal transcription courses you can choose from.