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How Are Medical Transcriptionists Paid
Your Professional Image As a Medical Transcriptionist
Medical Transcriptionists: Ethics and Confidentiality

What Skills Do You Need For A Medical Transcriptionist Career

medical transcription skillsMany times, people interested in medical transcription have worked in other fields and have other unrelated career skills. I am frequently asked if these skills can transfer into helping them learn medical transcription.




This is actually a great question to ask about any career you may be interested in. It’s always nice to know that your current skill set will assist you in excelling in your next career move.

Using Your Existing Skills

People who have worked in healthcare or legal will usually do well in medical transcription. The skills of organization, typing, dealing with people, and attention to detail transfer well into the career of medical transcription.

Other skills that are useful in learning medical transcription are:

  • data entry
  • computer or technical career skills
  • any career where one works with numbers

Why numbers? Working with numbers takes excellent concentration, excellent typing ability, and attention to detail. Additionally, I’ve never met a school teacher who did not excel in medical transcription. Anyone who is good with reading, writing, editing will also excel in medical transcription.

Medical transcriptionists are sitting most of the day, so a person who is used to working outside or being on their feet all day may need to adjust to the new work environment.

Obtaining New Skills

If you do not possess any of the above career skills, do not despair. A good online medical transcription school that offers comprehensive online training will teach you everything you need to know from the ground up.

Skills that should be taught in a good program are as follows:

  • Increasing typing speed and accuracy
  • Productivity tools like word expander software
  • Software programs like MS Word
  • Medical terminology across a variety of specialties
  • Anatomy
  • Pharmacology
  • Lab/Path
  • Report formatting
  • Contain all levels of the SUM CDs
  • Equipment needed within the industry (laptop computer, WAV pedal to control the flow of dictation, etc.)

Lastly, a good online medical transcription school that offers good online training will offer comprehensive job placement, and will work with you until your skill set is employable regardless of how long that takes.

The skills that you bring with you from your life experience, previous jobs and careers, and your natural ability are all very helpful, but your greatest asset is your own determination to stick with it. If you have made a decision to do well, then nothing can prevent your success within the career of medical transcription.


How Are Medical Transcriptionists Paid?

medical transcription pay

As a long-time medical transcription instructor, I am frequently asked how medical transcriptionists are paid and whether medical transcription is a career that offers good income potential or not. These are actually great questions for anyone interested in this career field to ask.

There are several methods to calculate medical transcription pay. The most common method by which MTs are paid is the “per-line” method, which will be explained in a bit. High-quality medical transcription training is a key factor in learning to transcribe both accurately and quickly. The more lines one can produce in an hour or day, the more money one makes.

Most medical transcription pay today is based on production. The amount of production is based on the quality of dictation, the experience of the MT, and the platform used to produce the finished product. Below are some examples of MTs daily pay based on the “per-line method.”

Also keep in mind that pay is usually raised with experience and great quality scores on the work produced.

Type of MT

Pay per transcribed line

Amount of lines produced per hour

Pay per hour

Brand new MT.07150$10.50 per hour
MT with one year experience.08200$14.00 per hour


MT with one year experience.10250$25.00 per hour

Within this structure are a number of differences that most new medical transcriptionists aren’t aware of, if their training program doesn’t cover the employment aspects of the job.

The biggest difference is in HOW the MT service figures out WHAT is a line. There are actually an unlimited number of ways a company could configure what a line means. However, there are a few solid methods that many services use already. Let’s look at a few:

Visual Character Counting Method

The first “line counting” method most MT services use is called counting by the “visual character.” This means that if you can see the character on the screen, it’s counted as a character. A common number for the visual character counting method is 65 (which, incidentally, is the average number of characters on one line of a typed 8-1/2 x 11 sheet of paper.)

The visual character counting method includes all commas, periods, quotation marks, etc., but does not include things like bolded words (which would normally have counted twice – once for the character and once for the bolding of it.)  Some companies use 55 as the number for the visual character count while other companies use a higher number, such as 70. Obviously the lower the number here, the better.

To figure the number of “lines” in a 65-character visual character counting method, you would configure your software to show you the number of visual characters, then divide by the number the company considers a line (55, 65 or 70). This will give you the number of lines typed for that document.

When you’re paid a certain dollar amount per line (let’s use $.10 as a round figure for an example) then you simply multiply your “line count” using this method by ten cents per line.

To recap, here are the steps involved in configuring this line counting method:

  1. Know how many visual characters the company counts as “a line.” We’ll call this A.
    In this example, A is 65 characters.
  2. Divide the # of visual characters in your document by A. In this example, let’s say we have a document that is 2000 characters. Divide 2000 by 65 for a total of 30 lines.
  3. Multiply the # of lines by your production rate per line. 30 lines x $.10 per line = $3.00 for that page.

Of course, you probably wouldn’t do this on a per-page basis – most MT services prefer to configure it all automatically once you’ve finished your work for the day. However, this example is given to show the simplicity of the configuration.

The Gross Line Counting Method

One common method used years ago was very profitable for the transcriptionist, but not so profitable for the MT service. This gross line method counts any characters on any line of the page as a full line.

Basically, this means that if you have 10 lines with only one word on each line, you’ll have 10 lines. When you multiply this by the same $.10 per line rate as above, you get the same production pay as is used in the Visual Character line counting method.

However, there is much, much less work involved to earn that rate of pay. We tell our students that if you get a job offer using this method of line counting, you’re probably talking with one of the lucky few MT services that still do this.

The Normal 65- or 55-character Line Counting Method

Another common method some MT services still use is the simple Line Counting Method. This is defined as the number of KEYSTROKES in your document divided by what the service considers a line (usually 65). Usually bolded characters are counted as 2 keystrokes – once for the character and once for the bolding of it. Underlined characters would be counted as 2 keystrokes as well.

But There Are Still Some Variations…

As you can see, MT services will USUALLY make the most money if they pay their MTs by the visual character method. I say “usually” because there are some variations within some services that may influence the line counting method, sometimes in your favor and sometimes in their favor.

Let’s take a quick look at a few of those:

Predefined Templates

Most large MT services have predefined templates for each medical facility for which they type, as well as for the types of reports within that facility. It just makes good economic sense to not have to type the hospital name and address over and over when it’s the exact same in each document. This also extends to the form where the patient information is typed in – the patient name box is always in the same place on the document, along with the Medical Record number and a multiple of other identifying factors. For this reason, most large MT services will not pay for the predefined templates. Even within the specific types of reports, you can have headers that will be identical from report to report. You won’t be typing this data, so you won’t get paid for it.

Predefined Normals

Almost all MT services provide this service to their clients, and sometimes you can make a lot of money from it. A predefined normal is a paragraph or two of a normal finding on a diagnostic report.

For example, a chest x-ray that is normal will have the same exact wording on every report. To save time, the MT service will develop a predefined normal in which the transcriptionist will use a “code” to insert this predefined normal. By typing this specific “code” into the document, all the paragraphs will pop up and be inserted automatically.

You’ll find this type of shortcut most often used in radiology reports, and they can greatly accelerate your speed if the service charges the client — and pays you for – all the words within the paragraphs.

Computer Shortcuts

Many of the smaller MT services will use software such as Microsoft Word as their platform, and therefore, the transcriptionist can use any number of computer shortcuts to help accelerate her production.

For example, MS Word has an informal word expander included within it, so that when you set it up once, you can type just a few keystrokes for a medical term or phrase. We talk about this word expander in more detail in another article on our blog.

Another computer shortcut is the medical spellchecker which will highlight any terms that are misspelled, even drug names. To get the correct spelling, you would simply right click on the term and choose the corrected spelling.

Another popular computer shortcut for transcriptionists is the macro. It’s really not difficult to set up a macro in Microsoft Word, and there are any number of tutorials on the web now showing you how to do so. (We also teach this in our program.)

By setting up macros, you can set up any number of predefined normals your physician uses throughout the day. You can set up the entire template so that it pops up with just a few keystrokes at the beginning of your document. You can also switch between documents such as the macro I set up for our transcriptionists years ago, which helped them keep track of their word counts for each document.

With just a touch of a couple of keys, the macro would do a complete word count of the document, then switch pages, copy the patient name then tab over and paste the number of words, then return one line to await the next input, then switch back to the document being worked on. It happened so fast sometimes you weren’t sure if it even worked or not!

Macros set up to perform routine functions like this could end up saving you literally hours of work each week.

Word Expander Software Programs

If you’re serious about maximizing your MT production, you may want to consider word expander software, which we discuss in our training program quite extensively. (It’s all about working smarter!) This software uses the same principle of typing a few keystrokes for a longer medical word, phrase, or paragraph, and can save a tremendous amount of time once you get used to the software.

For example, the average rate that a transcriptionist can type is about 1:3 or 1:4 meaning for every one minute of audio dictation, it would take about 3 or 4 minutes to transcribe it. For the transcriptionist who is using a word expander software program and working smartly, she is able to transcribe in real time and keep up with the dictation, greatly reducing the time it takes to produce a document. Of course that means more documents are able to be produced in the same time period, which means more income for the transcriptionists.

That’s how, years ago, I was able to average anywhere from $30 to $50 an hour doing medical transcription working for myself with a few good clients. I used a combination of all of these tricks and shortcuts to maximize production and increase my speed.

We teach all of these methods to our students in the advanced portion of our MT training program along with anatomy and physiology, 19 different medical specialties, laboratory and pharmacology, and computer knowledge along with information on starting your own business if that’s what you want to do. The results have been phenomenal for our graduating students who have learned it’s much more profitable when you work smarter from the beginning!


As you can see from the information above, an experienced MT who knows how to use productivity tools such as word expanders, predefined normals, computer macros, and who is fast and accurate can produce a lot of lines per hour. Also, the “easier” the dictation and more familiar an MT is with it, the faster they become.

There are some MTs who can produce 300+ lines per hour on relatively easy work, and they make GREAT money. Also, please keep in mind that the rates above are for MTs who work for an MT service. Pay is normally about 50-100% higher for MTs who get their own clients.

Good medical transcription training should include training in how to get your own clients, how to use productivity software, and how to research terms quickly and efficiently using quality reference sources to help you maximize your efficiency and thereby increasing your production right from the beginning.


Your Professional Image as a Medical Transcriptionist


When we talk about professional image usually the picture that comes to mind is dressing professionally and conducting yourself well in an interview situation. Since it is common for Medical Transcriptionists to work at home, you may never actually meet your employer. So what does professional image mean in this context?

MTs need to be trustworthy, dependable, and competent because we deal with confidential medical records. From the first contact with a prospective employer it is important to begin projecting these characteristics immediately.

How can you project trustworthiness and dependability? You can do this by simply doing everything that you agree to do. In other words, if an employer wishes to schedule a telephone interview with you and you set up a time to talk at 2 p.m., make sure that you are on time and prepared for the interview. You could have a list of questions to ask or a list of your qualifications to discuss over the phone. This will project both trustworthiness and dependability. (In Module 30, we cover this in much more detail, including how to get business on your own.)

How can you project competence before you are hired? Competence comes through in your resume. Is it neatly arranged? Is it perfect grammatically without typos, misspellings or grammar errors? Also, most companies will give you a transcription test to complete before making a final hiring decision. You will be evaluated on how quickly you complete the test, neatness, organization, style, grammar, punctuation, and a basic knowledge of proper formatting procedures. (Don’t worry — in Module 30, we cover these items completely.)

Also, many MTs forget that following the instructions for the test (example: how to download, instructions for formatting, instructions for sending it in, etc.) may be as important as the test itself. Employers want to know that you are able to handle all aspects of the testing process with ease and confidence which exhibits the trait of competence.

Also, it is important to note that there are differences between the work environment of MTs that work in a hospital or clinic and those that work at home. MTs who work at home can dress casually or even not get dressed all day. Whereas, MTs who work in facilities such as a hospital or physician’s office would need to pay attention to how they dress, wear their hair and makeup, etc. to project a professional image. The at-home MT does most of their image projecting over the phone and through personal correspondence like e-mails, faxes, etc.

As mentioned earlier, at the conclusion of your training at MTACC you will work through our employment and technology modules. These modules will explain how to prepare proper resumes, interviewing techniques, and testing procedures. We’ll help you to prepare a professional resume if you don’t already have one. Additionally, by the end of your studies with us, you will have a professional image already in place, and your skill level will be more than competent. We also help you with job placement! We believe in our graduates and will do everything in our power to help you to excel in your new career!


Medical Transcriptionists: Ethics and Confidentiality


Medical transcriptionists understand that the medical record is a legal document, and handling such sensitive information requires the utmost of professional ethics and confidentiality. Because of the confidential relationship between the physician and the patient, each medical record must remain absolutely confidential.

As a working MT you should never relay patient information to outside parties. It is very important to take the security of the patient record seriously. This means that even if you are transcribing your best friend’s reports, the fact that you do so should never be discussed.

Most facilities and MTSOs (medical transcription service owners) require the transcriptionist to sign a confidentiality statement upon hiring, and violation of this is cause for termination and possibly legal recourse. Make it a practice to transcribe your reports, proof and edit them, and then forget about them. Most confidentiality has been broken because transcriptionists talk to their friends about an unusual problem she has encountered in a medical record. The problems that could occur with this are:

A. Somebody could overhear you, and that somebody could be a relative of the patient.

B. Your friend could know the patient in question and spread the news even further.

C. You portray a less than professional image when discussing contents of medical reports.

(Of course this does not include asking transcription-related questions.)

Ownership of the healthcare record belongs to the facility, but the patient is entitled to copies when a written request has been issued. Unless it is your job specifically, the medical transcriptionist should never make copies for the patient when requested directly by the patient or a family member. Remember, your job is to keep the records confidential at all times.

There are new guidelines concerning medical records in a set of laws called HIPAA (Health Insurance Portability and Accountability Act.) Parts of the HIPAA laws discuss the handling of medical records, and this could affect MTs that work at home. MTs who work at home are being encouraged to take measures to protect any information on their computers or on floppy disks. Some of these measures include password protecting your computer, keeping your virus definitions up to date, and locking any floppy disks that may contain confidential information in a file cabinet or box. It’s also important not to let anyone have access to the part of your computer that contains vital patient information and diagnoses. One transcriptionist I know was haphazard about doing so, and her husband’s boss’s medical reports were discussed. This type of thing is in direct violation of HIPAA Federal laws and could have serious consequences. Therefore, always protect your information on your computer (and shred any trash with patient names) once you begin working on the job.

Many MT services are now using “encryption” to send/receive medical records through e-mail. Encryption is a process that uses special encryption software to protect the electronic transfer of medical records. One of the more popular types of encryption programs is Cryptext which is inexpensive and very easy to use. We will explore this software and more later in the course.

Electronic signatures are popular methods of signing medical reports by the dictating physicians. This means that the physician’s typed name on the report is sufficient instead of a physical signature. Electronic signatures, however, open the door for errors that would not be caught because the physician is not reading or signing the reports. Because of this, it is vitally important that the medical transcriptionist have a complete understanding of the dictation they are transcribing in order to ensure they are transcribing exactly as the doctor dictates. That’s just another reason why a good MT course is important to your career!