The healthcare industry, especially in the US, is highly dependant on insurance. Physicians and doctors are required to document all their cases for insurance purposes. Earlier, doctors used to transcribe the notes themselves, a function which was later taken over by secretaries. However, with the standardization of procedures in the early 1990s, documentation requirements and pressures on doctors increased. This became an unmanageable task for doctors as the process was not only time consuming but also required transcription skills. Thus began the emergence of the medical transcription (MT) industry, as we know it today!

Demand growth for medical transcription

Changes in the US healthcare industry over the past four decades have affected the medical transcription industry dramatically. From the 1960s, when the job title was medical secretary to now when it is known as medical transcriptionist, the industry has come a long way. Transcription equipment has also undergone a change - from manual typewriters to computers with sophisticated software, and from plastic belts to digital recordings and speech recognition software. A variety of factors led to an explosion in demand for medical transcription.

Emphasis on using standard styles
The US healthcare industry went through a major change in the 1990s, when the need to standardize transcription style in order to clarify medical terminology was recognized. Further, the American Association of Medical Transcription (AAMT) Book of Style for Medical transcription was published in 1995. This led to increased emphasis on standardized documentation and accuracy.

Regulations and stiffer standards for documentation generated greater demand for professional transcription services. Healthcare providers must adhere to the Health Insurance Protection and Accountability Act (HIPAA). This has meant even more pressure on providers for accurate documentation. Especially since the US government is now taking stern measures against defaulters.

Reimbursement demands and documentation overload
In parallel, Medicare, Medicaid and insurance companies started demanding legible patient care documentation to comply with US regulation. Medical practice in the US is bound by strict codes of statutes. If these are violated it can lead to costly malpractice lawsuits. Hence, healthcare providers need to adhere to the required level of documentation.

Increase in transcription costs
With the increasing pressure on healthcare facilities to transcribe all documents, demand for resources such as equipment, technology and qualified personnel increased. This led to a commensurate increase in costs.

Aging population in the US
Healthcare spending in the US is increasing at a rapid rate primarily owed to its growing and aging population. Not surprisingly, older healthcare recipients undergo greater number of tests and treatments. This increases the requirement for transcription.

Widening demand-supply gap

The profession of medical transcription requires knowledge of English and medical terminology coupled with the ability to work with technology. With the increase in transcription work in the US, demand for qualified medical transcriptionists also rose. However, the demand was not met with adequate supply due to the lack of qualified medical transcriptionists in the country. According to US Bureau of Labor Statistics (BLS), Medical transcriptionists held about 98,000 jobs in 2006. About 41% worked in hospitals and another 29% worked in offices of physicians.

However, industry experts believe this is a gross underestimate as the figures include only medical transcriptionists employed directly in the healthcare sector. There are no available statistics of employment with MTSOs or home based transcriptionists. Each doctor requires on an average two medical transcriptionists to handle all the records. This means that there is a theoretical demand for approximately 834,000 medical transcriptionists. Even assuming the number of medical transcriptionists is 3 or 4 times the number put out by the Bureau of Labor Statistics, there is a huge shortfall.

Hence, the US healthcare industry is taking steps to strengthen local as well as global supply capability in order to fill the necessary demand supply gap. On one hand, the government is encouraging young college graduates to take up medical transcription as a serious career. While on the other hand, healthcare organizations are increasing the amount of work being sent offshore.