THERE WILL ALWAYS BE MEDICAL TRANSCRIPTION
by Paul Van Dyck

For the past 25 years I have been gainfully employed as a medical transcriptionist. I am married, own my home and a fairly well-maintained Dodge conversion van. My wife April occasionally gets comments like "it must be a burden to care for your blind husband." She explains to people that she does not work outside the home and that "Paul is the breadwinner; he supports me." My employer, Southwest Washington Medical Center, has a good reputation for hiring people with disabilities: I work as a transcriptionist, and a deaf girl works in accounting.

Admittedly I was quite upset when in June of this year we changed to a totally new dictation/transcription system called Edit Script. Voice recognition software listens to the dictation and then produces a draft which is then edited by the transcriptionist. My immediate fear was that my gainful employment was about to go away and I would have to try and get work as a piano tuner!

Fortunately, Edit Script and other voice-recognition software are not quite as good as a skilled transcriptionist or even someone whose second language is English. I'm sure you have had dealings with such technology when calling customer service or directory assistance.

Phone: Please say the city and state.

Person: Vancouver Washington.

Phone: That's Cougar Washington. Is that correct?

Person: No, Vancouver Washington

Phone: That's Fort Cooper Washington. Is that correct?

Person: No! damn it! Van-cou-ver Washington

Phone: One moment. An operator will assist you.

Medical documentation is much more complicated and the results can be pretty startling when the link between the doctor and the transcriptionist includes this new software.

Doctor: This pregnant female was 4 to 5 centimeters dilated.

Draft: This pregnant female was 45 centimeters dilated.

Doctor: The primary care physician is Dr. Dronkowski.

Draft: The primary care physician is a drunken housekeeper.

No, I didn't make that one up!

The trick for the blind transcriptionist is that now instead of listening to the dictator then typing what is said, one must listen to the dictation, and follow along listening to the screen reader, making necessary corrections and trying not to laugh out loud. The sighted can simply listen to the dictation and follow the little red box as it moves along the line of text, kind of like following the bouncing ball and singing along with Mitch. (If you don't get that reference, ask someone over 50.)

I thought about taking early retirement, age 60, or even getting a medical retirement. I do hear voices in my head, but the voices stop when I take off the headset! Maybe I could launch a discrimination complaint in that the women in my office run their fingers through my guide dog's hair, but not mine? But only losers quit the race before they reach the finish line. My speed is increasing with this new skill of hearing multiple voices, and without dedicated people in this field, medical documentation for patients would be in serious trouble.

The goal for the blind transcriptionist should be not to lose heart. I have gone from working with typewriters and carbon paper to word processors. Word processors? Oh, yes, you have to see a TV screen and don't hear the click of the keys, can't feel where the IBM Selectric ball is along the line or how far up or down you are on the paper. Then came the Apple IIe and Bill Grimm's program for the Echo Speech synthesizer. The computer actually TALKS! It's a miracle! Shortly after the switch to Windows-based programs and WordPerfect 5.1 (still the best word processor ever made) came the dreaded mouse with its visual pointers and cursor. (It is said that a cursor is what you become when your computer crashes.) We had to learn how to use the keyboard commands to facilitate our use of Microsoft Word, or as we like to call it, Microsoft Weird.

We have transitioned from dictation belts and manual typewriters, then IBM Selectrics and cassettes (both standard and micro), to very sophisticated word processors with digitally recorded dictation, speech recognition software, screen readers, telecommuting, but we still have the necessity of highly skilled and well-trained medical transcriptionists. Our job is not going away, just changing. With motivated people, and dedicated organizations like ACB, the employment possibilities for the blind can only get better.


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