Transcriptionists are Gone
Transcriptionists are Gone!
–an old pathologist’s lament
Our transcriptionists are being replaced by a computer voice recognition system. This is a sophisticated system allowing multiple pathologists to dictate at the same time, and the software transcribes voice into words. Each pathologist can review his/her dictation instantaneously on their monitor as the words are spoken. This new dictation process has a learning curve, but now the software and the pathologists have eliminated the transcriptionists’ jobs. But wait a second, they did more than just type the reports, didn’t they? Yes, besides typing, they acted as quality control filters for what everyone sent out as a finished report. A good part of the departmental reputation resulted from the transcriptionists’ commitment to making sure our reports were as exceptional as possible. The pathologists strove for excellence every day, and so did our transcriptionists.
What about the quality filter? A seasoned transcriptionist knows the format of a report. In general biopsies can be pretty simple dictation, especially when the diagnosis is normal and/or benign. Now when the biopsy report is malignant, the report becomes more complicated and special attention to details is required. The larger the specimen, often the larger the report because it is much more complicated analysis. In the case of breast malignancy, the reports are very complex, long and detailed. Lots of data needs to be included in the reports. So, the transcriptionist filter is something like an editor: an actual human review of the text, content and diagnosis in our reports. These ladies are trained in fast typing, but they also understand the content of our reports and make sure the text of the reports reflect the final diagnosis. They perform in essence as quality control filters. Computer voice recognition does none of this.
In addition to typing, these ladies surveil all of the activities of the front office. Incoming phone calls are handled by the receptionist first, and all overflow goes to “guess who”? The front office handles a heavy volume of phone calls all day long: 1. numerous calls for pathology reports, 2. many requests for slides to be sent heather and yon, 3. Requests for special studies send outs, and 4. being the “first line” for the professional staff of pathologists. The work our transcriptionists do cannot be overstated—indeed, it is overwhelming. They contribute to the reputation of the department in so many ways. While the professionals in the department bask in the stellar reputation we have for accurate and quick diagnostic abilities, there are some ladies in the background who help make it happen on a daily basis.
And as the transcriptionists’ jobs are eliminated, there is a real sadness in the realization that our independent quality filters are gone too. There will be fewer people in the front office to do all of the random jobs that happen every day, and nobody is identified to act as reviewers and editors, a very important task that is being overlooked by the people who make decisions in the mahogany section. In fact, the decision makers likely don’t even understand the loss and its long-term implications.