The act of doing medical transcription itself is a deed needing total involvement of almost all your senses and on the top of it if you stumble upon bad dictators and blanks, urgh, you may curse your stars for choosing this career or your bad luck that day. Blanks, the crossword puzzles in medical transcription are real brain teasers not only for beginning medical transcriptionists but also for experienced ones. On our daily chores in medical transcription, it is unavoidable to have a day without a blank in our transcripts. May be it’s the accent of the doctor, poor audio, background noise, mumbling doctor, a new word, doctor turning away from the microphone or lot other reasons that may put us in trouble. We may not be able to grasp what the doctor is dictating, the result - blank in the transcript. Are there any ways to zero in on words that the doctor mumbles so that blanks are reduced? Yes, to some extent we can reduce blanks. How?

Don’t hesitate to leave blanks: Yes, don’t hesitate to leave blanks in reports while you are on the first go. It’s one thousand times safer to leave a blank than to guess and insert a word on the first go, as your mind and ear may get accustomed and justify to what you have put there in as a doubtful word while hearing multiple times when you edit or rehear later. Hence while typing a report first, if you are unsure of what the doctor says, better leave that space as blank than to do a guess work. While typing, you hear sentences in pieces that you may not be able to catch what is there in the doctor’s mind but when you hear the whole sentences at a stretch you can almost fill in 95% of the blanks so left.

Think contextually: Now that you have typed your report in full and are listening/editing the report you have typed, you’re listening sentences at a single stretch in full and you could see many of the blanks getting filled without teasing brain. Still left with blanks? Now start thinking contextually. If you think the word is something related to anatomy, then think of the surrounding structures, their names, their action etc., and you’re going to get that word. If it’s a drug, go through the symptoms and complaints and correlate that word with these and you might have got the word that is there at the blank by this time. If it’s an abbreviation, think of all the possible terms that could fill in there and it’s sure you are going to get that word.

Search the internet: If you think the blank is a new drug, then search the internet for that. Similar is the case with hospital names, doctors’ names or patient names. I have compiled a list of useful websites for reference in medical transcription.  Checkit out.

Refer previous reports: Check if any previous reports have been transcribed by you of the same doctor or if any previous reports of the same dictator done by someone else are available for reference. The doctors dictate mostly stereo type reports and if at all you miss a word in your transcript, you can trace it out with his/her previous reports.

Refer similar reports: For eg., if it is an MRI of the lumbar spine, the anatomy is going to be the same whoever dictates, hence refer MRI of lumbar spine of various other dictators.

Borrow ears: As a last resort, request help from your friends in the same career as they may hear it differently than what you hear.

Practice makes perfect: Efficiently use your free time to practice those tough dictators. Listen to the voice files with the earlier transcript of the tough dictators wide open in front of you so that you are prepared to face them bravely next time.

Bring it to the notice of the doctor: If you have access to the dictating doctor, bring to his/her attention the bad state of dictations. Encourage him/her to go through the Tips For Dictating Physicians and AHDI’s (formerly AAMT) Dictation Best Practices.

Though it’s a tedious and time consuming process to fill in blanks especially with those tough doctors, we have no other way than to utilize our full vigor. Unless you are sure that the word matches the context and what the doctor dictates, don’t take any chance by inserting a phonetically similar word leading to an interpolation error, after all these are all health and life related records. Blanks are always better than sound alikes and errors and it’s better to admit your defeat than to act smart.