Although sources cannot agree on how many words there are in the English language, one thing is for certain: there are a lot of words—anywhere from several hundred thousand to close to a million, all comprised of the measly 26 letters in our English alphabet! The sheer number of words available for use can sometimes make word building and transcription seem like a daunting task, but the challenge doesn’t end there! Let’s take a look at some of the word challenges medical transcriptionists face and how these challenges can be overcome.
There can be more than one spelling for a single term.
It’s inevitable that somewhere during your MT training, you will be made aware of the fact that some terms have more than one correct spelling. There may be a British and an English spelling, or an old and a new spelling, or simply a more and a less common spelling. Whatever the case, you must be able to decide which spelling to use. How should you make this decision? First, check your account specifics. Account specifics trump everything. If your client has a preference, their preference is more important than anyone else’s preference. Sometimes your account guidelines might simply state to use AHDI BOS guidelines for spellings. In other words, use the preferred spelling. This can be determined by using a reliable medical dictionary. The spelling that has the definition with it is the preferred spelling, while the term that redirects the user to another spelling is the less-preferred spelling. For example, if you look up fontanel in Dorland’s Medical Dictionary, you will see that it re-directs users to fontanelle (the preferred spelling). This particular term brings up another issue, which will be discussed next.
Sometimes the preferred English spelling is not the preferred medical spelling.
If you type fontanelle into an MSWord document, you will find it gets underlined in red and the suggested spelling fontanel is given. Correspondingly, http://www.onelook.com provides 21 general entries for fontanel but only 18 general entries for fontanelle. In contrast, the same compiled dictionary site provides 6 medical matches for fontanel yet provides 9 medical matches for fontanelle. The rule of thumb is this: In medical reports, use the spelling that is preferred by medical dictionaries.
Words aren’t always spelled how they sound.
With hundreds of thousands of words available for our use, no medical transcriptionist is going to be able to spell every single one of them. An MT who has very good base knowledge of prefixes, root words, and suffixes may be able to spell a word based on its meaning. Often, though, an MT will need to begin the search for a word based on phonetics, or how the word sounds. You may remember rhymes from elementary school such as “i before e, except after c” and “when two vowels go walking, the first one does the talking.” From an early age, we became acutely aware of how
complicated the English language can be and that how a word sounds isn’t necessarily how it is spelled.
Spelling a word phonetically, however, can sometimes get us heading in the right direction. For example, if you put fanenstial incision into http://www.google.com, you will find that you are re-directed to the correct spelling Pfannenstiel incision. Another way to search for a word is to take advantage of fuzzy searches. This may not work at all for the far-fetched spellings, but it works quite nicely when you can clearly understand part of a term being dictated. Of course, your search doesn’t end there. Once you find a possible spelling, you must verify that it is spelled correctly AND is the correct
term for the report context, by looking it up in a medical dictionary or other reliable resource. On occasion, you might transcribe a legitimate term only to find out that it doesn’t fit the report context. What might be the problem? Read on to find out.
Words can sound alike but have different meanings.
One of the most well-known medical examples of this is ileum and ilium. These two words refer to two different parts of the human body, and it is the responsibility of the transcriptionist to ensure that they are transcribing the correct word. Since both words are pronounced the same, the MT must know the definitions in order to differentiate between the two words. Being familiar with medical
terminology is essential, and when the transcriptionist doesn’t understand a term, they need to look it up in a reliable resource to make sure the term is correct. It is a good idea to keep a sound-alike list on hand, whether it is one you’ve created yourself or have borrowed from another source. Not all sound-alike terms have to sound exactly alike to be worthy of a place on your list. A mumbling dictator has a real talent for pronouncing sellar and cellular the same way, which brings us to the last word woe discussed in this article.
Dictators like to make up words.
Try as you might, there will come a time during a report when you stop and say, “That is SO NOT a word!” Go ahead, and see if you can find verborrhea or suprabuttock in a reliable medical terminology resource. In easily rectified sentences, many accounts will allow you to either use the correct word (D: The patient had reoccurring episodes. T: The patient had recurring episodes.) or slightly edit the sentence to allow for the correct word form (D: The patient’s lips were pallorous. T: The patient had pallid lips.). On the other hand, some made-up words are so common and easily understood that your client may want them to be transcribed as dictated, while words as eccentric as verborrhea and suprabuttock definitely warrant a flag.
Finally, there is one simple approach that can be applied to all of these situations. It will help you to research better, hear better, and discern better. I’m sure you’ve heard it before, but it’s worth repeating: Practice, practice, practice!