The decision to start with acute care or clinic work is not going to make or break the rest of your medical transcription career, but it does matter. It’s a choice better made on purpose than left to chance. To help you decide, here are some characteristics of acute care transcription:

  • You work primarily for hospitals and urgent-care facilities.

  • You work on a large variety of report types crossing numerous specialties and subspecialties, including operations (which many medical transcriptionists find fascinating).

  • There is a large, often changing pool of dictators, making it harder (if not impossible) to learn their idiosyncrasies and create time-saving shortcuts.

  • There is a heavier concentration of English as a second language (ESL) dictators.

  • You’re virtually always required to work at least one weekend day.

  • There is often higher deadline pressure with tighter turnaround times.

  • A greater depth and breadth of skills are needed, which usually translates into a higher rate of pay.

  • Skills are very transferrable to other acute-care or clinic medical transcription positions.

And here are some characteristics of clinic transcription:

  • You work primarily for physician offices and specialty groups.

  • There are fewer report types to master — typically limited to H&Ps, office notes, consultation reports, and referral letters.

  • There is a smaller pool of dictators, making it easier to learn their idiosyncrasies and create time-saving shortcuts.

  • The turnaround times are typically not as tight and you’re under somewhat less pressure.

  • You have the potential to earn more money with less stress if the stars align (and you’re a master of shortcuts).

  • The skillset isn’t as marketable due to the laws of supply and demand.

  • The work is more repetitive and potentially less intellectually stimulating than acute care work.

You also can specialize in a field like radiology or oncology, but that’s more likely to be an option for experienced medical transcriptionists than newcomers to the field.