section of a Discharge Summary and start to dictate laboratory test results or x-ray results without dictating a heading for this new section. If this occurs, the appropriate course of action on the part of a medical transcriptionist is to paragraph after the Physical Examination and insert the appropriate paragraph heading such as “Laboratory Data,” or “Laboratory and X-ray Data,” before transcribing the actual data.Sometimes a physician will dictate the singular form “diagnosis” and then list several diagnoses. The heading is appropriate to use either “Diagnosis” or “Diagnoses.” Diagnoses are usually listed vertically as a universal rule regardless of where or who you work for. This provides greater ease in reading.

A medical transcriptionist may wish to place numbers before a long list of diagnoses, regardless of whether or not the numbers are dictated by the physician. If the physician begins the diagnosis section dictating numbers and then only dictates one diagnosis, do not place a number in front of this one diagnosis. If the dictator dictates a long list of “anything” and loses track of his or her numbers, the medical transcriptionist should always transcribe the correct list instead.Many dictators will dictate when to begin a paragraph. The medical transcriptionist should insert the paragraphs as dictated unless of course it is not grammatically correct to proceed as the dictator dictates the paragraphs. Paragraphs may also be added when the dictator fails to dictate one and it would be appropriate to break up long reports or to set up a new heading such as to separate “Findings” from the “Operative Procedure.”

Some dictators may dictate “new line,” which actually means “new paragraph.”Many hospitals, clinics, and physician offices store standard format outlines for each type of report dictated on the computer’s memory as templates, which are easily pulled up by the medical transcriptionist. This procedure has introduced greater conformity in format style within an institution and makes it absolutely painless for the medical transcriptionist to have to make adjustments and remember each format for each type of report dictated.This article is FREE to publish with the resource box.About the Author:Connie Limon, Medical Transcriptionist. Visit us at http://www.aboutmedicaltranscription.info for more information about the unique and rewarding career choice of Medical Transcription. Join Camelot Articles http://www.camelotarticles.com and submit your original articles for website promotion and backlinks.

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