Medical transcriptionists work in a variety of settings i.e., hospitals, multi-specialty clinics, solo physician practices, transcription companies, home offices, radiology clinics, pathology laboratories, tumor boards, law offices, and even veterinary hospitals. Some work as employees while others prefer the independence of being "freelance" MTs. Qualified MTs may eventually become supervisors, managers, and teachers, while others may establish their own transcription companies.

Hospitals and medical centers: In the not-too-distant past, medical transcriptionists employed by hospitals worked under the direct supervision of a medical record director, also known as a health information manager. Today, it is common for a hospital's transcription staff to be centralized and perhaps operate remotely from the health information management department.

Most modern hospital transcription departments are headed by transcription supervisors who may or may not be medical transcriptionists. This supervisor may work under the direction of the health information manager or may report directly to a hospital administrator. However, MTs who perform specialty transcription such as radiology or pathology, may work within or adjacent to those departments.  Look for administrators who teach each employee how to become a medical transcriptionist that is a true professional.

In large teaching hospitals, some medical transcriptionists function as secretaries/transcriptionists in the offices of physicians who act as department heads for the various medical specialties within the institution.

Hospitals may offer competitive salary and benefit packages for medical transcriptionists, particularly larger hospitals in metropolitan areas.  Also, many offer some type of incentive pay plan that enhances the income potential of productive MTs.

Hospitals offer opportunities for advancement into supervisory positions for motivated employees. Hospital transcription provides a wide range of dictation types, covering all medical specialties and challenging areas of interest to transcriptionists. Facilities and equipment are often state-of-the-art.

Traditionally, hospital employment has offered job security and stable work schedules. In addition, some hospitals include in their benefit packages the payment of professional membership dues and/or registration fees for continuing education events such as conventions and seminars.

Physician offices and clinics: The small office environment can be decidedly more personal, often providing a family-like atmosphere. Employees in such environments may enjoy medical and retirement benefits and a predictable income, although with the decline in physician income due to managed care, some offices no longer offer benefits to their employees.

Physician office/clinic hours may more readily accommodate the needs of MTs with school-age children, seldom requiring weekend work. In addition, transcriptionists may enjoy the direct contact with physicians, who may be more appreciative of their work, more accessible for questions, and more willing to take the time to teach and offer real-time feedback for a new MT.  And, although the transcriptionist may become proficient and competent, advancement in this environment may be somewhat constrained.