Saturday, March 8, 2008

Sources of "Aggravation" for the Medical Transcriptionist

By Connie Limon

A source of difficulty in medical transcription is the existence of homonyms or homophones. Homonyms are two or more words that are spelled and pronounced the same but differ in meaning. An example would be mole ‘small mammal,’ mole ‘pigmented nevus,’ mole ‘uterine neoplasm,’ mole ‘breakwater,’ mole ‘unit of measure based on molecular weight. A set such as this should cause no problem for the medical transcriptionist, because the world mole is always spelled the same regardless of the meaning in dictation context.

Similar to homonyms is “homographs.” Homographs are words spelled the same but pronounced differently. These types of words should create no ambiguity in medical dictation.

Homophones demand alertness and judgment. Sometimes you can tell the difference from the context. Many homophone pairs are created by our custom of reducing unaccented vowels to a neutral “uh” sound. We can hear this sound in the second syllables of the words “callus” and “callous,” “mucus” and “mucous,” “villus” and “villous.” Only the medical dictation context alerts the medical transcriptionist whether to type the noun form in –us or the adjective form in –ous.

Styles of pronunciation characteristic of certain regional or ethnic dialects may create homophones in medical dictation of some speakers. A person may fail to distinguish between finally and finely, another between then and than, or between his and he’s, and, long and lung.

Homophony is not confined to pairs of words. A phrase may sound almost exactly like another phrase, but of entirely different and sometimes opposite meaning.

The medical transcriptionist must not only discriminate between homophones, but also perform a variety of normalizing operations, which might include:

• Recognizing variant pronunciations and reducing them to their conventional or normal forms before typing them into the report.

• Some deviations may result from speech impediments on the part of the dictator such as tongue-tie or obstruction of the nasal passages

• Some are due to dialectal variations

• Speech habits learned in childhood

Transcription tips:

• Both root words ren- (renal) and nephr- (nephrolithiasis) refer to the kidney. Ren is Latin and nephris is Greek

• Both root words vesi- (vesical neck) and cyst- (cystoscopy) refer to the urinary bladder. Vesic- is Latin and cyst- is Greek.

• Be aware not to confuse the term prostate (a gland of the male reproductive system through which the urethra passes) and the term prostrate (an adjective describing a posture of submission, exhaustion, or extreme grief).

• Some words have more than one acceptable spelling. For example, calix/calices is preferred, calyx/calyces is an acceptable alternative. Preferred spellings may vary among English and medical references.

• Slang terms such as Cath for catheterization and cysto for cystoscopy should be translated and spelled out by the medical transcriptionist in the final medical report.

This article is FREE to publish with the resource box.

© 2007 Connie Limon All Rights Reserved

Written by: Connie Limon, Medical Transcriptionist. Visit us at for more information about the unique and rewarding career choice of Medical Transcription. Join Camelot Articles and submit your original articles for website promotion and backlinks.

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