URL: http://www.entrepreneur.com/magazine/entrepreneursstartupsmagazine/2005/october/80216.html

Question: I'm a nurse who wants to leave the stress and strain of nursing. I believe I could do medical transcription from home, but I've heard a lot of medical-transcription work is being offshored, which keeps American workers' pay rates down. Is this still a good business?

Answer: Medical transcription, like most tasks that can be done on a computer, is being offshored, particularly to India, Pakistan and the Philippines. However, the demand for medical transcription work in the United States remains strong, and legislation is pending in some states to prevent the sharing or disclosing of personal health and financial data outside the U.S. In fact, California passed such a law last year, but it was vetoed by the governor. The pressure for protective legislation has been fed by cases in which Indian and Pakistani transcriptionists threatened to make the medical records they had worked on public on the internet because they had not been paid.

Another reason medical transcriptionists remain in demand in the U.S. is because of the amount of training it takes someone without a health-care background to learn how to do it. You must know medical terminology and be able to make sense out of doctor and other health-care provider notes and dictation. So opportunity remains for Americans who want to enter this field-particularly workers like yourself, who enter from a career in nursing and plan to work for perhaps another 10 years or so.

Competition from abroad, however, is impacting what transcriptionists are paid. The average rate medical transcriptionists charge-10 to 14 cents a line-has hardly changed since 1991, when we researched the industry for the first edition of The Best Home Businesses. And since this work is done in India for about half that rate, you can expect pay in this industry to be static at best.

As an independent medical transcriptionist, expect your work to come from local clinics and group medical practices. Although any medical health provider or facility that sees patients has transcription needs, the smaller organizations are less likely to outsource. Still, since overnight work is one of the selling points for overseas transcription services, you may need to offer extraordinary customer service to be competitive, such as pickup and delivery to those doctors who still use tapes, seven-day-a-week service or phone-in dictation.