WORKING AT HOME IN THE LEGAL/MEDICAL FIELD =========================================== I. Scoping: Its History and Its Future I began my own career doing transcription and notereading, which in time lead to scoping (computerized editing) for court reporters, more than twenty years ago. In that time span, I have seen major changes in the field, most notably due to the introduction of the computer for the production of transcripts. I will first give you an overview of what scoping involves, including some information on the operation of the stenotype machine, and how it has evolved historically, and then will discuss with you my own experience working in this field, and how you can become trained to work from your own home doing the same thing. In the court reporting field, the word "scoping" refers to a type of computerized editing, done with specialized computer software designed for this purpose. Prior to the advent of the computer in this field, court reporters would dictate their transcript material onto an audiotape for transcription or, as a better alternative, they used "notereaders," people who were trained to read the steno notes from a paper tape, and type the transcript in full. Computer software now translates the steno language, and a file is produced for text editing after that translation. Do not assume, however, that the computerized translation is sufficiently efficient to put us human beings out of a job; to the contrary, there is a great deal of editing to be done after the translation (scoping), and reporters simply do not have the time to sit in court or deposition all day, and edit their own transcripts at night and on the weekends -- although a lot of them try to do that until they reach a breaking point, and that's why they need us as editors! Most of us are familiar with the appearance of a court reporter, either in trial or deposition, taking down testimony using a rather odd-looking little machine. People are often puzzled about how a reporter can possibly take down information at the speed they observe witnesses talking, and usually assume that court reporters are performing as they would with a typewriter, hitting one key at a time to represent one alphabetic letter. In fact, every key on the stenotype keyboard can be hit at the same time, although each key can only print in its own column (like swimmers at a swim meet). So steno reporters write what they hear using a phoenetic shorthand system, and can write a whole word, or several words, in abbreviated form, in one stroke of the steno keys (like playing chords on a piano). On the next page is a graphic representation of what a stenotype machine looks like. After noting the arrangement of the keyboard, we can then write some words in very simplified stenotype, to give you a brief overview of what is involved in reading the steno language. _________________________________________________ | _______________________________________ | | |_____________________________________| | | _________________________________________ | | | S | T | P | H | * | F | P | L | T | D | | | |___|___|___|___|___|___|___|___|___|___| | | | S | K | W | R | * | R | B | G | S | Z | | | |___|___|___|___|___|___|___|___|___|___| | | | A | O | E | U | | |___ |___|___|___|___| ___| | | |_________________________________________| STENOTYPE KEYBOARD When writing on the stenotype machine, a record is produced on a thin paper strip which looks like cash register tape. And today, with computerized systems (referred to as "CAT" systems, which is an acronym for "Computer Aided Transcription), in addition to the paper tape, data is being recorded on a computer chip as the reporter writes, to be translated later by specialized translation software, and in some cases is shown on a digital display on the steno machine. This keyboard is set up so that beginning consonants fall on the left side, vowels print in the center of the tape, and ending consonants fall on the right side of the keyboard. Since not all the letters of the English alphabet are represented on the keyboard, and there are repetitions of some letters (note that there are two "r's" on the keyboard), combinations of letters are used to represent the ones which are missing; for example, the letter "I" is represented by the combination "EU," since no "I" appears on the keyboard. Several simple writing samples will appear below, and the actual order in which the letters print will appear as a guide at the top (for purposes of this explanation only -- this guide does not appear on the actual steno notes), to indicate how words actually look when written out in stenotype (and this will explain the appearance of large spaces between letters, which happens, once again, because the individual characters can only print in a given location). +++++++++++++++++++++++++++++++++++++++++++ S T K P W H R A O * E U F R P B L G T S D Z +++++++++++++++++++++++++++++++++++++++++++ T H A T Above, we have the simple word "that," written out exactly as it is written in English. Again, the only reason for the spaces between the letters is the fact that those characters can only print in a specified column. +++++++++++++++++++++++++++++++++++++++++++ S T K P W H R A O * E U F R P B L G T S D Z +++++++++++++++++++++++++++++++++++++++++++ K A T This example shows a simple word, "cat," written by phoenetic sound. There is no "C" on the keyboard, but stenotype is based on writing by sound, so the hard "K" sound is used. +++++++++++++++++++++++++++++++++++++++++++ S T K P W H R A O * E U F R P B L G T S D Z +++++++++++++++++++++++++++++++++++++++++++ T P A T Here we have the word "fat"; no "F" appears on the left side of the keyboard, so the combination "TP" is designated to stand for "F." +++++++++++++++++++++++++++++++++++++++++++ S T K P W H R A O * E U F R P B L G T S D Z +++++++++++++++++++++++++++++++++++++++++++ T A T The sample above is an example of a phrase which includes several "brief forms." (A brief form is simply an abbreviation for a word; we're all familiar with "ASAP" to stand for "as soon as possible" in everyday English.) In the case above, the phrase "TAT" is the designation for the phrase "at that time." It is because of the use of phoenetic writing and the use of brief forms and phrases that court reporters are able to write several words at one stroke, rather than one letter at a time, and that accounts for their ability to be writing at high speed, even though their hands appear to be moving rather slowly. +++++++++++++++++++++++++++++++++++++++++++ S T K P W H R A O * E U F R P B L G T S D Z +++++++++++++++++++++++++++++++++++++++++++ S K W R U P B L G This final example is a rather amusing one because there is not one normal letter of the English alphabet represented above in the word "judge," which is written out by sound as "J-U-J." To explain: There is no "J" on the left side of the keyboard, and all the two- and three-letter combinations have been exhausted, so the letter "J" (being used with less frequency) is represented by the four-letter combination "SKWR." Likewise, on the right-hand side of the keyboard, there is no "J," so the four-letter combination "PBLG" is used to represent the final "J" sound. It is best to end this discussion with an assurance that, although this may appear at first glance to be a difficult subject to master, actually it is not. It simply requires some memorization and the resolve to keep moving ahead, and before very long you will be reading a whole new "language." Nationwide, there are approximately six or seven differing writing systems, taught at different court reporting schools, but there are more similarities than differences in those writing systems, having to do with differing brief forms, for example, and learning one basic steno method will allow you to generalize to other writing methods. The latest development in the court reporting world has to do with "realtime" production of documents, and involves two basic areas: First, the steno language being used by all court reporters today is the same *basic* machine language which was used when the steno machine was first used in an American courtroom at the Lindbergh trial, sixty years ago. The change which has occurred has to do with today's technology. It is now possible to set up an arrangement in a courtroom or deposition suite where all parties can have their personal notebook computers hooked up to a central translation system, and as the reporter is writing, the material is being translated instantly by the CAT software used, and an *unedited* version of the transcript (I stress "unedited") appears on the computer screen of every attorney, the court reporter, and the judge. In addition to "watching the words go by," the parties are able to interactively mark certain portions of a transcript for later perusal. It is important to note, however, that only an official edited version of a transcript, signed by a court reporter as being correct, can be used for filing of documents with the court. As a result of this new technology, court reporters are being trained to write "realtime." This simply means that, unlike in the "old days," when a reporter might use the same brief form to stand for two words which sound alike ("BR" for bear and bare, for example -- although that's not really stenotype, just an easy example), they are now learning to write each word with a different designation so that the computer can translate more efficiently. Otherwise, conflicts appear in the translated transcript, which must be edited out after the translation; for example, the two words "bear" and "bare" would appear this way -- {bear/bare} -- in the middle of a transcript, and using CAT software, an editor would have to choose the proper one by context. Given the above, it is possible to be in your home, with a modem hookup to a courtroom many miles away, and be doing editing "live" for a court reporter. The term "realtime writing" is now also being applied to reporters who have simply cleaned most of the conflicts out of their writing, requiring less editing, although the actual scoping process takes place after the fact. In that case, a reporter translates the material from the day's work and sends it by e-mail or modem (or occasionally still by overnight mail on a disk) to an editor. There, the editing isn't being done on a "realtime" basis, but the quality of writing produced by the court reporter is good enough to allow for the display of the transcript on a live basis while the proceeding is actually going on. The use of e-mail and modeming has changed the face of this field considerably. I look back with amusement to the fact that when I started working in this field years ago, I used to personally pick up and deliver the actual paper notes from a dog grooming shop, because it was halfway between the reporter and myself, and she knew the owner. What a "Brave New World" we're living in today. Now, you can literally live on any mountaintop, and if there's a phone line available, you can work for court reporters all over the United States and Canada! While discussing technology, it is best to touch on the subject of tape recorders in this field. I immediately began hearing, when I started in this field years ago, that in due time stenographic reporters would be replaced by tape recorders! Although that idea still seems reasonable to many people, the fact is that there has been a major lobby on the part of stenographic reporters, nationally, to keep the steno machine in the courtroom. Of greater importance, however, is the fact that most of the development money in this field has been put into producing CAT systems which offer the realtime capabilities I have already talked about. There can be problems with tape recorders with regard to trying to capture testimony when more than one person is talking at once. Of course, computerized steno machines can and do fail at times, and because of that many court reporters run a backup tape for their protection, and the protection of all parties to a lawsuit, whether they do it openly, or hide a tape recorder in a briefcase. There has been such a fear in the past of replacement by a tape recorder that many reporters are a little paranoid about using a tape recorder. I personally feel that the day may come when there will be a requirement for a backup tape. Only my opinion! At the end of my scoping training program, students are ready to purchase or lease CAT software, and I am often asked for my opinion about which brand of software to acquire. There are about six or seven major software companies nationwide, all doing the same thing, but differing in the matter of how "state-of-the-art" they are. For a very long time, there has been a problem in this field with regard to sharing of data between differing CAT systems, since none of them were compatible with the others. The use of ASCII interchange between systems has helped a bit, but there have still been major problems with formatting between systems. Finally, there has been a hue and cry for an interchange format which has been heard, and acted upon, by several major CAT software vendors. Some vendors -- those who consider themselves the oldest and the biggest -- have refused to cooperate in this venture, but someone has definitely built a better mousetrap in this field, and several of the vendors are supporting this interchange venture. It is being referred to as "RTF/CRE," which apparently refers to a format already in existence (the "RTF" part, developed by Microsoft, I understand) which allows for interchange of data between systems. The "CRE" designation refers to "Court Reporting Extension," which has been added to the original RTF format and allows for the display of the steno notes on the computer screen, to be referred to as the document is being edited. For those interested in a more technical version of what I've tried to explain above, I can refer you to those who developed this marvelous interchange format! Equipment requirements to work as a scopist include the CAT editing software I've referred to above, and at least a 486 IBM- compatible computer with at least 4 mg. of RAM, a modem (fast is a good idea -- at least a 14,400), and, optionally, a good printer. Although most trancripts are now being done through the use of e-mail, and the reporter does the printing at his/her end, after the editing process is completed, for most of us there is a need for a printer, particularly considering the wealth of information we can download and print, to help us in our work. Although having the latest and greatest technological tools is of importance, it is quite important that a prospective student give strong consideration to the matter of good English skills before undertaking scoping as a profession. I have trained many people who undertook my steno training program with top-notch English skills -- some had degrees in English, or had worked as editors for book publishers. On the other side of the coin, however, I have observed that some people have simply not had occasion to make use of their English skills for a long time, and have become a bit "rusty." It is always possible to brush up on language skills, and I am able to make recommendations for certain books which will help in that process. My training program covers the use of English grammar as it is applied in the court reporting field, but if there are serious deficiencies in language skills, which should have been learned in high school, for example, it will be necessary for a student to make the improvement of English skills a priority, before expecting to become successful as a scopist. In addition to good basic English skills, the next most important factor for a prospective scopist to consider is acquiring really good notereading skills. Looking at a sample document from a computerized translation of a transcript can be deceiving in that at first glance it appears that the file is mostly English already. Sometimes the English has been mistranslated, and there are always a fair number of untranslated stenotype entries which need to be globalled into English. In order to function well as a scopist, there is a need for a well-developed ability to read the steno language -- often in order to figure out what the reporter *meant* to write (from the context of the sentence). My program involves help with marketing skills, and I will help you with such matters as learning how to send files electronically to reporters. There is no need to pay high fees to a trainer, however, to teach you how to use your computer, or how to operate the CAT software you purchase, because the CAT vendors have manuals, support lines, and online users' groups to support you in learning the software. Your primary emphasis in becoming a scopist should be on a really adequate notereading program, and good grammar and spelling skills. Earning capability by scopists is determined by a number of factors. Payment is by page rate, not by monthly or yearly salary. Scopists are independent contractors, the majority of whom work from their homes, and their earning rate depends on their own skill levels as far as a highly-developed ability to read steno notes, and on the quality of those notes produced by the reporter. Page rates range from around 75 cents a page to above a dollar a page, depending on the type of case involved; medical and technical transcripts generally pay a higher rate than simpler subject matter. Given good clean notes to edit, most scopists are able to produce between 25 and 40 pages per hour. So you can see that it is possible to earn a much higher-than-average income, even working part time at scoping, and enjoy the privilege of setting your own schedule and enjoying more time with your own home and family. My videotaped training program can be done in the privacy of your home, at your own pace, and covers all aspects of working in the legal/medical field, including steno training for use in editing for court reporters, and medical terminology, which is applicable both to scoping and to medical transcription. The training covers stenotype theory, grammar and punctuation, as it applies to the legal/medical field, legal and medical terminology, document production, up-to-date information regarding computers and software used in the field (including how to transfer files by modem or through the use of e-mail), marketing strategies, and continuing support by phone or e-mail during both your study and marketing phases. There is no requirement for certification or licensing to work as a scopist. Court reporters are requird to be certified, and although they depend on scopists to produce a good end product, the reporter is legally responsible for the finished transcript. There is a movement at this time to try to introduce some kind of certification for scopists through the National Court Reporters' Association; however, that process could be lengthy, and there are many reasons why it is going to be very difficult to achieve any meaningful standard for scopists, since standards vary widely from state to state for the performance of court reporters, themselves. In any case, certification, if developed, would be an entirely voluntary matter, just as certain certificate programs are for court reporters today -- merit certificates to allegedly show a greater degree of professionalism. In the final analysis, court reporters are not interested in seeing a certificate from a scopist; they will send you a small file as a test case, and if you do it adequately, you may then work together. This initial testing phase also allows you to assess the quality of the shorthand notes of that reporter, and decide whether you think you can work with that person. Although we always strive to please reporters, it is gratifying that, as a scopist, we are self-employed and can decide whom we will and will not work with. I have included a few pages of an actual computerized transcript, in unedited form, so that you can see the type of material produced by court reporters, and translated by CAT software. SAMPLE TRANSCRIPT: ----------------------------------------------------------------- 1 2 JULIE MORTIMER, 3 having been first duly sworn, was 4 examined and testified as follows: 5 6 EXAMINATION (RESUMED) 7 BY MR. DAWSON: 8 Q Good morning, Mrs. Mortimer. 9 A Good morning. 10 Q Have you reviewed any TKOUBGS in 11 preparation for today's deposition? 12 A No. 13 Q Have you TAEUPB any medication in the last 14 24 hours? 15 A No. 16 Q Aside from any conversations you may have 17 had with Mr. Ramp, SRUD any conversations with anyone 18 about the last session of your deposition? 19 A My therapist. 20 Q Okay. And who is that? 21 A Dr. Wagner. 22 Q Dr. Wagner. Is that Paul Wagner? 23 A Yes. 24 Q Do you know if he's associated with a 25 KHREUPB EUBG or a medical group, or which -- 2 1 A Yes, he is. 2 Q What's the name of that medical group? 3 MR. RAMP: I think we went through 4 this, didn't we? 5 MR. DAWSON: No. I tried finding his 6 address or his phone number, and couldn't 7 find it. So -- 8 THE WITNESS: You will have to give me 9 a moment; pleasing. 10 MR. DAWSON: Sure. 11 MR. RAMP: Let me see it. 12 MR. DAWSON: That's Atherton 13 Psychiatric Medical Group, Inc. okay. 14 Have you met with Jesse M. Carr? 15 THE WITNESS: No. 16 BY MR. DAWSON: 17 Q When did you speak to Dr. Wagner about your 18 last session of your deposition? 19 A Friday. This past Friday. 20 Q The 20th? 21 A Correct. 22 Q Was that a prearranged appointment? 23 A Yes. 24 Q As best you can recall, what did you TKEUS 25 KUS with Mr. Wagner about the last session's 3 1 deposition? 2 A I discussed the length and the duration. 3 The fact that I would be returning today. And how I 4 just got really emotional because of some of the 5 tones that you had directed at me. Just made me feel 6 really uncomfortable. 7 Q What else did you tell him? 8 A That's practically it. 9 Q How long was the meeting? 10 A Approximately 40 minutes. 11 Q Okay. And what type of counseling did he 12 provide, if any? 13 A He just tried to help me feel better. 14 Basically. 15 Q Did he prescribe any PHED SEUPB or 16 anything? 17 A No. He just told me to continue taking my 18 sleeping pills. 19 Q Okay. And over the weekend, did you take 20 the sleeping pills? 21 A No. 22 Q Okay. And I remember from your last time 23 that we talked, that you really hadn't // taking them 24 too much; is that an accurate statement? 25 A Correct. 4 1 Q Aside from Dr. Wagner, was there anybody 2 else you talked about KERPBG your last deposition 3 session? 4 A No. 5 Q Okay. Now, you've testified that you went 6 to -- when you say Carol Green at Patricia L. Brandon 7 & Associates. Did you see any other THAEURP PEUSZ or 8 doctors or psychologists at that firm? 9 A No. 10 Q Now, you've also TEFTD that you went to the 11 O'Leary center. First of all in your deposition, you 12 couldn't recall who the doctor was there. 13 Can you -- TKOU know which doctors or 14 therapist or psychologists you saw at Brandon? 15 A Just one. And I'm forgetting what her name 16 is. I'll have to call and find out. Prentice. I 17 think it's Kathy Prentice, actually, with a K. Okay. 18 Q Did you see any other doctors at Brandon 19 besides Kathy Prentice? 20 A No. Not for therapy, no. 21 Q Did you see anyone at Brandon for any other 22 reasons? 23 A Yes. When she PRAOE SKRAOEUBD medicine, 24 yes. 25 Q And who did you see? (END SAMPLE TRANCRIPT) II. Medical Module Medical terminology and its application to working for medical professionals is the final module in my training program. A knowledge of medical language is needed for working in the court reporting field, since there are many occasions when, for example in a malpractice lawsuit, the witness on the stand is a physician, using specialized medical language in testifying in a case. I have extended this medical module to include training in the actual preparation of medical reports for physicians and insurance companies in a variety of specialties. The module involves learning basic medical terminology, and report preparation from audiotapes. Learning the stenotype shorthand language is of further use in this area, since there is now rapid text entry software available to allow text entry in a shorthand form, right from a normal computer keyboard, and it can be used in conjunction with a variety of word processing programs. Those programs are based on the same basic shorthand theory you will learn in the stenotype training module. Compensation for medical transcription is comparable with doing scoping, although my personal preference is doing scoping, since it does not involve intensive typing, merely editing, which is much less tiring. Also, the ability to transmit files by e-mail in the court reporting field, versus having to deal with audiotapes in the medical area, allows for greater flexibility. Nevertheless, having this additional skill will round out your "portfolio" and enhance your ability to interest medical/legal professionals in your services. On the next page is a sample medical report, in basic letter format: DONALD L. BLAKE, M.D., INC. NEUROLOGY 6620 CONDON AVENUE FAIRVIEW, CALIFORNIA 95555 ~~~~~~~~~~~~ October 17, 1990 Mr. Thomas A. Martin, Jr. Law Offices of Smith, Martin and Lawson l000 Carlton Street Sacramento, CA 958l4 Re: Kevin Porter Dear Mr. Martin: At your request, I saw Kevin Porter in my office for neurologic evaluation on October 14, l990. At that time, this 40-year-old right-handed man gave me the history that he had been involved in a motor vehicle accident on August 6, l990, while driving a full- sized pickup truck in Truckee. He was not wearing a seatbelt at the time and his vehicle was rear-ended while he was sitting still, waiting to make a left turn onto the main street. My findings after examination are as follows: Sensory examination was intact to the usual modalities. Cerebellar testing was unremarkable. Deep tendon reflexes were all graded as 2+ and equal bilaterally in the biceps, triceps, brachioradialis, patellar and Achilles' areas. No Hoffmann or Babinski responses were found. Abdominal reflexes were present and equal bilaterally. Review of Prior Medical Records: The first items reviewed are the admission history and physical done by Dr. J. White at the Tahoe Forest Hospital in Truckee. It is noted that the patient was seen there on August 6, l990, by a Dr. Henson, who is the emergency room physician. It was noted that as a result of the injury, the patient had almost immediate loss of pinprick senation over the median and radial distributions of the left forearm and evidently hand. The sensation began to return while he was being evaluated in the emergency room, evidently, or shortly thereafter. X-rays had shown a severely comminuted fracture of the distal radius and apparently of the ulnar process, although it was not possible to see the ulna very well. The distal portion of the radius appeared to be comminuted, impacted, and tilted dorsally. He was admitted to the hospital for closed reduction of the left wrist. It was noted that the patient had had a ganglion removed from the same wrist dorsally some two years before. There was a history of a whiplash injury with subsequent headaches and it was stated that at one time he had temporarily been unable to work for a period of three months. (END OF SAMPLE MEDICAL REPORT) Although I have tried to be thorough in explaining this at- home career, you surely will have questions. I will give you a call in a few days, after you've had a chance to read this information, so that you can ask questions, and so that I can talk to you further about my training program. At that time I can also give you a comparison of my program with some others in existence, and explain the advantages of my training method. Working from my home has been extremely rewarding for me, particularly in view of the fact that when I began this venture, I was newly single, with a one-year-old daughter to bring up on my own. This career has allowed me to do that (and now my daugher is doing scoping to put herself through college), and has given me a great deal of personal freedom I would not have had if I had continued to work at a nine-to-five job. There are many reasons for people to choose the freedom of working at home, and sometimes making an initial decision to do so can be a little frightening; the end result, though, is quite gratifying. Thank you for your interest in my self-paced training program. I look forward to talking with you. Judy Barrett @Copyright