While the national debate about offshoring – using employees in different countries around the world – can get quite heated at times, it's becoming more of an accepted fact in the transcription industry. One reason it's less controversial is that unlike outsourced call centers, medical dictation services don't deal with external customers: they work directly with your staff, so there's no public relations angle to worry about.

Many medical dictation services use both U.S. and international transcriptionists. This gives them a huge advantage in responsiveness: having a team of transcriptionists in the Philippines or India and one in the U.S. allows them to guarantee response times no matter when you submit your medical dictation, without having to operate two or three shifts in one location.

Professional transcription services only hire qualified transcriptionists – no matter where they're located. There should be little difference in accuracy, thanks to the amount of training MTs receive and the QA processes in place. And there is no denying the cost savings the services can pass on when they use offshore MTs for some or all of their work.

Some practices feel that it's important to use only U.S.-based transcriptionists. Most providers who have both U.S. and offshore employees will allow you to specify this preference, but you will likely pay higher rates for it.

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