In theory voice recognition is a great idea: it should enable quick and easy transcription of medical dictation. However we believe that there are a number of important benefits that may only be realised by outsourcing work to experienced medical transcriptionists:

• Medical secretaries often act as safety nets for their clinicians. Doctors may make mistakes in their dictation (e.g. dosage and other clinical errors), a human secretary will notice, bring them to the attention of the clinician and correct those, whilst a voice recognition computer lacks the common sense and contextual understanding to do so.

• The grammar and general English used in many medical dictations is poor: whilst human transcribers will endeavor to re-order the letter so that it is clear and easy to understand for the recipient, voice recognition will not be able to do so.

• As in all other fields the great advantage that human involvement has over computer automated systems (e.g. voice recognition) is that of common sense! A letter transcribed by a computer program may contain patently absurd phrases whilst a human has the common sense to ensure that the content and context of the transcript make sense.

• In order to use voice recognition effectively it is often necessary to train both the system into the dictating clinician's voice and also the clinician themselves to dictate in a particular way so that the system understands them. This is not only antagonistic to the clinicians but also causes problems where new or locum staff come into a department.