Until the twentieth century, physicians served both as providers of medical care and scribes for the medical community. After 1900, when standardization of medical data became critical to research, medical stenographers replaced physicians as scribes, taking their dictation in shorthand.

A few short years ago, medical secretaries worked face-to-face with the provider to produce reports using a typewriter and a bulky medical dictionary. Each provider had their own secretary for the purpose of transcribing and filing these reports.

In the late 20th century, with the advent of PC computers, dictation equipment, document editor applications and printers many moved on to computer based transcription which made it unnecessary for providers to work face-to-face with their secretaries. This resulted in out sourced transcription.

After 1990, with the advent of internet, cost savings and TAT offered by offshore transcription companies, it became obvious to offshore the transcription work.