Friday, March 22, 2013

Best Careers In Health Care For Job Security

With job growth projected to increase across the industry, choosing to work in health care could be a smart career move

Career #5: Pharmacy Technician

The U.S. Department of Labor predicts 32 percent growth over the 2010 to 2020 time frame for pharmacy technicians, making this another smart career option to consider.

Why It's Booming: There are a variety of factors at play in terms of why this career is growing. For one, advances in pharmaceutical research mean that more prescription medications are being used to fight diseases. The growing elderly population will equal more prescription drug use as well.

What Pharmacy Technicians Do: Pharmacy technicians might perform tasks like compounding or mixing medications, counting tablets, or answering phone calls from customers, according to the Department. Pharmacy technicians working in hospitals may also have different duties, like making rounds in the hospital to give medications to patients.

Education Options: The Department says that pursuing a career as a pharmacy technician usually requires earning a high school diploma. Some states may also require completing a formal education program and passing an exam, so be sure to check what the requirements are in your state.

Wednesday, March 20, 2013

Why EMRs Should Not Replace Medical Transcription

Although it was originally believed by some that the implementation of Electronic Medical Records (EMRs) was going to eliminate the need for medical transcription services, many healthcare organizations are finding that medical transcription not only improves the use of EMRs, but also provides numerous additional benefits. We have listed 11 important reasons why EMRs should not replace medical transcription services.

Medical Transcription:

1. Saves TimeDocumenting the patient encounter in an EMR is time-consuming. When physicians are required to key data directly into the EMR, it takes significantly more time to complete the clinical documentation. Incorporating medical transcription with the EMR makes more efficient use of the physician’s time. Medical transcription decreases the physician’s time of documenting in the EMR because it transfers the clerical, data-entry responsibilities away from the physician.

2. Integrates with EMRs
Medical transcription can seamlessly integrate with EMRs and can automatically populate the transcribed content into the appropriate EMR fields using discrete reportable transcription (DRT). With a medical transcription-integrated EMR, physicians have more time to focus on patient care and clinical activities.

3. Maintains Revenues
Often, when EMRs are implemented, the extra time needed by the physician to complete the clinical documentation in the EMR requires the healthcare organization to reduce the number of patients seen. Fewer patient encounters translates to reduced revenues. This reduction in revenue can be overcome by using medical transcription as a documentation tool for the EMR.

4. Reduces Data-Entry Costs
Physicians are an expensive resource. Prior to the implementation of EMRs, physicians would typically have not been used for data-entry tasks. By using medical transcriptionists to complete the physician’s patient-encounter note, it reduces the data-entry costs associated with creating the EMR documentation.

5. Improves Productivity
The practice of medicine is fast-paced. Dictation is the fastest method to complete clinical documentation. And, medical transcription does not compromise the physician’s productivity or the organization’s workflow.

6. Enhances Usability
Medical transcription complements EMRs and improves their usability. A lot of the patient-encounter notes cannot be easily captured by the EMR’s documentation options. Medical transcription provides a valuable, usable documentation tool for the EMR.

7. Creates Meaningful Notes
Medical transcription provides richer narrative information, as compared to what is produced with the EMR’s templates and point-and-click documentation. A more complete, contextual, and meaningful note is provided when medical transcription is used (and integrated) with the EMR.

8. Increases AccuracyFree-text typing into an EMR can have a high error rate. Medical transcription eliminates the need for physicians to type lengthy EMR notes. In addition, copied-and-pasted or templated text used in the encounter note may not always properly portray the patient’s status or current visit. Another benefit of medical transcription is that a medical transcriptionist can help improve the quality of the clinical documentation by identifying possible errors in the dictation.

9. Provides Familiarity Dictation is the preferred method of clinical documentation for most physicians. Also, it is a documentation process that many physicians are already familiar with today.

10. Requires No EditingWith medical transcription services, the physician does not serve as the clinical documentation editor, like with front-end speech recognition technologies.

11. Accelerates EMR Adoption
Medical transcription services can help accelerate and expand EMR adoption for healthcare organizations.

Wednesday, March 13, 2013

A Day in the Life of a Medical Transcriptionist (home-based position)

Medical transcription is a fast-paced, specialized healthcare field with our own language, rules and regulations. More appropriately, today we are known as a Medical Language Specialist (MLS) with responsibilities to preserve the accuracy and integrity of legal medical documents. No two days are the same on the job, and the learning never ends. Although we sometimes face challenges; they are resolvable, and there is always an abundant workload. Moreover, the ability to work from home makes this position highly desirable provided one is disciplined and focused.

At the medical center where I work, dictation can be done from either inside or outside
the hospital for all physicians with staff privileges by dialing into the dictation system to a designated number. All dictation is recorded through a digital system and is managed through an application called DVI that is nowsupported by Word Systems, Inc. At our institution, dictation and transcription are separated into two separate categories; radiology and medical. An on-staff dials into the DVI
phone line and keys in the pertinent information for the dictation. The dictations are set up in work types designated for the specific report that they wish to dictate; i.e., history and physical, consultation, operating report, discharge summary, cardiology procedure, radiology, etc. Once the
dictation is recorded on the DVIsystem, it is immediately off-loaded to our transcription program.

The transcription platform used is an Internet-based system called TA Client and is a
program that was created and supported by Arrendale Associates out of North Carolina.
Within the TA application, the “jobs,” (each dictated report) are housed in an area called job administration. This area holds all dictation that is waiting to be transcribed. Each document is assigned a work type and is weighted according to priority. Each transcriptionist has the capability to viewjob administration, which allows them to manipulate documents (should the need arise) for problematic dictations, to move them to a higher or lower priority, change the work type as necessary when there is an error, to work through a specific backlog or dictator, as well as to route preoperative reports to a designated area until the patient is assigned a current account number if the report is
being dictated preoperativelyso it is not kicked around by multiple associates until they are assigned an appropriate number.

The transcription system is set up such thatwhen a transcriptionist signs in to the program, the jobs auto-route to available transcriptionists two jobs at a time. As they complete one job and submit it, the queue will refresh and load another job. Each time a transcriptionist call up a report to do, she is prompted by a demographic screen that populates the patient demographic informationthat the dictator has keyed in (on a good day), providing there are demographics available. Sometimes, little to no information is given wherefore the MLS detective skills come into play. Again, the patient’s medical record is a number that stays the same no matter how many times they come to the medical center. The different stays are called encounters, and those numbers change each time they visit. These are called account numbers.

When the patient demographics populate on the screen and the tr
anscriptionist has verified through her headphones and the main frame (AS400) that the dictated text and the patient information match, she then clicks the button on the TA demographic screen that performs a lookup on the AS400 that will then link the patient
demographics with a Word document that is created. Now finally, the transcriptionist can begin the
transcription! With practice and repetition, this process moves quickly. The transcriptionists at our institution have three packets that have been distributed that outline our Transcription Overview, Transcription Style Guide, and Transcription Formats set forth by the department and the medical center that are to be followed when transcribing dictated documents. We alsoclosely follow the AHDI (Association for Healthcare Documentation Integrity) Medical Transcription Book of Style. IT is the responsibility of each transcriptionist to also keep a medical library up to date concurrent with use of reputable references from Internet web sites.

Once the medical document has been transcribed, it is the responsibility of the transcriptionist to spell check the document and make any revisions necessary and adding any carbon copies that need to be sent before submitting the completed record. Once the document has been submitted, it flows back to the hospital main frame (AS400) and from there is interfaced to the HPF (Horizon Patient Folder) in the form of a preliminary document. At this point in time, a deficiency is created for the physician to sign the document. It is imperative that the physician carefully reviews the content and makes
any necessary edits or changes before affixing their signature. This is now considered a
legal medical document. Once their signature has been affixed to the document, they can no longer edit the report and would have to make any further changes or additions in the form of a dictated “addendum or corrected copy,” that would require another signature.

We have the capability to create our own short cuts within the TA Client program and have created normals and samples that helpto enhance and boost our production. The medical center has set average turnaround times for our specific report types. The system is capable of monitoring these and we have the means to monitor how many jobs are out of turnaround by the job summary function of our TA (transcription) program. These turnaround times are monitored closely and are reported to out HIM director at the end of each month, who then in turn reports them to administration.

Medical transcriptionists are paid by productivity and are paid by the 65-character line. Our minimum requirement is equivalent to 150 lines per hour (for part-time) or an average of 12,000 lines per pay period (two weeks) for a full time employee (80 hours). Production statistics are submitted weekly by
the individual transcriptionist and are checked against the production report run fromthe transcription application. On the medical side, we have a three-tier incentive program that affords the opportunity for a greater earning depending on the lines per hour the transcriptionist transcribes and their ccuracy. All transcriptionists, while earning by production, are schedule for specific shifts and punch their time through a time and attendance program, which is necessary for calculation of their lines/reports per hour. Our part of the department is typically considered a 24/7 department and our staff coverage complies with this time frame.

Each transcriptionist receives an annual evaluation at which time a transcription quality assessment/audit is done to calculate average production (quality/quantity/accuracy) as part of an overall assessment for potential merit increase. Included in this annual evaluation are other things pertinent to our medical center asan individual institution and includes pieces like compliance with Net Learning. These mini in-service modules set up by the medical center for the purpose of continuing education thathelp us to stay abreast of JCAHO requirements, medical center policies and procedures, patient safety goals, OSHA requirements, hazardous materials and the like.

Medical transcription is an exciting but ever-changing field regardless as it is critical that
the medical documentation as dictated is as accurate as possible in order that we can provide the most current and complete up-to-date electronic medical record possible with the information that we are given. The medicalrecord will follow the patient their entire life and we try to make certain that while transcription, we consider that the patient we are serving could be our own family members.It is through the documentation as a joint effort between the dictator and the transcriptionist that other healthcare providers may be basing their current assessment of a patient and their subsequent ongoing care

Monday, March 11, 2013

Medical Transcription: What are you worth?
Consider the following earnings matrix which projects gross annual income for various combinations of daily line count production and average wage per line:

$.06 per Line
$.08 per Line
$.10 per Line
$.12 per Line
$.14 per Line
800 Lines
1,000 Lines
1,250 Lines
1,500 Lines
1,750 Lines
2,000 Lines

Skilled Medical Transcriptionists generally have little trouble finding work. Maximizing income, however, requires more than just falling into the first available job. In addition to possessing solid technical skills, the highest paid transcriptionists generally tend to have a positive self image and good people skills. Negotiating the right pay package requires a healthy dose of both. Sometimes it also means being willing to make a change or take a little risk. It should be obvious from the above compensation matrix that the greatest leverage lies in being willing to sell and service your own clients.

Annual income for full-time entry-level transcriptionists typing hospital reports averages between $20,000 - $35,000 - depending on location and proficiency. However, more experienced transcriptionists can expect to make double that amount - or more - on the basis of production, particularly if they are willing to develop their own customer base. Unfortunately, the pay differential between experienced and non-experienced transcriptionists is not typically as large in hospital settings where transcriptionists are often paid by the hour. This is one of the primary reasons that experienced transcriptionists tend to seek out positions as independent contractors or small business owners where they have the opportunity to leverage their earnings potential.

As an independent transcriptionist or service provider, the amount of money you make will be determined by your speed and proficiency. Average production based wages average between six and ten cents per line of transcription (based on a 65 keystroke line). If you are able to secure your own clients then you can expect to bill between fourteen and twenty cents per line for your work. Of course your overhead will have to be deducted from this amount. Still, this can mean a significant increase in income for those willing to learn how to sell their services to hospitals and clinics.

The primary factors which determine the income of a Medical Transcriptionist are as follows:
Competence and Experience
Speed and Efficiency
Risk Tolerance
Employee vs. Contractor
Geographic Location
Willingness to Accept Change

As a general rule, the industry pays a relatively high premium to transcriptionists who have a broad base of experience and competence - particularly in some of the more technically challenging specialties. Unfortunately, many highly qualified transcriptionists are not fully rewarded for their competence because they lack one of the other elements of success. For example, they may be geographically inflexible, or too conservative to try their hand at a more lucrative but potentially risky contracting arrangement.

Of course, some transcriptionists make a conscious decision to trade off a higher income for some additional flexibility, lower stress, or the opportunity to work from home. There is certainly nothing wrong with this as long as they understand the decisions they are making. Too many individuals simply shortchange themselves because of a reluctance to rock the boat. It is always adviseable to keep an open mind about potential opportunities to advance one's career or income.

An inexperienced Medical Transcriptionist will typically be better off with a compensation structure that guarantees an hourly wage. Securing a job with an hourly wage rate allows the new transcriptionist to earn a minumum amount of income during the least productive period of her career. Experienced transcriptionists are almost always better off being paid on production - provided they have the motivation to produce consistently.

Geographic location is still an important driver of wages - with those residing on the east and west coasts commanding the highest wages. This phenomena is primarily a consequence of the higher cost of living on the coasts. However, as remote dictation and transcription technology continues to proliferate, geographic pay differentials will begin to erode.

Most Medical Transcription operations are continually seeking new employees or contractors. The growth in the scope and complexity of medical records has been significant over the past several years and the demand for qualified help currently outstrips supply. There are abundant opportunities for an ambitious transcriptionist to increase his or her income.

If you are serious about your career it is important that you manage it aggressively. This implies that you do not necessarily settle for the first thing that comes along. If you are currently working as a Medical Transcriptionist and are dissatisfied with your current situation, you should take special care not to jump at the first opportunity that presents itself - simply as a means of getting out of an unpleasant situation.

Any move you make should be well calculated and meaningful. It should clearly move you in a positive direction. Be mindful of the fact that once you have made a move, you will typically be there for a while. That is why it is so important to make every move count. Make sure that every job change propels you to your next career plateau. You want to avoid making strictly lateral moves unless the new position will clearly provide an opportunity to gain a significant amount of valuable experience.

It is important to set stretch goals. Set your sights high and then work aggressively to sell yourself to employers. Think about getting the specialty training you need if that is standing in the way of your progress.

If you have not clearly thought through your career objectives then this is a good time to do so. Consider your objectives in the context of family, lifestyle, personal growth and income requirements.

Individuals who are most successful in their careers are typically those who are proactive. Waiting for opportunities to come to you is not the best way to manage your career. Think about where you want to be and then go after it.

Good luck!

Wednesday, March 6, 2013

About Medical Transcription - A Career in Healthcare Documentation - Ahdi

    If you are interested in Medical Transcription this is a great article:

    Table of Contents
    • What is a Medical Transcriptionist?
    • What does a medical transcriptionist do?
    • What characteristics do I need in order to become a medical transcriptionist?
    • Where do medical transcriptionists work?
    • Who do medical transcriptionists work for?
    • Where can I learn more about medical transcription?
    • How Do I Train for Medical Transcription?
    • What is the initial point of contact to begin MT education?
    • Which school should I go to?
    • What should I ask when I contact an approved school?
    • Is distance-learning a good idea?
    • Why are some approved schools more expensive than others?
    • How long does it take to become a medical transcriptionist?
    • How Does Apprenticeship Work?
    • What is an apprenticeable occupation?
    • Are apprentices paid?
    • Where can I find more information about the federally approved MT Registered
    • Apprenticeship Program?
    • Can I Find Employment?
    • Will it be easy for me to get a job?
    • Can I work from home?
    • Can I be self-employed and/or own my own MT service?
    • What can I expect to be paid once educated and working as an MT?
    • Who Promotes Medical Transcription?
    • What professional organizations serve the needs of medical transcription?
    • What credentials and designations are recognized by MT employers and peers?
    • Why are graduate certificates, professional credentials, and designations desirable?
    • What professional organizations represent medical transcriptionists?
    • What is the Future of Medical Transcription?

    Tuesday, March 5, 2013

    More about Medical Transcription


    Take dictation using shorthand, a stenotype machine, or headsets and transcribing machines.
    Return dictated reports in printed or electronic form for physician's review, signature, and corrections and for inclusion in patients' medical records.
    Review and edit transcribed reports or dictated material for spelling, grammar, clarity, consistency, and proper medical terminology.
    Transcribe dictation for a variety of medical reports, such as patient histories, physical examinations, emergency room visits, operations, chart reviews, consultation, or discharge summaries.
    Distinguish between homonyms and recognize inconsistencies and mistakes in medical terms, referring to dictionaries, drug references, and other sources on anatomy, physiology, and medicine.
    Translate medical jargon and abbreviations into their expanded forms to ensure the accuracy of patient and health care facility records.
    Produce medical reports, correspondence, records, patient-care information, statistics, medical research, and administrative material.
    Identify mistakes in reports and check with doctors to obtain the correct information.
    Perform data entry and data retrieval services, providing data for inclusion in medical records and for transmission to physicians.
    Set up and maintain medical files and databases, including records such as x-ray, lab, and procedure reports, medical histories, diagnostic workups, admission and discharge summaries, and clinical resumes.

    Tools & Technology

    Tools used in this occupation:

    Dictation machines — Desktop transcribers; Dictaphones; Transcribing equipment
    Facsimile machines — Fax machines
    Franking or postage machines — Postage meters
    Laser printers
    Notebook computers

    Technology used in this occupation:

    Electronic mail software — Email software; Microsoft Outlook
    Medical software — MedQuist DocQment Enterprise Platform; Misys Healthcare Systems software; PCC EHR; SpectraMedi EasyFlow
    Spreadsheet software — Microsoft Excel
    Voice recognition software — Crescendo Systems DigiScribe-XL; g-net solutions MTP; Nuance Dragon NaturallySpeaking Medical
    Word processing software — Corel WordPerfect software; Microsoft Word; SpeedUp Trans *; Sylvan Software ShortCut

    * Software developed by a government agency and/or distributed as freeware or shareware.


    Clerical — Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
    English Language — Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
    Computers and Electronics — Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
    Medicine and Dentistry — Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.


    Active Listening — Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
    Reading Comprehension — Understanding written sentences and paragraphs in work related documents.
    Writing — Communicating effectively in writing as appropriate for the needs of the audience.
    Time Management — Managing one's own time and the time of others.
    Critical Thinking — Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
    Judgment and Decision Making — Considering the relative costs and benefits of potential actions to choose the most appropriate one.
    Monitoring — Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.
    Speaking — Talking to others to convey information effectively.


    Oral Comprehension — The ability to listen to and understand information and ideas presented through spoken words and sentences.
    Written Comprehension — The ability to read and understand information and ideas presented in writing.
    Written Expression — The ability to communicate information and ideas in writing so others will understand.
    Speech Recognition — The ability to identify and understand the speech of another person.
    Near Vision — The ability to see details at close range (within a few feet of the observer).
    Oral Expression — The ability to communicate information and ideas in speaking so others will understand.
    Finger Dexterity — The ability to make precisely coordinated movements of the fingers of one or both hands to grasp, manipulate, or assemble very small objects.
    Deductive Reasoning — The ability to apply general rules to specific problems to produce answers that make sense.
    Problem Sensitivity — The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
    Category Flexibility — The ability to generate or use different sets of rules for combining or grouping things in different ways.

    Work Activities

    Interacting With Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
    Documenting/Recording Information — Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.
    Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources.
    Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data.
    Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job.
    Identifying Objects, Actions, and Events — Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events.
    Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
    Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work.
    Establishing and Maintaining Interpersonal Relationships — Developing constructive and cooperative working relationships with others, and maintaining them over time.

    Work Context

    Importance of Being Exact or Accurate — How important is being very exact or highly accurate in performing this job?
    Importance of Repeating Same Tasks — How important is repeating the same physical activities (e.g., key entry) or mental activities (e.g., checking entries in a ledger) over and over, without stopping, to performing this job?
    Spend Time Sitting — How much does this job require sitting?
    Time Pressure — How often does this job require the worker to meet strict deadlines?
    Spend Time Making Repetitive Motions — How much does this job require making repetitive motions?
    Indoors, Environmentally Controlled — How often does this job require working indoors in environmentally controlled conditions?
    Structured versus Unstructured Work — To what extent is this job structured for the worker, rather than allowing the worker to determine tasks, priorities, and goals?
    Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls — How much does this job require using your hands to handle, control, or feel objects, tools or controls?
    Face-to-Face Discussions — How often do you have to have face-to-face discussions with individuals or teams in this job?
    Freedom to Make Decisions — How much decision making freedom, without supervision, does the job offer?

    Job Zone

    Title Job Zone Three: Medium Preparation Needed
    Education Most occupations in this zone require training in vocational schools, related on-the-job experience, or an associate's degree.
    Related Experience Previous work-related skill, knowledge, or experience is required for these occupations. For example, an electrician must have completed three or four years of apprenticeship or several years of vocational training, and often must have passed a licensing exam, in order to perform the job.
    Job Training Employees in these occupations usually need one or two years of training involving both on-the-job experience and informal training with experienced workers. A recognized apprenticeship program may be associated with these occupations.
    Job Zone Examples These occupations usually involve using communication and organizational skills to coordinate, supervise, manage, or train others to accomplish goals. Examples include food service managers, electricians, agricultural technicians, legal secretaries, interviewers, and insurance sales agents.
    SVP Range (6.0 to < 7.0)

    There are 2 recognized apprenticeable specialties associated with this occupation:
    Medical Transcriptionist; Medical Transcriptionist

    To learn about specific apprenticeship opportunities, please consult the U.S. Department of Labor State Apprenticeship Information website.

    For general information about apprenticeships, training, and partnerships with business, visit the U.S. Department of Labor Office of Apprenticeship website.


    Percentage of Respondents Education Level Required
    81 Some college, no degree
    11 High school diploma or equivalent
    8 Associate's degree


    Interest code: CR

    Conventional — Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.
    Realistic — Realistic occupations frequently involve work activities that include practical, hands-on problems and solutions. They often deal with plants, animals, and real-world materials like wood, tools, and machinery. Many of the occupations require working outside, and do not involve a lot of paperwork or working closely with others.

    Work Styles

    Attention to Detail — Job requires being careful about detail and thorough in completing work tasks.
    Dependability — Job requires being reliable, responsible, and dependable, and fulfilling obligations.
    Independence — Job requires developing one's own ways of doing things, guiding oneself with little or no supervision, and depending on oneself to get things done.
    Integrity — Job requires being honest and ethical.
    Cooperation — Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.
    Achievement/Effort — Job requires establishing and maintaining personally challenging achievement goals and exerting effort toward mastering tasks.
    Initiative — Job requires a willingness to take on responsibilities and challenges.
    Adaptability/Flexibility — Job requires being open to change (positive or negative) and to considerable variety in the workplace.
    Stress Tolerance — Job requires accepting criticism and dealing calmly and effectively with high stress situations.
    Concern for Others — Job requires being sensitive to others' needs and feelings and being understanding and helpful on the job.

    Work Values
    Support — Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical.
    Relationships — Occupations that satisfy this work value allow employees to provide service to others and work with co-workers in a friendly non-competitive environment. Corresponding needs are Co-workers, Moral Values and Social Service.
    Achievement — Occupations that satisfy this work value are results oriented and allow employees to use their strongest abilities, giving them a feeling of accomplishment. Corresponding needs are Ability Utilization and Achievement.