I used to do the transcriptions at work. With the Audiologist they were easy because she spoke so clearly. The Neurologist I worked for outsourced them to a company in India. Usually his medical assistant would proofread them but sometimes I filled in. He didn’t speak as clearly so they would miss words. And were unfamiliar with American names. But he was way better than the doctor that shared space with us a couple days a week. He would stand at the nurses station in the back and mumble his notes quietly into a little recorder at 3x normal speaking speed. God Bless whoever had to type those out! Maybe they played them back at a slow speed.