Chapter 5: Direct Patient Care

Karen Piette and Kristen Hosey

It is likely that anyone that has visited a primary care provider in the United States has interacted with a Medical Assistant (MA). Medical assistants can do everything from managing a medical office, to working directly with medical providers assisting with exams, to scheduling appointments, performing billing and coding, and even verifying patient insurance. The MA scope of practice is large, and most states allow MA’s to perform numerous duties in medical offices.

Medical assistants can perform both clinical and administrative tasks in medical offices. Examples of clinical duties include recording patient history, measuring vital signs (blood pressure, temperature, respiratory and heart rates, oxygen saturation), administering patient injections, performing phlebotomy assisting with patient exams and minor surgical procedures, preparing blood samples for laboratory tests and entering patient information in medical records.

Patient’s arm with a tourniquet on ready for a blood draw.
Figure 5.4. A medical assistant performing phlebotomy (drawing blood) in the medical office / Photo Credit: Los Muertos Crew, Pexels License

In addition to clinical duties that MA’s can perform are front office, administrative duties. Administrative duties that can be performed by a MA include billing and coding, front desk check-in responsibilities, conducting referrals, and scheduling patient appointments. Just to name a few! The MA position is very versatile in medical offices which is one of the reasons they are so in demand.

Medical Assistants may also manage medical offices. MA’s who manage a medical office typically have a minimum of an associate degree on top of their required certification. Leadership skills, strong planning and organizational skills, human resource skills, and efficiency are personal skills and characteristics often needed for success in management.

Employment Opportunities for Medical Assistants

Medical assisting is an in demand career. According to the U.S. Bureau of Labor Statistics, the Occupational Outlook Handbook projects that employment will grow 16% from 2021 to 2031, which is faster than the average for all occupations.

MA’s typically can be seen in ambulatory care clinics, doctors or providers offices, and out-patient clinics. MA’s can work at a variety of medical specialties such as pediatrics, orthopedics, primary care or dermatology amongst many others. One unique aspect in some rural areas is that a MA may even float to multiple facilities with their provider. Typically, MAs will be found in outpatient settings. Due to staffing shortages post-COVID-19, some MAs may even work in long term care facilities as well, but this has not been common practice.

A Day in the Life of a Medical Assistant:

A typical day for a medical assistant often varies. MA’s must be adaptable and work well with others in order to tackle all tasks that come their way. MA’s mainly work in healthcare facilities that conduct traditional business hours. However, this can vary if the medical facility has clinic hours in the evening and on weekends (urgent care, for example).

Healthcare professional speaking with a pediatric patient and guardian at the front desk
Figure 5.5. Checking In Patient At A Pediatric Office / Photo Credit: Los Muertos Crew, Pexels License

Upon arrival at the facility, the MA will check their patient schedule and prepare for the day. This includes checking patient supplies in exam rooms and stocking as necessary, prepping supplies, sterilizing instruments, etc. Once patients arrive, the MA will pull the patients into the exam room, take patient histories, vital signs and find out why the patient is in the facility (presenting or chief complaint). The MA will document all this information in the patient’s electronic record. The MA will then notify the provider that the patient is ready.

The medical assistant may remain in the exam room with the provider as needed or the provider may only want the MA in attendance periodically depending on the patient’s chief complaint. The MA may assist the provider in examinations and minor surgical procedures.

MA’s also perform other duties regularly. They set up and breakdown operating rooms as well as sterilize instruments in the autoclave in preparation for the next day. Therefore, knowledge regarding sterilization procedures and autoclave operation is an important aspect of their job.

Throughout a patients’ medical visit, the MA is responsible for making patients feel comfortable to allow the provider to conduct a productive visit. MA’s need to have a friendly and kind demeanor to put patients at ease. Medical providers see numerous patients in one day, therefore, the MA is also tasked with assisting providers in staying on time through open communication and efficiency.

At the end of the day, the MA should make sure their exam rooms are well stocked, instruments and equipment are sterilized and even glance at the next day’s schedule to see if anything else needs to be done in preparation.

Medical Assistant Requirements and Qualifications

MA training programs typically last approximately 12 to 15 months, depending on the state and higher education setting. Coursework for MA programs typically include anatomy and physiology, medical terminology, first aid, medical law and ethics, coding and insurance processing, medication administration and computer skills. There could be a minimum age requirement of 18 years before program start, or practicum start, depending on the MA program. Typically, a background check is required.

Following clinical and administrative coursework, an MA student will also take part in a practicum experience in a physician’s office (minimum of 160 hours) at the end of their educational training. Following practicum, the MA student graduates with a certificate. Many MA programs offer the option of an associate degree as well.

A Certified Medical Assistant (CMA) typically completes a certification or associate degree from either a regional or nationally accredited institution. Following graduation, the MA candidate sits for a national licensure examination, such as that offered by the American Association of Medical Assistants (AAMA). The CMA AAMA examination is a national credentialing exam that, if successful, allows CMA’s to work in any state in the United States. The AAMA exam is a computer adaptive examination that needs to be completed at a testing center.

Some states have required licensure to practice as a MA. Washington state has mandatory licensure. The state defines duties of MA’s into two categories: the MA-C and the MA-R. The MA-C stands for medical assistant certified, while MA-R stands for medical assistant-registered. The MA-R becomes a MA through apprenticeship models (on the job training) or sponsorship from a licensed medical provider. The MA-R does not have a certification or degree in medical assisting and, therefore, may be limited to certain jobs within the state of Washington.

An excellent training program will be accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES). Accreditation allows graduates to sit for the CMA American Association of Medical Assistants (AAMA) examination. Since this is not just a national organization, but is also internationally recognized, the CMA will allow MAs to have the most flexibility in movement and work.

Continuing Medical Education

The AAMA certification requires Continuing Education Credits (CEU) to stay credentialed. Within 5 years, 60 CEU’s are required to stay certified, or the examination may be taken again to re-certify. The AAMA offers CEU’s online and many counties provide CEU’s to community members through country chapters associated with the AAMA. There are also state and national conferences as well that provide CEU’s.

Attributions

  1. Figure 5.4: image released under the Pexels License
  2. Figure 5.5: image released under the Pexels License
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