The Medical Assisting Profession
Learning Objectives
1. Define, spell, and pronounce the terms listed in the vocabulary.
2. Briefly discuss the history of medical assisting as a profession.
3. Discuss the versatility of a career in medical assisting.
5. Comprehend the current employment outlook for the medical assistant.
8. Discuss the aspects of the medical assistant’s performance on a successful externship.
9. List three unacceptable behaviors on the externship site.
10. Explain why continuing education is so important to the medical assistant.
Vocabulary
certification (ser-tuh-fuh-ka′-shun) The attesting of something as being true as represented or as meeting a standard; the result of having been tested, usually by a third party, and awarded a certificate based on proven knowledge.
continuing education units (CEUs) Credits for courses, classes, or seminars related to an individual’s profession that are designed to promote education and to keep the professional up to date on current procedures and trends in the field; CEUs often are required for licensing.
intangibles (in-tan′-juh-buls) Qualities that cannot be perceived, especially by touch, or cannot be precisely identified or realized by the mind.
invasive Involving entry into the living body, as by incision or insertion of an instrument.
phlebotomy (fli-bah′-tuh-me) An invasive procedure used to obtain a blood specimen for testing, experimentation, or diagnosis of disease.
profit sharing Offer of a part of a company’s profits to employees or other designated individuals or groups.
stock options Offers of stocks for purchase to a certain group of individuals or certain groups, such as employees of a for-profit hospital.
versatile (vur′-suh-til) Embracing a variety of subjects, fields, or skills; having a wide range of abilities.
Scenario
Sandra Ramirez is a single mother who has decided on medical assisting as a career. She has always been interested in the medical field and wants a job that will allow her to spend evenings and weekends with her 3-year-old son, Roberto. The idea of working in a physician’s office appeals to her, and she has applied to a school that is close to her apartment and day care provider. She plans to attend day classes and work part-time after school until it is time to pick up her son.
Sandra is very excited about her new career and has set several goals for her training. First, she hopes to attain perfect attendance, and second, she would like to graduate with honors. She has budgeted her study time and plans to ask her instructors during the first 2 weeks of school for suggestions on how she can better prepare for classes and examinations. Sandra will find medical assisting to be a rewarding career and respected profession.
While studying this chapter, think about the following questions:
• What goals might Sandra have at the commencement of her training? At the end of training?
• How can Sandra make the most of her time attending school to become a medical assistant?
According to the U.S. Department of Labor’s Occupational Outlook Handbook, medical assisting employment will grow 31% in the decade between 2010 and 2020, making this career field one of the fastest growing occupations in the United States. Much of this growth will be the result of an increase in the number of group practices, clinics, and other facilities that need a high number of support personnel. This makes the medical assistant who can handle both clinical and administrative duties particularly valuable to the physician.
A career as a medical assistant is challenging and offers job satisfaction, opportunities for service, financial reward, and possibilities for advancement. Men and women can be equally successful as medical assistants. Individuals considering the medical assisting discipline must be dedicated and committed and must have a strong desire to become caregivers. Caregivers are people who have the ability to put the needs of the patient first, and they have a sincere concern for those who are not at their best. A caregiver must feel an obligation to assist the patient in whatever way possible and must have patience with those who, at times, are more difficult. This strong inner desire is one of the most important qualities of the successful professional medical assistant. Through the development of this “care giving” mentality, many personal rewards will follow, as will a long and beneficial career.
The History of Medical Assisting
The first medical assistant was probably a neighbor of a physician who was called on to help when an extra pair of hands was needed. As time passed and the practice of medicine became more organized and more complicated, some physicians hired nurses to help in their office practices. Gradually, record keeping, data reporting, and an increasing number of business details became important to physicians, and they realized a need for an assistant with both administrative and clinical training. Nurses were likely to have training only in clinical skills; therefore, many physicians began training them or other individuals to assist with all of the office duties. Community and junior colleges began offering training programs that focused on both administrative and clinical skills in the late 1940s. Medical assistant organizations at the local and state levels began developing around 1950, and soon after, certifying examinations became available. Today medical assisting is one of the most respected allied health fields in the industry, and training is readily available through community colleges, junior colleges, and private educational institutions throughout the United States.
The American Association of Medical Assistants (AAMA) was co-founded by Mary E. Kinn, who served as the organization’s president in 1958. She helped to establish a certifying program for members of the AAMA and chaired the certifying branch in 1959. Kinn authored this textbook from 1967 through 1999 and then retired. She is greatly respected for her contributions to the field of medical assisting.
The Scope of Practice of a Medical Assistant
Today’s medical assistant is a versatile professional. The duties that medical assistants perform vary not only from office to office, but even within the same office. Medical assistants perform routine duties within the offices of many types of health professionals, including physicians, chiropractors, podiatrists, and others. According to the Occupational Outlook Handbook, more than half of the total number of medical assistants work in a physician’s office. Individuals with medical assisting training can accomplish various jobs in the hospital environment, and some are employed by freestanding emergency centers or surgery centers. Opportunities for medical assistants are growing because of the constant change within the medical profession and the surge of cross-training, which means that one individual is trained to do a variety of duties. Medical assistants work under the direct supervision of a physician in the office and perform tasks delegated by the doctor or supervisor.
The AAMA once defined the scope of practice as the “performance of delegated clinical and administrative duties within the supervising physician’s scope of practice consistent with the medical assistant’s education, training, and experience.” This definition remains accurate today. The duties performed by the medical assistant do not constitute the practice of medicine. Students should review the definition and requirements of the scope of practice for medical assistants in their individual states.
The two major categories of duties that medical assistants perform are administrative tasks and clinical tasks (Figure 3-1). On the administrative end of the spectrum, medical assistants greet patients who arrive in the office or clinic and obtain basic registration information. They may enter information into a computer and assemble the patient’s paper or electronic medical record. They are trained to do office bookkeeping, which may be done electronically or manually. The medical assistant is trained in filing procedures and in proper techniques for adding information to the medical record. A basic knowledge of procedure and diagnosis coding is important today, and some medical assistants concentrate strictly on the billing and coding career option. They are able to complete insurance claim forms and determine insurance coverage and limitations for the patient. Medical assistants answer telephones, schedule appointments, update medical records, and handle all types of correspondence. Often the medical assistant schedules outpatient procedures and hospital admissions and may coordinate consultations with physicians. Those who enjoy the administrative side of the profession often enter office management positions.
The clinical duties that medical assistants perform are just as broad as the administrative duties. These professionals prepare patients and the equipment needed before examinations and assist the physician during patients’ office visits. They assist with or perform basic testing procedures and are usually proficient in phlebotomy. Medical assistants are trained in first aid skills and cardiopulmonary resuscitation. They collect and prepare laboratory specimens, and they know how to follow the regulations established by the U.S. Occupational Safety and Health Administration (OSHA) and the Clinical Laboratory Improvement Amendments (CLIA). Often medical assistants working in the clinical area are responsible for inventorying and ordering supplies. When directed by a physician and allowed by the state, they may administer various types of medications and perform x-ray examinations, if trained to do so. Medical assistants also perform electrocardiograms and prepare patients for x-ray evaluations. They assist in minor surgical procedures, prepare sterile trays, and perform autoclave sterilization procedures for instruments. Other clinical duties involve taking medical histories from patients, patient teaching, and obtaining and recording vital signs. Medical assistants who enjoy the clinical side of the profession may become office managers or may supervise other medical assistants.
Duties and restrictions related to medical assisting vary from state to state, but in most of the United States, the medical assistant performs as an agent of the physician and is under the physician’s supervision. This means that the medical assistant performs actions that he or she is told to perform by the physician and that the physician is responsible for those actions. The command may be relayed to the medical assistant from the physician verbally, through a supervisor, or by way of the office policy and procedure manual. Respondeat superior is a Latin term meaning “let the master answer.” Physicians are responsible not only for their own actions, but for the actions of employees performing within the scope of their employment.
A Career in Medical Assisting
Trained medical assistants are equipped with a flexible, adaptable career in which they experience the rewards of helping other people (Figure 3-2). The skills acquired by the medical assistant are valuable, and employment is readily available anywhere in the world where medicine is practiced. Many medical assistants pursue their careers far beyond the usual retirement age, because physicians realize the value of the experienced, mature employee. This career attracts the nontraditional student who may be older than the average postsecondary student by a decade or more. Although many older students feel intimidated by the classroom, they often have excellent experiences in school and reach the top of the class. Medical assisting is more than suitable for the student just exiting high school. Many individuals plan to work as medical assistants to earn a viable income while pursuing further academic studies.
The practice of medicine has changed dramatically in the past several decades. Increasing costs have created a trend away from hospital-based treatment and toward the delivery of care in physicians’ offices and in outpatient ambulatory clinics. Although physicians have employed medical assistants in their practices for many years, computerization and technologic advances have created more opportunities for formally trained medical assistants, and their responsibilities have similarly increased. Clearly defined educational requirements have been established, and this has resulted in improvement of the quality and accessibility of medical assistant training. These requirements have also helped create a healthy respect for medical assistants, who are considered an integral part of today’s allied health field.
Employment for medical assistants is abundant. As mentioned previously, the Labor Department projects that the medical assisting field will grow much faster than the average for all occupations; a growth of 31% is expected in the medical assisting field between 2010 and 2020. In 2010, medical assistants held approximately 527,600 jobs in the United States, and about one half of those were in physicians’ offices. The projected employment for 2020 is 690,400 medical assistants. According to the Department of Labor, job growth will be so great because of the increasing number of group practices, clinics, and other healthcare facilities that need a high proportion of support personnel, particularly medical assistants who can handle both administrative and clinical duties. Additionally, the movement toward electronic medical records has resulted in a strong demand for medical assistants who can manage health information. Jobs may also be available with federal agencies, such as the Department of Veterans Affairs, the Public Health Service, and armed forces clinics or hospitals.
Most medical assistants derive a high degree of satisfaction from their work. Job turnover among medical assistants is surprisingly low; some begin working with a physician when the practice is opened and stay until the physician’s retirement. In the past, physicians often would hire any individual to perform office and clinical duties, but these people frequently were untrained and unprofessional; they therefore could be paid a minimum amount for their work. Most physicians have learned that hiring an untrained person to work in the medical office usually is more expensive in the long run. Untrained assistants often make errors that are costly to the practice, and these assistants require much more supervision; this means that the supervisor’s time is not used for the duties that he or she would normally perform because the medical assistant is not completely able to work alone. Formal training and certification are valuable not only to the medical assistant, but also to the physician-employer.
Medical assistants are compensated in various ways, some by hourly wages and some by salary. The earnings vary from place to place. Overall, medical assistants can expect a healthy return on their investment in training, experience, and skills. Most physicians realize that a good medical assistant is worth a higher than average wage, and a medical assistant with formal training is almost always compensated on a higher scale than one with no training. The Occupational Outlook Handbook reports statistics on the average salaries for many different career fields, including medical assisting. (This information can be accessed at www.bls.gov/oco. Annual salary updates are also available on the Web site.) More information on salaries may be obtained by monitoring the local classified advertisements and by checking online job information on sites such as Yahoo! Careers. Medical assistants must determine a realistic entry-level salary for their geographic area. Often graduates expect to make a much higher salary than is reasonable right after graduation with little or no experience.
The medical field offers great benefits to employees. Usually, the larger the organization, the better the benefits and perks. Most employers offer a health insurance plan or managed care plan to their employees. Often a life insurance program is included, and dental insurance is always a valuable benefit. Some companies have profit-sharing plans and stock options, as well as a retirement plan. Some organizations give their employees access to credit unions, and many have discount options at local businesses, such as uniform shops. Other benefits may include uniform stipends or reimbursement, tuition reimbursement, and continuing education allowances.
Remember that you should consider benefits and perks when contemplating a job opportunity. Many medical assistants may choose to work for less money if the benefits and the opportunities for advancement are good. Consider driving time, holidays, paid parking, sick days, vacation days, and facilities when choosing a job. Do the co-workers seem to enjoy one another’s company and get along? Is the physician friendly or more aloof? All of these should be weighed carefully before the final decision is made as to which position to accept. Some facilities pay more and offer fewer benefits, whereas others pay less and offer more benefits. It is a truism that “money is a byproduct of services rendered.” Nowhere is this more accurate than in the medical field. When the patients are served well, the medical assistant becomes more and more valuable to the employer and is compensated accordingly.
Professional Appearance
A well-groomed medical assistant in appropriate attire has a positive psychological effect on patients. The essentials of a professional appearance are good health, good grooming, and suitable dress.
Good health requires adequate sleep, balanced meals, and enough exercise to keep fit. Medical assistants can set a good example by living a sensible, healthy lifestyle that includes regular checkups for their own physical condition, both medical and dental. A radiantly healthy office staff presents the best possible public relations image for the physician.
Good grooming is little more than attention to the details of personal appearance. Personal cleanliness, which includes taking a daily bath or shower, using deodorant, and practicing good oral hygiene, is vital. Perfume and aftershave cologne should not be used or should be applied lightly, because patients and co-workers may be allergic to some scents. Makeup should be conservative and applied moderately. Heavy or exaggerated makeup is out of place in the professional office; subtle eye and lip makeup is best. Clear or muted shades of nail polish are best, and long nails are not only inappropriate but can be dangerous to the patient and the medical assistant. Nails must be kept clean and at a very conservative length. The medical assistant’s hair should be shiny, clean, neatly styled, and off the collar.
Medical assistants usually wear a uniform or laboratory coat; this not only presents a professional appearance, but also identifies the assistant as a member of the healthcare team (Figure 3-3). Medical professionals rarely wear traditional white in today’s medical facilities, although it is appropriate if allowed in the office policy manual. Fashionable styling makes it possible for the medical assistant’s uniform to be both practical and attractive. Women may choose to wear pantsuits, which are available in white or a variety of colors; a two-piece dress uniform in white or a color; an attractively styled traditional white uniform; or a scrub set. Scrubs have become increasingly popular and much more attractive over the past decade. They now are often made of pretty fabrics in rich colors and patterns and are much better suited for the professional office than the old green or blue scrubs worn in the surgical suites of hospitals.
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