Brandon Tipps is a medical assistant who works with his father, Dr. Rick Tipps. Brandon has considered continuing his education to become a doctor, but he is not sure whether he would like to be a medical doctor, an osteopathic physician, or a chiropractor. He decided to spend his summer off from college working in his father’s family practice so that he can get a closer look at the inner workings of a physician’s office.

Brandon has assisted with every procedure in the clinic, including the administrative skills required in the front office. The staff has been impressed with Brandon’s ability to do any task, no matter how small, as if it were the most important task in the office. He continuously moves from employee to employee to ask what he can do to help. When the administrative medical assistant working in the front office, Darla Grover, was injured in a car accident and had to be off work for a while, Brandon stepped right in to do her job and quickly learned her duties. His help enabled the office to continue to run smoothly even with one employee absent for several weeks.

Brandon has an excellent command of the English language and types about 60 words per minute. Because he is organized and efficient, he can handle the enormous amount of incoming and outgoing mail with very little assistance from the office manager. He also is able to answer phones and schedule appointments. He speaks clearly and is an expert in customer service. Many of Dr. Tipps’ patients have known Brandon since he was a small child, and they enjoy seeing him helping in his father’s office. The patients and staff alike will certainly miss him once he returns to college.

While studying this chapter, think about the following questions:

• What types of difficulties can arise when a physician’s family member works at the office?

• How do proofreader’s marks help the medical assistant save time?

• What types of impressions could be formed by people who receive mail from a physician’s office?

• Explain why any written communication discussed in this chapter should be worded in a professional manner.

Written correspondence and mail processing consume a large part of the day of the administrative medical assistant. When asked what skills they most want in an administrative assistant, many physicians specify the ability to spell accurately and to write a good letter. When a physician delegates the responsibility for composing letters or reports with the potential to reflect positively or negatively on the practice, he or she is expressing confidence in the medical assistant’s abilities.

Importance of Written Communications

Written communications offer the perfect opportunity for making a good impression on others. However, communications that make such an impression do not just happen; they require thought, preparation, skill, and a positive attitude. Written communications include original letters, memorandums, replies to inquiries, responses to requests for information, telephone messages, e-mail, transcriptions, orders for supplies, instructions for patients, and a variety of other forms. Communications that are courteous to the reader, correct in content, and concise without being curt are most appreciated. Remember that people may misjudge the “tone” of an e-mail and determine that the sender was rude or hateful, when the sender may have just been very direct and pointed. Communication truly is both an art and a skill. The ability to communicate effectively is extremely important to the administrative medical assistant who wants to succeed and advance his or her career.

13-1

Critical Thinking Application

Brandon has just found a small backlog of correspondence that accumulated during the first 3 days Darla was out of the office. A large amount of mail comes to the office each day. How can Brandon manage the daily mail and clear the pile of communications that accumulated over those 3 days?

Reflection on the Physician

Each member of the staff must be conscientious about the documents and materials in the office and those that leave it. An envelope addressed carelessly or a patient information sheet that has been photocopied over and over implies that the office staff is not concerned about the appearance of documents that leave the office. If the staff is careless in this respect, many patients assume the staff is careless with everything, including patient care.

Everything that happens in the medical office reflects on the physician or physicians who practice there. Letters with misspelled words or errors give the reader a negative impression of the physician and the practice itself. Great care must be taken to ensure that each document in the office and sent from the office is well written and grammatically correct. Table 13-1 lists some frequently misspelled and misused words. For a list of more misspelled medical words, visit the Evolve site at evolve.elsevier.com/kinn.

TABLE 13-1

150 Frequently Misspelled or Misused English Words

absence	corroborate	inimitable	persistent	ridiculous
accede	definitely	inoculate	personal	sacrilegious
accessible	description	insistent	personnel	seize
accommodate	desirable	irrelevant	possession	separate
achieve	despair	irresistible	precede	siege
affect	development	irritable	precedent	similar
agglutinate	dilemma	judgment	predictable	sizable
all right	disappear	labeled	predominant	stationary
altogether	disappoint	led	predominate	stationery
analyses (pl.)	disastrous	leisure	prerogative	subpoena
analysis (s.)	discreet	license	prevalent	succeed
analyze	discrete	liquefy	principal	suddenness
anoint	discriminate	maintenance	principle	superintendent
argument	dissatisfaction	maneuver	privilege	supersede
assistant	dissipate	miscellaneous	procedure	surprise
auxiliary	drunkenness	mischievous	proceed	tariff
balloon	ecstasy	misspell	professor	technique
believe	effect	necessary	pronunciation	thorough
benefited	eligible	newsstand	psychiatry	tranquility
brochure	embarrass	noticeable	psychology	transferred
bulletin	exceed	occasion	pursue	truly
category	exhilaration	occurrence	questionnaire	tyrannize
changeable	existence	oscillate	rearrange	unnecessary
clientele	February	paid	recede	until
committee	forty	pamphlet	receive	vacillate
comparative	grammar	panicky	recommend	vacuum
concede	grievous	parallel	referring	vicious
conscientious	height	paralyze	repetition	warrant
conscious	incidentally	pastime	rheumatism	Wednesday
coolly	indispensable	perseverance	rhythmical	weird

Writing Skills and Composing Tips

All medical assistants must know the fundamental skills of proper business writing. Most business letters should be less than one page long and carefully organized (Procedure 13-1). This takes practice and preparation. Everyone who writes letters develops a personal style.

Procedure 13-1

Compose Professional Business Letters

GOAL: To compose a professional business letter that conveys accurate, helpful information that is easily understood, clearly written, and free of both spelling and grammatical errors.

EQUIPMENT and SUPPLIES

• Computer

• Word processing software

• Correspondence to be answered

• Other pertinent information needed to compose a letter

• Electronic or paper dictionary and thesaurus

• Writer’s handbook

• Portfolio and/or templates

Procedural Steps

1. Determine the reason for initiating a letter or other type of communication.
PURPOSE: To ensure that the goals of the correspondence are fulfilled and that relevant information has been identified and included.

2. Make any necessary notes on the letter or a copy of the letter. A scrap sheet of paper may be used.

3. Prepare a draft of the letter, using good grammar, and save it in the computer.
PURPOSE: To put the thoughts on paper for later revision and to make the letter easy to understand.

4. Proofread a printed copy of the letter, using proofreader’s marks to make corrections.
PURPOSE: To see the document as it will look once printed and to speed the process by using proofreader’s marks.

5. Make any necessary corrections.

6. Allow the physician or other interested parties to proofread the letter, if the medical assistant is not the person whose signature will appear at the bottom.
PURPOSE: To give the physician an opportunity to correct the letter and add thoughts, if desired.

7. Make any final changes, then print the letter on stationery. Allow the person whose name appears at the bottom to sign the letter.

8. Address the envelope using optical character reader (OCR) guidelines and place the letter and any supporting documents inside (see Procedure 13-5 for OCR guidelines).

9. Mail the letter using the correct postage.
PURPOSE: Using incorrect postage or guessing can delay delivery of the document.

The medical assistant should carefully read the letter to be answered. Make note of or underline any questions asked or materials requested. Decide on the answers to the questions and verify the information; this is called annotating. Draft a reply, proofread it, and then rewrite for clarity (Procedure 13-2). Keep most sentences short. Put only one idea in each sentence and eliminate superfluous words. Be careful about using medical terms in correspondence with patients. Instead, use language the reader can easily understand.

Procedure 13-2

Organize Technical Information and Summaries

GOAL: To compose information accurately and in an organized manner, using strong spelling and grammatical skills, so that it meets the goals of the writer and is usable by the receiver.

EQUIPMENT and SUPPLIES

• Stationery

• Computer or typewriter

• Correspondence to be answered or notes

• Guide for proofreader’s marks

Procedural Steps

1. Scan the letter or memo to be answered or the notes about the correspondence to be written and highlight any questions that should be answered or points to be made.
PURPOSE: To ensure that the goals of the correspondence are fulfilled and that relevant information has been identified and included.

2. Write the letter or memo using good grammar.

3. Print a draft copy of the letter or memo. Read it carefully and highlight changes to be made or note any additions to be made. Use proofreader’s marks.
PURPOSE: Reading a hard copy of a letter or memo is more conducive to finding errors and grammatical mistakes.

4. Revise the letter or memo using the notes and proofreader’s marks.

5. Read the letter or memo once again on the screen. Perform spelling and grammar checks if those tools are available on the computer.
PURPOSE: To locate any missed errors or misspelled words.

6. Print a final draft. Read the letter word for word and check once again for errors.

7. Have another person proofread correspondence that is especially important.
PURPOSE: Often another person can find missed errors quickly.

8. Complete the final preparations for mailing the letter or distributing the memo. Address the letter using guidelines for optical character reader (OCR) and fast processing at the post office.

Most physicians use a highly professional and formal style in their dictation. The medical assistant responsible for composing correspondence for the office should strive for the same degree of formality the physician uses. It would be inappropriate for the assistant to write in a breezy, informal style when acting as the representative of an employer with a more formal approach. The principal point to remember is that every letter produced in your office should project the image of the physician, regardless of who composes or signs the letter.

Grammar Review

Good grammar is essential to the writing of effective, professional business letters. Medical assistants must understand the elements of acceptable grammar and writing skills.

Parts of Speech

Nouns.

A noun is a person, place, or thing. Nouns can also be thoughts, ideas, or concepts, such as freedom or courage. Common nouns name general persons, places, or things (e.g., teacher and city). Proper nouns are specific (e.g., Mrs. Adams and New York City).

Pronouns.

Pronouns replace nouns and provide the writer with shortcuts so that proper nouns do not have to be repeated constantly. Pronouns include words such as it, you, he, she, her, his, them, mine, you, yours, its, ours, and theirs.

Verbs.

Action verbs are words that express movement, such as run, drive, or type. Linking verbs express a condition or state of being; they include is, am, are, was, be, and been. Linking verbs also express the senses, as in smell, hear, taste, touch, feel, and look.

Adjectives.

Adjectives can describe nouns and pronouns, or they may show which one, how many, and what kind of. A, an, and the are special types of adjectives called articles. Examples of adjectives include a golden sunset, a playful dog, and a crooked nose.

Adverbs.

Just as adjectives describe nouns, adverbs describe verbs, adjectives, or other adverbs. Adverbs specify when, where, to what extent, or how. Examples include unusually warm, never won, and quite cold.

Prepositions.

Connecting words that show a relationship between nouns, pronouns, or other words in a sentence are called prepositions. Examples of prepositions include by, from, of, to, in, at, with, into, and on.

Conjunctions.

Conjunctions join words or phrases. These helpful words include and, or, nor, and but.

Interjections.

Interjections show strong feeling. They often are followed by an exclamation point and sometimes by a comma. “Ouch! That really hurt!” is a sentence that uses an interjection.

Making Sense of Sentences

Sentence structure is important when writing a professional letter or document. Medical assistants should know the basics of good sentence structure so that written documents make sense and represent the medical facility and staff in a positive way.

Types of Sentences.

The four basic types of sentences are declarative, interrogatory, imperative, and exclamatory. Declarative sentences make a statement, whereas interrogatory sentences ask a question. Imperative sentences state a command or request. Exclamatory sentences express strong feeling.

Declarative:	She was the last person here.
Interrogatory:	Are we going to the fair today?
Imperative:	Clean your room before dinner.
Exclamatory:	I am so excited for you!

Sentence Structure.

When written correctly, sentences follow certain patterns. Three very basic patterns are used to construct sentences:

• Subject—predicate

• Subject—object

• Subject—complement

The subject of a sentence usually is a noun; it is the word or group of words that acts, or that is acted on or described by the verb. The predicate is the part of the sentence that contains the verb; it tells what the subject is doing or experiencing, or what is being done to the subject. The object is a noun, pronoun, or group of words functioning as a noun or pronoun that receives the action of the verb. The complement is a word or group of words in the predicate that renames or describes a subject or object in the sentence.

Sentence Errors.

Three main sentence errors plague most writers: the sentence fragment, the run-on sentence, and the comma splice.

A sentence fragment is an incomplete thought or a part of a sentence that is punctuated as though it were a complete sentence: Although the doctor had seen the patient.

A run-on sentence contains independent clauses that do not have a semicolon, a comma, or a conjunction between them. These are also called run-together or fused sentences: The office was clean when the staff left on Friday the doors were locked.

A comma splice is a sentence in which a comma alone joins independent clauses: The storm grew worse, it began to snow.

Personal Tools

Competent handling of written communications requires a basic knowledge of composition. A personal reference library that includes an up-to-date standard dictionary, a medical dictionary, a composition handbook, an English language reference manual, and a thesaurus is a tremendous help.

Those who have difficulty with spelling should keep a small, loose-leaf, indexed notebook or card index of troublesome words. If you need to look up the spelling of a word in the dictionary, record the word in the notebook or card index for quick reference. The physician or a medical assistant familiar with the practice might compile a basic list of frequently used medical terms and abbreviations as a reference.

Equipment and Supplies

To create a favorable impression with letters, the medical assistant must use good equipment and high-quality supplies. Regardless of the kind of equipment available, the medical assistant is responsible for knowing how to use it to the best advantage and how to keep it in good working condition. If the equipment manual is available, study it and keep it handy for reference when problems occur. Know how to maintain equipment so that the effort invested in composing correspondence has a high-quality appearance.

Equipment

Computers

Computer applications and electronic technology have made all types of communication easy, efficient, and effective. Various letters and documents can be saved and reused time after time by changing the name and the basic information in the text. Computers can add graphics to text, compute figures, and use multimedia in communications, all of which enhance the document’s appearance and effectiveness.

Copiers

Maintain the copier so that copies are crisp and clear. The toner cartridge must be replaced or refilled when necessary, and this can be expensive. Multiple copies of documents usually are made on a copier rather than printed from the computer.

Scanners

Occasionally documents are scanned and sent by e-mail. Scanners provide high resolution and can produce images of written text and photos. Scanners often are used to create images so that older documents can be stored.

Printers

Machines that function only as printers are available and quite inexpensive; however, most medical offices can benefit from an all-in-one printer. These machines print, fax, copy, and scan laser-quality documents. Many all-in-one printers available today have advanced features, such as lab-quality photo printing, printing on both sides of the paper, and wireless connectivity.

Supplies

Stationery

Paper quality unquestionably affects the reader’s overall impression of the communication. Stationers or printing companies are qualified to advise on the selection of paper, which can range from all sulfite (wood pulp) to all cotton fiber (sometimes called rag). Letterhead paper usually is bond paper that has a cotton fiber content of 25% or higher.

The weight of a type of paper is described by the substance number. This number is based on the weight of a ream that consists of 500 sheets of 17- × 22-inch paper. The higher the substance number, the heavier the paper. If the ream weighs 24 pounds (lb), the paper is referred to as Sub 24 or 24-lb weight. Letterhead stationery and matching envelopes are usually 16-, 20-, or 24-lb weight. This often is abbreviated as 16#, 20#, or 24#.

Sizes and Types of Letterhead Paper.

Letterhead paper is available in four basic sizes:

Standard or letter	8½ × 11 inches
Monarch or executive	8½ × 10½ inches
Baronial	5½ × 8½ inches
Legal	8½ × 14 inches

Standard letterhead is used for general business and professional correspondence. Letterhead should be well designed and of a high-quality paper. The letter represents the sender and can help the receiver form an impression of the professionalism of the business.

Bond paper has a felt side and a wire side. When a sheet of letterhead is picked up and held to the light, a design or letters can be read from the printed side. This design, called a watermark, is an indication of quality. The side from which the watermark can be read is the felt side of the paper and the side on which printing or typing should be done. The watermark should always read across the page in the same direction as the typing.

13-2

Critical Thinking Application

Brandon realizes that his father’s office does not have a method of logging letters sent by certified mail. This forces the receptionist to dig through a patient’s file to determine whether certified mail was actually sent and the notice of delivery received. How can this issue be resolved?

Continuation Pages.

The second and continuing pages of a letter are placed on plain bond that matches the letterhead in weight and fiber content; these are called continuation pages. The stationery used for continuation pages should exactly match the letterhead but should not have the letterhead printing. Using different paper for the continuation pages is considered unprofessional.

Envelopes.

Just as the continuation pages should be the same type of paper as the letterhead stationery, so should the envelopes. Envelopes are available in three basic sizes or types:

• No. 10

• No. 6¾

• Window

No. 10 envelopes are the general business size used for letter and legal stationery. No. 6¾ envelopes and window envelopes often are used for statements.

Letter Styles

A business letter usually is arranged in one of three styles: block, modified block or standard, or modified block indented. A fourth style, simplified, occasionally is used. The block and modified block styles are most commonly used in the physician’s office.

Simplified Letter Style

In the simplified letter style, all lines begin flush with the left margin (Figure 13-4). The salutation is replaced with an all-capital subject line on the third line below the inside address. The body of the letter begins on the third line below the subject line. The complimentary closing is omitted. An all-capital typed signature is entered on the fifth line below the body of the letter.

Types of Punctuation for Letter Styles

Traditionally the punctuation pattern used is based on the letter style. Normal punctuation is always used in the body of a business letter. In the other parts, either standard or open punctuation is used.

When standard punctuation is used, a colon is placed after the salutation, and a comma is placed after the complimentary closing. This is the punctuation pattern most often used, and it is appropriate with the block or modified block letter styles. When open punctuation is used, no punctuation is used at the end of any line outside the body of the letter unless that line ends with an abbreviation. This pattern is always used with the simplified letter style.

Spacing and Margins

Generally, centering a letter on the page is the most attractive presentation. This is easily done with computer programs, such as Microsoft Word or WordPerfect. Business letters almost always are single spaced. If a letter consists of only a few lines, double-space both the inside address and the message and indent the first line of each paragraph five spaces.

The first typed entry, which is the date on the first page of the letter, usually is placed on the third line below the letterhead or on line 13 if the paper has no letterhead. The typing on continuation pages begins 1 inch from the top.

On standard letterhead, the side margins are usually 1 to 1½ inches on each side. If a letter is very short, making the margins wider creates a better appearance.

A 1-inch margin is the minimum at the bottom of the page. This can be increased if the letter will be carried over to a second page. Never use a second page to type only the complimentary closing and signature. Carry over a minimum of two lines of the body of the letter onto a continuation page. The heading of continuation pages is single spaced.

The Parts of a Letter

The structure of a letter and its placement on the page have been fairly well standardized into four main parts:

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Tags: Kinns The Medical Assistant An Applied Learning Approach

Apr 6, 2017 | Posted by admin in MEDICAL ASSISSTANT | Comments Off

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