Medical Assistants in the office - page 10

This is probably going to open a can of worms.............but how do you all feel about replacing nurses in the office setting with Medical Assistants? How (if at all) do you feel it affects patient... Read More

  1. by   Standardethics
    No...thank you for contacting the AAMA. I can file a complaint with the State Board of Licensure against a named physician. The Board attorney urged doing just that if I want to see a change in this practice. Here's the conundrum: I think I may be about to see one of the better interventional cardiologists around, but the support staff, "La Team" as always referenced, does not have the qualifications I, or any patient should expect when dealing with life/death. I've contacted a well-known hospital to ask them how many RNs work in their cardiology labs/departments. Awaiting return call.

    As you say, the utter lack of supervision is more than distressing. it is not as though excellent care cannot be provided by a lay person for many issues. However, I want a crackerjack science-leanred RN clinician by my side, thank you very much. Right now, it looks like I'll opt to forego care rather than be confronted with yet another fouled procedure. Who knows? Maybe I'll be better off.
  2. by   hayest
    Quote from WA-Educator
    I manage a urology clinic and I have to say that our CMAs are terrific. They are conscientious, well trained, educated, professional and hard working. In fact, we try to hire CMAs for all our staffing needs now. And, no, its not that they are "cheaper". We pay the CMA/LPN/RN according to their experience and the position they fill rather than for their credentials. Our CMAs do very well with triaging and patient education and prescriptions, and never roam beyond their scope of practice. Guess I can't agree with some of your statements. Every profession has its share of poorly trained "non-thinkers"
    In most states, MA's cannot do triage.
  3. by   Standardethics
    First - it's impossible not to be repelled by the quote given, equating CMAs, LPN, and RNs as comparable. No doubt that incompetency can't be found on any level. As to MAs not doing triage in most states - we live in a world where there is increasing acceptance in the arbitrary and frivolous definitions and use of words. "Triage" is one example. What does it mean when the word is used. What are patient expectations. As with "nurse." There is no need to accept this trend. Words have meaning and expectations are intrinsic to them. Proper use can mean the difference, ultimately, between life and death.
  4. by   TheGooch
    Quote from Red Kryptonite
    You're a weirdo who refuses to let anyone tattooed or pierced touch you because you assume they have hepatitis, and who refuses male nurses caring for you but are fine with male doctors.

    I think it's time to add to my ignore list.
    LOL.
    Seems to me hayest is someone who needs to come down from that high and might horse she rode in on.
  5. by   hayest
    Quote from TheGooch
    LOL.
    Seems to me hayest is someone who needs to come down from that high and might horse she rode in on.
    I wish I had a high and mighty horse, but it was only a pony.
  6. by   ®Nurse
    Quote from Standardethics
    Final straw yesterday. (I did post some of this in another forum- sorry). The final straw came today when the office where I specifically asked to speak to the "triage nurse," lied when I verified that I was speaking to an RN. We're talking cardiac intervention office here. I've now contacted state legislators to institute laws regarding who can do what and with whom and how they are identified. I came here today, urge all RNs, AAS, CNAs, BSNs, MSNs, and PHDs to take a public stand, including contacting state legislators, against the practice of using medical assistants in the offices for clinical care without proper name tags and public education. As a result of the lie, I learned that the specialty cardiology practice has not one RN in the office. All the "triage nurses" are medical assistants and not certified. How can I not cancel my appointment under these circumstances.




    Calling yourself a nurse is a crime, no less

    The state of California has a growing list of MA’s who held themselves out to be a nurse and found out the hard way that it is illegal to do so.
  7. by   lindarn
    You also might want to try, the State Attorney General's Office, to lodge a complaint. To have employees on your staff, that either hold themselves up to a professional title, or the practice physicians, present their staff as, "professionals", but have no educational qualifications, is fraud.

    How do individuals, who have NO education in nursing or the medical field, provide teaching, and medication explanations, to patients. They have no qualifications to do so.

    I would move up the food chain, until I got the response that I want.

    JMHO and my NY $0.02
    Lindarn, RN, BSN, CCRN (ret)
    Somewhere in the PACNW
  8. by   Standardethics
    People will perform any duty given them because they are empowered to do so. State law defining "nurse" would have to be changed in order for the State AG to become involved. The problem is, very much, at the top. That does not mean that medical practitioner offices and hospitals need to aid and abet. Maybe hitting the insurance companies and Medicare on this would be most effective.

    It is even worse than MA's being called "nurses." I'm sure I already said this, like a broken record, but the receptionists are dispensing far more information and transmitting far more information to and from the practitioners than even the MAs.

    Meanwhile, I am without medical care. No cardiologist, no primary care physician, no GI specialist...an RN in the office would never allow this to happen, even if she or he had to challenge the status quo.
  9. by   am27
    First, I'm almost certain that the post stating one can become a medical assistant after completing a six month program was actually talking about a nursing assistant certification program. I've never ever heard of such short programs other than nursing assistant programs. Most (if not all) places of employment where medical assistants are employed require an associate's degree in Medical Assisting. I was previously a medical assistant and I obtained my "diploma" in medical assisting through a 10 month long program with an eight week externship program over seven years ago, and that was one of the last schools to offer such a program. It's really unfair to call a profession "individuals with NO education in the medical field" when that is absolutely not the case.

    Medical assistants should not and do not perform "phone triage" and every clinic that employs them will tell you this too - they perform "telephone messaging" or "clinical messaging." Unless a medical assistant is working outside of his or her duties, they are not performing actual triage or giving advice based on their own judgment. The medical assistant's role in communication is to obtain and relay information between the provider and the patient. This is not to say that acting outside of their scope does not happen, but what is described as "triage" is probably not the case.

    In the several years that I was a medical assistant and worked along with countless other medical assistants, I can completely honestly say that I never knew of one that referred to his or herself as a nurse. I was always perfectly comfortable and proud to describe myself as So-and-so's assistant. In my experience, it's always been the provider or the patient referring to support staff/medical assistants as nurses. in most cases, I would not go out of my way to correct someone. However, I would never ever, as well as any other medical assistant I've been aware of, said, "Yes" if I were asked if I was a nurse or so-and-so's nurse.

    This whole thread seemed to bash the profession of medical assistants like they are trying to assume a role that they do not own, as well as giving a feeling that medical assistants hold less importance than other roles. There are unprofessional, boundary-crossing, less-than-qualified people of every career, INCLUDING nurses.

    A medical assistant's job duties entail ANYTHING a practicing provider instructs the medical assistant to do whether it's written, verbal, standing orders, or implied instructions. A medical assistant does not work under a registered nurse's license as long as there is a practicing provider in the workplace, even if the provider is not physically there.

    I actually started my career as a medical assistant in a clinic that did not even have nurses in clinic. I was one of those medical assistants "doing phone triage" and "assessing patients" (gasp!) and even staying in the fine lines of not actually triaging or assessing, I enjoyed being such a vital part of the care team and clinic and with the help and encouragement of the physicians and patients I worked with, I went back to school so that I COULD call myself a nurse and perform those duties for real. Not to mention being compensated way more appropriately. When I moved after a few years, I started working as a medical assistant at a new clinic that did employ RNs in clinic. The clinic RNs that I know sit at a desk and process electronic refill requests and the occasional phone triage, which is usually, "You need to be seen" to increase RVU's. Not to mention a sense of disconnect, lack of individualized care, and sense of impersonal care because these nurses never actually get to know the patient like the medical assistants do. If your clinic employs nurses to room patients, obtain prior authorization for medications, or perform procedures like administering injections (abx, vaccines, allergy injections, contraception, hormones, etc.), obtaining specimens for testing (venipunctures, heel sticks, urine caths, etc.), and countless other things that a medical assistant is very well qualified to do, they WILL hire them to "replace" nurses because they can pay them a LOT less to do the same tasks.

    All of the nurses on this thread that expressed concern about medical assistants working under their license can fricking CHILL OUT. As well as the posters worried about career they receive from medical assistants. Acknowledging there are good and bad EVERYONE at EVERYWHERE you go, unfortunately this pertains to the clinics that you seek your care from, as well as taking care of your families and friends. Medical assistants are most commonly the middleman between you and your provider and a bad attitude won't do your mind or body any good. In order to receive the best care from your provider, you really need to trust their staff. Providers rely SO HEAVILY on their support staff, which is only increasing due to the increased patient numbers resulting in less dedicated time that the provider themselves can spend dealing with the patient directly or indirectly. The medical assistants are the ones that OFTEN know their patients way better than their providers know them.

    Length of formal education hardly translates to level of quality patient care. I know medical assistants that outperform nurses everyday in areas of therapeutic communication, gathering of objective and subjective patient data, education/instruction of any topic, whether it's steps before a procedure, reconciliation of medications, or skills like injections, phlebotomy, urinary catheterization, the list goes on.

    For myself and a lot of close acquaintances, being a medical assistant and the yearning for wanting to independently perform and get credit for providing higher levels of care is a big motivator and paved the path to become a nurse. We are all healthcare providers and we are all part of a team.

    Oh, and good luck bringing up the concerns about medical assistants acting outside of their scope to the AAMA and/or state legislature!
  10. by   klone
    Quote from am27
    First, I'm almost certain that the post stating one can become a medical assistant after completing a six month program was actually talking about a nursing assistant certification program. I've never ever heard of such short programs other than nursing assistant programs. Most (if not all) places of employment where medical assistants are employed require an associate's degree in Medical Assisting.
    Okay, I just wanted to address your first sentences, since I saw some glaring errors. CNA programs last 2-4 WEEKS, typically. So no, a 6-month program would not be in nursing assisting.

    Most MA programs I am familiar with are 6-12 months in length. Here's an example of one such program that's 6 months:

    Medical Assisting | Emily Griffith Technical College

    If I feel up to it later, I might address your other points.

    I'm curious, why would you spend the time and money getting an Associate's degree in medical assisting, when you could get an Associate's degree in nursing and make 2-3x the salary?
  11. by   nursel56
    Quote from am27
    First, I'm almost certain that the post stating one can become a medical assistant after completing a six month program was actually talking about a nursing assistant certification program. I've never ever heard of such short programs other than nursing assistant programs. Most (if not all) places of employment where medical assistants are employed require an associate's degree in Medical Assisting.
    That actually isn't true in California. You don't need any training to be an MA if a licensed professional trains you.

    It's really unfair to call a profession "individuals with NO education in the medical field" when that is absolutely not the case.
    Maybe they meant NO prior education, which is true.

    A medical assistant's job duties entail ANYTHING a practicing provider instructs the medical assistant to do whether it's written, verbal, standing orders, or implied instructions. A medical assistant does not work under a registered nurse's license as long as there is a practicing provider in the workplace, even if the provider is not physically there.
    No, they cannot do ANYTHING a practicing provider instructs them to do. In fact, some MAs have come to this forum and asked if we thought they were treading on thin ice with some of the things their supervisors asked them to do.

    An approach based on patient safety is always better than one based on imagined competition with other people's roles.

    I have no problem with MAs, either, and in all my years of clinic/doctor's office employment the few I've worked with understood their role quite well.

    The nurse is trained to think differently than a Medical Assistant. If I were advising a prospective nursing student to get experience in the healthcare field I would advise them to become a CNA rather than an MA.

    I don't understand why pushing the limits of your education with respect to the two areas you mentioned is something to feel good about. The rules are in place to protect the public from harm, not to make people feel bad.
  12. by   BuckyBadgerRN
    I don't believe any such thing exists. Why would any one get an AD in MA when they can get an AD as an RN? It would be wholly irresponsible for an MA to do ANYTHING that an MD asks of him/her if it's not something they are not allowed to do by law. If an MD asked you to hang a unit of blood you're saying it's OK to do that? Because it's not.

    Quote from am27
    First, I'm almost certain that the post stating one can become a medical assistant after completing a six month program was actually talking about a nursing assistant certification program. I've never ever heard of such short programs other than nursing assistant programs. Most (if not all) places of employment where medical assistants are employed require an associate's degree in Medical Assisting. I was previously a medical assistant and I obtained my "diploma" in medical assisting through a 10 month long program with an eight week externship program over seven years ago, and that was one of the last schools to offer such a program. It's really unfair to call a profession "individuals with NO education in the medical field" when that is absolutely not the case.

    Medical assistants should not and do not perform "phone triage" and every clinic that employs them will tell you this too - they perform "telephone messaging" or "clinical messaging." Unless a medical assistant is working outside of his or her duties, they are not performing actual triage or giving advice based on their own judgment. The medical assistant's role in communication is to obtain and relay information between the provider and the patient. This is not to say that acting outside of their scope does not happen, but what is described as "triage" is probably not the case.

    In the several years that I was a medical assistant and worked along with countless other medical assistants, I can completely honestly say that I never knew of one that referred to his or herself as a nurse. I was always perfectly comfortable and proud to describe myself as So-and-so's assistant. In my experience, it's always been the provider or the patient referring to support staff/medical assistants as nurses. in most cases, I would not go out of my way to correct someone. However, I would never ever, as well as any other medical assistant I've been aware of, said, "Yes" if I were asked if I was a nurse or so-and-so's nurse.

    This whole thread seemed to bash the profession of medical assistants like they are trying to assume a role that they do not own, as well as giving a feeling that medical assistants hold less importance than other roles. There are unprofessional, boundary-crossing, less-than-qualified people of every career, INCLUDING nurses.

    A medical assistant's job duties entail ANYTHING a practicing provider instructs the medical assistant to do whether it's written, verbal, standing orders, or implied instructions. A medical assistant does not work under a registered nurse's license as long as there is a practicing provider in the workplace, even if the provider is not physically there.

    I actually started my career as a medical assistant in a clinic that did not even have nurses in clinic. I was one of those medical assistants "doing phone triage" and "assessing patients" (gasp!) and even staying in the fine lines of not actually triaging or assessing, I enjoyed being such a vital part of the care team and clinic and with the help and encouragement of the physicians and patients I worked with, I went back to school so that I COULD call myself a nurse and perform those duties for real. Not to mention being compensated way more appropriately. When I moved after a few years, I started working as a medical assistant at a new clinic that did employ RNs in clinic. The clinic RNs that I know sit at a desk and process electronic refill requests and the occasional phone triage, which is usually, "You need to be seen" to increase RVU's. Not to mention a sense of disconnect, lack of individualized care, and sense of impersonal care because these nurses never actually get to know the patient like the medical assistants do. If your clinic employs nurses to room patients, obtain prior authorization for medications, or perform procedures like administering injections (abx, vaccines, allergy injections, contraception, hormones, etc.), obtaining specimens for testing (venipunctures, heel sticks, urine caths, etc.), and countless other things that a medical assistant is very well qualified to do, they WILL hire them to "replace" nurses because they can pay them a LOT less to do the same tasks.

    All of the nurses on this thread that expressed concern about medical assistants working under their license can fricking CHILL OUT. As well as the posters worried about career they receive from medical assistants. Acknowledging there are good and bad EVERYONE at EVERYWHERE you go, unfortunately this pertains to the clinics that you seek your care from, as well as taking care of your families and friends. Medical assistants are most commonly the middleman between you and your provider and a bad attitude won't do your mind or body any good. In order to receive the best care from your provider, you really need to trust their staff. Providers rely SO HEAVILY on their support staff, which is only increasing due to the increased patient numbers resulting in less dedicated time that the provider themselves can spend dealing with the patient directly or indirectly. The medical assistants are the ones that OFTEN know their patients way better than their providers know them.

    Length of formal education hardly translates to level of quality patient care. I know medical assistants that outperform nurses everyday in areas of therapeutic communication, gathering of objective and subjective patient data, education/instruction of any topic, whether it's steps before a procedure, reconciliation of medications, or skills like injections, phlebotomy, urinary catheterization, the list goes on.

    For myself and a lot of close acquaintances, being a medical assistant and the yearning for wanting to independently perform and get credit for providing higher levels of care is a big motivator and paved the path to become a nurse. We are all healthcare providers and we are all part of a team.

    Oh, and good luck bringing up the concerns about medical assistants acting outside of their scope to the AAMA and/or state legislature!
  13. by   pfchang
    I know medical assistants who have had 3 months of training. I have worked with medical assistants who respond to the term Nurse and do not correct the patient and tell them they are NOT a nurse. I have worked with medical assistants who triage and give advice and it WAS outside their scope of practice. Cost cutting measures have resulted in many clinic RNs being replaced by MAs. I lived it. It was not a good thing for patients. Trying to educate all patients needing an RN educator in a 14 provider practice was impossible. Oh, and running the anticoag clinic, triaging and being pulled to solve all the problems on a moment's notice? Give me a few more RNs if you want the job done properly.

    Just because you have not experienced this does not mean is does not happen. It does.

    Edited to add that I have worked with some wonderful MAs.

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