Medical Assistants in the office

Specialties Ambulatory

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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 care?

Do any of the MA's in your offices refer to themselves as "nurses"? Have you had any problems with the knowledge base of the MA's? How are they with patient education?

May be just my situation, but I have run across some significant problems in this area................and not sure how to address it...........or even if I can address it.

Recently I wrote a thread about a conversation I had with a billing clerk who worked in general surgeons office. The doctor had begun using her to assist him with office visits. She had to come in on Saturday to finish her paper work because the patient care duties during the week were putting her behind on paper work. This person has not a smidgeon of training for these duties but I bet patients think she is a nurse. So I guess that is the next great wave of deskilling. People with no training and no skills taking over nursing task.

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" :)

ohmom2boys you are so right!!! Thank you for your comment. i have ben out of the field for a couple of years but MA's doplay a vital role in the office. i am a MA soon to start school to become a RN because the doctor's office i was in only wanted me up front doing paper work where as a MA can do Patient Care as well as office work. I wanted some interaction witht he patient outside of asking for their insurance card and copay...........

I see I have to go back to xchool for that but that's cool ,too.

Just my thoughts.........

Medical Assistants should never call themselves nurses and neither should the rest of the staff or the physicians. Most clinic will stop that practice if we alert them to the fact that it is illegal (at least in WA State, and I suspect other places, too).

I think most clinic do that because they are too impatient to keep them straight. Plus, because the medical assisting profession is not as well known as nursing is, the public is more comfortable with the "nurse" title. Regardless of the reason, it isn't right and it isn't legal.

CMAs have their own credentials (hard earned!) and their own education and training. Many are one year graduates and many are two year, AAS degree graduates. They are the only allied health professional trained specifically for the ambulatory care setting and are extremely appropriate for the doctors offices and clinics.

Only qualified medical assistants should use that title and only qualified nurses should use the "nurse" title.

Specializes in tele.

I am a new RN working in cardiothoracic nursing at a hospital so I do not work office nursing. But I do play that rather uncomfortable and dreaded patient role from time to time. A few days ago, I went in to meet my new doc. Of course I met the MA first. She took the vitals and history. I found myself translating everything for her so she would understand. It seems to me that MA's also play a vital role but the final word should always come from the nurse.

On a side note, I found this doc and the MA to be very respectful of my oppinions regarding my healthcare. Its just kind of nice to have someone to respect me as a nurse who is educated about my own plan of care. Heaven knows, I have had some bad experinces with other docs over the last 6 months.

I don't really have an opinion but on weither they should or shouldn't be in the office but have an incident I would like to get some feed back on. We have had students in our office for clinicals. So far it hasn't been really good but we said that we (the girl in front and I, since we deal with them mostly) would try it one more time.

Anyway, we have had this one for a maybe three weeks. There are three people in our office and the office manager. (I am the nurse) This medical assistant STUDENT starts complaining on how I asked her to do something and why didn't I do it myself....and she continues to say that when I was gone she was able to do it and why didn't I. I was shocked. I thought that this was way out of line. Yes, she probably did have time since she doesn't do authorizations, answer phone triage, call in medications, talk to physical therapist, case workers and etc that I do since I have been doing my job for 3 years.

So my question is what would you do? I wasn't mad because she was too stupid to be mad at. I know what I do and I know what she does. But what do I do now. I am going to go to RN school in January and the office has told her that we will need someone to fill in when I am gone to clinicals. Give me your thoughts....

She might not be the best person for that job, but don't paint the entire profession of medical assisting with one or two bad experiences. Surely you have met some nurses that you don't care for, I certainly have! There are many nurses who are lazy, incompetent, stupid and dishonest. But we still greatly respect nurses and the profession of nursing, don't we??

It also might be the school and the program in your area. Maybe it isn't the best. See if you can get involved with guest speaking or even teaching a class. Maybe serving on the advisory board. Maybe you could have a positive influence on the quality of their graduates. I assume the program is accredited with AAMA? If not, do not, I repeat, do not take any more of their grads. And make sure they know why. Mention the accreditation issue.

You might also take a close look at your attitude, perhaps you decided early on that you weren't going to like this one since you didn't like the first one? In my position, I find that people will rise to the level of your expectations and when we treat people with respect and caring we are often rewarded with higher performances.

I looked and I didn't see that it was accredited. What does that mean?

I feel like I had an open mind towards this girl, I even suggested that she may be right for the position in our office. I am going to school and need someone to cover when I am at class two afternoons a week. Also I need someone to learn my job as no one can cover if I am ever gone.

I thought that everything was okay until the meeting and that is why I am blowen away and not sure how to handle it. I was asked to be on the advisor board and going to attend a luncheon on Friday.

Do I mention this to her instructor? Do I just ignore it? I am just not sure. I do feel that it was very out of line and inappropriate for a student to question the way a person does their job after only a few weeks in the office. I have been there for 3 years and was even the office manager for a long time.

I appreciate your feed back.

Jill

I definitely think you should talk to the instructor and/or program director. It's really important that students learn professional behaviors while they are in school. Once the student has graduated, there isn't much the instructors can do, but you can help make the program better by serving on the advisory board and make sure the program knows how important professional behaviors are! BTW - You can call AAMA (1-800-228-2262) to check on the accreditation issue.

Good luck!

I called the instructor on Monday since she wouldn't talk to me all day. The instructor was glad that I called her and completely understood where I was coming from. She agreed that she was out of line to question how I do my job after being in our office only a short time. And she was upset that she went to the office manager and caused friction in our office. She is going to talk to her and let me know by the end of the week.

Good for you. Students have to learn to behave professionally for the patients, coworkers and supervisors. I bet the instructor will be sure to emphasize better communication skills in the future. I'm sure she (the instructor) is grateful that you took the time to let her know!

Cheers!

I AM AN ONCOLOGY PRACTICE OFFICE MANAGER. I AM NOT A NURSE BUT DO HAVE SOME ISSUES REGARDING MEDICAL ASSISTANTS. WE ARE A VERY BUSY ONCOLOGY PRACTICE WITH 6 RNs. AS OUR PRACTICE GREW AND SEVERAL YEARS AGO WE DECIDED TO HIRE A MEDICAL ASSISTANT TO HELP THE RNs WITH THINGS LIKE, TAKING VITALS, GETTING PATIENTS READY FOR DOCTORS VISITS, SCHEDULING TEST, DRAWING BLOOD, AND RUNNING CBCs. SINCE THAT TIME WE HAVE HIRED ANOTHER MEDICAL ASSISTANT (AS WE HAVE 2 LOCATIONS). THE ONE MEDICAL ASSISTANT HAS BEEN WITH US SINCE THE BEGINING AND HAS BECOME ALL OF THE RNs NIGHTMARE. SHE IS A VERY HARD WORKER AND HAS TAKEN ON MANY NEW DUTIES THAT IS VERY HELPFUL TO THE PRACTICE, HOWEVER SHE ALSO WANTS MORE. WE HAVE EXPRESSED TO HER THAT SHE SHOULD GO ON TO NURSING SCHOOL AS SHE WOULD MAKE A GOOD RN, BUT SHE IS CONTENT. SHE IS CAPABLE OF DOING OTHER DUTIES BUT IS IT RIGHT? SHE IS ALWAYS WANTING TO DO MORE (LIKE START IVs) AND IS ANGRY THAT WE WILL NOT ALLOW IT. SHE SAYS (AND IS PROBABLY RIGHT) THAT SHE IS CAPABLE AND COMPITANT. WE JUST KEEP TELLING HER THAT WE DO NOT NEED HER TO DO THIS. WE NEED A MEDICAL ASSISTANT, NOT ANOTHER NURSE. I KNOW SHE WANTS TO ADVANCE, BUT SHE HAS ADVANCED AS FAR AS SHE CAN WITH US. I HATE TO LOOSE HER, BUT I DON'T KNOW HOW TO KEEP HER SATISFIED WITH HER TITLE "MEDICAL ASSISTANT". WHICH IS A VERY IMPORTANT JOB ALSO.

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