Why hire an LPN rather than an MA for a doctor's office?

RazorbackRN, BSN, RN · Aug 11, 2008

Well, for one you are actually a licensed person who has much a more in-depth educational background in regards to medicine/nursing.

Of course, it will vary from state to state, but in my state an MA CANNOT:

Draw up medications for injections
Administer injections (big deal, especially in flu season)
Start IV's (probably a rare occurence in office setting, but always a possiblity)
Shoot an X-Ray
Venipuncture (unless they have also completed a phlebotomy training)
They cannot take/write physicians orders (again rare, but there are certain circumstances)
Assessments (other than BP/weight)

You would probably need to check with your local BON, but maybe this will help a little.

Jo Dirt · Aug 11, 2008

I know of doctor's who hire people off the street with no training and attempt to teach them what they want done in the office, for minimum wage.

After all, doctor's know they can pretty much run things their way.

A doctor who actually cares about the quality he is getting will look for either an MA or LPN. I think maybe the difference would be, an LPN is already trained knowledge-wise about things MA's didn't cover or spend a lot of time on in school. I believe MA's concentrate mostly on their office skills, while LPN's focus mostly on the medical aspects. Generally, the knowledge base of an LPN who has worked a med-surg or even a nursing home floor will be much greater than an MA.

HappyPediRN · Aug 11, 2008

MAs are taught just the hands-on technical skills involved. They are NOT educators and they cannot assess, which is the primary differences IMHO. They are not taught rationales or much pathophysiology in anywhere near the depth a nurse is. I started off as an MA and it was just a tease for me...the surface of the ice. I wanted more so I continued on to RN school. An MA does not have the ability to put 2+2 together when it comes to a patient's PMH and their current symptoms. A nurse can say okay you have a history of CHF and for the past three days you've had to use three pillows to sleep comfortably. The next step would be, okay have you put on any weight? Let's get you on the scale and then I'm going to check your ankles for any swelling. After your assessment you tell the doc, patient presents with XYZ..is it okay if I draw a BNP? If the doctor decides to order a script for Lasix the LPN would do med teaching. A medical assistant has NO business assessing or coming to those conclusions, nor do they have a license to educate about that new drug. An MA should also never triage. You have a license for a reason.

An MA focuses more on assisting the staff with setting up procedures, stocking, taking vital signs, scheduling, printing labs, and occasionally administering routine injections (this varies depending on state).

I hope this helps you distinguish your role when you present your case.

robynv · Aug 11, 2008

It really must vary from state to state because here in Colorado, when before i went back for my RN, i was a MA.

I did draw up and give injections and venipuncture on a very regular basis. I worked at an OB/GYN office and also filled in when the regular lab person wasn't there to draw labs. I gave Rhogam, Depo Provera, Depo Lupron, Betamethasone, Rocephin and flu shots mostly.

We did have RN's and LPN's as well. They got paid more, but did nearly the same as the MA's.

chowlover · Aug 11, 2008

Okay, i am an RN & I do work in a (large) FP office- have for a long time. We have CMA, LPN, a few other RNs. I do not know what the CMAs make but I know I do not make near what hospital nurses make. I am poor but happy.

Our MAs are all Certified- they have to take a national certification test. They can give all kinds of shots. They cannot start IVs, but we do not do Ivs all that often. They CAN call in new scripts to a drugstore or tell patients the Dr wants them to stop taking a med. they are having side effects.

They cannot be 'charge nurse'. They cannot do telephone triage or walk-in triage (we get a lot of walk in patients!). They cannot handle Narcs to my knowledge, but again we do not give Narcs all that often They can assist with procedures & we do lots of procedures.

Hope that helps.

butrfli · Aug 11, 2008

I can only speak from a MA's perspective because I worked as a Nationally Registered Medical Assistant for 15 years in various doctors offices. I've worked in one that had one LPN who handled all triage calls, called in meds, spoke to doctors/nurses on phone regarding patient's and helped the MA when the work load got too busy. The MA did all the patient care unless they needed help. However, other offices I worked at that didn't have LPN's, the MA's would do all the above plus chief complaints, vitals, EKG's, venipuctures, injections, assist in minor surgeries using sterile technique, etc. I guess it just basically depends on the doctors preference, pay scale, trust and capibility with who he hires. I always looked up to the LPN because I knew she had more education than I and I would seek her for advice and understanding. After years spent as an MA, I'm finally in nursing school to walk up the carerr ladder as an RN to finally fulfill what I always wanted to truly be! I hope everything works out for you. :up:

lpnstudentin2010, LPN · Aug 11, 2008

This is what the MA in my doctors office does:

Height/Weight/Vital Signs

Takes a history/finds out more about why you are there

Draws blood

Does EKG's

Calls scripts in to the pharmacy

Calls with test results (though she does not always talk to the doc first I dont think if they are normal because I was having stomach issues at one point and an ultrasound was ordered it came back normal and I had to say "so what are we doing next" she had to call me back after talking to the doctor)

I am not sure what else she does but these are the things she has done for me

Crystal2dish · Aug 11, 2008

LPN vs MA? In my experiences as an LPN working with MA's, I noted that the MA's had killer office skills - typing, phone, filing... They also could not administer narcotic or steroid injections. Otherwise, they pretty much did everything I did.

However, I had one experience after being hired for a conservative, Catholic organization that scared the bejeezuz out of me for a long time. I had been hired (after some of the most extended, thorough, and complete screening processes of my entire life that included everything but an anal probe) to work as a MA with 2 other ancient & wise LPN's and one nervously hyper MA with major control issues. I lasted exactly one week before being "let go" like a bag of garbage out the alley door. Why? I can only guess.

The organization changed the job description completely after I was kicked out the door. I checked. I believe I was "let go" because I tend to think and act with the autonomy of a Real Nurse and years of this behavior have made it impossible for me to choke down and swallow the expectations that my primary job responsibility was to Smile and make the patients feel comfortable in that special way Disney has trademarked.

The MA in this position had a beautiful smile and the ear of our floor manager. The MA was also sloppy, scattered, and didn't mingle well with her co-workers. By some unspoken default, I was passed on to be "oriented" to the unit by her. :uhoh21: I shadowed this MA as she processed and roomed pts and was horrified to find that she blew off every non-routine concern they had (ex: one pt was depressed and asked for information on health care directives, a standard packet we usually give to anyone who requests this). Nor did the MA extend herself past the basic routines. Ever. She never passed on any of the pt concerns to the MD nor did she ever remind the pt to talk to the MD about the concern. But she did smile and she did act like a cover model for Medical Assistant magazine (if there is such a thing!). And management loved her. And she resented me for jumping in to do the (nurse)things she wasn't doing.

The point being is that there are "good" MA's and MA's that could disappear forever :rolleyes: and never be missed. I have known some excellent MA's go on to become excellent RN's.

I would advise any nurse considering transitioning from shift work into the realm of medical office/clinic work to give some thought to their own strengths and what their future career goals are. Can you handle the diversity and challenges of a culturally diverse large city clinic or would the slower pace of a small yet culturally predictable GP clinic be for you? How do you feel about handling paperwork and working with computers? Are you able to create and maintain harmony with your team, no matter the disparity in personalities? Is there a union present? I have noted a big difference in morale between union and non union staff. If you live in a larger community, a suggestion would be to register with more than one agency and accept only assignments with clinics. That would then allow you to taste the offerings out there and the employer also gets to test you as a potential employee. Plus, agencies in bigger cities tend to be competitive and you are usually paid top dollar. And you can be hired for a company you have grown to love just by working there and doing your best without so much as a job interview! :grpwlcm:

**RosesrReder, BSN, MSN, RN** · Aug 11, 2008

It really must vary from state to state because here in Colorado, when before i went back for my RN, i was a MA.
I did draw up and give injections and venipuncture on a very regular basis. I worked at an OB/GYN office and also filled in when the regular lab person wasn't there to draw labs. I gave Rhogam, Depo Provera, Depo Lupron, Betamethasone, Rocephin and flu shots mostly.
We did have RN's and LPN's as well. They got paid more, but did nearly the same as the MA's.

Hmm, well, if I was an MA doing all of the above........I'd feel super cheated and scammed to say the least. Although you and the nurses did "nearly the same" I bet you did not make the same pay.

Not trying to start a flame war either.........just my 2 cents and observation.

HappyPediRN · Aug 11, 2008

Hmm, well, if I was an MA doing all of the above........I'd feel super cheated and scammed to say the least. Although you and the nurses did "nearly the same" I bet you did not make the same pay.
Not trying to start a flame war either.........just my 2 cents and observation.

No Jessy, you are exactly right. I worked as a certified medical assistant (whoopie) prior to nursing at a Women's Health/OBGYN/RE office and set up patient's for non-stress tests/recorded the data from it, set up and assisted with gynocological procedures (colpos, LEEP, paps, IUI, etc). I ran labs, gave injections, did first visit and PMH interviews, vital signs, called in scripts, filed, stocked, auscultated fetal heart tones, and so many other things. I refused to telephone triage (which the MAs did and should NEVER have done). We shared a lot of the same responsibilities with the nurses and got paid $13/hour and nurses got paid $25+/hour. They had extra responsibilities of course, as they should, (prenatal interviews, postpartum check ups, med teaching, etc)...but I do think I was a sucker to work for 13/hour.

iwanna · Aug 11, 2008

$13 an hr. for an MA? I am an LPN and maybe would get $13 hr. in a specialist's office. Your cost of living must be high. Or, is our pay rate just low? An MA in my area will start out at $9 an hr.