Can a medical assistant make an impact on your practice?
You may think you have an idea, but it’s the finer details that make a medical assistant a must-have on your staff. Medical assistants are in high demand in today’s marketplace because they can optimize the efficiency of the practice in a value-based environment. Smart healthcare providers see the value of a great medical assistant and reward them well with competitive wages and benefits, flexible working conditions, and signing bonuses.
It is very difficult to recruit and retain medical assistants in this low unemployment and highly competitive market, as evidenced by a review of job boards showing postings that have been open for months.
In fact, the job market for medical assistants will grow at a rate of 29 percent over the next ten years, according to the Bureau of Labor Statistics, which is much faster than the average job. With 634,400 medical assistant jobs in the market in 2016, that means that on average, there will be approximately 18,500 more medical assistants employed annually over the next ten years. Physicians will hire more medical assistants to perform administrative and clinical duties, to more effectively utilize the physicians’ time. As more physicians retire and physician shortages increase, especially in primary care, physician-centered practices are shifting into patient-focused teams with shared responsibility for care. Medical assistants will share in that team care.
Medical assistants can be very effective for your practice and help you achieve high marks on patient satisfaction, optimize reimbursement, and score big in quality care metrics. They can earn the trust and confidence of your patients every day on the telephone and in person. Enhanced roles for the medical assistant in patient outreach, health coaching, scheduling appointments, and clinical chart preview and review can optimize practice resources.
Medical Assistants Can Be Very Effective to Your Practice and Help You Achieve High Marks on Patient Satisfaction, Optimize Reimbursement, and Score Big in Quality Care Measures.
Significant Impact
The impact of medical assistants on patient and provider satisfaction, quality care, and reimbursement can be significant in a well-run practice or of minor impact where the medical assistants are underutilized. At Novant Health Medical Group, physicians rely heavily on their medical assistants for follow-up on pending orders and follow-through with lab results. Dorothy Butler, a Regional Manager at Novant in Charlotte, N.C., calls it “a marriage”. She says the medical assistant for each physician keeps the office and physician flowing effectively.
Medical assistants can greatly improve communication with the patient. Karen Ripper, CEO of the Day Medical Center in Stuart, Fla., attributes the practice’s improved patient satisfaction results specifically to one administrative medical assistant that understands the mission is to answer the telephone within two rings, to get the patient in to be seen, and to greet each patient warmly, welcoming the patient as if that patient is a VIP.
Administrative medical assistants can answer incoming telephone calls from patients with questions or concerns and schedule the patient for an appointment as needed. Patients are more satisfied explaining their issue to a clinical person rather than leaving a message with a non-clinical person and waiting for a return call to repeat everything they had already relayed. A high percentage of telephone calls are repeat calls, according to research in Family Practice Management, but those can be significantly reduced by using medical assistants instead of non-clinically trained staff. In addition to reducing the amount of work for staff managing repeat calls, the patients are happier when their issue is handled during their first telephone call into the practice.
The clinical medical assistants in a family medicine practice in Fayetteville, N.Y., discuss the medication list with the patients during the rooming process to help educate them about what each medication is for and how best to take it. Robert Feldman, MD, family medicine physician, says that the intake process “saves me time in the exam room so that I can focus on the patient’s acute and chronic conditions.” The medical assistants also perform discharge duties at the Day Medical Center with internal medicine physician Dr. Emmet Kenney’s patients. They do this by completing any orders in the exam room with the patient, such as scheduling follow-up appointments, administering injections, or instructing the patients about diagnostic orders.
Strong Patient Relationship
Simply because medical assistants spend more time with patients (answering their telephone calls, performing outreach, processing call backs to the patient, performing intake, rooming and discharge with the patient) than the physician, the patients develop a high level of trust in the medical assistant.
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This trust often is exhibited in information the patient shares with the medical assistant, information that the patient may be uncomfortable discussing with the physician. The medical practice that supports and encourages these relationships will benefit with improved patient satisfaction and higher quality scores. The patient that puts their trust in the medical assistant will more likely accept the coaching and instructions from that medical assistant and adhere to the treatment plan.
As the patient grows to trust the medical assistant, they become more comfortable relying on them for information about their chronic disease, their medicines, and their treatment plans. Patients that visit or call the practice very frequently (almost monthly) look to that medical assistant as their care manager. Even if the medical practice does not label the medical assistant with the official role of care manager, a competent medical assistant performing at the top of their scope of practice can evolve into one as their relationship with patients develops. They communicate with the patient to assess their needs and consult with the physician on the appropriate services for the patient.
The medical assistant as health coach and educator creates an active partnership with the patient. The medical assistant is more likely than the physician to uncover non-adherence and coach the patient through the obstacles. Taking the time, building the relationship, providing a safe and non-judgmental environment for the patient ultimately results in adherence to goals and objectives and improves quality scores, with the upshot of better reimbursement and improved patient care.
Cost Benefits
Typically, medical practices find it economical to recruit and retain medical assistants for the clinical care team instead of licensed or registered nurses. The general ranges for hourly rates are lower for medical assistants, so salary and benefit costs are lower in a medical practice that employs medical assistants instead of nurses, which means profitability is higher.
However, aside from the simple salary and benefit cost calculation, the revenue generation aspect of using medical assistants in the practice should be considered. For example, by employing medical assistants and developing protocols and clinical care expectations, the medical practice can save physician time with each patient, which allows the physician to see more patients. Take the case of Patsy Brown, administrator of Summit Medical Associates in Hermitage, Tenn. She found that by employing medical assistants who are certified (credentialed) to preview schedules for missing screenings, the practice earned financial bonuses for hitting quality of care initiatives. Seeing more patients in a value-based model improves access measures and quality of care by reaching patients that may not have been accommodated. (If a patient does not get an appointment, they do not get their wellness exams nor receive recommended screenings). Success in the value-based healthcare delivery system includes better quality scores.
Researchers at the University of Cincinnati found that practice transformation requires strong relationships between the professionals having main contact with patients and their colleagues. Summit Medical Associates’ physicians and medical assistants exemplify this research finding in their Patient Centered Medical Home (PCMH) team-based practice models with their physician-medical assistant teams. The result of these high functioning teams for Summit is increased medical revenue.
When a medical assistant works at the top of their scope of practice, it means they are performing clinical duties and tasks that providers do not need to perform, such as electrocardiograms, phlebotomy and lab testing, data entry into the EHR, diagnostic procedures, suture removal, patient education, and coaching. Medical assistants can make the outgoing telephone calls to patients to deliver test results, explain medication and dosing changes and to schedule patients for follow up appointments or screenings as needed. The physician is relieved of the non-face-to-face care, which is a significant responsibility in value-based care, and allows them to form better relationships of their own with the patient. Better relationships result in improved quality scores and better reimbursement.
Certification: Critical To Success
Medical practices want to hire the best, qualified individual who will make a positive contribution to quality patient care. Certified professionals function at the top of their scope of practice, which brings a higher level of efficiency and value to the medical practice. Russell West, talent acquisition professional, with Northwestern Medicine in Chicago, Ill., said education and certification is required because the scope is vastly different; medical assistants need more and better skills. Novant Health Medical Group also requires all medical assistants be certified.
Medical assistants that have been certified require less on the job training, which means they will be performing as needed in the practice more quickly. In fact, employers are looking at certification as a way to assess whether an individual possesses the skills and knowledge required for successful performance. The requirements for eligibility to sit for the certification examination generally include completion of a rigorous training program that is suitably accredited or proof of a certain number of years of work as a medical assistant. Medical assistant education can be two-year college programs, one-year diploma programs, or nine-month certificate programs. Once a medical assistant program is completed or the required work experience has been met, a medical assistant may become nationally certified.
Certain state laws and federal regulations, especially if the practice sees Medicaid patients, also require certification to fully practice in the field. While certification is not required in all states, employing credentialed medical assistants enhances your practice operations. Certification shows a commitment to the profession and demonstrates that the medical assistant meets rigorous standards established and verified by a third-party organization. It also shows dedication to maintaining quality and continued education on a regular basis. Medical assistants who are certified are required to maintain certification and therefore stay abreast of changes in the industry, including innovation in the role of the medical assistant as the healthcare industry continues to evolve. It is in the best interest of the practice to monitor certification status of their employees to maintain the highest quality of care. Value-based care initiatives present new demands on the medical practice and medical assistants can play a key role with appropriate training.
By hiring and deploying a credentialed medical assistant, the medical practice can achieve higher levels of patient satisfaction and improve quality care initiatives, while optimizing physician time and increasing reimbursement for a profitable operation.
Conclusion
Well-qualified medical assistants develop relationships with patients that reduce the time burden felt by physicians and keep the patients happy and satisfied with the care and service they receive. Both administrative and clinical medical assistants contribute to streamlined patient flow, effective facility utilization, improved quality initiatives and better reimbursements. The Family Medicine of Weston practice in Weston, Fla. has successfully recruited and retained medical assistants for every administrative and clinical position. The practice achieves high patient satisfaction scores with high marks from contracted payers. Dr. Alberto Rengifo, the physician owner of the five-provider practice, values and rewards the medical assistants, because he knows they are the key that takes the medical practice from good to great in the eyes of the patients, in day-to-day satisfaction, and in the financial success of the practice.
Rosemarie Nelson is a professional speaker and consultant with 30 years experience in health care as a practice manager, in information technology, and as a consultant to physician practices, specializing in practice operations management and electronic medical record systems.
Core Competencies Of A Medical Assistant Making The Grade As A Medical Home
Without a medical assistant, a medical practice ineffectively uses physician time and may not meet the needs of the patients.
Imagine the practice with no medical assistant. Who greets and rooms the patient? Who answers patient telephone calls regarding clinical issues? Who administers the flu shot? Who weighs the baby? Who obtains the patients’ vital signs, retaking a blood pressure when the patient asks to have it repeated because the first reading is high? Who performs an electrocardiogram? Who follows up on missing lab test results?
Some would answer that a nurse or even the physician can complete these duties. But consider the cost of physicians and nurses taking on those roles. Aside from significantly higher salary, the missed opportunity of what the physician or nurse could be doing instead of performing the duties of a medical assistant is very costly. Patient access to the practice is reduced and physician satisfaction is low. Patients are not happy if they have long wait times and don’t have their calls returned in a timely manner.
A medical assistant creates value in the practice by making the operation flow effectively. Although some medical assistants perform both administrative and clinical functions, others may choose to focus on just one side. Typically, a certification exam will cover both. In successful practices, such as Fayetteville Gastroenterology Associates of Fayetteville N.C., medical assistants rotate through administrative and clinical roles, which creates a cross-trained team that does not become complacent in their duties. Because medical assistants cover a range of responsibilities, they can be your most flexible practice resource.
Administrative
- Telephone skills for receiving incoming calls and making outgoing calls to meet patient needs.
- Knowledge of appointment scheduling protocols for acute and/or urgent visits and skilled in the technology for scheduling patient visits.
- Capability to review appropriateness of the daily patient schedule and take corrective action as necessary (i.e. if the appointment is for review of labs, but no lab results are available, reschedule the patient with instructions to obtain labs).
- Patient registration in the practice management system including capturing insurance information.
- Understanding insurance protocols and regulations for properly scheduling lab and diagnostic procedures for patients and obtaining authorization and referrals (verifying the patient is eligible for the service under their insurance plan) per physician orders.
- Fluent in the technology of the practice (telephone and voicemail system, auto-attendant and call transfer, practice management and EHR, insurance eligibility, e-fax, scanning documents into appropriate systems and files, ancillary systems for order and result processing at affiliated diagnostic and hospital systems).
Clinical
- Understanding that the priority is the check-in, rooming, and discharge of the patients with the goal to keep providers on schedule.
- Capability to capture the patient history, verification of medications, take vitals, and record the reason for visit during the rooming process and prepare the patient for a physical exam or procedure.
- Administer injections per physician orders.
- Enter orders into the computer system, as directed by the physician.
- Perform certain laboratory tests.
- Schedule follow up appointments for patients as a component of patient visit discharge.
- Prepare exam rooms daily and turn over exam rooms for each patient visit.
- Sterilize medical equipment.
- Dispose of contaminated supplies.
- Perform phlebotomy services as ordered by the physician.
- Perform electrocardiograms, suture removal, and change dressings.
- Educate patients regarding discharge instructions, medication dosing protocols, and treatment plan, providing face-to-face coaching.
