The Professional Medical Assistant

The Professional Medical Assistant
Chapter 2 The Professional Medical Assistant Copyright 2016 by Elsevier Inc. All rights reserved.

Copyright 2016 by Elsevier Inc. All rights reserved.
Lesson 2.1 Objectives Describe the history of the medical assisting profession. Explain how a medical assisting education program becomes accredited. List character and personality traits of effective medical assistants. Describe the appearance and behavior of a professional medical assistant. Copyright 2016 by Elsevier Inc. All rights reserved.

Lesson 2.1 Objectives (Cont.)
Describe principles of effective time management. Define professionalism for physicians and medical assistants. Copyright 2016 by Elsevier Inc. All rights reserved.

Introduction to Professional Medical Assisting
Medical practice before 1960s Early medical practices were mostly solo practices Physician performed most duties within the office Physician also made house calls Patients often seen without appointments Why did physicians make house calls before 1950? ((Making house calls kept costs down and allowed the physician the ability to see multiple patients.) Why did they stop making house calls? (Physicians stopped making house calls when more diagnostic tests, laboratory tests, and treatments required more equipment.) Copyright 2016 by Elsevier Inc. All rights reserved.

Introduction to Professional Medical Assisting (Cont.)
Gradual increase in scope and complexity of ambulatory care Government programs required office to submit insurance claims More diagnostic testing done in the office Nurses did not want to do clerical work How has the practice of medicine changed in the past 40 years? (Advances in medical science made more diagnostic tests, laboratory tests, and treatments available and necessary for good medical care. Laboratory and diagnostic testing have increased in amount and complexity, along with the administrative equipment and technology.) During the past 40 years, what factors increased the amount of paperwork that a medical office needed to complete? (When government insurance programs were introduced, the medical office was expected to complete and submit insurance forms. Gradually, almost all insurance billing has shifted to the health care provider.) Copyright 2016 by Elsevier Inc. All rights reserved.

Introduction to Professional Medical Assisting (Cont.)
Gradual increase in scope and complexity of ambulatory care Hiring and training medical assistants freed nurses to work in hospitals Medical assistants took on both administrative and clerical tasks AAMA formed in 1956 Why did the profession of medical assisting develop? (As services expanded, physicians hired nurses to help them. Often, nurses were unable or unwilling to assist with the administrative aspects of the practice. This opened the way for medical assistants to come in and assist with administrative duties and then with patient care.) What are the two professional organizations for medical assisting that are nationally recognized? (American Association of Medical Assistants [AAMA] and the American Medical Technologists [AMT].) When was the AAMA recognized by the U.S. Department of Education? (1978.) Copyright 2016 by Elsevier Inc. All rights reserved.

Educational Programs for Medical Assistants
Training programs were established lasting 6 months to 2 years Some programs sought accreditation to achieve high standards Two recognized accrediting agencies Commission on Accreditation of Allied Health Education Programs (CAAHEP) Accrediting Bureau of Health Education Schools (ABHES) Certification examination for students of accredited programs Accredited programs must include at least 160 hours of practicum What is accreditation? (Recognition by regional or national organizations for maintaining certain standards.) What process do medical assisting schools follow in order to obtain and maintain accreditation? (The program must prepare a written report showing how the educational standards of the agency are being met. Then an accreditation visit is made to validate the report.) What is a practicum? (A supervised work experience that is required in an educational program that usually unpaid. Formerly called an ”externship.”) Copyright 2016 by Elsevier Inc. All rights reserved.

Characteristics of Medical Assistants
Character Traits Reliability and dependability Organization Honesty Tolerance Identify specific ways that a medical assisting instructor or medical assisting supervisor could assess the following in a medical assistant: reliability, dependability, organization, honesty, and tolerance. Why is it important for a medical assistant to be reliable and dependable? (The medical assistant is an integral part of the office practice, so their presence at work is extremely important.) Why is it important for a medical assistant to be tolerant of different beliefs and cultural practices? (Tolerance allows the medical assistant to work effectively with co-workers and patients from a variety of religious, ethnic, and cultural backgrounds.) See Procedure 2-1: Locating and Defining a State’s Legal Scope of Practice. Copyright 2016 by Elsevier Inc. All rights reserved.

Characteristics of Medical Assistants (Cont.)
Personality Traits Interested in people Warm, caring Able to put the needs of others first Able to remain calm in difficult situations Do you believe that individuals can strengthen or change their personalities? (Answers will vary.) Why is it important for a medical assistant to be warm, caring, and interested in people? (It helps the medical assistant communicate effectively with patients.) Copyright 2016 by Elsevier Inc. All rights reserved.

Appearance and Behavior Neat, clean, well-groomed Courteous Willing to take initiative Ability to act or follow through without being supervised Identifying and performing needed tasks without being told to do so How long does it take to make a judgment about another person during the first interaction? (Judgments are made within seconds of meeting another person.) How might a patient respond if a medical assistant’s pants are frayed at the bottom because they are too long? (Patients may react negatively if they feel that the medical assistant is not clean or well-groomed.) Give examples of taking initiative appropriately. (A medical assistant is expected to figure out what needs to be done and how to help out without being asked.) Why do students sometimes hesitate to display initiative? (In school, students learn to wait for someone to tell them exactly what to do and how to do it. In the workplace, the opposite quality is valued.) Copyright 2016 by Elsevier Inc. All rights reserved.

Appearance and Behavior Time management Able to adapt to change Able to work with others (team members) Medical assistants need to be well versed in all areas of time management. This can extend to planning, setting goals, prioritizing, and analyzing the effectiveness of how time has been used. Some medical practice personnel have found that making task lists has proven effective when prioritizing activities. Why does change occur so often in the medical office? (Changes in equipment, procedure, and staff are extremely common, because methods are always being updated and changed.) How should a medical assistant react to change? (The medical assistant should approach change with tolerance and enthusiasm; the assistant needs to adapt to the office setting rather than expecting the office to adapt to him or her.) What are important elements of working well with others? (Helping others; maintaining a positive attitude and not complaining; avoiding gossip; working within the established chain of command; handling stress without losing emotional control; keeping perspective; accepting corrections or criticism without become defensive; learning from mistakes.) Copyright 2016 by Elsevier Inc. All rights reserved.

Professionalism for Physicians
Physicians treat patients on the basis of scientific knowledge Physicians can receive ethical guidance from several sources AAMA code of ethics State and federal regulations HMOs or PPOs in which they participate National medical board of their specialty or subspecialty What is professionalism for physicians? (Treating patients based on the body of scientific knowledge physicians have accumulated, and continue to accumulate, during their working lifetimes.) Is a physician’s professionalism limited to the medical (or surgical) treatment of patients? (Physicians are also bound by ethical standards and legal regulations.) How do physicians know what is professional and what is not considered professional? (There is a variety of sources for professional guidance: the AMA codes of ethics; state and federal regulations; regulations of the hospital[s] to which the physicians admit patients; any open-panel health maintenance organizations or preferred provider organizations in which the physicians participate; the national medical board of their specialty or subspecialty.) Copyright 2016 by Elsevier Inc. All rights reserved.

Professionalism for Physicians (Cont.)
Medical practice is influenced by the philosophy of the Hippocratic Oath Key concepts include confidentiality and avoiding harm to patients Medical knowledge no longer considered secret and restricted only to physicians State and federal laws also define the practice of medicine for physicians For more information on unprofessional activities of physicians, see Highlight on Unprofessional Conduct for a Physician. Copyright 2016 by Elsevier Inc. All rights reserved.

Professionalism for Medical Assistants
Should accept responsibility for own actions Should adhere to the AAMA Code of Ethics Respect patients Maintain confidentiality Continue education Perform community service The AAMA and AMT provide a set of standards that define professional practice for medical assistants. Copyright 2016 by Elsevier Inc. All rights reserved.

Professionalism for Medical Assistants (Cont.)
Ways of responding to unprofessional behavior of others If on the same level, discuss calmly with the individual involved If on a higher level, discuss with the office manager Reports can be made to the state organization that licenses professionals such as physicians or nurses if the behavior poses a danger to patient care What should the medical assistant do if he or she thinks that a co-worker has acted inappropriately or unprofessionally? (The medical assistant should first discuss the situation with the co-worked by calmly and objectively describing the actions or behavior that he or she considers unprofessional. If the person doesn’t correct the behavior, it is appropriate to report the behavior to the office manager.) What behavior have students experienced in the medical office that is inappropriate or unprofessional? How should the individual have acted? (Answers will vary.) Copyright 2016 by Elsevier Inc. All rights reserved.

Copyright 2016 by Elsevier Inc. All rights reserved.
Lesson 2.2 Objectives Identify organizations and publications that guide professional behavior for physicians and medical assistants. Differentiate between various national credentials for medical assistants Describe how professional organizations support the profession of medical assisting. Identify the administrative tasks and clinical tasks performed by a medical assistant. Copyright 2016 by Elsevier Inc. All rights reserved.

Lesson 2.2 Objectives (Cont.)
Discuss the medical assistant’s role in the operation of the medical office and patient education. List employment opportunities for medical assistants. Copyright 2016 by Elsevier Inc. All rights reserved.

Certification for Medical Assistants
Usually not licensed but are encouraged to become certified AAMA and American Medical Technologists (AMT) provide certification for medical assistants National certification examination to become certified Recertification by continuing education or taking examination again Why is certification important? (When an unbiased national organization validates knowledge and skills, the employer can be sure that the medical assistant has excellent qualifications.) Certification is important for medical assistants who live in a state that does not regulate unlicensed health professionals. Copyright 2016 by Elsevier Inc. All rights reserved.

American Association of Medical Assistants
Administers the Certified Medical Assistant (AAMA) examination Medical assistant must take and pass the examination May use the initials CMA (AAMA) as a title Discuss the certification examination of the AAMA in detail if your graduates are eligible to take it. Copyright 2016 by Elsevier Inc. All rights reserved.

American Medical Technologists
An organization that offers several certifications Medical assistants may take an examination to be certified as: A Registered Medical Assistant (RMA) Certified Medical Administrative Specialist (CMAS) Registered Phlebotomy Technician (RPT) Discuss the RMA certification examination in detail if your graduates are eligible to take it. Discuss other medical assisting certification examinations that you might recommend for your graduates. Copyright 2016 by Elsevier Inc. All rights reserved.

Certification for Medical Assistants
California Certifying Board for Medical Assistants (CCBMA) Administers the California Certified Medical Assistant examination National Healthcareer Association (NHA) National Center for Competency Testing (NCCT) The National Healthcareer Association offers certification for certified clinical medical assistant (CCMA), certified medical administrative assistant (CMAA), certified EKG technician (CET), and/or certified phlebotomy technician (CPT). The National Center for Competency Testing offers testing for graduates of affiliated programs as well as medical assistants with experience or training through the military. They offer certification for medical assistant (NCMA), a medical office assistant (NCMOA), an ECG technician (NCET), and/or a phlebotomy technician (NCPT). Copyright 2016 by Elsevier Inc. All rights reserved.

Obtaining Additional Credentials
CPR certification Performing first aid, hearing tests, limited x-ray examinations, or other specialized tests Phlebotomy certification Administrative and/or coding specialist certification In some states, an individual must register as a medical assistant Discuss CPR certification at the health provider level. How can a medical assistant obtain CPR certification at the health provider level? (Training in CPR is offered directly through the American Red Cross and the American Heart Association and by hospitals and other health care agencies.) Identify other specific clinical certifications that a medical assistant might obtain. (Medical assistants may take courses in first aid, hearing tests, performing x-rays, or other specialized tests. A medical assistant may be required to obtain a separate certification in phlebotomy. A medical assistant working with a podiatrist may obtain a certification as a podiatric medical assistant (PMAC) or a certified ophthalmic assistant (COA) if working with an ophthalmologist.) What are administrative certifications that a medical assistant might obtain? (Certified Medical Administrative Specialist [CMAS]; certified coding associated [CCA]; certified coding specialist [CCS]; certified coding specialist-physician based [CCS-P].) Are there any special requirements for medical assistants in your state? (Answers will vary.) Copyright 2016 by Elsevier Inc. All rights reserved.

Professional Organizations
Peer Support Can be found through local and national meetings Professional journals facilitate communication What are local chapters of national professional organizations and when do they meet? (Answers will vary.) How can medical assistants benefit from attending meetings of professional organizations? (They are able to enter a network of peers with whom they can share and from whom they can learn. They can also obtain insurance at a reasonable cost, professional journals, and other sources of information.) Copyright 2016 by Elsevier Inc. All rights reserved.

Professional Organizations (Cont.)
Continuing Education Professional organizations provide continuing education programs Continuing education contact hours are called continuing education units (CEUs) CMA (AAMA) must recertify every 5 years with 60 CEUs RMA certified after January 2006 must recertify every 3 years with 30 CEUs Why is continuing education important for medical assistants? (The medical field is constantly changing, so it is important for the medical assistant to keep skills up to date, attain new skills, and obtain new information about professional practices.) Copyright 2016 by Elsevier Inc. All rights reserved.

Legislative Advocacy Professional organizations monitor legislative initiatives that affect the profession of medical assisting State organizations provide a forum to push for new legislation In some states, the profession of medical assisting is defined in state law. Copyright 2016 by Elsevier Inc. All rights reserved.

Publications, Newsletters, and Websites CMA Today is a publication of the AAMA Journal of Continuing Education Topics and Issues is a publication of the AMT State and national professional organizations maintain websites Conferences are held nationally by the AAMA What is the value of professional journals for the medical assistant? (They help the medical assistant stay up-to-date on issues in their field.) What is the value of national conferences for the profession of medical assisting? (They enhance communication and contact among members of the profession.) Copyright 2016 by Elsevier Inc. All rights reserved.

Role of the Medical Assistant
Administrative Responsibilities Making appointments Scheduling office appointments Scheduling referrals to other specialists and completing paperwork Scheduling inpatient and outpatient admissions and procedures What kinds of appointments might be scheduled by the medical assistant? (Office appointments; appointments made with other medical facilities [consultation with a specialist, a diagnostic procedure, outpatient surgery, continuing therapy or rehabilitation, hospital admission]; some patients may need multiple appointments scheduled.) Copyright 2016 by Elsevier Inc. All rights reserved.

Role of the Medical Assistant (Cont.)
Administrative Responsibilities Filing medical records Maintaining and filing medical records and reports Managing information if an electronic medical record is used Transcribing dictation or printing and filing reports transcribed by an outside service Creating letters or other documents Each patient encounter with a clinician is followed by documentation of the patient’s visit. The medical assistant files the reports after the physician has approved them. Copyright 2016 by Elsevier Inc. All rights reserved.

Administrative Responsibilities Performing accounts receivable procedures Accepting payments Totaling charges Recording charges and payments Billing, insurance, and collection procedures What procedures does the medical assistant perform related to the patient’s charges, billing, and insurance? (The medical assistant must know how to accept and document payments, total and enter charges, code the procedures and/or diagnostic tests performed, and enter payments received.) Copyright 2016 by Elsevier Inc. All rights reserved.

Administrative Responsibilities Preparing bank deposits Managing bank accounts Performing accounts payable procedures Paying bills Keeping records related to payments Why is it important for the medical assistant to understand procedures for writing checks and making bank deposits? (These activities need to be performed on a regular basis so it is beneficial for medical assistants to be familiar with them.) Copyright 2016 by Elsevier Inc. All rights reserved.

Clinical Responsibilities Collecting and processing specimens Performing diagnostic tests Cardiac testing (ECG) Respiratory testing Other When does the medical assistant collect blood, urine, or throat specimens? (Depending on the type of office, the medical assistant may participate in these clinical activities.) What are diagnostic tests that the medical assistant might perform? (Electrocardiograms, respiratory testing, etc.) Copyright 2016 by Elsevier Inc. All rights reserved.

Clinical Responsibilities Preparing patients for examination Taking medical history and/or chief complaint Taking measurements Taking vital signs Preparing examination and treatment room between patient visits Ask students to share experiences about being prepared for ordinary examinations, physical examinations, and specialty examinations (such as Pap tests). What must the medical assistant do to prepare the examination room between patient visits? (Make sure that there is fresh paper on the table, that the proper instruments and supplies are available for the next examination or procedure, and that the necessary equipment is available and in working order.) Copyright 2016 by Elsevier Inc. All rights reserved.

Clinical Responsibilities Assisting with examinations and procedures Helping during examinations Passing instruments and supplies Removing sutures, bandaging and changing dressings Preparing for and assisting with minor surgery How might medical assistants assist with examinations and procedures? (The medical assistant settles a patient into an examination room and positions and drapes the patients for portions of the examination. Medical assistants may also pass instruments and supplies to the physician during procedures, may remove sutures, and may change sterile dressings.) What types of procedures are usually done in the medical office? (Minor surgeries or sterile procedures can be performed in the office.) Copyright 2016 by Elsevier Inc. All rights reserved.

Clinical Responsibilities Performing treatments Nebulizer treatments Hot and cold packs or compresses Administer medications and immunizations Administering first aid or assisting with emergency care Are medical assistants allowed to administer medications and immunizations in your state? (Answers will vary.) Medical assistants must be prepared to perform emergency care and administer first aid in case of an office emergency. Copyright 2016 by Elsevier Inc. All rights reserved.

Managing the Medical Office Performing operational activities Taking inventory of supplies and equipment Maintaining equipment Purchasing supplies and equipment Reviewing and/or revising office policies and procedures A medical assistant may also be in charge of contracting a uniform service to launder the staff’s laboratory coats or the patients' gowns. Copyright 2016 by Elsevier Inc. All rights reserved.

Managing the Medical Office Performing risk management activities Promoting health and safety for office personnel Supervising the infection control plan Taking measures to prevent fires Providing for proper disposal of biohazard waste and controlled substances Why is risk management important? (It helps minimize the chances of the practice being sued by a patient or disciplined by a regulatory agency.) Copyright 2016 by Elsevier Inc. All rights reserved.

Managing the Medical Office Maintaining records related to the management of the office Insurance records Quality control records Maintenance contracts Personnel records Financial/tax records What kinds of records must be maintained? (Patient records, office insurance records, quality control records, maintenance contracts, personnel records, and financial records.) Copyright 2016 by Elsevier Inc. All rights reserved.

Patient Education and Coaching Often responsible for educating patient about office policies and procedures May provide information about maintaining health to patients as directed by physician May teach a patient about ways to manage his or her disease or condition Patient Navigation Remove the obstacles patients face in accessing/receiving treatment What is the medical assistant’s role in patient education? (The medical assistant is often responsible for educating the patient about office procedures, maintaining health, and locating community resources.) What is health coaching? (A process that helps patients identify their values related to health, set health goals, and take steps to meet their personal goals.) The PCMH attempts to coordinate a patient’s care through the office of the primary care provider. Copyright 2016 by Elsevier Inc. All rights reserved.

Employment Opportunities
Medical assisting is a fast-growing occupation Locations for employment Physician offices Hospitals Other medical practitioners Schools, laboratories, outpatient care centers Where do medical assistants work? (The majority work in physicians' offices, others work in offices of other health practitioners, hospitals, outpatient care centers, schools or other education facilities, medical laboratories, government agencies, employment services, and nursing care facilities.) What is the job outlook for medical assistants? (Medical assisting is projected to be one of the fastest growing occupations in the period between 2008 and Job prospects are excellent for medical assistants who’ve completed a formal educational program.) Copyright 2016 by Elsevier Inc. All rights reserved.

Employment Opportunities (Cont.)
Opportunities for career advancement May require additional education or training Office management Instructor in medical assisting program Other health career What opportunities for career advancement for medical assistants exist that do not necessarily require additional education? (Medical assistants have the opportunity to become an office, practice, or department manager, often using management skills that can be learned mainly on the job.) What types of educational programs might medical assistants pursue in order to advance to related job opportunities? (To become a medical assisting instructor, it is necessary to have an Associate in Science Degree or higher and to be either a CMA or RMA. Clinical advancements require additional training in a formal education program preparing for a health career.) Copyright 2016 by Elsevier Inc. All rights reserved.

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