MA-Ch1 Foundational knowledge

Do MAs work in inpatient or outpatient settings?

outpatient/ambulatory settings

What is an MAs scope of practice based on?

laws, certification, and training

Licensure

• allow physicians to diagnose, treat, and prescribe legally

• ensures only qualified individuals with the appropriate education and skills can provide medical care

What governs licenses of physicians?

• state medical practice acts, which vary by state

How is licensure obtained?

• passing examination

• reciprocity: a state recognizes a license from another; mutual agreement between two states to recognize each other's licenses

• endorsement: existing certification meets standards of another state and state recognizes your existing out-of-state license by evaluating equivalence

Inpatient vs. Outpatient clinics

• inpatient: formally admitted to a hospital

• outpatient/ambulatory: not formally admitted/ same day care

Primary care clinics

• routine and preventive care

• outpatient

• first point of contact

• wellness checkups, immunizations, chronic disease management, minor acute illnesses

Specialty care clinics

• focus on specific medical conditions or body systems

• patients referred here for chronic, more complex conditions

• specialists like cardiologists, oncologists, etc.

Home health

• medical care for patients unable to leave home

• prescribed by licensed providers for short-term care

• Ex. PT, OT, speech therapy

Mobile health units

• vehicles equipped with medical tools and diagnostic equipment, making healthcare more accessible to underserved, rural communities

• Ex. COVID vaccines, tests

Hospice

• end of life care to bring comfort and improve quality of life for terminally ill patients

• inpatient or outpatient

• nurses, social workers, and spiritual counselors

Patient centered medical home (PCMH)

• model for healthcare delivery of coordinated, comprehensive, patient focused care

• uses inter-professional care team

• centers on the relationship between a patient and their primary care physician

• single clinic, home

Role of MAs in PCMH

• administrative and clinical tasks

• vitals, coordination between providers and specialists, patient education, filing patient information

Telehealth

• virtual healthcare service through video-calls

• helps make healthcare more accessible and flexible and reduces spread of contagious disease

Telehealth vs. In-person

• telehealth: medication changes, reviewing chronic conditions, patient education, lab/imaging results, counseling, minor rashes,

• in-person: new or worsening pain, diagnostic tests, physical exams

Patient portal

• secure online system allowing patients to access their health info

• viewing lab results, visit summaries, scheduling appointments, messaging healthcare team

• increase transparency, reduce wait times

Fee-for-service model

• insurance model where healthcare workers are paid for each individual service they perform

• each service has a procedure code and charge thats processed by billing department and sent to insurance (or patient if uninsured)

• insurance processes claim and then patient pays predetermined portion (copay, coinsurance, deductible)

• advantages: patients only pay for services they receive

• disadvantages: unnecessary tests increase costs for patient and providers

Value-based care plan

• U.S is shifting to this model over fee-for-service

• focuses on quality of care over just quantity of care

• providers are rewarded for keeping patients healthy and positive health outcomes

• clinics receive financial incentives for meeting quality goals

Quadruple aim of value-based care plan

1. improve patient outcomes

2. patient satisfaction

3. lower costs

4. provider well-being

Managed care

general term for health plans that coordinate patient care in network of hospitals & providers where care is pre-paid or in scheduled payments

Capitation

providers get set monthly payment from patients based on health and demographics

Health maintenenace organization (HMO)

• contracts with specific providers and hospitals for care

• requires referrals for specialists and pre-approval for certain procedures

Preferred provider organization (PPO)

• patients can see any provider but is more cheap for services within network

• no referrals needed

Point of service plan (POS)

• combines HMO + PPO

• any provider can be seen but cheaper in network

• may/ may not require primary care provider

Who are generally the first point of contact?

• general practitioners

• family practitioners

• internal med/ internists

• receptionists

General practitioners

• care for acute (short-term) and chronic (long-term) illness

• preventative care

• holistic approach

Family practitioners

• care for patients of all ages

• diagnose and treat broad range of illnesses

• mainly preventative care like checkups, vaccines

Internists (internal mecicine)

• treat adults but some can specialize in pediatric internal medicine

• manage chronic illness and complex conditions and also common illness

Ancillary services

additional healthcare services that support patient diagnosis, treatment, and recovery

• each one addresses a specific medical need

• urgent care, laboratory services, diagnostic imaging, OT, PT

Urgent care

• alternative ED for non-life-threatening conditions

• shorter wait times, walk-in appointments, extended hours

Laboratory services

diagnostic tests on bodily fluids to help identify medical conditions

Diagnostic imaging

• uses x-rays, MRI, ultrasound, etc. to take internal body images to confirm or rule-out medical conditions

Occupational therapists

• help patients with physical, developmental, or mental limitations regain independence in daily activities by developing treatment plans

Physical therapy

helps patients restore strength, mobility after injury or surgery

Complimentary therapies

non-traditional healing approaches used w/ medicine to improve health

• acupuncture, chiropractic medicine, energy therapy, dietary supplements

Acupuncture

inserting needles into specific points on body to relieve pain

Chiropractic medicine

diagnosing and treating musculoskeletal pain using spinal manipulation and alignment techniques

Energy therapy

balances body’s energy flow to support emotional and physical wellness

• Ex. reiki

Dietary supplements

• things like vitamins, minerals, herbs with therapeutic properties

• MAs should remind patients to discuss supplement use with their healthcare provider to ensure safety and avoid interactions with prescribed medications

Physician assistant (PA)

• licensed professionals who work under MDs or DOs

• can diagnose, treat, prescribe

• 4 yrs bachelors + 2 yrs PA school

Nurse practitioner

• receive advanced degrees beyond registered nurses (RNs)

• have extensive clinical experience

• can diagnose, treat, prescribe

• mostly work under physician but in some states they can practice independently

Licensed practical nurse (LPN)

• complete 1 year of an accredited nursing program

• pass state board exam for licensure

• work under RNs and physicians

• vital signs, administering medications, wound care

• employed in long-term care facilities and have a limited scope

Registered nurse (RN)

• complete advanced education through an associates degree in nursing, hospital-based diploma program, BSN

• must pass state licensure exam

• have broader scope than LPNs—perform more complex procedures, work in wide range of settings

What does CBCS stand for?

certified billing and coding specialist

What does CEHRS stand for?

certified electronic health records specialist

When did the first professional MA association form?

1956

When was the field of MAs recognized?

in 1978 by the board of education

Administrative responsibilities of MAs

• managing patient appointments

• updating demographic and insurance info of patients

• submitting insurance claims and collecting payments

Clinical responsibilities of MAs

• collecting and processing lab specimens

• performing diagnostic tests like EKG

• preparing examination rooms for patients

• vital signs

• administering medications and vaccines

What are some things outside of an MAs scope of practice?

• diagnosing

• prescribing

• interpreting diagnostic results

• performing independent procedures

Physician schooling

• 4 years for bachelors

• 4 years of med school MD or DO

• 2-7 years of residency

• passing 3 parts of USMLE to practice independently

Medical doctors (MD)

• focus in allopathic/ traditional medicine relying on modern medicine and scientific methods

Doctor of osteopathic medicine (DO)

• similar training to MD but receive additional training in holistic, whole body care as well as osteopathic manipulative treatment (OMT)

Medical laboratory technician

• perform diagnostic tests on blood, urine, and other bodily samples to help detect and monitor diseases

• work under medical technologists or pathologists

Medical receptionist

• first point of contact

• manage check in and out procedures, schedule appointments, answer phone calls, front desk help

Pharmacy technician

• assist pharmacists with dispensing medications, managing inventory, prepare prescriptions, label medications, and handle customer inquiries

• work under licensed pharmacist

Physical therapists (PT)

• helping patients restore movement, strength, and flexibility following injury, surgery, or illness through treatment plans

Radiology technician

• operate medical imaging equipment like X-ray, CT, or MRI machines to assist providers in diagnosing and monitoring disease

Certification

• process that demonstrates professional competency in a field

• generally voluntary but some states mandate it for certain MA tasks

Advantages of certifications

• more job opportunities

• higher starting salaries

• credibility

• career advancement

Maintaining certification

• MAs need to maintain and renew their certification regularly to stay current with standards and practices

• renewal of certification every 2 years

• take certification exam again or 10 hours of continuing education

Role of MAs in telehealth

• scheduling virtual appointments

• sending and testing video links

• coordinating follow-up care

• gathering patient information before visit

MA responsibilities with patient portals

• uploading documents and test results

• helping patients enroll and navigate their account

• explaining privacy, messaging, log-in procedures

MAs role with specialty healthcare services

• communicate with specialists office to schedule appointments

• transfer medical records and lab results

• support specialists by preparing rooms and assisting with procedures

Collaborative care

healthcare model in which multiple healthcare professionals from different disciplines work together to coordinate and provide patient care

Accountable care organization (ACO)

• an ACO can be comprised of any number of healthcare providers, including primary care physicians, specialists, hospitals and payers.

• ACO members collectively assume financial responsibility for patients and patient populations entrusted to them

• medical neighborhoods