Ch 1 The Medical Assistant, Health Care Team, and Medical Environment

Health care provider

A physician, nurse practitioner, or physician assistant licensed to examine, diagnose, and prescribe treatment to patients.

Explain the meaning of scope of practice for medical assistants.

Medical assistants may only work within the boundaries of what they are legally and ethically allowed to do.

Ambulatory care

Services provided on an outpatient basis without admission to a hospital.

Certification

Implies that an individual has met certain competencies in their field.

Mid-Level practitioners

Physician assistants and nurse practitioners are considered mid-level practitioners.

Allied health

Encompasses a broad range of health professions that are distinct from doctors and nurses, including medical assisting.

Patient navigator

A liaison between the health care system and patient/family/caregiver.

Medical scribe

Accompanies a physician into the exam room and documents the encounter into the medical record.

Accreditation

The process by which an educational institution or program establishes credibility or legitimacy by complying with predetermined standards

Tact

The ability to communicate and act with sensitivity, discretion, and diplomacy. It involves knowing exactly what to say or do in delicate or difficult situations without offending others or hurting their feelings

What are the three broad areas of medical assisting?

1. General skills

• Included in the areas of psychology, communication, professionalism, medical law/regulatory guidelines, medical ethics, risk management, quality assurance and safety, and medical terminology.

2. Administrative skills

• Helps manage the business affairs of the practice and includes categories such as medical reception, patient navigator/advocate, medical business practices, establishing patient medical records, scheduling appointments and practice finances.

3. Clinical skills

• Divided into areas that include anatomy and physiology, infection control, patient intake and documentation of care, patient preparation and assisting the provider, nutrition, collecting and processing specimens, diagnostic testing, pharmacology and emergency management/basic first aid.

To be successful as an MA, you must learn a specific:

a. knowledge base.

b. set of skills.

c. set of behaviors.

What role should the medical assistant take on concerning communications when working with patients?

Communication liaison

Differentiate between the administrative and clinical job duties of a medical assistant.

Administrative duties:

• Help manage the office side of the practice and include categories such as reception, medical records, appointments, and practice finances

  • Ex: Scheduling appointments, medical record preparation, demographic data review, providing resource information, office supply inventory, equipment maintenance, accounts receivable/payable, payment receipts, managing petty cash, CPT/ICD-CM coding, and insurance claims.

Clinical duties:

• Involve direct patient care and include recording vital signs, collection of specimens, administering medications, and preparing patients for exams

  • Ex: Performing vital signs, performing sterilization and minor surgery procedures, collecting and processing specimens, performing ECGs, administering medications, performing phlebotomy, performing patient screenings, preparing patients for exams, and responding to emergencies.

Common work environments for medical assistants

Physicians' offices, specialty practices, urgent care centers, clinics, hospitals, labs, insurance companies, billing companies, and government agencies.

Why is it important for medical assistants to know the role of other health care providers?

Knowing the role each professional plays enables you to speak more intelligently with others in the medical field and become more efficient in your role.

Patient-centered medical home (PCMH)

A team-based model of care led by a personal provider who provides continuous and coordinated care throughout a patient’s lifetime to maximize health outcomes.

Clinical skills

Skills that vary by state laws and are an extension of the provider’s responsibilities of assessment, examination, diagnosis, and treatment.

General skills of medical assistants and examples of skills

Skills necessary regardless of whether working in a clinical or administrative capacity.

• communication

• medical law/knowledge

• professionalism

Administrative skills

Skills that help to manage the business affairs of a medical practice.

Hospitalist

A provider who works with patients admitted to the hospital.

Solo practice

When an individual provider makes all the decisions for the practice.

Partnership

Two or more providers who have a legal agreement to share in the total business operation of the practice.

Multi-provider clinic

A group practice that consists of three or more providers who share a facility for the purpose of practicing medicine.

Urgent care center

Ambulatory care centers that take care of patients with acute illness or injury and those with minor emergencies; used quite often when patients cannot see their own provider.

Advocate

One who assists the patient, or acts on his or her behalf.

Patient navigator

A person under the provider’s supervision who guides a patient through their health care (explaining insurance, financial info, taking complaints, and helping them understand their rights).

Principles of self-boundaries

In general, medical assistants cannot examine, diagnose, or prescribe treatment. Each state has its own medical practice act that dictates responsibilities.

Credentialing

The process of establishing the qualifications of certified and licensed medical professionals and assessing their background and legitimacy.

AAMA (American Association of Medical Assistants)

Provides the CMA (AAMA) credential. Requires graduating from a CAAHEP- or ABHES-accredited institution. Exam is taken at a Prometric center within a 90-day window.

AMT (American Medical Technologists)

Provides the Registered Medical Assistant (RMA) and Certified Medical Administrative Specialist (CMAS) credentials. Exam can be taken at PearsonVUE.

NCCT (National Center for Competency Testing)

Provides the National Certified Medical Assistant (NCMA) credential. Application must be received within two weeks of the requested test date.

NHA (National Healthcareer Association)

Provides eight certification exams for allied health care specialties.

AAPC (American Academy of Professional Coders)

Provides the Certified Professional Coder (CPC) credential and offers training/certification in medical billing and coding.

Registered Nurse (RN)

One who has completed a course of study at a state-approved school of nursing and passed the NCLEX-RN exam.

Nurse Anesthetist

An RN licensed to administer anesthesia who has completed an advanced training program and passed the certification test.

Nurse Midwife

An RN licensed to care for women in labor and to deliver babies. Most states require certification in addition to the state nurse license.

Nurse Practitioner (NP)

An RN licensed to practice medicine and to work as a midlevel practitioner.

Licensed Practical Nurse (LPN)

A nurse trained in basic nursing care who usually works under the direction of an RN or a physician.

Medical Assistant career growth projection (2018–2028)

Expected to grow by 23% according to the United States Department of Labor.

Biofeedback therapy

A non-invasive, mind-body technique that teaches you to consciously control normally involuntary bodily functions, such as heart rate, muscle tension, and breathing. By using sensors and visual or auditory monitors, patients can see their physiological stress responses in real-time and learn to regulate them.

Homeopathic therapy

a 200-year-old alternative medical system based on two main principles: "like cures like" (the idea that a substance causing symptoms in a healthy person can treat similar symptoms in an ill person) and the "law of minimum dose" (the belief that higher dilutions increase a remedy's potency).

Magnet therapy

an alternative practice that uses static magnets or electromagnetic fields placed on the body to alleviate pain and accelerate healing. Despite its popularity in wellness circles, major health institutions state that the scientific evidence supporting these benefits is largely limited to the placebo effect.

Naturopathic medicine

A distinct healthcare system that blends traditional healing practices with modern complementary medicine

Gynecology

Gynecologist: Diagnosing and treating diseases and disorders of the female reproductive tract; strong emphasis on preventive measures. (Target: Female adolescents and adults)

Hematology

Hematologist: Diagnosing and treating diseases and disorders of the blood and blood-forming tissues. (Target: Adults of all ages, infants and children, both sexes)

Hospitalist

Hospitalist: Work with patients admitted to the hospital. They work in many departments and reduce the load of hospital visits for the primary care provider and specialist. (Target: Adults of all ages, children, both sexes)

Infertility

Infertility specialist: Diagnosing and treating problems in conceiving and maintaining pregnancy. (Target: Couples who desire to have children but cannot)

Internal medicine

Internist: Diagnosing and treating diseases and disorders of the internal organs. (Target: Adults of all ages, both sexes. Do not typically treat children.)

Interventional cardiology

Interventional cardiologist: Catheter-based treatment of structural heart diseases. (Target: Adults of all ages, both sexes)

Nephrology

Nephrologist: Diagnosing and treating diseases and disorders of the kidney. (Target: Adults, children, both sexes)

Neurology

Neurologist: Diagnosing and treating diseases and disorders of the nervous system. (Target: Adults, children, both sexes)

Nuclear medicine specialist

healthcare professional who administers radiopharmaceuticals and operates special cameras (like PET or SPECT scanners) to monitor how the pharmaceuticals localize in specific organs

Obstetrician

Providing direct care to women during pregnancy and childbirth and immediately thereafter.

• (Target: Pregnant patients)

Occupational medicine specialist

Diagnosing and treating diseases or conditions arising from occupational circumstances (e.g., disorders caused by chemicals, dust, or gases).

• (Target: Adults of all ages, both sexes)

Oncology specialist / Oncologist:

Diagnosing and treating tumors and cancer.

• (Target: Adults of all ages, children, both sexes)

Ophthalmologist

Diagnosing and treating diseases and disorders of the eye.

• (Target: Adults of all ages, children, both sexes)

Orthopedist

Diagnosing and treating disorders and diseases of the bones, muscles, ligaments, and tendons and fractures of the bones.

• (Target: Adults of all ages, children, both sexes)

Otorhinolaryngologist (ENT specialist)

Diagnosing and treating disorders and diseases of the ear, nose, and throat.

• (Target: Adults of all ages, children, both sexes)

Pathologist

Performing analysis of tissue samples to confirm diagnosis.

• (Target: Usually has no direct contact with patients)

Pediatrician

Diagnosing and treating diseases and disorders of children; strong emphasis on preventive measures.

• (Target: Infants, children, and adolescents)

Physical medicine specialist

Diagnosing and treating diseases and disorders with physical agents (physical therapy).

• (Target: Adults, children, both sexes)

Plastic surgeon:

Evaluates and improves the appearance of scars, deformities, and birth defects; also provides elective procedures that patients desire for aesthetic purposes.

• (Target: Adults of all ages, children, both sexes)

Psychiatrist

Diagnosing and treating pronounced manifestations of emotional problems or mental illness that might have an organic cause.

• (Target: Adults of all ages, children, both sexes.

• Note: Child psychiatry is a further specialized field dealing exclusively with children and adolescents.)

Pulmonary, thoracic, or cardiovascular specialist

Diagnosing and treating diseases and disorders of the chest, lungs, heart, and blood vessels. (Target: Adults, both sexes)

Radiologist

Diagnosing and treating diseases and disorders with Roentgen rays (X-rays) and other forms of radiant energy.

• (Target: Adults of all ages, children, both sexes)

Sports medicine specialist

Diagnosing and treating injuries sustained in athletic events.

• (Target: Adults, especially young adults (athletes), both sexes)

Surgeon

Diagnosing and treating diseases, injuries, and deformities by manual or operative methods.

• (Target: Adults of all ages, infants, children, both sexes)

ER or trauma provider

Diagnosing and treating acute illnesses and traumatic injuries.

• (Target: Adults of all ages, infants, children, both sexes)

Gerontologist or geriatrician

Diagnosing and treating diseases, disorders, and problems associated with aging

• TargOlder adults, both sexes

Family practitioner

Similar to general practice in nature, but centering on the family unit

• Target: Adults of all ages, infants and children of all ages, both sexes

Endocrinologist

Diagnosing and treating diseases and malfunctions of the glands of internal secretion (hormones)

• Target: Adults of all ages, children, both sexes

Dermatologist

Diagnosing and treating disorders of the skin

• Target: Adults of all ages, children, both sexes

Cardiologist

Diagnosing and treating abnormalities, diseases, and disorders of the heart

• Targtet: Adults of all ages, children, both sexes

Anesthesiologist

Administering anesthetic agents before and during surgery

• Target: Adults of all ages, children, both sexes

Allergist

Diagnosing and treating conditions of altered immunologic reactivity (allergic reactions)

• Target: Adults of all ages, children, both sexes

Medical billers

Create a billing statement listing all charges the patient has incurred for services rendered and send the bill to the patient, insurance company, or attorney. They work in doctor’s offices, hospitals, medical billing companies, and insurance companies.

Medical coders

Use an alphanumeric coding system for all diagnoses and all procedures in a manner that results in the maximum reimbursement for the provider and in fewer fees billed to the patient. They work in the same environments as medical billers.

Medical Office Managers

Supervise members of the medical office staff, coordinate schedules, perform human resource functions, and oversee the daily operations of the office. These individuals usually work in physician offices, clinics, and urgent care centers.

Phlebotomist

Ahealth care worker whose primary responsibility is to obtain blood samples.

• Other duties include the transportation, handling, and processing of blood specimens for analysis.

• Phlebotomists work in a variety of settings including doctor’s offices, outpatient laboratories, skilled nursing facilities, and hospitals.

Food and Drug Administration (FDA)

Legislation that gave status to Public Health Service and the Food and Drug Administration. In 1953, the two became part of the Department of Health, Education, and Welfare, which has since become the Department of Health and Human Services.

National Institutes of Health (NIH)

One of the world’s foremost medical research centers

Clinical Laboratory Improvement Amendments (CLIA)

Establishes guidelines for operating laboratories

Occupational Safety and Health Administration (OSHA)

An organization that protects employees in the workplace

Uniform Anatomical Gift Act

An act that allows living individuals to indicate their desire for their organs to be gifted at the time of death

Patient Protection and Affordable Care Act

An act that expands access to health insurance

Medicare Part D

A prescription drug plan for seniors to make drugs more affordable

National Institute of Health (NIH)

One of the world's foremost medical research centers

Hill-Burton Act

Legislation responsible for improving construction of hospitals

World Health Organization (WHO)

A specialized agency of the United Nations that cooperates to control and eradicate disease worldwide

Medicaid

A federal organization that provides for the medical care of the indigent

Controlled Substances Act

Legislation that helps control the abuse of drugs

Health Insurance Portability and Accountability Act (HIPAA)

Intended to limit health administration costs and provide for patient privacy

professional behaviors of medical assistants include…

being accurate, adaptable, courteous, confident, dependable, empathic, honest, initiative-taking, patient, punctual, respectful, and tactful, as well as being a team player

Sole proprietorshop

Solo practice

Job outlook for medical assistants

Very promising

• Due to the versatility of medical assistants as well as to our aging population.

• The field of medical assisting is expected to grow 23 percent through 2028.

Botique medicine

A system where patients pay an added fee in exchange for more personalized care and better access to their providers for medical services

What describes the role of an Accountable Care Organization (ACO)?

• Voluntary Collaboration: An ACO is a voluntary group of doctors and hospitals that collaborate to provide coordinated care to Medicare patients.

• Shared Responsibility: These groups take collective responsibility for the quality and total cost of care for their assigned patient population.

• Efficiency Rewards: If the ACO succeeds in delivering high-quality care while reducing unnecessary Medicare spending, it may be eligible to share in the savings.

Ayuvedic medicine

a traditional healing system originating in India, identifies three vital energies or principles present in all things: Vata (air and space), Pitta (fire and water), and Kapha (water and earth).

• These three fundamental energies are known as doshas. Ayurvedic philosophy maintains that these doshas govern all physical, mental, and emotional characteristics, and health is achieved when they are in perfect balance.