Health Care Systems and Settings

• The medical field has a complex structure comprising various components, terminology, and expectations.

• A holistic approach is essential for understanding healthcare roles and the teamwork necessary for optimal patient care.

• Medical assistants (MAs) play a pivotal role in the healthcare team, undertaking both administrative and clinical responsibilities.

Medical Assistant Roles and Responsibilities

• Roles: MAs work alongside providers in outpatient or ambulatory settings; they can perform both administrative and clinical tasks.

• Duties include:

• Administrative Duties:

  • Scheduling appointments

  • Patient registration (collecting demographics and eligibility information)

  • Updating patient records

  • Sending claims to insurance

  • Collecting copays and other patient responsibilities

• Clinical Duties:

  • Collecting and processing lab specimens

  • Performing diagnostic tests like EKGs and spirometry

  • Preparing examination rooms and patients for procedures

  • Measuring vital signs and administering medications/immunizations.

• MAs are evolving into roles involving patient navigation and care coordination, requiring collaboration with the health care team.

Scope of Practice

• The scope of practice defines the tasks MAs can perform based on their training and state regulations.

• MAs should only perform tasks they are trained for and must stay informed of their state's regulations regarding medical assisting.

• Organizational policies also dictate the specific duties that MAs can undertake.

Medical Assistant Certification

• Credentialing is achieved through a national certification exam. Continued education can lead to additional certifications such as:

• Certified Medical Administrative Assistant (CMAA)

• Certified Phlebotomy Technician (CPT)

• Certified EKG Technician (CET)

• Certified Billing and Coding Specialist (CBCS)

• Certified Electronic Health Records Specialist (CEHRS)

Health Care Provider Roles

• Physicians:

• Must be licensed to practice and complete extensive education (8 years of schooling + residency)

• There are MDs (Medical Doctors) and DOs (Doctor of Osteopathy), with similar roles but different training approaches.

• Midlevel Providers: Nurse Practitioners (NPs) and Physician Assistants (PAs) have critical roles, often providing patient care alongside supervision from physicians.

• Nurses: Vary from Licensed Practical Nurses (LPNs) to Registered Nurses (RNs), with RNs having broader scopes.

• Allied Health Professionals: Include roles such as medical laboratory technicians, occupational therapists, and pharmacy technicians.

Licensure vs. Certification

• Licensure: Required for physicians; ensures safety and competence.

• Certification: While not mandatory for MAs generally, it can enhance job prospects and career advancement.

• Certification maintenance is necessary to stay updated in the field.

Types of Health Care Organizations and Delivery Models

• Inpatient vs. Outpatient Care: Inpatient care requires hospitalization; outpatient includes primary and specialty care clinics.

• Primary Care Clinics: Handle routine visits and preventive care.

• Specialty Care Clinics: Focus on specific health issues.

• Home Health: Provides care at home, often post-acute hospitalization.

• Mobile Health Units: Bring services, such as vaccinations, directly to communities.

• Hospice: Offers palliative care for terminal conditions.

Patient-Centered Medical Home (PCMH)

• A model where comprehensive care is coordinated through a primary care physician utilizing a team approach.

Technology in Health Care

• Telehealth: Allows virtual appointments, simplifying access while maintaining certain responsibilities for MAs, like scheduling and patient interaction.

• Patient Portals: Enable patients to access their health information online, fostering engagement in their care.

Health Care Payment Models

• Fee-for-Service: Traditional model where services are billed individually.

• Value-Based Care: Focuses on patient outcomes and satisfaction, rewarding preventive and holistic approaches.

General vs. Specialty Health Care Services

• General Health: Offers a holistic approach to patient care including GPs and family practitioners.

• Specialist Care: Involves specific diagnoses and treatments beyond generalist capabilities (e.g., cardiologists, dermatologists).

Ancillary Services and Complementary Therapies

• Ancillary Services: Include urgent care, lab services, and diagnostic imaging.

• Complementary Therapies: Focus on holistic approaches like acupuncture and chiropractic care.