CH 1- THE MEDICAL ASSISTANT, HEALTH CARE TEAM AND MEDICAL ENVIRONMENT

THE ROLE OF THE MEDICAL ASSISTANT

• Most versatile allied health occupation in today’s health care environment  

• Performs routine administrative and clinical tasks in a variety of offices and clinics

• Also employed in general medical and surgical hospitals including private and state facilities

• Duties will vary according to the location, specialty, and type of practice or setting

• Liaison between the doctor and the patient 

• Medical assistant is of vital importance to the success of the medical practice

• In order to become a successful medical assistant, you need to acquire specific:

  • Knowledge base (theory)

  • Skills (procedures)

  • Behaviors (professional characteristics and attitudes)

IS MEDICAL ASSISTING RIGHT FOR YOU? ACCORDING TO THE AMERICAN ASSOCIATION OF MEDICAL ASSISTANTS (AAMA) IF YOU CAN ANSWER “YES” TO THE FOLLOWING QUESTIONS, MEDICAL ASSISTING IS PROBABLY FOR YOU:

• Are you looking for a meaningful job?

• Do you like helping others?

• Do you have an interest in health and medicine?

• Are you a “people person”?

• Are you good at multitasking—switching tasks throughout the workday?

• Do you like variety in your job?

• Would you like to enter a career in an expanding field?

KNOWLEDGE, SKILLS, AND RESPONSIBILITIES OF THE MEDICAL ASSISTANT

• AAMA routinely completes an occupational analysis, which identifies critical responsibilities performed by CMAs (AAMA)

• Analysis is used as a marketing tool and resource for CMA (AAMA) educators as well as CMAs working in the field

• The skills listed are applicable to all medical assistants across the spectrum

• CMA (AAMA) Certification/Recertification Exam is divided into three content areas

  • General, administrative, and clinical

• American Medical Technologists website also supplies a document of various tasks that medical assistants perform

GENERAL SKILLS

• Psychology

• Communication

• Professionalism

• Medical law/regulatory guidelines

• Medical ethics

• Risk management

• Quality assurance and safety

• Medical terminology

DEMONSTRATING PROFESSIONALISM

Professionalism evolves throughout a career and includes:

• Tact

• Diplomacy

• Courtesy

• Respect

• Dignity

• Responsibility

• Selflessness

ADMINISTRATIVE

Administrative skills help manage the business affairs of the practice. Categories include:

• Medical reception

• Patient navigator/advocate

• Medical business practices

• Establishing patient medical records

• Scheduling appointments and practice finances

• Examples of administrative skills:

  • Medical record preparation

  • Demographic data review

  • Providing resource information

  • Office supply inventory

  • Equipment maintenance

  • Accounts receivable/payable

CLINICAL DUTIES

• Nutrition

• A & P

• Infection control

• Patient intake and documentation of care

• Patient preparation and assisting the provider

• Collecting and processing specimens

• Diagnostic testing

• Pharmacology

• Emergency management/basic first aid

BOUNDARIES OF MEDICAL ASSISTANTS

MEDICAL ASSISTANT WORK ENVIRONMENT

Solo practices

Partnerships

Multi-provider clinics

Urgent care centers

Managed care operations

Accountable care organizations (ACO)

Hospitals

Patient-centered medical home (PCMH)

JOB OUTLOOK FOR MEDICAL ASSISTANTS

• Employment of medical assistants projected to grow 23 percent from 2018 to 2028

  • Growth of the aging baby-boom population will continue to spur demand for preventive medical services

• As physician practices expand, they will hire more assistants to perform routine administrative and clinical duties

WHICH OF THE FOLLOWING ARE CLINICAL DUTIES OF A MEDICAL ASSISTANT

Wrapping surgical Instruments

PROFESSIONAL ORGANIZATIONS FOR MEDICAL ASSISTANTS**

• Medical assisting organizations that provide services to members, such as:

  • Credential examinations

  • Continuing education opportunities

• Organizations that accredit medical assisting programs

  • CAAHEP

  • ABHES

• American Association of Medical Assistants (AAMA)*

  • MA Credential offered: CMA(AAMA)

• American Medical Technologists (AMT)*

  • MA Credentials offered: RMA (AMT) and CMAS (AMT)

  • Other health care credentials offered as well

• National Center for Competency Testing (NCCT)*

  • MA Credentials offered: NCMA, NCMOA

  • Other health care credentials offered as well

• National Healthcareer Association (NHA)

  • MA Credentials offered: CCMA, CMAA

  • Other health care credentials offered as well

• American Academy of Professional Coders (AAPC)

  • CPC (outpatient physician office credential)

  • CPC-H (outpatient hospital/facility credential)

  • CPC-P (payer coding credential)

  • Other certifications available for coders as well

POLL TIME THE AAMA TRACES ITS ROOTS BACK TO WHAT YEAR?**

• 1955

A BRIEF HISTORY OF MEDICINE 

• Primitive human beings 

  • Infectious diseases and epidemics 80% of the population died by the age of 30

  • Risk of widespread diseases increased with community settlements and animal domestication

• Hippocrates, the founder of scientific medicine (460 BCE)** 

  • Shifted medicine from priests to scientific study 

  • Taught that illness was not punishment for sins 

  • Listened to the chest (2000 years before the stethoscope) to diagnose diseases

  • Code of behavior, the Hippocratic Oath

A BRIEF HISTORY OF MEDICINE MEDICAL SCHOOLS

• Salerno, Italy (850 CE)

  • Site of outstanding medical school

  • A union of eastern and western knowledge

  • Teaching used scientific, rational basis

  • Taught anatomy and surgery

• Other medical schools

  • Located in Paris, Oxford, Cambrigdge

  • Religious and scholarly factions prohibited advancement

  • Dissection rarely performed

ALTERNATIVES TO THE TRADITIONAL MEDICAL MODEL

• Complementary alternative medicine (CAM)**

  • Supplement or add to conventional form of medicine

  • Take account of the whole person, including all aspects of lifestyle.

• Acupuncture, Aromatherapy, Ayurvedic Biofeedback, Faith, Hand reflexology, Homeopathy, Humor, Magnet therapy, Massage, Naturopathy, Tai Chi, Visualization/guided imagery, Yoga

HEALTH CARE PROVIDERS

• An individual who examines, diagnoses, and prescribes treatment to patients

  • Physicians are most common health care providers

• May also be an organization (hospital, clinic)

PHYSICIANS

• Education and training requirements

  • Undergraduate degree, 4 years

  • Medical school, 4 years

  • 3-8 years of internship and residency

• Licensure requirements

  • Must pass all sections of the United States Medical Licensing Examination (USMLE)

  • Vary by state

  • Must continue education and training requirements

  • Must continue their education following licensing by completing CME units

• Reciprocity

  • Where one state recognizes the licensing requirements of another state as being similar or more stringent than their own

• Revocation of license

  • Temporary or permanent suspension of license

  • Conviction of a crime

  • Unprofessional conduct

  • Proven fraud in application of license

  • Incompetence

• PHYSICIANS- MD: Doctor of Medicine

→ DO: Doctor of Osteopathic Medicine

• Both are licensed physicians; have similar educational and licensing requirements

→ PhD: Holds a doctorate degree in a particular discipline; completed highest level of study in that area

GENERAL OR FAMILY PRACTICE

• General/family practitioners see all types of patients

• Specialty and subspecialty areas require additional years of study.

• See Table 1-2 for areas in which a physician may specialize.

PHYSICIAN SPECIALISTS

• Allergist

• Neurology

• Gynecologist

• Dermatologist

• Endocrinologist

• Nuclear Medicine

• Ophthalmology

• Psychiatrist

• Psychologist

• Otorhinolaryngologist

NON-PHYSICIAN SPECIALTIES

• Chiropractor – Doctor of Chiropractic (DC)

• Dentist – Doctor of Dental Surgery (DDS), Doctor of Dental Medicine (DMD)

• Podiatrist – Doctor of Podiatric Medicine (DPM)

• Optometrist – Doctor of Optometry (OD)

• Psychologist – Doctor of Philosophy (PhD)

MID-LEVEL PRACTITIONERS

• Nurse Practitioners (NP) and Physician Assistants (PA)

• Allowed to examine patients, order diagnostic testing, prescribe certain medications

• Activities may be directed by a supervising physician, or may work autonomously (per state law)

NURSES

• Registered Nurse (RN)

  • Must meet educational requirements, pass the NCLEX-RN, licensed to practice by state

• Nurse Anesthetist

  • Certified to administer anesthesia

• Nurse Midwife 

  • Helps to care for a pregnant woman when she is giving birth

• Licensed Practical Nurse (LPN)

  • Works under the supervision of RN or physician

HEALTH CARE TEAM MEMBERS

• Audiologist

• Dietician

• Emergency Medical Technician (EMT)

• Medical biller 

• Medical coder

• Medical office manager

• Phlebotomist

• Physical therapist

• Radiologic technologist

• Hospital registrar

• Nuclear medicine technologist

• Respiratory therapist

• Laboratory technician

• Limited x-ray machine operator

• Occupational therapist

• Pharmacy technician

• Sonographer

• Surgical technologist

THE IMPACT OF GOVERNMENT ON HEALTH CARE

• The Federal Government has provided impetus and influence in the growth of health care through grants, funding, and regulations

  • Food and Drug Administration (1930)

  • National Institutes of Health (1930)

  • Hill-Burton Act (1946)

  • World Health Organization (1948)

  • Medicaid (1965)

  • Medicare (1966)

  • Clinical Laboratory Improvement Amendments (CLIA) (1967)

  • Uniform Anatomical Gift Act (1968)

  • Occupational Safety and Health Administration (OSHA) (1970)

  • Controlled Substances Act (1970)

  • Health Insurance Portability and Accountability Act (HIPAA) (1996)

  • Medicare D (2006)

  • Patient Protection and Affordable Care Act (2010)

  • Controlled Substances Act (1970)

  • Health Insurance Portability and Accountability Act (HIPAA) (1996)

  • Medicare D (2006)

  • Patient Protection and Affordable Care Act (2010)

CHAPTER SUMMARY

• Most medical assistants work in ambulatory care settings or outpatient health care facilities.

• Three main areas of medical assisting are general, administrative, and clinical

• Professionalism includes accuracy, adaptability, courteousness, confidence, dependability empathy, honesty, initiative-taking, patience, punctuality, respectfulness, and tactfulness

• Medical assistants may work with physicians in a variety of environments 

• The job outlook for medical assistants continues to be very promising

• The AAMA offers the CMA credential; the AMT offers the RMA and CMAS (AMT) credentials; the NCCT offers the NCMA credential; the NHA offers the CCMA and CMAA credentials; the AAPC offers coding certifications

• The Greek physician Hippocrates is considered the father of medicine; today’s physicians repeat a modern version of the Hippocratic oath

• CAM treatments supplement conventional medicine

• A health care provider is an individual licensed to examine, diagnose, and prescribe treatment to patients seeking assistance. An organization may also be referred to as a health care provider.

• Physicians require substantial education, training, and state licensing to practice.

• Numerous physician specialists focus on different aspects of medicine.

• Midlevel practitioners include PAs and NPs.

• Levels of nursing include LPN, RN, nurse midwife, and nurse anesthetist.

• The federal government provides funding and regulates medicine.

CH 2- PROFESSIONALISM

Professionalism is the manner, behavior, and attitude of someone in a professional environment.

• Aspects of professionalism include: 

  • Being well-groomed and dressed appropriately

  • Effective communication skills

  • Responsibility

  • Integrity

  • Accountability

  • Time Management

PROFESSIONAL BEHAVIORS

• Professional traits include 

  • Accurate, Adaptable, Courteous, Confidential, Dependable, Empathic, Honest, Initiative, Integrity, Patient, Punctual, Respectful, Friendly attitude, Genuine smile, Perception as a professional

INITIATIVE

• Demonstrating resourcefulness

• Being on time

• Being dependable

• Performing assigned tasks in a reasonable amount of time correctly and efficiently

• Having innovative thinking and problem-solving ability

• Being a quick learner

• Having confidence to try something new that could potentially improve efficiency

CONFLICT MANAGEMENT

• Try to resolve conflicts with a co-worker directly by communicating with the other person.

• If that fails, take the matter to the office manager who will work with you to resolve the conflict.

• Human resources may assist with conflict management

ACCEPTANCE OF FEEDBACK

• Constructive feedback (constructive criticism)

  • Based on observations

  • Specific to information or issues surrounding that observation

• Two ways to provide feedback:

  • Positive feedback, or praise for the performance/action

  • Negative feedback, or criticism/opinion

• Tips for accepting negative feedback:

  • Wait 5 seconds to process what is being said

  • Find the benefit of what is being expressed

  • Do not blame the messenger 

  • Hear the other person out

  • Thank the person for the feedback 

  • Reflect on what is being said

  • Follow-up later with person to see if things have changed

• Resiliency

  • Overcoming negative feelings related to feedback

  • Bouncing back stronger and wiser

  • Growing personally and developing higher self-esteem

SELF-CONFIDENCE

Definitions of self-confidence vary from person to person, such as

Something that develops with knowledge and experience

“Fake it until you make it” by appearing strong regardless of how you feel on the inside

“If you know it, show it”

SELF-AWARENESS

• Provides knowledge of who you are and what you value to build your confidence

• Provides an intrinsic notion when something is not going right and changes need to be made

• Provides insight to celebrate when things are going great.

• A personal performance evaluation about your strengths, weaknesses, motivators, emotions, and beliefs.

PROFESSIONAL APPEARANCE**

Cleanliness: Shower daily, wear deodorant, perform twice daily oral hygiene

Posture: Reflects poise and confidence

Hand care: Keep fingernails manicured and trimmed, follow guidelines regarding artificial nails/polish, perform hand hygiene regularly

Hair: Keep hair clean and away from your face; fasten long hair

Proper attire: Wear clean, well-kept clothing, follow attire guidelines

Fragrances: Follow facility guidelines for fragrance use

Jewelry: Do not wear jewelry except for wedding rings/watch; follow facility guidelines

Cosmetics: Cosmetics should be tasteful and skillfully applied.

TIME MANAGEMENT

Goals to assist with time management

Make a daily, prioritized list of tasks and projects

Learn to say no to low-priority requests

Do not be a perfectionist for tasks that do not require your best effort

Stay away from bad habits that rob your time

FLOOR MANAGEMENT PRIORITY 

RESPECT FOR INDIVIDUAL DIVERSITY

• Diversity includes cultural, ethnic, and social differences among people.

• Managers, supervisors, and employees need to find ways to embrace and respect diversity in their departments and the organization.

• Recognizing personal bias is the first step in preventing them from affecting the way you conduct yourself at work.

• Suggestions for embracing diversity and being respectful include: 

  • Getting to know someone with a different background than your own.

  • Asking for feedback and opinions from a diverse group of people when confronted with an issue in the workplace.

  • Remembering patients may be new to this country and have challenges of their own with learning and understanding a different language and way of life. 

  • Learning a few phrases or polite expressions in other languages.

  • Avoiding language that degrades a specific group of individuals such as calling women “girls” or making jokes that have religious or cultural implications.

  • Continuing your learning to develop cultural competence.

CRITICAL THINKING

• Critical thinking involves the process of:

  • Observing available information and determining what the main issue is;

  • Forming beliefs (developing arguments using supportive evidence); and

  • Coming to a conclusion (deciding which view is most reasonable).

• Steps for problem-solving:

  • Determine just what the problem is and write it down. Ask whether there is a contributing problem chain or series of events.

  • Gather facts and ideas to help you decide what to do about it.

  • List possible decisions and what you think each outcome will be.

  • Use analytical and creative thinking.

  • Prioritize your decisions and begin testing them one by one until results are satisfactory to you and others concerned.

CONTINUING EDUCATION

• Ways to stay current with changes and advances in the health care field:

  • Belonging to a professional organization, like AAMA, AMT, NHA

  • Taking continuing education units (CEUs) to keep certification status current

  • Attending industry events

  • Reading industry journals

  • Taking refresher courses on topics of interest

  • Discussing your goals with your supervisor

HOW MANY NHA CONTINUING EDUCATION UNITS ARE REQUIRED FOR NHA CERTIFICATION RENEWAL

• 20 UNITS EVERY TWO YEARS

CH SUMMARY

• Professionalism is the manner, behavior, and attitude of someone in a professional environment.

• Professional behaviors include being accurate, adaptable, courteous, confidential, dependable, empathetic, honest, patient, punctual, respectful, and a team player as well as showing initiative and integrity.

• Professional appearance includes cleanliness, proper posture, and proper attire. Follow facility guidelines related to attire.

• Time management involves planning and prioritizing your tasks appropriately.

• Diversity includes numerous factors, such as culture, ethnicity, social status, gender, age, sexuality, and ability

• Biases and prejudices can lead to assumptions that result in disparities and negative outcomes in a patient’s health care.

• Critical thinking is an approach to handling interpersonal problems and concerns, using a step-by-step approach to problem solving.

• Continuing education is education designed to further skills and knowledge in a specific field. Professional organizations, such as the AAMA, AMT, and NHA, offer continuing education to members.