Positioning Medical Assistants for a Greater Role in the Era of Health Reform

Abstract

Medical assistants (MAs) are one of the fastest-growing occupations in the United States. As of 2014 there were about 585,000 MAs in the United States, and the Bureau of Labor Statistics projected the MA workforce to grow by 29% from 2012 to 2022. The MA population is primarily female, ethnically and racially diverse, and paid about $15.01 per hour. MAs are primarily educated in private schools, many at for-profit institutions. The MA curriculum and length of training can be quite varied and can lead to uneven preparation for practice. Traditionally, the MA role has involved a limited clinical role and little involvement with team care, particularly in larger practices or clinics. Medical groups, clinics, and health systems are now taking a new look at MAs and how they can play a greater role in reforming health care delivery models. Expanded roles for MAs might include health coach, referral coordinator, disease registry manager, and health screener using protocols. In expanding MA roles, education and regulatory issues need to be addressed by the provider community including current inconsistent regulation and certification requirements and the lack of preparation for expanded roles in traditional MA training programs. MAs are well positioned to help address challenges in the health care delivery system including improving access to care while reducing overall cost. Successful model practices using MAs in expanded roles need further formal evaluation and replication across practice settings.

Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)

“…The quality of MA education and training received varies widely, and no standard educational curriculum currently exists, especially for MAs to assume these new roles. 30 Practices that succeeded in this regard had a motivated registered nurse who took it on herself to provide training to the MAs. Educating MA students in this new PCMH model may help future MAs better integrate into team-based care while decreasing strenuous workloads for office staff.…”

New Roles for Medical Assistants in Innovative Primary Care Practices

“…The majority of training programs are 1 year or less and result in a certificate of completion. Private for‐profit schools are a major source of MA education, producing 82 percent of all MAs in 2013, and may be flexible in ramping up or down enrollment according to market demand (Chapman, Marks, and Dower ; National Center for Education Statistics ). The median wage for MAs in 2014 was $14.41 per hour (U.S. Bureau of Labor Statistics ).…”

Determining the effect of an educational intervention on medical support personnel's knowledge to administer a standardized developmental screening tool.

“…Despite the AAP's 2006 mandate, many general pediatricians' offices continue to struggle with implementing the recommendation of routine, standardized developmental screening during well-child visits (King et al, 2010). Several factors have reportedly made the process of early identification and timely referral of young children with developmental delays difficult, including: unfamiliarity with the screening tools used to detect developmental delays; insufficient time to administer standardized screening tools during well-child appointments; a lack of non-physician staff to assist with developmental screening; cost; and a lack of confidence in the ability to screen (Chapman, Marks, & Dower, 2015;Halfon et al, 2012;Jimenez et al, 2014;Rice et al, 2014;Sices et al, 2008;Sices et al, 2004). Support for this problem statement exists because of the nonfulfillment of the APA's clinical practice guidelines by general pediatric practitioners.…”

“…With developments in medical technology, a push toward evidence-based, patient-centered care, and the need to increase access to primary care, a transformation in healthcare delivery is occurring nationally (Bodenheimer et al, 2014). There are currently more than 591,000 medical assistants in the United States, with the Bureau of Labor Statistics projecting 138,900 new medical assistant jobs within the next decade (Chapman et al, 2015). On average, this group is paid about $15.01 per hour (Chapman et al, 2015).…”

“…There are currently more than 591,000 medical assistants in the United States, with the Bureau of Labor Statistics projecting 138,900 new medical assistant jobs within the next decade (Chapman et al, 2015). On average, this group is paid about $15.01 per hour (Chapman et al, 2015).…”