Tailoring Career Ladders for Medical Assistants in Primary Care: A Qualitative Assessment

Abstract

Background: Growing demand for medical assistants (MAs) in team-based primary care has led health systems to explore career ladders as one solution to improve MA recruitment and retention. The practical implementation of career ladders remains a challenge for many health systems, and an improved understanding of MA perspectives on career ladders is needed. Methods: Semi-structured focus groups were conducted August to December 2019 in primary care clinics based in three health systems in California and Utah. MA perspectives of existing career ladders, including acceptability, appropriatness and impact on career intentions were discussed, recorded, and qualitatively analyzed.Results: Ten focus groups conducted with 59 participants showed the MA employment decisions were influenced by a number of factors, with opportunities for economic and professional growth predominating. MA career aspirations varied, with “stepping stone” MAs using their role to advance into other health professions and “contented career” MAs hoping to grow within their MA career. Career ladders were acceptable in theory but MAs felt current implementations could benefit from clear and transparent expectations for advancement, consistent recognition of training, experience and work responsibilities, the ability to advance in place, and career counseling. Conclusion: MAs held positive perceptions of career ladders, yet recommended a number of improvements to their practical implementation across three institutions. The emergence of two distinct clusters of MA professional needs and desires suggests an opportunity to further optimize career ladders to provide tailored support to MAs in order to strengthen the healthcare workforce and talent pipeline.