The Financial Cost of Medical Assistant Turnover in an Academic Family Medicine Center

Friedman, Jessica; Neutze, Dana

doi:10.3122/jabfm.2020.03.190119

Cited by 15 publications

(15 citation statements)

References 16 publications

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“…For instance, "Lost 1 or more office managers or head nurses" was included as one type of disruption, although the loss of these roles may be experienced quite differently by practices, and each loss should be counted separately to determine disruptive load. Write-in responses and qualitative data suggest that other potential disruptions that should be considered for inclusion in survey response categories include loss of MAs, 65,88 system-level leadership turnover, 89 practice expansions, and consolidations. 83,84 A separate and important consideration is turnover in the facilitator role.…”

Section: Discussionmentioning

confidence: 99%

“…[49][50][51][52][53][54][55][56][57] However, facilitators and researchers alike note that practice disruptions like turnover, EHR implementation, and ownership or leadership change can present serious obstacles to practices' engaging in facilitation and QI. 39,[58][59][60][61][62][63] In particular, pervasive turnover 44,64,65 is noted as highly disruptive for team building and retaining institutional knowledge, reducing the capacity and motivation of remaining staff to do QI. 66 Few studies, though, have systematically examined the prevalence and impact of different types of disruptions on practices' participation in facilitated QI.…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Major Disruptions on Practice Participation in Facilitation During a Primary Care Quality Improvement Initiative

et al. 2022

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Background: Disruptions in primary care practices, like ownership change, clinician turnover, and electronic health record system implementation, can stall quality improvement (QI) efforts. However, little is known about the relationship between these disruptions and practice participation in facilitated QI.Methods: We explore this relationship using data collected from EvidenceNOW in a mixed-methods convergent design. EvidenceNOW was a large-scale facilitation-based QI initiative in small and medium primary care practices. Data included practice surveys, facilitator time logs, site visit field notes, and interviews with facilitators and practices. Using multivariate regression, we examined associations between disruptions during interventions and practice participation in facilitation, measured by in-person facilitator hours in 987 practices. We analyzed qualitative data on 40 practices that described disruptions. Qualitative and quantitative teams iterated analyses based on each other's emergent findings.Results: Many practices (51%) reported experiencing 1 or more disruptions during the 3-to 15-month interventions. Loss of clinicians (31.6%) was most prevalent. In adjusted analyses, disruptions were not significantly associated with participation in facilitation. Qualitative data revealed that practices that continued active participation were motivated, had some QI infrastructure, and found value in working with their facilitators. Facilitators enabled practice participation by doing EHR-related work for practices, adapting work for available staff, and helping address needs beyond the explicit aims of EvidenceNOW.Conclusions: Disruptions are prevalent in primary care, but practices can continue participating in QI interventions, particularly when supported by a facilitator. Facilitators may benefit from additional training in approaches for helping practices attenuate the effects of disruptions and adapting strategies to help interventions work to continue building QI capacity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effects of Major Disruptions on Practice Participation in Facilitation During a Primary Care Quality Improvement Initiative

et al. 2022

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“…5,28 Create advancement-in-place opportunities For the "contented career" MAs, we heard that opportunities that allow for advancement within their current MA profession may increase job satisfaction and thereby retention with its downstream nancial and organizational bene ts. 10,11 Literature outside healthcare also suggests that organizations can bene t when promoting from within, given that employees retain institution-speci c knowledge that increases productivity. 29,30 We note major barriers to facilitating MA advancement within their current roles include licensing restrictions and common sta ng structures in primary care-MA role expansion may mean MAs have taken over the historical positions they might have once stepped up into.…”

Section: Build the Bridge To Other Health Professionsmentioning

confidence: 99%

“…5,9 Efforts to employ and retain such a valuable workforce are of considerable interest to healthcare organizations, given the shortage of available MAs, annual turnover rates of 20-30%, and replacement costs that reach 40% of MA yearly salary. 10,11 Research around these challenges is limited; lack of career advancement opportunity 10,12 and negative perceptions of organizational culture may contribute to MA turnover. 13 Given these challenges, many organizations are exploring novel solutions to recruit and retain the MA workforce with the goal of ultimately improving patient outcomes and workforce e ciency.…”

mentioning

confidence: 99%

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

Vilendrer

Amano

Brown‐Johnson

et al. 2021

Preprint

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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.

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“…Efforts to employ and retain such a valuable workforce are of considerable interest to healthcare organizations, given the shortage of available MAs, annual turnover rates of 20–30%, and replacement costs that reach 40% of MA yearly salary [ 10 , 11 ]. Research around these challenges is limited; lack of career advancement opportunity [ 10 , 12 ] and negative perceptions of organizational culture may contribute to MA turnover [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

A qualitative assessment of medical assistant professional aspirations and their alignment with career ladders across three institutions

et al. 2022

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Background Growing demand for medical assistants (MAs) in team-based primary care has led health systems to explore career ladders based on expanded MA responsibilities as a solution to improve MA recruitment and retention. However, the practical implementation of career ladders remains a challenge for many health systems. In this study, we aim to understand MA career aspirations and their alignment with available advancement opportunities. 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 career aspirations and their alignment with existing career ladders were discussed, recorded, and qualitatively analyzed. Results Ten focus groups conducted with 59 participants revealed three major themes: mixed perceptions of expanded MA roles with concern over increased responsibility without commensurate increase in pay; divergent career aspirations among MAs not addressed by existing career ladders; and career ladder implementation challenges including opaque advancement requirements and lack of consistency across practice settings. Conclusion MAs held positive perceptions of career ladders in theory, yet recommended a number of improvements to their practical implementation across three institutions including improving clarity and consistency around requirements for advancement and matching compensation to job responsibilities. 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.

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The Financial Cost of Medical Assistant Turnover in an Academic Family Medicine Center

Cited by 15 publications

References 16 publications

The Effects of Major Disruptions on Practice Participation in Facilitation During a Primary Care Quality Improvement Initiative

The Effects of Major Disruptions on Practice Participation in Facilitation During a Primary Care Quality Improvement Initiative

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

A qualitative assessment of medical assistant professional aspirations and their alignment with career ladders across three institutions

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