Medical Assistants Play Vital Role in Innovative Practices

Medical assistants (MAs) are on the rise. According to this year's Physicians Practice Staff Salary Survey, of the 40.7 percent of practices that have added staff, 56.7 percent added a medical assistant. This made it the top position added by practices among respondents.

The vital role MAs are playing in today's practice doesn't surprise Susan Chapman, PhD, RN, professor at the UCSF School of Nursing's Department of Social and Behavioral Sciences. Chapman and her team recently conducted a study on how innovative primary-care practices are using MAs. By collecting data at 15 case study sites, the researchers found that MAs could take on a number of important tasks in the practice such as health coach, medical scribe, possible translator for bi-lingual patients, health IT super user, and more.

"It's a team enterprise. Medical assistants have been in the office for quite some time, RNs [at small practices] have pretty much disappeared. They're too expensive and the work that needs to be done doesn't need their skill level….MAs [are] the main member of team in the small office. There is a physician or two and a team of MAs in the office," Chapman says.

Indeed, other than front-desk staff, MAs are the most common position at a medical practice. Just under 77 percent of practices say they had an MA on staff, according to the Staff Salary Survey. But it's not just small practices that can utilize an MA. Chapman says for all practices involved with patient-centered care models, MAs offer the ability to connect with patients before and after their office visit. This is especially the case for patients with complex diseases that require specialized care.

"For example, some MAs are doing preparation for the office visit. [In some practices, they call the patient and say, 'You're coming in this week, did you get the laboratory test done? Bring the record from your Glucose check.'…The idea is [there is] better patient care and improved outcomes if you [perform these] services that don't occur during the visit," says Chapman.

In some of the case studies that the UCSF team looked at, MAs formed a stronger bond with patients than the physicians themselves. At these practices, Chapman says MAs were able to connect and get patients to understand their care plan in a way that no other provider could. "Health coaching may be better served coming from someone who is better attuned with [the patient]," she says.

Financial Reasons

That's not the only reason for practices to bring in an MA, though. Chapman says MAs have a relatively short training period and can be paid at a lower level than other staff members.  

According to the Staff Salary Survey, an MA with 20+ years' experience, on average, made $39,434 per year. The only other positions on the staff that averaged less in income for that amount of experience were the front-desk and medical records clerk. In addition, researchers found that MAs offered a return on investment at many practices, with their services leading to increased patient throughput and thus, more revenue. 

Despite all of this, UCSF researchers say there are multiple roadblocks that have prevented them from taking on a larger role at the practice level. The biggest one, Chapman says, is a lack of buy-in from practice leadership. "You need buy-in in terms of the concept and you need buy-in in terms of actual resources to get this up and moving," she notes. "There are people on the healthcare team that believe MAs should be taking on these roles. That's something that just gets worked out, either with the practice not going forward or those people leaving the practice."

Another roadblock is MA retention, Chapman says. Because it's often among the lowest paid members of the staff, the job faces sharp rates of turnover, she says. It's important, she notes, for practices to keep MAs satisfied with their jobs.

"[Turnover] means that [a practice's] investment into an MA goes somewhere else. There has to be an investment in MA satisfaction and keeping MAs happy. That means [focusing on] workload, how much they contribute, and whether or not they feel valued…the kinds of things that make anyone satisfied with their job," Chapman says.