Registered Nurses an Ideal Fit for Primary Care Practices

Is it fair to say that most physicians would select to have a medical assistant (MA) in their office as their “right hand?” MAs can take care of most of the prep work, vital signs, and charting that a physician needs to adequately keep patient load propelling through the hours of the day. At times, and in certain practices however, the benefits of having a registered nurse outweigh the cost benefits of an MA.

It can’t be argued that MAs are less expensive in salary than nurses. MAs hold a certificate that can be earned in an average of 40 weeks, and there are no specific license or education criteria required in most states. There are only a handful of states that have state certification exams and registration in similar manner to that of other healthcare professionals. In general, the MA must work under the direct supervision of a physician, and only perform tasks that they have been specifically trained to perform. In most states, an MA can perform routine tasks and procedures such as measuring patients' vital signs, recording information in medical records-keeping systems, preparing and handling medical instruments and supplies, preparing specimens of bodily fluids and tissues for laboratory testing, and all of the administrative duties associated with a medical office. The line is typically drawn at administering medications, giving injections, educating patients on test results, medications, and disease processes, although there are a handful of states that allow those duties with extra certifications.

So why would you hire an RN for a higher salary? Well, that depends on your practice. There are a few good reasons to hire an RN.

1. If you do any sort of procedures in office, be it cosmetic procedures or traditional family practice minor procedures. RNs are of benefit because they can do more than an MA (in most states) to assist you and free you up to be seeing other patients simultaneously. RNs can also see patients for follow up of these procedures, report findings to you, and let you know if there are post-procedure reasons to see the patient.

2. If you have multiple MAs in your clinic, then a clinician with a higher license (RN or LPN/VN) level is needed to write policies and procedures and supervise the MA staff. The RN can directly supervise the MAs instead of having the physician stop the flow of clinic to supervise.

3. If you have a busy telephone triage situation in your office where your patients call frequently with in depth questions, an RN can take most of that off of your hands, simply from their more in-depth knowledge base, and legal ability to teach patients about disease processes and discuss test results. An MA legally should consult with the physician and give verbatim responses to patient questions regarding symptoms, disease process, and medication interactions.

4. If you are a single physician practice seeing 45 or more patients per day, an RN will be more in line with your needs, as they can help take patient load off your hands as well.

There are some benefits to hiring only MAs. Unlike RNs they have not suffered a shortage in recent years. Ideally they are trained to specifically work in a physician office, whereas most RN training is hospital focused. Typically the deciding factor is that an MA can be hired for about one third to one half the annual salary of an MA.

There are times when having one MA on your staff is sufficient. An excellent rule of thumb is if you are a single physician practice, seeing 25 or fewer patients in a day, you should have the time to manage your practice with the assistance of an MA.

The bottom line is when it comes to hiring an MA or an RN or anything in between, working together in a clinic environment is something similar to a marriage, and you must work together to provide the best care for your patients in a timely and profitable manner for your business.

Audrey "Christie" McLaughlin, RN, runs NTX Medical Sales & Service, a sales and consulting firm that specializes in the business of medicine. She has over 12 years experience in helping physicians and hospitals provide the best medical care while growing their revenue and keeping down costs. E-mail her here.