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The Role of the Medical Assistant in Your Office Practice

By Debbie Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company

thedoctors.com

Amedical assistant (MA) can be a versatile and valuable addition to your office practice. If used effectively, an MA can improve workflow, increase patient satisfaction, and reduce physician burnout. An MA can manage front-office functions and handle some clinical duties. However, relying on an MA to perform tasks outside the scope of practice can place both you and your patients at risk. Over-delegation of tasks can compromise patient safety, resulting in adverse outcomes and claims.

Know Your MA’s Scope of Practice

The MA’s scope of practice varies by state, and regulations may include very specific lists of approved and unapproved activities, while some states do not address scope of prac tice at all. The MA generally works under the license of the supervising physician.

Be aware that different states allow MAs to perform varying clinical functions, so always check state regulations.

Use specific protocols, orders, and directions so that the MA knows how to perform approved functions and all MAs in your office perform duties consistently.

Consult your state licensing board or your patient safety risk manager if you have questions about scope of practice.

Telephone Triage

Only physicians or qualified licensed staff, such as registered nurses, nurse practitioners, or physician assistants, should provide telephone advice. Written protocols and standing orders must be used by the office staff and should include instructions on standard questions to ask the caller, recom mended responses for minor problems, and which calls to refer immediately to a physician.

Differentiate the MA’s Tasks

The MA cannot make independent medical assessments, triage, prescribe, renew prescriptions, or give any type of medical advice—even if asked.

Caution your MA about expressing opinions to patients, even if asked during a casual conversation. The MA should refer the patient’s concerns to the physician.

The MA can convey basic clinical information on behalf of the physician and follow established clinical protocols when speaking with patients when the information conveyed does not require independent medical judgment, assess ment, or advice from the MA.

Do not refer to your MA as “nurse” and caution office staff against doing so. The term nurse implies advanced educa tion and licensure and, if used inappropriately, could result in professional board investigations and prosecution. All staff members should wear nametags that designate their professional titles, and MAs should be instructed to correct patients who refer to them as “nurse.”

(CONTINUED ON PAGE 26)

thedoctors.com

Adequate MA Training and Oversight

Delineate the MA’s responsibilities in a written job description and provide comprehensive onboarding for each new MA.

Review each new MA’s educational curriculum and work experience carefully. Assess and document the skill level and core knowledge of each MA that you supervise, and incorporate checklists, hands-on demonstrations, and written tests as they relate to specific job duties within your medical specialty. This should be done when each MA is hired and repeated periodically as needed. Provide and document additional training for any areas of deficiency or newly acquired skills. Maintain all records in administrative files.

Provide in-depth training and monitor adherence to medical record documentation protocols to ensure quality and consistency across the practice and that all medical records are complete.

Provide training on patient relations and communications as the MA-patient interface significantly affects patient satisfaction within your practice.

Introduce MAs to the concept of safety culture and how it is prioritized within your practice.

Incorporate team training (e.g., TeamSTEPPS®) and emphasize the important role of the MA as a member of a highly effective team.

Provide direct supervision until the MA demonstrates the required level of competency.

Periodically assess and provide feedback on the quality of the MA’s work.

Make Practice Improvements

Ask your MA to pursue certification (e.g., American Association of Medical Assistants), and provide access to continuing education resources.

Provide periodic in-service training and ongoing skills verification.

Create a culture of psychological safety in which the MA feels comfortable asking questions about job tasks or clinical duties and speaks up about patient safety concerns without fear of reprisal.

Do not ask the MA to perform any duties that run counter to the scope of practice within your state or that conflict with the written job description.

Complimentary Continuing Education

The Doctors Company offers complimentary on-demand courses that can help you reduce risk and improve safety. Some courses can also help office staff enhance patient relations, manage challenging patients, and improve teamwork communication. For a complete catalog visit the Education and CME page on our website at www.thedoctors.com/patient-safety/ education-and-cme/.

The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.

Reprinted with permission. ©2019 The Doctors Company (www.thedoctors.com).

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