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Chapter 1 Introduction to Medical Assisting
Terms in this set (26)
Healthcare is changing at a rapid rate. Advanced technology, implementation of cost-effective medicine, and the aging population are all factors that have caused growth in the healthcare services industry. As the healthcare services industry expands, the U.S. Department of Labor projects that medical assisting will be the fastest-growing occupation between 2008 and 2018. The growth in the number of physicians' group practices and other healthcare practices that use support personnel will in turn continue to drive up demand for medical assistants. Medical assisting is the perfect complement to this changing industry.perform a variety of duties that make them well-qualified to enter a variety of job openings in the healthcare industry. This chapter provides an introduction to the medical assisting profession. It will present a general description of your future duties, credentials, and needed training. Some basic facts about professional associations, organizations, and professional development related to medical assisting are also discussed. All of this will help you to enter your career as a medical assistant.
Responsibilities of the Medical Assistant
Your specific responsibilities as a medical assistant will probably depend on the location and size of the facility, as well as its medical specialties. Medical assistants work in an administrative, clinical, and/or laboratory capacity. As an administrative medical assistant, you may handle the payroll for the office staff (or supervise a payroll service), obtain equipment and supplies, and serve as the link between the physician and representatives of pharmaceutical and medical supply companies. As a clinical medical assistant, you will be the physician's right arm by maintaining an efficient office, preparing and maintaining medical records, assisting the physician during examinations, and keeping examination rooms in order. Your laboratory duties as a medical assistant may include performing basic laboratory tests and maintenance of laboratory equipment. In small practices, you may handle all duties. In larger practices, you may specialize in a particular duty. As a medical assistant grows in his or her profession, advanced duties may be required. The lists of duties are provided to help you better understand what you will be doing when you practice as a medical assistant.
Medical Assisting Organizations
A multitude of organizations guide the profession of medical assisting. These include professional associations such as the American Association of Medical Assistants (AAMA) and the American Medical Technologists (AMT), as well as accrediting and other organizations. As a future medical assistant, knowledge of these organizations will help you make critical decisions about your career.
Professional associations set high standards for quality and performance in a profession. They define the tasks and functions of an occupation, and they provide members with the opportunity to communicate and network with one another. They also present their goals to the profession and to the general public. Becoming a member of a professional association helps you achieve career goals and furthers the profession of medical assisting. Joining as a student is encouraged and some associations even offer discounted rates to students for a specified amount of time after graduation.
American Association of Medical Assistants
The seed of the idea for a national association of medical assistants—later to be called the American Association of Medical Assistants (AAMA)—was planted at the 1955 annual state convention of the Kansas Medical Assistants Society. The next year, at an American Medical Association (AMA) meeting, the AAMA was officially created. In 1978, the US Department of Health, Education, and Welfare declared medical assisting as an allied health profession.
The AAMA works to raise standards of medical assisting to a more professional level. It is the only professional association devoted exclusively to the medical assisting profession. Its creator and first president, Maxine Williams, had extensive experience in orchestrating medical assisting projects for the Kansas Medical Assistants Society. She also served as co-chair of the planning committee that formed the AAMA.
AAMA Occupational Analysis
In 1996, the AAMA formed a committee whose goal was to revise and update its standards for the accreditation of programs that teach medical assisting. The committee's findings were published in 1997 as the "AAMA Role Delineation Study: Occupational Analysis of the Medical Assistant Profession." The study included a new Role Delineation Chart that outlined the areas of competence to be mastered as an entry-level medical assistant. The Role Delineation Chart of the CMA (AAMA) was further updated in 2003 to include additional competencies. In 2009, it was updated again and was renamed the Occupational Analysis of the CMA (AAMA).
The Occupational Analysis provides the basis for medical assisting education and evaluation. Mastery of the areas of competence listed in the Occupational Analysis is required for all students in accredited medical assisting programs. The Occupational Analysis includes three areas of competence: administrative, clinical, and general. Each of these three areas is divided into two or more narrower areas, for a total of 10 specific areas of competence. Within each area, a bulleted list of statements describes the medical assistant's role.
According to the AAMA, the Occupational Analysis may be used to
Describe the field of medical assisting to other healthcare professionals.
Identify entry-level areas of competence for medical assistants.
Help practitioners assess their own current competence in the field.
Aid in the development of continuing education programs.
Prepare appropriate types of materials for home study.
Professional Support for CMAs (AAMA
When you become a member of the AAMA, you will have a large support group of active medical assistants. Membership benefits include
Professional publications, such as CMA Today.
A large variety of educational opportunities, such as chapter-sponsored seminars and workshops about the latest administrative, clinical, and management topics.
Local, state, and national activities that include professional networking and multiple continuing education opportunities.
Legislative monitoring to protect your right to practice as a medical assistant.
Access to the website at www.aama-ntl.org.
American Medical Technologists (AMT)
is a nonprofit certification agency and professional membership association representing over 45,000 individuals in allied healthcare. Established in 1939, AMT began a program to register medical assistants at accredited schools in the early 1970s. The AMT provides allied health professionals with professional certification services and membership programs to enhance their professional and personal growth. Upon certification, individuals automatically become members of AMT and start to receive benefits. You will read more about the benefits of joining a professional organization later in the chapter. The AMT provides many certifications, including the Registered Medical Assistant RMA (AMT) credential and the Certified Medical Assistant Specialist CMAS (AMT) credential.
Professional Support for RMAs (AMT)
The AMT offers many benefits for RMAs (AMT). These include
Membership in the AMT Institute for Education.
Group insurance programs—liability, health, and life.
State chapter activities.
Legal representation in health legislative matters.
Annual meetings and educational seminars.
Access to the website at www.amt1.com.
Other Medical Assisting Organizations
In addition to the AAMA, which provides the CMA credential, and the AMT, which provides the RMA and CMAS credentials, many organizations provide certification testing and medical assisting credentials. Specific information about medical assisting credentials is discussed later in this chapter.
National Healthcareer Association (NHA)
This organization was established in 1989 as an information resource and network for today's active healthcare professionals. NHA provides certification and continuing education services for healthcare professionals and curriculum development for educational institutions. They offer a variety of certification exams, including Billing and Coding Specialist (CBCS), Medical Administrative Assistant (CMAA), and Clinical Medical Assistant (CCMA). Some of the NHA's programs and services include:
Certification development and implementation.
Continuing education curriculum development and implementation.
Program development for unions, hospitals, and schools.
Educational, career advancement, and networking services for members.
Registry of certified professionals.
Healthcare educators working in their various fields of study develop the National Healthcare Association certification exams. The NHA is a member of The National Organization of Competency Assurance (NOCA)
National Center for Competency Testing (NCCT)
This is an independent agency that certifies the validity of competency and knowledge of the medical profession through examination. Medical assistants and medical office assistants receive the designation of National Certified Medical Assistant (NCMA) and National Certified Medical Office Assistant (NCMOA) after passing the certification examination. The NCCT avoids any allegiance to a specific organization or association.
The National Association for Health Professionals (NAHP)
NAHP (www.nahpusa.com) offers multiple credentials for healthcare professionals. The organization, which has been in existence for 30 years, prides itself in making the process of obtaining a credential an accessible, affordable, and obtainable goal for those individuals who wish to show commitment to their chosen profession. Having multiple credentials with one agency makes maintaining continuing education easier for practicing healthcare professionals. The NAHP offers many credentials, including the Medical Assistant, Phlebotomy Technician, EKG Technician, Coding Specialist, Administrative Health Assistant, Patient Care Technician, Dental Assistant, Pharmacy Technician, and Surgical Technician credentials.
confirmation by an organization that an individual is qualified to perform a job to professional standards. Registration is the granting of a title or license by a board that gives permission to practice in a chosen profession. Once credentialed, you earn the right to wear a pin that is obtained through the credentialing organization.
Medical assisting credentials such as certification and registration are not always required to practice as a medical assistant. However, employers today are aggressively recruiting medical assistants who are credentialed in their field. Small physician practices are being consolidated or merged into larger providers of healthcare, such as hospitals, to decrease operating expenses. Human resource directors of these larger organizations place great importance on professional credentials for their employees.
An accredited medical assisting program is competency based; this means that standards are set by an accrediting body for administrative and clinical competencies. Accrediting bodies are discussed later in this chapter. It is the educational institution's duty to ensure that medical assisting students learn all medical assisting competencies and that evidence is clearly documented for each student. Periodic evaluations are performed by the accrediting agencies to ensure the effectiveness of the program.
Competencies and proficiency assessments are parts of the CMA (AAMA) examination. For example, administering medications is a competency required of accredited medical assisting programs and is a component of the CMA (AAMA) examination. The CMA (AAMA) credential and the affiliation with a professional organization demonstrate competence and provide evidence of training. They also lessen the likelihood of a legal challenge to the quality of a medical assistant's work. Basically, there is less chance of malpractice if employees are credentialed through either AAMA or RMA. School accreditation and credentials will be discussed in more detail later in this chapter.
State and Federal Regulations
Certain provisions of the Occupational Safety and Health Administration (OSHA) and the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) are making mandatory credentialing for medical assistants a logical step in the hiring process. These two (OSHA and CLIA '88) regulate healthcare but presently do not require that medical assistants be credentialed. However, various components of these statutes and their regulations can be met by demonstrating that medical assistants in a clinical setting are certified. For example, some physician offices perform moderately complex laboratory testing on-site. The medical assistant can perform moderately complex tests if she or he has the appropriate training and skills.
credential is awarded by the Certifying Board of the AAMA. The AAMA's certification examination evaluates mastery of medical assisting competencies based on the Occupational Analysis of the CMA (AAMA), which is available at www.aama-ntl.org/resources/library/OA.pdf. The National Board of Medical Examiners (NBME) also provides technical assistance in developing the tests.
CMAs (AAMA) must recertify the CMA (AAMA) credential every 5 years. To be recertified as a CMA (AAMA), 60 contact hours must be accumulated during the 5-year period: 10 in the administrative area, 10 in the clinical area, and 10 in the general area, with 30 additional hours in any of the three categories. In addition, 30 of these contact hours must be from an approved AAMA program. The AAMA also requires you to hold a current CPR card.
The recertification mandate requires you to learn about new medical developments through education courses or participation in an examination. Hundreds of continuing education courses are sponsored by local, state, and national AAMA groups. The AAMA also offers self-study courses through its continuing education department.
As of June 1998, only completing students of medical assisting programs accredited by CAAHEP and ABHES are eligible to take the certification examination. The AAMA offers the Candidate's Guide to the Certification Examination to help applicants prepare for the examination. This guide explains the test format and test-taking strategies. It also includes a sample examination with answers and information about study references. Some schools have also incorporated test preparation reviews into their programs. They do this because the credentialing agencies require a certain percentage of students to pass the program in order for the schools to keep their accreditation.
As of January 2009, the CMA (AAMA) examination is computerized. These computerized tests may be taken any time at a designated testing site in your area. You may search the Internet for an application and test review materials. Once you have successfully passed the CMA (AAMA) examination, you have earned the right to add that credential to your name, such as Miguel A. Perez, CMA (AAMA).
The American Medical Technologists (AMT) organization credentials medical assistants as Registered Medical Assistants (RMA) or Certified Medical Assistant Specialists (CMAS). Although this section focuses on the RMA credential, you can find more about the CMAS credential on the AMT website at www.amt1.org.
The AMT sets forth both educational and experiential requirements to earn the RMA (AMT) credential. These include
Graduation from a medical assistant program that is accredited by ABHES or CAAHEP, or is accredited by a regional accrediting commission, by a national accrediting organization approved by the U.S. Department of Education, or by a formal medical services training program of the U.S. Armed Forces.
Alternatively, employment in the medical assisting profession for a minimum of 5 years, no more than 2 years of which may have been as an instructor in the postsecondary medical assistant program.
Passing the AMT examination for RMA (AMT) certification.
RMAs (AMT) must accumulate 30 contact hours for continuing education units (CEU) every 3 years if they were certified after 2006. RMAs (AMT) who were certified before this date are expected to keep abreast of all the changes and practices in their field through educational programs, workshops, or seminars. However, there are no specific continuing education requirements. Once a medical assistant has passed the AMT exam, she has earned the right to add RMA (AMT) to her name: Kaylyn R. Haddix, RMA (AMT).
The RMA (AMT) and CMA (AAMA) Examinations
The RMA (AMT) and CMA (AAMA) qualifying examinations are rigorous. Participation in an accredited program will help you learn what you need to know. The examinations cover several distinct areas of knowledge, including
General medical knowledge, including terminology, anatomy, physiology, behavioral science, medical law, and ethics.
Administrative knowledge, including medical records management, collections, insurance processing, and the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a set of government regulations that help ensure continuity and privacy of healthcare, among other things.
Clinical knowledge, including examination room techniques, medication preparation and administration, pharmacology, and specimen collection.
Each certification examination is based on a specific content outline created by the certifying organization. You should research the Internet to gain additional information regarding any of these certifications. Obtaining Certification/Registration Information through the Internet.
With the emergence of formal training programs for medical assistants and the continuous changes in healthcare today, the role of the medical assistant has become dynamic and wide ranging. These changes have raised the expectations for medical assistants. The knowledge base of the modern medical assistant includes
Administrative and clinical skills.
Patient insurance product knowledge (specific to the workers' geographic locations).
Compliance with healthcare-regulating organizations.
Exceptional customer service.
Current patient treatments and education.
The medical assisting profession requires a commitment to self-directed, lifelong learning. Healthcare is changing rapidly because of new technology, new healthcare delivery systems, and new approaches to facilitating cost-efficient, high-quality healthcare. A medical assistant who can adapt to change and is continually learning will be in high demand.
Formal programs in medical assisting are offered in a variety of educational settings, including vocational-technical high schools, postsecondary vocational schools, community and junior colleges, and 4-year colleges and universities. Vocational school programs usually last 9 months to 1 year and award a certificate or diploma. Community and junior college programs are usually 2-year associate's degree programs. Training can be obtained through traditional classroom as well as online settings.
Accreditation is the process by which programs are officially authorized. The U.S. Department of Education recognizes two national entities that accredit medical assisting educational programs:
Commission on Accreditation of Allied Health Education Programs (CAAHEP). CAAHEP works directly with the Medical Assisting Educational Review Board (MAERB) of Medical Assistants Endowments to ensure that all accredited schools provide a competency-based education. CAAHEP accredits medical assisting programs in both public and private postsecondary institutions throughout the United States that prepare individuals for entry into the medical assisting profession.
Accrediting Bureau of Health Education Schools (ABHES). ABHES accredits private postsecondary institutions and programs that prepare individuals for entry into the medical assisting profession.
Accredited programs must cover the following topics:
Anatomy and physiology
Medical law and ethics
Oral and written communications
Clinical and administrative procedures
High school students may prepare for these courses by studying mathematics, health, biology, keyboarding, office skills, bookkeeping, and information technology. You may obtain current information about accreditation standards for medical assisting programs from the AAMA.
Medical assisting programs must also include a practicum (externship) or work experience. This applied training is for a specified length of time in an ambulatory care setting, such as a physician's office, hospital, or other healthcare facility. Additionally, the AAMA lists its minimum standards for accredited programs. This list of standards ensures that all personnel—administrators and faculty alike—are qualified to perform their jobs. These standards also ensure that financial and physical resources are available at accredited programs.
Graduation from an accredited program helps your career in three ways. First, it shows that you have completed a program that meets nationally accepted standards. Second, it provides recognition of your education by professional peers. Third, it makes you eligible for registration or certification. Students who graduate from an ABHES- or CAAHEP-accredited medical assisting program are eligible to take the CMA (AAMA) or RMA (AMT) immediately.
Your practicum (externship) or work experience is mandatory in accredited schools. The length of your experience will vary, depending on your particular program, so familiarize yourself with the program requirements as soon as possible. Since this is a mandatory part of the program, no matter how good your grades are in class, if the work experience is not completed, you will not graduate from the program.
Your practicum (externship) or work experience is an extension of your classroom learning experience. You will apply skills learned in the classroom in an actual medical office or other healthcare facility. You also earn the right to include this applied training experience on your résumé under job experience, as long as you title it as "Medical Assistant Practicum, Externship, or Work Experience." The Preparing for the World of Work chapter will further explain your practical work experience.
refers to skills and knowledge attained for both personal development and career advancement. During your training, you should strive to improve your knowledge and skills. This will help you transition into your first job with ease. You can also gain valuable knowledge and skills through volunteering prior to or in addition to work experience obtained as a student.
Once you have entered the world of work as a medical assistant, you will want to continue to develop in your profession. This can be done by gaining more knowledge and skills through additional training, cross-training, and/or other forms of continuing education. During your training and practice as a medical assistant, you must know and work within your scope of practice and network to improve yourself professionally.
Volunteering is a rewarding experience. Before you even begin a medical assisting program, you can gain experience in a healthcare profession through volunteer work. As a volunteer, you will get hands-on training and learn what it is like to assist patients who are ill, disabled, or frightened.
You may volunteer as an aide in a hospital, clinic, nursing home, or doctor's office, or as a typist or filing clerk in a medical office or medical record room. Some visiting nurse associations and hospices (home-like medical settings that provide medical care and emotional support to terminally ill patients and their families) also offer volunteer opportunities. These experiences may help you decide if you want to pursue a career as a medical assistant.
The American Red Cross also offers volunteer opportunities for student medical assistants. The Red Cross needs volunteers for its disaster relief programs locally, statewide, nationally, and abroad. As part of a disaster relief team at the site of a hurricane, tornado, storm, flood, earthquake, or fire, volunteers learn first-aid and emergency triage skills. Red Cross volunteers gain valuable work experience that may help them obtain a job.
Because volunteers are not paid, it is usually easy to find work opportunities. Just because you are not paid for volunteer work, however, does not mean the experience is not useful for meeting your career goals.
Include information about any volunteer work on your résumé—a computer-generated document that summarizes your employment and educational history. Be sure to note specific duties, responsibilities, and skills you developed during the volunteer experience. Refer to the Preparing for the World of Work chapter for examples of résumés.
Continuing education and training are essential to your career as a medical assistant. As discussed earlier, continuing education is mandatory for maintaining your certification or registration. In addition, you may want to become multiskilled. Many hospitals and healthcare practices are embracing the idea of a multiskilled healthcare professional (MSHP). An MSHP is a cross-trained team member who is able to handle many different duties. Reducing Healthcare Costs As a result of healthcare reform and downsizing (a reduction in the number of staff members) to control the rising cost of healthcare, medical practices are eager to reduce personnel costs by hiring multiskilled health professionals. These individuals, who perform the functions of two or more people, are the most cost-efficient employees.
Expanding Your Career Opportunities Career opportunities are vast if you are self-motivated and willing to learn new skills. If you continue to learn about new administrative techniques and procedures, you will be an important part of the healthcare team.
Following are some examples of positions for medical assistants with additional experience and certifications:
Medical Office Manager
Medical Assisting Instructor (with a specified amount of experience and education)
Patient Care Technician
Medical Biller and Coder
If you are multiskilled, you will have an advantage when job hunting. Employers are eager to hire multiskilled medical assistants and may even create positions for them.
You can gain multiskill training by showing initiative and a willingness to learn every aspect of the medical facility in which you are working. When you begin working in a medical facility, establish goals regarding your career path and discuss them with your immediate supervisor. Indicate to your supervisor that you would like cross-training in every aspect of the medical facility. Begin in the department in which you are currently working and branch out to other departments once you master the skills needed for your current position. This will demonstrate a commitment to your profession and a strong work ethic. Cross-training is a valuable marketing tool to include on your résumé.
Scope of Practice
Professional development includes knowing your scope of practice and working within it. Medical assistants are not "licensed" healthcare professionals and most often work under a licensed healthcare provider, such as a nurse practitioner or physician. Licensed healthcare professionals may delegate certain duties to a medical assistant, providing she or he has had the appropriate training through an accredited medical assisting program or through on-the-job training provided by the medical facility or physician. Questions often arise regarding the kinds of duties a medical assistant can perform. There is no universal answer to these questions. There is no single national definition of a medical assistant's scope of practice. So, the medical assistant must research the state in which he or she works to learn about the scope of practice. In general, a medical assistant may not perform procedures for which he or she was not educated or trained. The AAMA and AMT are good resources to assist you in your research. The AAMA Occupational Analysis is also a helpful reference source that identifies the procedures that medical assistants are educated to perform.
Networking is building alliances—socially and professionally. It starts long before your job search. By attending professional association meetings, conferences, or other functions, medical assistants generate opportunities for employment and personal and professional growth. Networking, through continuing education conferences throughout your career, keeps the doors open to employment advancement.
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