What exactly is a "Medical Assistant"?

Discussion in 'Off The Beaten Track' started by dupa, Jan 25, 2011.

  1. BigB08822

    BigB08822 Well-Known Member

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    Why do you think all nurses are going to be nice because you experienced a nice nurse before? That was a person and he or she was nice and just so happened to be a nurse. You could run into another nice person who happens to be an MA as well.
  2. PDilemma

    PDilemma Well-Known Member

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    I was at the doctor a week ago. The MA who was actually not quite an MA yet--doing her internship--was very nice. She did my vitals and history and took blood. She did a great job--and I was asked how she did since she's training. There is a nurse (LPN) at my doctor's office, on the other hand, who is and always has been quite prickly. I assume these are personality traits of the people in question, not reflections of their training or qualifications.

    Meeting one MA and deciding they are all bad based on that person's demeanor seems very unfair.
    Last edited: Jan 25, 2011
  3. emason

    emason Well-Known Member

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    Sorry, but any ol' body cannot do it. The MA at my doctor's office is fabulous; for instance, she is the only one who can draw blood from me who can find a decent vein in under ten minutes. I've been to clinics where the help dithers around for half an hour before anyone gets anywhere and I've been to the hospital where I ran through 3 doctors in 20 minutes before anybody could draw blood successfully. Elizabeth at the doctor's office nails it every time in about 60 seconds flat.
  4. Buzz

    Buzz Well-Known Member

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    Not too long ago you only needed as little as two years of training before calling yourself a nurse and one year before becoming a registered practical nurse. Now that has changed and nurses can study for four years or more now before becoming qualified nurse. An RPN (that what we call the job here in Canada) study for two years while support workers or healthcare aides study for about nine months, up from as little three months a few years ago. Nurses are also in high demand and smaller offices and towns have problems finding nurses to fill certain positions. Maybe that has changed now with the downturn but increasing training and scope of responsibility for healthcare aides helps to alleviate some of the problems caused by increasing health care costs and staff shortages. There are also nurses who are able to prescribe drugs. The job descriptions for each of the above positions have radically changed over the years and so must our perception of what people in those positions are capable of doing.
  5. 1lutz2klutz

    1lutz2klutz New Member

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    Nurse Practitioners have a master's degree in nursing and can work independently in clinics. They have a certain range of medications that they can prescribe including anti-biotics and some pain killers. You can often find Nurse Practitioners in places like Minute Clinics. My sister is an NP in Neurology and specializes in Parkinson's disease and movement disorders.

    A Physician's Assistant also has a master's degree and can perform similar duties to an NP BUT a PA must always be working under the direction of the MD. An NP actually has more freedom to practice independently than a PA does.
  6. mkats

    mkats New Member

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    dupa, honestly, as an MA I'm kind of insulted that because you met one of us who's mean, apparently we seem to all make life difficult for you. Generalizing much?

    No, I'm not an nurse, but I did undergo a good deal of training to get my MA certificate. I have a bachelor's degree in biology from Duke, spent countless hours volunteering in a hospital, and am in the process of applying to graduate school. I have given hundreds of shots and had a grand total of zero complications. Last week I gave a PPD to a lady who said it was the least painful one she'd had in 30 years. With the exception of once, I have never had to go beyond one stick to get blood. Every single day, every single patient, I make sure I give the best possible care.

    I know my patients by name and their histories and what sports teams they support. I make sure to welcome new patients and tell people happy birthday if they're unlucky enough to be here on their birthdays. When patients call, they ask for me by name because I do a damn good job and they know it.

    So yeah, I guess I'm just some ol'body out there. And I can say with 100% honesty that the two MAs I work with give it just as much effort.

    Did it ever occur to you that maybe you just hit one bad egg?

    :rolleyes:
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  7. bardtoob

    bardtoob Well-Known Member

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    You are precisely the type of person to which I was referring, and there is a lot of opportunity to advance within healthcare beyond the simple tracks of either being a physician or a nurse.

    However, I will say there are very respectable people that will end their careers as MAs, and they will have found their careers to have been very satisfying. They, along with their Nursing Assistant counterparts in Acute Care and Skilled Nursing facilities and Home Health Aides, do a lot of the day to day care of patients as the profession of nursing moves towards care planning/prioritizing, interventions, and advanced clinical skills.
    Last edited: Jan 26, 2011
  8. ArtisticFan

    ArtisticFan Well-Known Member

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    The technical college I work at has a very popular medical assisting program, as well as a certified nursing assistant program. The medical assisting program is much more stringent and there is a waiting list a mile long to get into the doors to even take the placement tests.

    There is often a discussion about the lack of nurses and other healthcare professionals, but there is also a lack of qualified and good healthcare teachers. A good nurse does not necessarily make a good teacher and vice versa.
  9. BaileyCatts

    BaileyCatts Well-Known Member

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    Kinda of off topic .... so a Medical Assistant actually does more than work the front desk/office management then? I was thinking of applying for some medical assistant jobs because the descriptions all describe office management/desk work/administrative tasks, but not doing medical tasks (which I have no training for). I'm a secretary, so probably not a good idea to apply for "medical assistant" jobs then?
  10. Buzz

    Buzz Well-Known Member

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    You could work for a doctor or in a medical setting as medical secretary. I have seen jobs in the health care field that are purely clerical. There was a position in a hospital near me for a full time person to deal with the menu and patient meal orders etc. (I hope I remember that right. LOL ) But yeah if you want to be a medical assistant you will need additional training.
  11. mkats

    mkats New Member

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    BaileyCatts - I don't do any front desk work at all; we have 3 MAs and we all work purely in clinical. I think the main job of MAs is usually in the back but may include a little front work if the days are slow.
  12. numbers123

    numbers123 Well-Known Member

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    IIRC you are a PA? right? As an RN, I find your digs at a "highly paid expensive RN" rather :huh:. There are things that an "expensive nurse" can do that a CMA doesn't. My physician's office employs: PA, RN, LPN, CMA. In my state physicians often look down the noses at APRNs because of the medical vs. nursing models of practice.

    The CMA does a good job of vital signs and blood draws. But she does not have the nursing background to recognize drug interactions, know the right questions to ask about dosages . The RN does the ECGs, blood draws from PICC, infuses drugs via the PICC, etc. The PA sees patients with routine illnesses, the physician does all the major illness management, complicated illnesses. The RN also gets reports from the hospitalist, schedules any diagnoistic studies, etc. The RN calls with normal and abnormal lab reports and what the dr. wants to do. The RN will call prescriptions into the pharmacy per physician orders. The medical secretary does scheduling, reminder calls, directs phone calls to the appropriate care provider, etc.
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  13. dupa

    dupa Home Sweet Home

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    Who's generalizing?



    Yes it did, which is why I asked the question in the first place. Defensive much?
  14. indicatoto101

    indicatoto101 New Member

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    I've been to appointments at various clinics and didn't care if I was serviced by an MA or nurse. In fact, I couldn't even tell the difference. From my point of view, I don't care how much education someone has in doing vitals and taking medical hx since more direct experience will offset knowledge. Really, why pay more for the same service?
  15. bardtoob

    bardtoob Well-Known Member

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    There is no dig. Keep in mind that IceAlisa lives in an area where RNs receive, due to high demand and low supply, some of the highest pay anywhere in the US and about double to triple the pay of an MA in that area, and, based on your quote of her post, she is facetiously saying that Dupa thinks only a Nurse Practitioner (NP) is qualified to take vital signs in a clinic, which is silly since nobody needs to have a Master's Degree and years of ICU, ER, or OR experience to take a blood pressure in a clinic. In fact, it is a waste of resources that are in low supply.

    And, of course, Cardiac Monitoring in a clinical setting, IV Meds, PICC Line access, etc. are things an RN should be handling, not only because those are so complex and/or invasive, but because any patient that needs those things is or has been very ill and, therefore, has a complex clinical history that needs consideration.
    Last edited: Jan 27, 2011
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  16. genegri

    genegri Active Member

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    Aha, so that is what we met in Minute Clinic in Miami. I wondered about her! My dad had a sore throat while we were on vacation and we went to a Minute Clinic and this young girl saw him. I thought she was too young to be a doctor but didn't like to ask.

    After reading this thread, I bet she was an NP. Well, that particular girl was completely useless. But overall I can see the benefit of having an NP instead of a doctor when it comes to minor illness like a cold or a small infection.
  17. mkats

    mkats New Member

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    Uh, you?

    But by all means, if your poor little median cubital is too :drama: at the thought of being pricked by an MA, then by all means, let the MD know... just don't be surprised when he sends you right back to me. Or tells you to find a new doctor, which is probably what he'd do. ;)
    Last edited: Jan 27, 2011
  18. Kelli

    Kelli New Member

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    To add to this, NPs are licensed and regulated by the state Board of Nursing, so their scope of care is determined on a state-by-state basis. In New Hampshire, an NP can function fully independently, while other states require collaborating physicians. PAs always practice under a physician. As a huge generalization, NPs tend to focus more on primary care while PAs work in procedure based specialties like surgery or orthopedics. But that's also pretty dependent on location. In my area, there are more NPs than PAs. Most jobs are advertised as an NP job but say in the description a PA is acceptable as well. That's mostly due to the fact that we have a number of NP programs in the area and few or no PA programs.
  19. numbers123

    numbers123 Well-Known Member

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    According to this site, CMA average salaries, LPN in a clinic setting, RN in an Outpatient Clinic setting, nurse practitioner (APRN) - depends on speciality, PA salaries,

    The RN and LPN salaries reflect a wide range of what a Outpatient Clinic Nurse is defined as including a speciality clinic where the RN is the lead manager of several nursing employees. The CMA typically works in a physician's office and is managed by the physician. The nurses in an office setting that I know, earn less than that average because they trade salary for benefits of no weekends, no nights, no on-call status, weather days off, usually do not have health insurance benefits, etc.
  20. bardtoob

    bardtoob Well-Known Member

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    ^ Yeah, then IceAlisa was coming from a totally different perspective. These salary ranges are not at all applicable in her area. The cost of housing requires that the median salary be significantly higher than the national average.

    ETA: I just typed in my own zip code, and every one of these jobs has a salary range that is above the 90th percentile nationally.
    Last edited: Jan 27, 2011
  21. IceAlisa

    IceAlisa Port de bras!!!

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    If I quoted how much some experienced RN make around here, you'd :eek:
    http://news.everest.edu/post/2010/07/how-much-does-a-registered-nurse-make-in-california
    Last edited: Jan 27, 2011
  22. numbers123

    numbers123 Well-Known Member

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    but the question is - does the nurse in an office make that much. I would guess not. And many of those high end jobs are for speciality RNs, case managers, management, etc.
    I contend that the office nurse does not make anywhere close to that $38...something. Most office nurses I know make less than a school nurse (which is also a very low paying position). Last I checked here, the office nurse position that I applied for was $16.29 an hour and that was with 33+ years experience/no benefits. Starting wage was 15.45, but they would consider the $16.00 range because of experience and a master's degree.
    But I do get it, you and bard think nurses are too expensive to provide care to clients.
    By the way, what does a PA, MD make in your area?
  23. bardtoob

    bardtoob Well-Known Member

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    In California, non-management RNs in large healthcare systems are members of unions/professional organizations. When a healthcare system has both hospitals and clinics, the unions/professional organizations demand comparable pay for full-time clinic nurses as full-time hospital nurses. This sets the prevailing wage, which drives up salaries in general, including for RNs not represented by a union/professional organization. Keep in mind that the trade off of working in a clinic vs a hospital in large healthcare systems is the opportunity for on-call and overtime pay, as wells as a particular type of patient. Remember that some RNs choose their place of work based on the population. Some prefer ICU patients, which have a ratio of 2 patients:1 RN in California, while others prefer ER patients, NICU, etc.
    Last edited: Jan 27, 2011
  24. numbers123

    numbers123 Well-Known Member

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    :wall: Every nurse that I know has chosen the field that he/she would like to work in. That is not the issue here. i understand that CA nurses' union is very active. If you are going to generalize for the going wage, then I will give you the going rate for a annual physical. I just had mine, not part of a group, but the individual insurer has neogiated the same rates as a large PPO.
    The exam was $319.45. My private insurer neogiated the price to $292.18 for the exam, the pap smear, mammogram and lab procedures was another $350.00 negoiated down to 315. (give or take a few dollars and cents). For that amount of money, I do not think that it is unreasonable to ask for a nurse.
    And if you read the link provided, it was an educational institution's site. Do you think that they will list the minimum wage earned by a nurse in your state.
    Let's say for the purpose of this exercise, the doctor sees 20 clients who need an annual physicial each month. Just for that population there would be $144,000.00 revenue. And there would be illnesses, hospitalization follow-ups, etc. to increase revenue. I understand where dupa is coming from. But YMV a great deal.
    Didn't answer the question of PA or MD salaries in your area.
  25. bardtoob

    bardtoob Well-Known Member

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    I could not give you a reliable market analysis of the cost of an individual patient's healthcare without more criteria. However, I would include the cost of facilities, equipment, waste disposal, insurance, etc., in addition to the things you listed if I did do one, which could not pay for itself with 20 patients.

    . . . I know. Hard to believe. The standard of care is really high, which means cost is also really high.
    Last edited: Jan 27, 2011
  26. sailornyanko

    sailornyanko New Member

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    Lazy bums. Call me an oldschool doctor, but automatic machines that take BP are never as precise as an old fashion manual baumanometer. The machine just can't get those 5 different Kotkoroff beats only a trained ear can. In Mexico it's kind of the opposite how they treat doctors because MAs and PA don't exist. Kind of degrades me as a doctor to be harassed on the job to do menial tasks when the place is understaffed. :slinkaway
    Last edited: Feb 9, 2011
  27. sailornyanko

    sailornyanko New Member

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    Is that common in the US? I can understand why it would be important to know why someone is there THAT day if it's a simple thing like a diabetic that came to pick up his monthly presciption, but only a doctor is trained with the eye to ask the right questions. Taking a good medical history is one of the hardest things in medicine because asking the right question can direct you to the diagnosis. House's cases sometimes are very typical manifestations of a disease (like the episode where a guy got brucelosis by eating non pasteurized cheese), but by not making a good history they spend the whole episode running around in circles like idiots. :dog:
  28. IceAlisa

    IceAlisa Port de bras!!!

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    Umm, House is TV medicine. My husband and I find that show highly amusing abecause to how little it corresponds to reality.
  29. Mayra

    Mayra Well-Known Member

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    The hourly wage you mentioned above is more or less what a Medical Assistant gets paid here in Southern California. Certified Nursing Assistants can get paid anywhere from 9$ to $14(leaning more towards the lesser pay scale) an hour depending on experience, location and what area of healthcare you work in.

    I'd wager a guess that salaries in California are higher for everyone, not just Registered Nurses when compared to many parts of the country. Then again, you also have to factor in cost of living. For example IceAlisa is from the Bay Area. Need I say more? :lol:

    Mayra - an overpaid So Cal RN :rolleyes:
  30. Skittl1321

    Skittl1321 Well-Known Member

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    The people taking medical history are never the doctors, in my experience- the doctors ask questions based on what is written down in the medical history/complaints.

    When DH was air force and I had to go to military hospitals, they used a computerized symptom machine. I was explaining I had pains in my wrist, that were nerve pains due to my spinal cord injury. The tech (no idea what they actually were, but they were low level enlisted, which usually, but not always -don't flame me-, implies they did not get a bachelors degree) zeroed in on "wrist pain" and said that there was nothing to click that indicated spinal cord symptoms. I practically had to shout at them that I had broken my neck, and I KNEW it was spinal cord issues. He kept telling me I should go get my wrist x-rayed first to make sure it wasn't broken.

    It was SO frustrating.
    Last edited: Feb 9, 2011
  31. Twilight1

    Twilight1 Well-Known Member

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    This thread reminds me of phone calls I receive at work asking me if I have medical training on addiction. I am usually the one calling docs to get opiate protocol meds set up, explaining what Benzo loads are, walking them through basic withdrawal that they had a lecture on in school and obviously didn't pay attention to because they had to learn so many other things.

    I find it somewhat offensive that just because someone doesn't have a few letters (aka M.D or R.N.) behind their name, they don't know what they are doing. Many times, they are the one's explaining what it is that needs to be done for a patient to the doctor. Not knocking docs because they are so busy, and their are so many things they have to learn/ understand. But IMHO, it makes sense for them to lessen their burden on competent people whom specialize in their respective areas be it registered nurses, practical nurses, nursing aids, medical assistants etc.

    I LOVE that show, but the addiction storylines always drive me bonkers!! But I love Hugh Laurie and Omar Epps. :D
  32. IceAlisa

    IceAlisa Port de bras!!!

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    I have a crush on Hugh Laurie. (who doesn't) :shuffle:
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  33. Aceon6

    Aceon6 Get off my lawn

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    Late to the thread, but the MAs at the group practice we use do a lot more than vitals and histories. Each care team has a dedicated MA who actually gets to know the patients (imagine that!) When you call in for a same day appt, the MA records the symptoms and directs the call appropriately (not an easy task sometimes), and s/he also helps the NPs triage walk ins. I suspect those MAs make around $15/20 an hour.
  34. Prancer

    Prancer Ray Chill Staff Member

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    The way it commonly works is that new patients are given a pile of forms to fill out. Sometimes the MA will fill out the forms for the patient while asking the same questions, but the MA doesn't deviate from what is being asked. The MA will also ask why the patient is being seen for the specific visit, and will take vitals.

    The doctor will then grab the chart (or if the office is modern, it's all done on computer), look at why the patient is there and glance over the vitals, then come in and do an exam. During the course of the exam, the doctor will consult the medical history that has been supplied (if necessary) or will ask more questions (if necessary). If the doctor wants blood tests or some treatments, the MA will do them.

    At my current doctor's office, the MA is the one who calls with test results and other issues that may come up, and if I have questions about something, I will call her and she will get answers and get back to me.; she's the doctor-patient go-between. But my doctor has been known to pick up the phone and call me herself sometimes, too.
  35. Kelli

    Kelli New Member

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    Where I am now, the LPN does HPI (history of present illness), PMH (past medical history), meds and allergies. The NP reviews pertinent HPI and PMH and does the ROS (review of symptoms). The practice sees mostly injuries and no chronic diseases, so the mechanism of injury (HPI) and ROS (for example, numbness, tingling, etc in an injured limb) are the most important. It's very dependent on the site in which you are seen/practice, but there's nothing wrong with having lesser, but still well trained, individuals doing parts of the history.
  36. IceAlisa

    IceAlisa Port de bras!!!

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    Where I work ROS stands for Review Of Systems.
  37. nubka

    nubka Well-Known Member

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    I've never had a MA take my medical history. They take my blood pressure, temp, and ask me why I'm seeing the the doctor that day, but no history.
  38. Veronika

    Veronika gold dust woman

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    I was supposed to see an MD today, but she cancelled on me--I saw an NP instead, and it was fine. It's still better than the dismissive MDs at urgent care.

    I was very conscious of the fact that I was talking to an MA when I first got there, thanks to this thread. :lol:
  39. genevieve

    genevieve drinky typo pbp, closet hugger Staff Member

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    I never pay attention to who is taking my stats at the doctor's. I only get annoyed when I give someone a complete history, they leave, and the doctor comes in and asks me all the same questions :lol: But I have no idea if the previous person is an MA, a NP, an LPN, or some joe off the street with a lab coat. next time I go I should see if I can tell (I don't even recall if people wear tags that would identify their position).
  40. IceAlisa

    IceAlisa Port de bras!!!

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    I don't wear a lab coat or a tag. We've been recently given tags at one of the groups I am with but no one wears them. The pin would damage my clothes. :glamor: :drama: