What exactly is a "Medical Assistant"?

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

  1. IceAlisa

    IceAlisa Épaulement!!!

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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
  2. 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?
     
  3. 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
  4. 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.
     
  5. 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
  6. 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
  7. 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:
     
  8. IceAlisa

    IceAlisa Épaulement!!!

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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.
     
  9. 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:
     
  10. 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
  11. 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
     
  12. IceAlisa

    IceAlisa Épaulement!!!

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    I have a crush on Hugh Laurie. (who doesn't) :shuffle:
     
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  13. 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.
     
  14. Prancer

    Prancer The "specialness" that is 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.
     
  15. Kelli

    Kelli 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.
     
  16. IceAlisa

    IceAlisa Épaulement!!!

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    Where I work ROS stands for Review Of Systems.
     
  17. 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.
     
  18. 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:
     
  19. 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).
     
  20. IceAlisa

    IceAlisa Épaulement!!!

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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:
     
  21. Prancer

    Prancer The "specialness" that is Staff Member

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    The only times I have ever been misdiagnosed were at urgent care--where the doctors ask all the questions about my medical history :lol:.

    I hate going to urgent care. I wish my body would cooperate with me on that one and stop falling apart on Friday nights.
     
  22. IceAlisa

    IceAlisa Épaulement!!!

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    My last two visits to the ER were very specific and the diagnosis was a no-brainer. One was a textbook peritonsillar abscess (yuck) and the other, just over the weekend was a textbook otitis media. A first year medical student could have diagnosed that.

    You never want to be an "interesting" or "challenging" case.
     
  23. Wiery

    Wiery Well-Known Member

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    Very true!
     
  24. numbers123

    numbers123 Well-Known Member

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    IME most doctor's offices/clinic discourage the credentials listed on a name tag. In my internal doctor's office, there are no name tags worn - i just know what their credentials are because I ask. In my ENT office, I happened to have worked with a couple of the staff nurses so I know their credentials.
    The last time I was at my internal doctor's office, the CMA did measurements one of which was incorrect (the nurse came in to verify it as it was inconsistent with a measurement taken 5 weeks earlier). If you are doing a quick review of symptoms questionairne and quick measurements because you are sick - ok, go ahead.

    But when it comes to listing my medications with dosages and the frequency I prefer to talk to the RN. With my annual physical, I brought in the list of medications I am taking, the spelling, any otc medications and vitamins. The CMA was reading off the list from my chart. Which included an antibiotic that I had prescribed 3 months earlier, a solumedrol pack prescribed 3 months earlier and antibiotic ear drops prescribed 3 months earlier. When I said I wasn't taking those medications anymore, she said why not - the doctor will want to know why you quit taking them. Uh, they were prescribed for a specific illness and specific timeframe.
     
  25. Prancer

    Prancer The "specialness" that is Staff Member

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    I didn't think I was challenging at all. I had, after all, already diagnosed myself :p.

    Me: I have a lung infection.
    Doctor: Thank you for your input, Dr. Prancer. Now let's see what you really have. I would say you have a cold.
    Me: I have a lung infection. I have had at least six lung infections and I am positive this is a lung infection. Colds don't faze me at all; I don't even run a fever with a cold.
    Doctor: If you've had six lung infections, then you must not take very good care of yourself. What you have now is a cold, which is a virus, and there is nothing I can do for you. Go home--fluids, bedrest.

    I had a lung infection--which was very bad by Monday.

    Me: I have a rash that is spreading very quickly and it's itching horribly.
    Doctor: Wow, I've never seen anything like that before.
    Me: I think I need a steroid cream
    Doctor: Nah, it must be some kind of allergy. Put some Benadryl on it and wrap it in Saran wrap, so you don't rub it off.
    Me: I already tried Benadryl and it didn't help at all.
    Doctor: It will help if you use the Saran Wrap. Trust me.

    So I put Benadryl on it and wrapped it in Saran Wrap, and then on Monday went to the dermatologist, who was aghast at the Saran Wrap and gave me a whopping dose of steroids--shot, cream AND pills.

    I also think that Urgent Cares are staffed mostly by doctors who don't have sufficient social skills to have their own practices :shuffle:.

    I've had some very bad experiences in Urgent Cares.
     
  26. Aceon6

    Aceon6 Get off my lawn

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    We've had good luck with urgent care, but ours is staffed by MDs and NPs who are part of the regular practice teams within the medical group. Every MD and NP in the group does a rotation at least once a month. They have full access to the medical records, and will contact the PCPs or treating specialists if they need to. They use a "call first" system, so they actually call up your records before you come in and are ready to take you if you're really sick. It's really nice, but I realize that most folks don't have access to such large groups.
     
  27. Prancer

    Prancer The "specialness" that is Staff Member

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    I used to go to a practice that had an after hours urgent care. If you were a patient of the practice, they treated it like an office visit. That was REALLY nice while it lasted, but then the doctors had a fight and all of them left but one--and he was the one I just couldn't stand. I kept going to him for a while, but one day he told me my blood pressure was really high and I heard myself say "It's only high when I am seeing you."

    And I realized that was true and left.
     
  28. Kelli

    Kelli Member

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    It does where I work too, unless I'm not paying attention to what I type...
     
  29. IceAlisa

    IceAlisa Épaulement!!!

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    My guess is that urgent care docs wade through hundreds and hundreds of viral colds a day fighting off patients demanding antibiotics. So to them Prancer is the boy who cried wolf #146 but in her case she turned out to be right and there was a wolf. Not that it's a good excuse for not being more careful; and certainly it's not Prancer's fault that so many people go to the doctor with a cold asking for antibiotics.

    I've read that low levels of vitamin D are linked with frequent colds but am not sure where I saw this or how good the research was. May be I should try it.
     
  30. Debbie S

    Debbie S Well-Known Member

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    At my recent visit to the primary care doc, the medical asst measured my height and weight before I saw the doc. She informed me I was 4'9" - which was wrong unless I had suddenly shrunk a few inches. I told her it was 4'11" and she said she'd try again. So she pulls the measuring stick up and then says "Look". I stepped off and turned around and pointed out to her that it was on 59 1/2". She said "Right, four-nine." I explained to her that no, 60 inches would be 5 feet and 1/2 inch less is 4'11 and 1/2". She didn't even react and I'm quite certain she didn't change what she wrote down - why the feck she didn't just write the number of inches and leave it at that, I don't know.

    I told my doc about it, b/c I was so annoyed, but she didn't have the chart with the measurements with her so she couldn't check. And with everything she has to do and think about, she probably forgot what I said the minute she walked out of the room. So my med records are now incorrect b/c of a stupid med asst. Hopefully, the next time I'm there, I'll get someone who knows how many inches are in a foot. Or just writes down the inches w/o trying to convert them into feet.

    And at the end of my visit, the brilliant med asst came back into the room to give me my tetanus booster. Sorry if this offends anyone here, but I wasn't too thriled about having my arm stuck with a needle by someone who can't even do 2nd grade math. Not that I had a say. My arm hurt like hell afterward, which I don't remember after my last booster, but that was 10 years ago so I may have forgotten.
     
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