What exactly is a "Medical Assistant"?

[IceAlisa]

If I quoted how much some experienced RN make around here, you'd

California Averages

Statistics for California are even more detailed (although this local data is only available for 2008). They show that in the Golden State, the median income for registered nurses is $38.93 per hour, or $81,000 annually, approximately 25 percent higher than the national average. Registered nurses in the lowest tenth percentile currently earn about $27.40 per hour, or $57,000 annually (including many entry-level RNs), while those in the top tenth percentile earn about $55.54 per hour, or $115,500 annually.

(Naturally, what you earn will depend on many factors, including your education, experience, professionalism, work attitude, local market conditions, place of employment and own hard work.)

http://news.everest.edu/post/2010/07...-in-california

[numbers123]

If I quoted how much some experienced RN make around here, you'd

http://news.everest.edu/post/2010/07...-in-california

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?

[bardtoob]

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.

[numbers123]

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 also 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.

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.

[bardtoob]

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.

[sailornyanko]

As a matter of fact BPs are taken by machines these days, operated by nurses or MAs as the case may be. I don't understand the need for an overqualified individual to perform rather simple tasks.

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.

[sailornyanko]

It doesn't take years of clinicals to learn how to take vitals and a medical history, which is pretty much what MAs do.

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.

[IceAlisa]

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

[Mayra]

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.

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?

Mayra - an overpaid So Cal RN

[Skittl1321]

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.

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.

[Twilight1]

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.

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

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

[IceAlisa]

I have a crush on Hugh Laurie. (who doesn't)

[Aceon6]

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.

[Prancer]

Is that common in the US?

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.

[Kelli]

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.

[IceAlisa]

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.

Where I work ROS stands for Review Of Systems.

[nubka]

It doesn't take years of clinicals to learn how to take vitals and a medical history, which is pretty much what MAs do

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.

[Veronika]

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.

[genevieve]

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 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).

[IceAlisa]

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.