Medical assistant

Medical assistants can be licensed or unlicensed health care workers who perform the administrative and clinical tasks that keep the offices of physicians, podiatrists, chiropractors, and other health practitioners running smoothly. They should not be confused with physician assistants, who examine, diagnose, and treat patients under the supervision of a physician. The term "Medical Assistant" may have legal status in some nations, whereas elsewhere they may be a loosely defined group.

Summary
Historically, medical assistants in the United States were trained-on-the-job medical support staff without a specific group identity. With encouragement and support from the American Medical Association (AMA), the American Association of Medical Assistants (AAMA) was founded in 1956.

Medical assistants have traditionally held jobs almost exclusively in ambulatory care centers, urgent care facilities, and physicians’ clinics, but this is now changing. Medical assistants now find employment in both private and public hospitals, as well as inpatient and outpatient facilities. They assist a wide variety of medical doctors, including specialists such as podiatrists, and are no longer bound as generalists.

Medical assistant duties vary from office to office, depending on the location and size of the practice, and the practitioner’s specialty. In small practices, medical assistants are usually generalists handling both administrative and clinical duties, and reporting directly to an office manager, physician, or other health practitioner. Those in large practices tend to specialize in a particular area, under the supervision of department administrators.

Education
Formal education of medical assistants usually occurs in vocational schools, technical institutes, community colleges, proprietary colleges, online educational programs or junior colleges. The curriculum presented should be accredited if its graduates plan to become either certified or registered. In 2005 there were 500 medical assisting programs accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and about 170 accredited by the Accrediting Bureau of Health Education School (ABHES). Accreditation by CAAHEP, ABHES or other accreditation associations usually requires that the schools curriculum provide sufficient classroom, lecture, and laboratory time.

Certification and registration
Certification is a voluntary process which is strongly backed by the AAMA and a number of other well-respected certification bodies in the United States as a way to guarantee competency of a medical assistant at a job-entry level. Certification is usually achieved by taking a test, issued by the National Board of Medical Examiners and AAMA,and offered three times a year in January, June, and October, at over 200 different test sites across the United States.

Successful completion of the exam earns the taker the proper credentials to become a Certified Medical Assistant, or CMA. National certification is legally required in order for any medical assistant to adhere to CMA status. The title CMA then follows postnominally.

A medical assistant may choose another possible credential over CMA, and become a Registered Medical Assistant (RMA) instead. Again, credentialing is completely voluntary. The American Technologists (AMT) agency is responsible for certifying MAs who choose this course.

AMT first began offering this certification in 1972 on the months of June and November, through a computerized exam, much like the one offered by the AAMA. AMT therefore has its own conventions and committees, bylaws, state chapters, officers, registrations, and revalidation examinations. To become eligible to hold the title of RMA a student must be at least 18-years-old and either pass a medical assisting curriculum at a school accredited by either ABHES or CAAHEP, or possess a minimum of 5 years experience. The initials RMA then follow the individual’s name.

RMAs have historically been very active in legislation, seeking protection for medical assistants, as well as continuously encouraging improved educational curricula.

Scope of practice
As medical assistants are not licensed professionals they are always required by law to work under the direct supervision of a licensed health care provider such as a physician, registered nurse, nurse practitioner or physician assistant whenever they provide direct (hands-on) patient care procedures.

In several states unlicensed health care providers, including medical assistants, are required to have an authorization by the state in which they reside to perform needle injections; such as allergy testing, purified protein derivative (PPD) or Mantoux skin tests, and venipuncture. Some states require that medical assistants who draw blood for lab tests are certified, and have passed a practical examination as part of their phlebotomy training. In other states MAs need permission from the state to expose patients to X-rays.

Medical assistants perform many administrative duties, including answering telephones, greeting patients, updating and filing patients’ medical records, filling out insurance forms, handling correspondence, scheduling appointments, arranging for hospital admission and laboratory services, and handling billing and bookkeeping.

Clinical duties vary according to state law and include taking medical histories and recording vital signs, explaining treatment procedures to patients, preparing patients for examination, and assisting the physician during the examination. Medical assistants collect and prepare laboratory specimens or perform basic laboratory tests on the premises, dispose of contaminated supplies, and sterilize medical instruments. They instruct patients about medications and special diets, prepare and administer medications as directed by a physician, authorize drug refills as directed, telephone prescriptions to a pharmacy, draw blood, prepare patients for X-rays, take electrocardiograms, remove sutures, and change dressings. Last but not least they serve as direct link and communicator between patient, physician, and other health care professionals whenever there is a need.