Why is it important to rethink the role of the MA?

Medical assistants (MAs) are essential staff at most primary care practices. They keep patients flowing through the clinic and ensure that providers have the information and tools they need. But MAs are often capable of doing much more. As one of the first points of contact for patients, they often have a deep knowledge of patients’ personal and medical histories. Most are also adept at using the electronic health record (EHR), and with proper training, they can play major roles in preventive care, coaching patients, and population management.

How should the role of the MA change?

Traditionally, MA activities have been limited to things like rooming patients, taking vitals, setting up equipment, and helping with paperwork. In most LEAP sites, MAs are responsible for a much broader range of activities, including:

  • Helping with pre-visit planning
  • Answering phones, triaging calls, and generally serving as a primary point of contact for patients
  • Reconciling medications
  • Scribing for providers
  • Conducting patient outreach
  • Health coaching and motivational interviewing
  • Patient education
  • Participating in quality improvement work
  • Performing injections, tests, and procedures (as allowed by their license)—including EKGs, blood tests, spirometry, etc.

What do we gain by making these changes?

The benefits of encouraging MAs to take on more responsibilities include:

  • Better customer service
  • Better performance metrics
  • More effective patient outreach
  • Increased efficiency because providers and other specialized staff can focus on tasks that require their level of expertise
  • Added capacity if MA role expansion allows other team members to independently take on clinician work (RNs, pharmacists, behavioral health specialists)

Webinar: Enhancing the role of the MA

High Plains Community Health Center Transformation Story

  1. Select a model.

    Explore the different models available among the tools and select one—or combine them—to ensure the role fits your practices culture and resources.

  2. Check state policies.

    Research your state’s policies on MA scope of work to ensure that your new model complies with state regulations and that your MAs are doing all their “license” allows. This is an action step that may apply to other team members, but we found that MA scope of practice and certification policies appeared more variable across states and had a bigger impact on MA roles than was true for other roles.

  3. Make the business case.

    You might need to build the business case at your organization for having MAs take on new tasks. It might also be necessary to hire more MAs to ensure coverage and minimize burn out.

  4. Hire the right person.

    Excellent MAs need to have a range of skills, not all of which are necessarily provided through MA training courses. Many LEAP sites hire for attitude and train for clinical knowledge and skills. Critical skills include a strong customer service orientation, an eye for detail, and the ability to work well on a team. It often helps to hire staff from the cultures and communities of patients that the clinic serves.

  5. Provide training and supervision.

    MAs often go through a formal training and certification process. However, many LEAP sites hired people with little to no health care experience and trained them to be an MA. Regardless, for MAs to take on different tasks, they will often need additional training in motivational interviewing, quality improvement, leadership, and other areas. New MAs sometimes spend up to six months training. The resources in this section will help you explore different training options for your MAs.

  6. Provide a career ladder and opportunities for growth.

    The MA role is an entry level position that often attracts smart, dedicated individuals. Providing a clear career ladder and/or opportunities for growth and skill development helps minimize turnover, improves morale, and rewards high performers.

Publications

Webinar and power point presentations

  • Webinar and power point presentations

    Webinar: Enhancing the role of the MA

    Learn about expanding MA roles in this webinar featuring LEAP sites. This is part of a great series of webinars on Advancing Team-based Care organized by Community Health Center, Inc. Slides are also available at http://weitzmaninstitute.org/NCA

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Video

  • Video

    High Plains Community Health Center Transformation Story

    Learn how one LEAP site has expanded the MA role. High Plains CHC in Colorado has 3 Patient Facilitators per care team, who rotate front and back office tasks, coordinate referrals, do immunizations, and bring everything to the patient into one room during visits.

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  • Video

    Scribing Model: 2 Clinical Assistants with 1 provider

    Learn how one LEAP site developed a developed a scribing model, by watching this video. In this model at Family Care Network, a provider has two flow staff (MAs or LPNs), called Clinical Assistants, who are trained to scribe during the patient visit and work with patients to ensure they understand information from the provider. This enables the provider to spend less time on documentation and less time with each patient per visit, while providing patients with high quality care.

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  • Video

    Supporting MA role expansion

    In this video, learn how one LEAP site developed supports for MAs to function in an expanded role. West County empowers MA's by providing thorough orientation to the role, training, standing orders, and having MA role-specific metrics.

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  • Video

    Union Health Center Career Ladder

    Watch this video about the career ladder at LEAP site Union Health Center. MA’s can move into more advanced roles by showing strong communication skills, critical thinking, and collaboration. The first step up is becoming a Health Coach, supporting patients with chronic conditions in goal setting and self-management support. Health Coaches can then be promoted to floor coordinator, to manage patient flow for a care team, schedule provider time, and assist MAs

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Case summariesVignettes, profiles and testimonial videos

  • Case summaries

    High Plains Community Health Center—Redesign Expands Medical Assistant Roles

    Learn how one LEAP site has expanded the MA role. High Plains CHC in Colorado has three Patient Facilitators per care team who rotate front and back office tasks, coordinate referrals, do immunizations, and bring everything necessary to the patient into one room during visits.

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Role featuresJob descriptions, career ladders and other HR materials

  • Role features

    "Share the Care" Assessment of Team Roles and Tasks

    This is an example of a planning tool, to assess who is currently doing what tasks in your practice and then who should be doing each task, based on how we learned that LEAP sites define clear roles and responsibilities. Task distribution will vary from practice to practice, but the tool is in the discussion about roles that this worksheet can stimulate. Your practice may be able to redestribute tasks in a way that better fits your workforce and patient needs.

  • Role features

    Patient Facilitator Job Description

    Here is the job description of an MA role, patient facilitator, at one LEAP site (High Plains). In Colorado, MAs do not need to be certified, so this site has found success in hiring people with customer service and interpersonal skills without having any MA certification or experience. The practice provides robust training on the clinical skills to meet those job responsibilities (see Action Step 5).

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  • Role features

    Patient Care Assistant (Medical Assistant) Job Description

    Here is the job description of an MA role, patient care assistant, at one LEAP site. At this site, Union Health Center, MAs take an active role in patient education and can be promoted to Health Coach (see Action Step 6)

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  • Role features

    Care Team Medical Assistant Job Description

    Here is the job description of the Care Team MA at one LEAP site, Sebastopol/West County, reflecting the MA's role in managing patient flow, leading care team huddles, and performing population management during sanctioned time each week.

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  • Role features

    Care Team MA report card

    At LEAP site West County Health Centers, care team MAs receive "report cards" that show their progress in meeting the preventive care needs of their patients. The MA supervisor (an MA who has been promoted to oversee all MAs at that site) reviews the report card with each MA to discuss what is working well and what might be improved to achieve population management targets.

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  • Role features

    Medical Assistant Pay Scales

    See the compensation that one LEAP site provides to MAs as they expand their skillset and take on additional responsibilities with the organization. MAs can work in the lab, imaging, or move into clinic management positions. Promoted MAs have served important roles in opening new practices as the organization rapidly expands access in the community.

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Staff trainingTutorials, training manuals, etc.

  • Staff training

    Introduction to Care Team Roles and Understanding the MA Scope of Practice

    See how one LEAP site trained all care team members about the scope of practice for MAs in California.

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  • Staff training

    Medical Assistant Externship Clinical Protocol

    West County/Sebastopol uses the MA extern program at a nearby college to assess fit of potential care team MAs. Externs who thrive in the team model are hired on full time and this is a very successful mechanism to sustain good MAs.

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  • Staff training

    Care Team Medical Assistant Training Curriculum

    See what one LEAP site has developed as a training curriculum for an expanded MA role. Training includes what it means to be in charge of patient flow, how to lead care team huddles, how to perform population management for their patient panel, and communication skills for interviewing patients and working with team members. They developed protocol for all responsibilities and workflows, to support MAs as they work at the top of their license.

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  • Staff training

    Patient Facilitator Competency Checklist

    See the Competency Checklist used by one LEAP site to ensure Patient Facilitators (MAs) have demonstrated competency over the course of their first six months of training. This site also closes the clinic for one hour every week for ongoing training and refreshers.

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  • Staff training

    Clinical Assistant Training Manual

    Learn how one LEAP site trains Clinical Assistants as scribes, in a model with 2 Clinical Assistants per provider. Clinical Assistants are MAs and LPNs.

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ToolkitsImplementation guides and other documents with extensive resources included

Clinical protocolStanding orders, risk stratification forms and hospital transition protocols

  • Clinical protocol

    MA and Nursing standing orders

    See several examples of standing orders for MAs and nurses, including reading PPD results, administering asthma medications, ordering labs, and more.

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  • Clinical protocol

    High Plains Community Health Center Standing Orders

    See an example of MA standing orders from a LEAP site.

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  • Clinical protocol

    Miramont Family Medicine Standing Orders

    See an example of MA standing orders from a LEAP site.

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  • Clinical protocol

    Care Team MA Diabetes Protocol

    See an example of MA standing orders from a LEAP site.

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  • Clinical protocol

    Care Team MA HIV Protocol

    See an example of MA standing orders from a LEAP site.

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LEAP Learning ModuleOther helpful topics included in this website