Medical Assistants: Helping Physicians Meet New and Shifting Patient and Staffing Demands



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Medical Assistants: Helping Physicians Meet New and Shifting Patient and Staffing Demands Donald A. Balasa, JD, MBA, Executive Director, Legal Counsel American Association of Medical Assistants Health Professions Network October 14, 2011, Jacksonville, FL

Definition of Medical Assistant Educated to work in outpatient/ambulatory care settings; Works under direct physician supervision; Able to be delegated back office clinical duties, front office administrative duties, and patient education.

According to the Bureau of Labor Statistics, the number of medical assistants is expected to grow by 34% from 2008 to 2018 (from 483,600 to 647,500), much faster than the average for all occupations. Why? Increasing demand for health care in general; Patient Protection and Affordable Care Act; More care being provided on an outpatient basis.

Accreditation of Medical Assisting Programs Two programmatic academic accrediting bodies for medical assisting: Commission on Accreditation of Allied Health Education Programs (CAAHEP) and Accrediting Bureau of Health Education Schools (ABHES). Medical Assisting Education Review Board (MAERB) of the American Association of Medical Assistants (AAMA) Endowment is a committee on accreditation (CoA) of CAAHEP.

Increase in Number of Schools with CAAHEP Accredited Programs April 1992 200 October 1997 300 April 1999 400 October 2001 500 Early 2012 600 Why? As of June 1998, only CAAHEP graduates were eligible to take the CMA (AAMA) Certification Examination.

Increase in Number of Candidates for the CMA (AAMA) Certification Examination Very few states require the CMA (AAMA) as a legal requirement for particular duties. However, increasing numbers of employers prefer to hire, or insist on hiring, CMAs (AAMA). Also, increasing numbers of malpractice insurance carriers are requiring credentials for medical assistants. Eligibility requirement for the CMA (AAMA) Certification Examination: graduation from a CAAHEP or ABHES (as of 2002) accredited medical assisting program.

Increasing Number of CMAs (AAMA) Applicants for initial CMA (AAMA) certification: 2006 15,014 2007 15,928 2008 18,827 2009 12,505 2010 18,379 2011 22,000 (approximately) New CMAs (AAMA): 2006 6,502 2007 6,711 2008 7,207 2009 6,104 2010 7,967

CAAHEP and ABHES Accredited Medical Assisting Programs In postsecondary public, private for profit, and private not for profit schools; Two year associate degree programs, or one year certificate or diploma programs; Traditional programs or distance education (partial or total) programs.

Requirements for Academic Programs Must prepare students who can provide a quality of services that protects the public from substandard care. Must prepare students who can provide a quality and quantity of services that meets the needs of employers. Must provide education that imparts to medical assisting students what they need to: Know Do Be Didactic, psychomotor, affective Knowledge, skills, and attitudes (KSAs)

What About Provider Based Education Programs? Regardless of educational setting, medical assisting academic programs must provide the breadth, depth, and rigor of education required to protect the public from substandard medical assisting services and to protect employers from substandard medical assisting employees. CAAHEP permits consortium sponsors: A consortium sponsor is an entity consisting of two or more members that exists for the purpose of operating an educational program. In such instances, at least one of the members of the consortium must meet the requirements of a sponsoring educational institution as described in I.A. I.A A sponsoring institution must be a post secondary academic institution accredited by an institutional accrediting agency that is recognized by the U.S. Department of Education

CMA (AAMA) Certification Examination Accredited by the National Commission for Certifying Agencies (NCCA); Utilizes the National Board of Medical Examiners (NBME) as test consultant; Only medical assisting credential that requires graduation from a medical assisting academic program.

CMA (AAMA) Certification Examination CMAs (AAMA) must recertify every 60 months by continuing education or retesting to keep the certification current. Only current CMAs (AAMA) are permitted to use the credential in connection with employment. Only medical assisting credential that requires current CPR certification. Disciplinary Standards for CMAs (AAMA).

How Can Medical Assistants Especially CMAs (AAMA) Help Physicians Meet New Staffing Demands?

The Patient Centered Medical Home (PCMH) Movement The Patient Centered Medical Home (PCMH) is an approach to providing comprehensive primary care for children, youth, and adults. The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient s family. Joint Principles of the Patient Centered Medical Home, 2007, American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association

Why the CMA (AAMA) Is an Ideal Allied Health Professional for the PCMH The Core Curriculum for Medical Assistants, (Core Curriculum) referenced in the CAAHEP Standards requires students to apply critical thinking skills in performing patient assessment and care. The Core Curriculum requires students to perform these responsibilities: Apply active listening skills. Demonstrate empathy in communicating with patients, family, and staff. Demonstrate respect for diversity in approaching patients and families.

Why the CMA (AAMA) Is an Ideal Allied Health Professional for the PCMH The Core Curriculum requires students to recognize the role of patient advocacy in the practice of medical assisting, and advocate on behalf of patients. The electronic medical record is a key component of the PCMH model. The Core Curriculum requires students to execute data management using the electronic medical record (EMR). Enhanced access to care is available through systems such as open scheduling in a PCMH approach. A medical assisting student must learn to manage appointment schedule, and schedule patient admissions and/or procedures.

What Has the AAMA Done to Respond to the Rapid Growth in the Profession? The CMA (AAMA) Certification Examination used to be given three times a year. Beginning in 2009, the Examination has been administered via computer at Prometric testing centers. To meet the increasing demand for recertification of the CMA (AAMA), the Continuing Education Board of the AAMA has offered more continuing education courses online. The online AAMA Continuing Education Registry has been upgraded and made faster. MAERB has implemented the efficiency enhancing processes established by CAAHEP. My legal blog has enabled me to answer scope of practice questions more quickly.