Medical Assisting - Unmasked

Schools advertise medical assistant courses stating you will become a valued member of a medical team. They portray the job in pictures. First the assistant is taking a patient's blood pressure, smiling as if she has all the time in the world. Next, the actress will have a chart in her hand, standing next to a doctor, again all smiles, as if she is conferring with him.

Reality is very different. I worked doing medical assisting for over ten years.

Those wanting to enter this field should have a clear idea of what the job entails.

I am part of the generation whom were trained in house. Training was offered to secretaries or clerks who were interested. Ironically, the pay is equal to or lower than what the clerical staff earns.

Job duties may vary office to office. Larger offices use assistants mainly for putting patients in exam rooms, asking the patient why they are there, bringing up the medical chart on the computer, typing in the date, and keying in why the patient came in.

In smaller offices the duties are more diverse.

Charts are put out in the order patients come in. They then bring the patient to an exam room, blood pressure is not taken yet. Having the patient sit and answer questions first, allows their blood pressure to come down. A patient may have felt rushed or feel apprehensive, and resting for a few minutes helps with a more accurate reading.

First header information is recorded on a blank sheet of paper, to include date and reason for the visit. It could be as simple as a sore throat or a more complex problem as chest pain.

Next a list of diagnoses is recorded, ie; high blood pressure, hyperlipidemia, or hemorrhoids.

A current list of medications is recorded. Dosages and how often the medication is taken needs to be documented. An experienced medical assistant will be able to recognize when there is a disparity between the medications given and the diagnoses the patient carries. Questions are asked such as "this medication is usually taken for herpes, what are you on this medication for?"

Allergies are recorded next, consisting of allergies to medications, adhesive tape, dye, or shellfish.

Finally, the blood pressure is taken, along with temperature, pulse, respiratory rate, height and weight.

Blood pressure can vary between arms by as much as ten points. Taking a manual blood pressure versus using a machine, can be difficult to hear on chronically ill patients. Therefore, using both arms is necessary, at times, before a blood pressure is obtained. In addition, if a patient comes in and her/his pressure is high, an assistant may want to take a reading in both arms. Generally, a physician will take it again during his examination.

OTHER DUTIES

1. Performing electrocardiograms. Frequently this is done during the patient's visit. Either the doctor will request one,or if the patient
complains of having had chest pain, the assistant will take one before the doctor sees the patient.

2. Blood draws. Smaller offices do not have their own phlebotomist. The assistant performs this duty. In the morning, those patients needing fasting blood work will come in. Blood draws are also done during office hours at the physician's request. Blood draws must be prepared before being sent out. Usually a form is filled out with the patient's demographics and insurance numbers are recorded. Blood will need to spin down for twenty minutes in a centrifuge before being ready to be sent.

3. When lab results come in, they need to be attached to the patient's chart and put on the doctor's desk for review. Results that are grossly abnormal should be given to the doctor as soon as possible. The doctor will sign the blood work. Then it is back to the assistant who will call the patient with the results and then book any further testing needed.

4. Phone calls will be directed to the medical assistant when a patient has an acute medical problem. If there is no nurse in the office, the assistant will decide who comes in or the office manager will cover that duty.

5. Sample medications. Drug reps will leave samples of medications. These medications must be recorded as coming into the office. The date received, name of the medication, amount of medication received, and lot numbers need to be recorded.

When medication samples are given to a patient, that needs to be recorded with the above information in addition to the number of samples given and the patient's name.

This requires an immense amount of work, but for those will no insurance coverage and the retired patient, it is of tremendous benefit.

6. Keeping the medicine cabinet up to date, throwing away medicines that are out of date, organizing so that each medication is easy to find, is a duty that the assistant performs.

7. Restocking supplies in each exam room.

Many above duties are performed while putting patients in exam rooms.

The unspoken rule is, the doctor does not wait for patients to be put in rooms. Assistants must have the rooms filled and keep ahead of the doctor always.
Frequently they will need to stay after hours. If the doctor is running late, office hours become extended. An assistant must stay untill the last patient has gone, and at times even longer. The end of the day is when you can sit and go over phone calls and/or lab results with the physician. Some phone calls must be made that night, while other calls can wait.

Doctors have malpractice insurance. The medical assistant is not covered under his policy.

Those who thrive on pressure, being busy, and working with the public will enjoy this job.

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