Effective Use of Medical Assistants

Exerpt from:
An effective way to use assistants - Training nurses and MAs to take histories and provide patient education boosts productivity, income, and quality of care.
Publish date: Aug 3, 2007
By: Ken Terry
Source: Medical Economics

http://www.modernmedicine.com/modernmedicine/article/articleDetail.jsp?ts=1273337223786&location=http%3A%2F%2Fwww.modernmedicine.com%2Fmodernmedicine%2FMedical%2BPractice%2BManagement%25253a%2BStaffing%2FAn%252Deffective%252Dway%252Dto%252Duse%252Dassistants%2FArticleStandard%2FArticle%2Fdetail%2F443727&id=443727

Peter B. Anderson, a family physician in Newport News, VA, has three part-time nurses and a medical assistant--the equivalent of two full timers--who do nothing but take patient histories, document encounters, and teach patients to follow his treatment plans. These staffers cost a lot more than the single MA who supports the typical doctor. Yet in the four years since Anderson implemented "team-based care," he's seen his productivity-and his income--soar.

Patient satisfaction and quality of care are up, too. "Even if I didn't make a nickel more, I'd never go back to the old system. My charts are so complete that I'm not wasting time going down rabbit trails. And the patients love it," he says....

...When Anderson comes into the exam room, the nurse or MA hands him an EHR-generated list of current problems, meds, and lab results, and summarizes the patient's symptoms and history. The doctor follows up with the patient as needed, then conducts the physical exam while the assistant documents his findings and recommended treatment. The assistant spends another two to five minutes on patient education, while Anderson moves on to the next patient....

...Suppose you pay an RN $20 an hour, or $700 for a 35-hour, four-day week. If the average primary care visit nets $60, you'd have to see 12 extra patients a week to break even. "If you could see one more patient a day, or four patients a week beyond the break-even point, that's $240 a week for 48 weeks a year, or $11,520. Your only extra operating costs would be for drugs and supplies, which are about 4 percent of overhead. So the money in your pocket would be 96 percent of that $11,520," Scroggins says. Multiply that figure by the 10 patients or so beyond his break-even point whom Anderson is able to accommodate each day, and you can see why he's bringing home an extra $100,000 a year...

...With that kind of payoff, why are relatively few primary care physicians using this model? Scroggins attributes it to PCPs' reluctance to delegate any of their clinical duties, for any number of reasons. Some, like FP Jeffrey K. Pearson of San Marcos, CA, prefer to spend more time interacting with their patients. "I get a feel for what's going on by listening to them talk," says Pearson. Others may be afraid that having an assistant take histories will reduce patient satisfaction.

But that's not likely, argue Scroggins and Flora Nielsen, a former president of the American Association of Office Nurses. "The patient judges the total experience," says Scroggins. Adds Nielsen, "If the nurse takes the history and the doctor has all the significant data in front of him when he comes in and can focus better on the patient's problems, I don't think anyone would have a problem with that." ...

See the original article for more details.

Since 2007, the data shows that patient satisfaction increases, rather than decreases.