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Medical Assisting Specialty Practices

A Certified Medical Assistant, also known as a CMA, is a
healthcare professional that is cross-trained to work in many different areas
in a doctor’s office under the supervision of a physician. Although a CMA
usually only averages around $30,000 a year, CMA’s can work in the front
office, clinical setting, laboratory setting, and anywhere they are needed.
CMA’s can work in many different types of offices, and are very important in a
practice. The two types of medical practices that will be talked about in this
paper are gynecology and family medicine.

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Scope of practice for a Medical Assistant in North Carolina

The scope of practice for a Certified Medical Assistant
working in the front office includes checking patients in, telephone triage,
scheduling appointments, updating patient medical records, filing paperwork,
medical coding and billing functions, preparing correspondence, performing
accounting functions. (Medical Assistant Resources, 2015)

The scope of practice for a Certified Medical Assistant
working in the clinical setting includes calling a patient from the waiting
room, and walking with them to the exam room, taking their vital signs,
collecting information about the patient’s symptoms and writing down their
chief complaint so that the physician knows exactly what he is seeing the
patient for, collecting specimens and running lab tests, helping physicians
with exams, administering injections, bandaging wounds, providing patient
education, and making sure the patient understands the physician’s instructions
before they are released. (Medical Assistant Resources, 2015)

Providing patient education is one of the most important
parts of being a medical assistant. “Medical assistants are instrumental in
helping patients feel at ease in the physician’s office and often explain the
physician’s instructions.” (AAMA) When patients do not have the appropriate
information, the results of tests and medications could be inaccurate, and a
patient could be confused on what they need to do. Giving a patient the
information they need to take the medicine, or get ready for a test is
different than giving the patient advice on lifestyle changes and figuring out
what is best for them, that is called health coaching.

There is a short list of things that a CMA should not do and
that is recommend treatments that the physician has not, examine patients,
providing a patient with a written or oral diagnosis, prescribing medication,
and performing surgery. (Medical Assistant Resources, 2015) If a CMA does any
of the things out of their scope of practice it could result in a lawsuit,
because it is illegal. The lawsuit will fall on the physician and the medical
assistant. It could also result in termination of employment and revoking of
the medical assistant’s certification.

Gynecology

            In a
gynecology office or an OB/GYN there is one focus, and that is women. The term
OB/GYN refers to obstetrician and gynecologist. An obstetrician is a physician
that specializes in delivering babies and a gynecologist is a physician that
specializes in diseases of the female reproductive organs. The office “Provides
medical care related to pregnancy or childbirth and may also provide general
medical care to women.” (My plan, 2016) There are also opportunities to advance
your career in a gynecologist’s office, such as becoming a sonographer. To
become a sonographer, there is a one-year certificate program, a two-year
associates degree program, four-year bachelor’s degree, or master’s degree. (Burton,
Elizabeth.)

I held an interview with Marie
Putman, a CMA at Harmony Center for Women’s Health and Vitality in Boone, North
Carolina, since August of 2016. When asked what a day in the office was like
she replied “Not every day is the same since there are days that the provider
is in surgery, days they are on call delivering babies at the hospital and then
of course patient days. On patient days you start by opening your rooms, making
sure they are stocked and ready to go. Then you print your schedule for the day
and make sure you have all the necessary things for each visit (IUD’s, etc.)
also make sure that there are no errors in the schedule or questions that you
may have for the provider so that you can have everything ready for each visit
(records for referrals, do I need an ultrasound in the room?) Then of course
you work the patients up. At the end of the day clean and turn down rooms. Wash
and put any instruments you used into the autoclave, and gather linens. On surgery
days, you will have in office surgeries or the provider has surgery at the
hospital. On call days you will sometimes have emergent office visits, but you
are also responsible for the nurse visits (urine checks, labs, Depo Provera
injections.) Down time on these days are spent working on referrals and
precerts.” Putman claims that the office sees around 20 to 25 patients a day on
patient days, so in this specialty a medical assistant stays busy.       When it came to the pros and cons of
working in gynecology, Putman couldn’t think of many cons, but said it gets a
little dramatic when working with women only. She had previously worked in a
family practice and says that she really enjoys working at Harmony Center for
Women, because it focuses only on one specific specialty and the was the
biggest pro for her. Coming from a family practice, she wasn’t sure if she
would like women’s health, but she was offered the oppourtunity to work there
and decided to pursue it, once she got there she loved it. She claims that the
office she works in is a team effort and everyone chips in and enjoys being
there. That is the way an office should be.

There are many medications
prescribed at an OB/GYN, but when Putman was asked what the main ones her
office prescribed were she told me the following, “Depo-Provera, Mirena,
Paragard, Nexplanon, Premarin, Estrace, Tri-sprintec, Loestrin, Venlafaxine,
and Diclegis.” There are also many injections that are given specific to a
gynecologist’s office. A few of them would be Rocephin, Depo-Provera, Makena,
and Betamethasone.

When asked why she was
passionate about her career as a medical assistant, Putman exclaimed “I love
helping people and getting to know them! The longer you are working in a
practice the more you will see a patient and get to know them, and begin to
relate to them. They will remember you each time and build trust with you if
you build that relationship. Sometimes when they come in they will even ask for
you specifically, and to me that is an amazing feeling! We get to see some of
our patients annually for their yearly examination, but we see our prenatal
patients over and over again until they deliver.” The biggest piece of advice
that Putman gave was “knowing a little bit about the female body and how it
works will help the things that you get trained in make a lot more sense.”

The interview with Marie was
very insightful and gave a lot of helpful information.

Family Medicine

           

            Family
Medicine practices deal with basically everything. It is not limited to a certain
disease or organ, the patients range from birth to death, and can be any
ethnicity or race. “The specialty of family medicine was created in 1969 to
fulfill the generalist function in medicine, which suffered with the growth of
sub specialization after World War II. Since its creation, the specialty has
delivered on its promise to reverse the decline of general medicine and provide
personal, front-line medical care to people of all socioeconomic strata and in
all regions of the United States” (AAFP, 2017) Family Medicine not only treat
illnesses, the provide routine check-ups, health-risk assessments,
immunizations, and counseling on maintaining a healthy lifestyle. (AAFP, 2017)
If there is something a Family Practice cannot perform or diagnose, they will
be referred to a different specialist.

            I held
an interview with Wanda Branch a Certified Medical Assistant at Hugh Chatham
Family Medicine in Elkin, North Carolina where she was hired directly after her
externship, and she explained what they do in the Family Medicine practice she
works in. “We do suturing here, we don’t have an x-ray machine or anything like
that, but we do would care here, you know, until we think they need to go to a
wound center or something, or we have a lot of diabetics, I mean we have all
kinds of things!” Branch claims that there are many things a medical assistant
should be able to do in Family Medicine, such as; “anything in the office, that
includes front desk, check-in and check-out, referrals, medical records. They
should be able to do anything with the doctor, work with the doctor. Weigh a
patient, get their blood pressure, temperature, heart rate, do
electrocardiograms, any kind of small procedures that the doctor does in our
office, they must assist with that. Opening up cysts, draining cysts, taking
off moles, anything like that.” 

            Like
with any other specialty practice there are pros and cons of working in Family
Medicine. The best pro Branch gave me was that it is very interesting to be
able to do everything, and the best con was that “You may get moved around to a
lot of different physicians because you’re able to do more things, like some of
the girls can only to one thing. So, you know, it may turn out that you have to
cover for other people if they are out. You may not always be at your job.” I
also interviewed Chelsea Millsaps of Stony Point Family Medicine, and she
explained what it was that made her so passionate about her career as a Medical
Assistant and why she loves working in Family Medicine. “I love my CMA job
because I get to help people. I love family practice because it’s so diverse.
You can see almost anything; from the flu or a cold, to cyst removal, or a
sliced open leg. It isn’t just one thing, one part of the body, its general.
Care starts here, then goes out from here. I get experience in a lot of
different areas like learning medication, drawing blood, assisting with sutures
and other minor procedures, giving injections, assisting with drawing fluid out
of a knee joint, assisting with bladder catheters. You never know what you will
see or learn!”

            There
are many medicines that are prescribed in family medicine, because there are so
many different types of patients and diseases, but the top fifteen would be
Metformin, Glimepiride, Actos, Lisinopril, Atorvastatin, Ambien, Adipex,
Losartan, Furosemide, Norco, Xanax, Gabapentin, Levothyroxine, and Tramadol.
There are also many injections used specific to family medicine. Those are
Decadron, Rocephin, Kenalog, Testosterone Cypionate, Flu vaccine, Tdap vaccine,
and Toradol.

            When
asked what the best piece of advice Branch could give for a medical assisting
student thinking about pursuing a career in Family Medicine, she replied “If
you have never worked in the medical field, all the things that you learn in the
books at school, are pretty much not, I mean they are going to be helpful, you
are going to learn the basics in school but it is according to what office you
work in, it is pretty much going to be learning as you go. You are going to
learn lots of things you never knew and never thought would go on in an office.
You are going to learn lots of things like that.” When thinking about this
piece of advice, it makes sense why as a medical assistant student you are
required to go out into a practicum site. That way it isn’t overwhelming when
the student gets out into a real job.

Conclusion

            In conclusion, I feel that both
specialties still appeal to me even after researching the two and interviewing
Medical Assistants from both specialties. I really think I would enjoy the diversity
of working in a Family Medicine practice. To me, not having to do the same thing
every day would make a job much more interesting. Gynecology also still seems very
interesting to me, mainly because of the prenatal care. Working with pregnant women,
I understand could be very difficult, but also very sweet. The advancing of a career
in gynecology stands out to me. Becoming a Sonographer could potentially be fun.
Not only could you work in gynecology with that degree, but you could work in other
types of specialties too. Family Medicine and Gynecology are both excellent fields
to work in as a Certified Medical Assistant, and either one would be a fantastic
job.

References
 

What is a Medical Assistant’s Scope of Practice?
(2015, December 29). Retrieved December 04, 2017, from https://www.medicalassistantresources.com/what-is-a-medical-assistants-scope-of-practice/

What is a Medical Assistant? (n.d.).
Retrieved December 04, 2017, from http://www.aama-ntl.org/medical-assisting/what-is-a-medical-assistant#.WiTjbEqnFPY

(n.d.). Retrieved December 04, 2017,
from http://www.myplan.com/careers/obstetricians-and-gynecologists/description-29-1064.00.html

Burton, E. (n.d.). Ultrasound
Technician | School, Salary & Career Facts. Retrieved December 04, 2017, from
http://www.innerbody.com/careers-in-health/how-to-become-ultrasound-technician.html

Family Medicine Specialty. (2014,
September 23). Retrieved December 04, 2017, from http://www.aafp.org/about/the-aafp/family-medicine-specialty.html

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