MEDICAL ASSISTANT

Medical assistants should not be confused with physician assistants who examine, diagnose and treat patients under the direct supervision of a physician. The duties of medical assistants vary from office to office, depending on office location, size and specialty. In small practices, medical assistants are usually "generalists", handling both administrative and clinical duties, and reporting directly to an office manager, physician or other health practitioner. Those in large practices tend to specialize in a particular area under the supervision of department administrators.

Medical assistants perform many administrative duties. They answer telephones, greet patients, update and file patient medical records, fill out insurance forms, handle correspondence, schedule appointments, arrange for hospital admission and laboratory services, and handle billing and bookkeeping. Medical assistants may also arrange examining room instruments and equipment, purchase and maintain supplies and equipment, and keep waiting and examining rooms neat and clean.

Clinical duties vary according to State law and include taking medical histories and recording vital signs, explaining treatment procedures to patients, preparing patients for examination and assisting the physician during the examination. Medical assistants collect and prepare laboratory specimens or perform basic laboratory tests on the premises, dispose of contaminated supplies and sterilize medical instruments. They instruct patients about medication and special diets, prepare and administer medications as directed by a physician, authorize drug refills as directed, telephone prescriptions to a pharmacy, draw blood, prepare patients for x-rays, take electrocardiograms, remove sutures and change dressings.

Assistants who specialize have additional duties. Podiatric medical assistants make castings of feet, expose and develop x-rays, and assist podiatrists in surgery. Ophthalmic medical assistants help ophthalmologists provide medical eye care. They administer diagnostic tests, measure and record vision, and test the functioning of eyes and eye muscles. They also show patients how to use eye dressings, protective shields, and safety glasses, and how to insert, remove and care for contact lenses. Under the direction of the physician, they may administer medications, including eye drops. They also maintain optical and surgical instruments and assist the ophthalmologist in surgery (see also Ophthalmic Technology).

Medical assistants work in well-lighted, clean environments. They constantly interact with other people, and may have to handle several responsibilities at once. Most full-time medical assistants work a regular 40-hour week. Some work part-time, evenings or weekends.

Because medical assistants deal with the public, they must be neat and well-groomed, and have a courteous, pleasant manner. Medical assistants must be able to put patients at ease and explain physicians' instructions. They must respect the confidential nature of medical information. Clinical duties require a reasonable level of manual dexterity and visual acuity.

Most employers prefer to hire graduates of formal programs in medical assisting. Formal programs in medical assisting are offered in vocational-technical high schools, postsecondary vocational schools, community and junior colleges, and in colleges and universities. Postsecondary programs usually last either 1 year, resulting in a certificate or diploma, or 2 years, resulting in an associate degree. Courses cover anatomy, physiology, and medical terminology as well as typing, transcription, recordkeeping, accounting and insurance processing. Students learn laboratory techniques, clinical and diagnostic procedures, pharmaceutical principles, medication administration and first aid. They study office practices, patient relations, medical law, and ethics. Accredited programs include an internship that provides practical experience in physicians' offices, hospitals or other health care facilities.

Although formal training in medical assisting is available, and generally preferred, it is not always required. Some medical assistants are trained on the job, although this is less common than in the past. Applicants usually need a high school diploma or the equivalent. Recommended high school courses include mathematics, health, biology, typing, bookkeeping, computers and office skills. Volunteer experience in the health care field is also helpful.

Two agencies recognized by the U.S. Department of Education accredit programs in medical assisting: the Commission on Accreditation of Allied Health Education Programs (CAAHEP) and the Accrediting Bureau of Health Education Schools (ABHES). In 1997, there were about 350 medical assisting programs accredited by CAAHEP and over 150 accredited by ABHES. The Committee on Accreditation for Ophthalmic Medical Personnel accredited 18 programs in ophthalmic medical assisting.

Although there is no licensing for medical assistants, some States require them to take a test or a short course before they can take x-rays or perform other specific clinical tasks. Employers prefer to hire experienced workers or certified applicants who have passed a national examination, indicating that the medical assistant meets certain standards of competence. The American Association of Medical Assistants awards the Certified Medical Assistant credential; the American Medical Technologists awards the Registered Medical Assistant credential; the American Society of Podiatric Medical Assistants awards the Podiatric Medical Assistant Certified credential; and the Joint Commission on Allied Health Personnel in Ophthalmology awards the Ophthalmic Medical Assistant credential at three levels: Certified Ophthalmic Assistant, Certified Ophthalmic Technician, and Certified Ophthalmic Medical Technologist.

Medical assistants may be able to advance to office manager. They may qualify for a wide variety of administrative support occupations, or may teach medical assisting. Some, with additional education, enter other health occupations such as nursing and medical technology.

The earnings of medical assistants vary widely, depending on experience, skill level, and location. According to the 1997 Staff Salary Survey published by the Health Care Group(, average hourly wages for medical assistants with less than 2 years of experience ranged from $8.07 to $10.90 in 1996. Average hourly wages for medical assistants with more than 5 years of experience ranged from $10.38 to $13.46. Wages were higher in the Northeast and West and lower in the Midwest and South.

Medical assistants held about 225,000 jobs in 1996. Seven in 10 jobs were in physicians' offices, and over 1 in 10 were in offices of other health practitioners such as chiropractors, optometrists, and podiatrists. The rest were in hospitals, nursing homes and other health care facilities.

Employment of medical assistants is expected to grow much faster than the national average for all occupations through the year 2006 as the health services industry expands due to technological advances in medicine, and a growing and aging population. It is one of the fastest growing occupations.

Employment growth will be driven by the increase in the number of group practices, clinics, and other health care facilities that need a high proportion of support personnel, particularly the flexible medical assistant who can handle both administrative and clinical duties. Medical assistants primarily work in outpatient settings, where much faster than average growth is expected.

In view of the preference of many health care employers for trained personnel, job prospects should be best for medical assistants with formal training or experience, particularly those with certification.