As demand for advanced practice providers continues to exceed supply in the labor market, many practices are increasingly turning to medical assistants (MAs) to fill workforce gaps. Although MAs offer the advantage of affordability, their more limited scope of practice presents its own set of challenges.
Unlike almost all other medical support staff, MAs are not required to be certified, and historically they usually were not, according to Debra Phairas, president of a San Francisco–based health care consulting firm. But, lately, the trend has been toward certification, particularly because the “meaningful use” law required certification for data entry employees—a development that surprised many practices.
The MA profession occupies a sort of legal gray area between medical and nonmedical personnel. Each state has its own laws regarding scope of practice, usually laid out by its medical association and accessible via the internet, Phairas says. In addition to the full range of front-desk clerical duties, MAs might perform diagnostic tests and laboratory services, maintain health records, explain treatments, and provide health coaching.
Salaries for certified MAs tend to be higher but are still well below those of nurses and physician assistants, often by as much as $20 to $30 per hour, according to Phairas. She suggests a thrifty strategy for hiring certified MAs: offer 3-month internships to nearby accredited institutions.
“You get to see if that person is a good fit with your practice,” she explains. “Since internships usually happen at the end of a training program, you can then offer to make that intern an employee.”
One pitfall to watch out for is overtime laws. Most states deem MAs to be nonexempt, hourly wage workers who are entitled to overtime pay. Many practices make the mistake of paying MAs a flat salary and then asking them to stay by the physician’s side for the typically long clinician workday. This puts the practice at risk of lawsuits by former employees seeking back pay, Phairas warns. The only exception would be if the MA were a supervisor and spent more than 50% of his or her time performing managerial duties, she says.
As valuable as MAs are, many tasks fall outside their purview. For example, most cannot administer intravenous injections. “That’s why practices really need to be up-to-date on their state’s scope of practice [laws],” Phairas explains.