Charting new career choices in medicine
Medical assistants in demand for clerical, clinical functions

by Mark Vinson

Ask Coral Hicks a question having to do with any part of the human body and there’s a good chance she can tell you more than you ever wanted to know.
Hicks, 26, isn’t a doctor or even a nurse, but she sees patients on a regular basis, can triage a multitude of illnesses and even provide a patient with treatment options and referrals to other clinics and hospitals.
Hicks, who has spent the past two years at Bellingham’s Bunks Medical Center, is what is known as a certified medical assistant (CMA), a group of professionals who comprise one of the fastest growing sectors in the Northwest. Few professions require a command of such a vast amount of knowledge or offer such a wide variety of daily tasks.
“The medical assistant is becoming more and more important as medicine has been changing,” said Dr. Rachel Wanne, a family practice physician at Bunks. “Doctors are relying more and more on their MAs to do more of the information gathering, more counseling with their patients, dealing with all kinds of phone issues and medication issues.”
A medical assistant’s day can encompass everything from scheduling appointments over the telephone, greeting patients in the office, taking vital signs, administering shots, authorizing prescription refills by phone, doing lab work to scheduling referrals to specialists and liaisoning with insurance carriers.
“I really enjoy working with the people, getting a chance to know them and their problems and helping them in any way that I can,” Hicks said. “I get to develop a relationship with the patients, which is kind of nice.”
Hicks chose the career of medical assistant instead of nursing largely because she preferred to work in an out-patient clinic, rather than in a hospital or nursing home setting.
“I like working in a small office where I have that chance to get to know my patients versus in the hospital where it’s more acute care,” she said.

Growing demand
A shortage of nurses has trickled down to the medical assisting field.
According to the Bureau of Labor Statistics, demand for medical assistants nationwide is expected to increase 59 percent by 2012. This is largely due to the increase in outpatient care.
“The older population is growing more and more, living longer,” said Barbara Dahl, a former practicing CMA who heads the medical assisting program at Whatcom Community College in Bellingham. “Patients aren’t going into the hospitals unless they are extremely sick.”
“We can’t put out enough graduates to fill the need. We’ve tried to expand our program and bring in more students to fill the need.”
The average starting salary for a CMA ranges from $11-16 per hour, depending on the practice they are working for, location and their education level.
“I don’t think that earning potential is the reason people are in the field,” Dahl said. “I think people are in the field because it’s clean work, it’s usually daytime work, it’s very interesting and you have so many choices.”
Medical assistants’ duties can be broadly split into two areas: clerical and clinical. The clerical involves making appointments, welcoming patients, coding charts, working with financial and insurance records and scheduling referrals. The clinical side includes taking vital signs, collecting blood and/or urine samples, giving shots, performing EKGs, pregnancy tests, counseling patients in person and over the phone and gathering information used by doctors.
“Most of the students have an interest in the back office, but a true CMA can do both,” said Jacqueline Cavanaugh, a former practicing CMA who teaches several classes at Whatcom. “You’re much more a part of a team if you’re well-rounded.”
Many medical assistants are assigned to work with a particular physician, becoming – as the term implies – an extension of the physician themselves.
“They have a designated person they work with and that really helps the patient and the physician,” said Denise Fischer, practice manager at North Sound Family Medicine, one of 12 Family Care Network clinics in Whatcom County.
Hicks, for examples, works with Dr. Karen O’Keefe, a family medicine practitioner at Bunks.
“We work really well together as a team,” Hicks said. “I think patients pick up on that also. I know what she expects from me and how she works.”
The field tends to be overwhelmingly female. In fact, all of the students currently in the MA program at WCC are female, although Dahl said the men who have graduated from the program have done quite well.
“With male doctors, if they’re doing an exam on a female patient, they have to have another female present,” Hicks said.

Career path
Becoming a medical assistant doesn’t happen overnight, but it doesn’t require a lifetime of schooling, either. Both Whatcom Community College (WCC), Bellingham Technical College (BTC) and Skagit Valley College (SVC) offer a two-year associates degree and a one-year certificate program that provide the training one needs to open doors.
“It’s a really good program they have set up,” Hicks said of WCC, where she received her medical assisting certificate. “They’re keeping up with what’s going on in the community, which is really important. It makes for an easier transition from school to the workforce.”
Dahl, who has co-authored a medical assisting textbook, came to WCC in 1990 and heads a program that currently has 22 students. Each student is required to complete a core curriculum that includes courses in anatomy and physiology, medical terminology, law and ethics, psychology, clinical procedures, medical billing and coding as well as lab work.
“It was intense,” said Rachael DeVries, who earned her associates degree at WCC and now works at Bunks. “My favorite part was all the labs. There’s a lot to learn, but if you’re willing to stick to it, it’s a good choice to go into.”
Jeanette Hemming, like Dahl, a former practicing CMA, started the program at SVC in 1995. It offers specialized certificates in medical front office, phlebotomy, medical billing and coding, dialysis technician, medical transcription and pharmacy in addition to the medical assistant certificate and associates degree.
Students range in age from 18-year-old Tracy Thomas of Anacortes, who wants to use the SVC program as a stepping stone to nursing school, to former homemakers in their 60s pursuing a new career.
“We have several students who are coming back for retraining, displaced homemakers and we’ve seen an increase in the number of male students,” Hemming said. Five of the 30 students in SVC’s medical assistant program are male.
“One of my favorite things is learning the anatomy of the body,” said Jocelyn Robinson, a student at WCC. “It’s amazing how bodies can repair themselves.”
Financial aid is available in the form of scholarships and loans and Worksource may provide funds as part of its worker retraining program.
The culmination of a student’s training is an unpaid six-week externship, where the student is placed in a medical office of their choosing with the opportunity to gain real-world experience and unlock the door to a career.
“Because of the market, many medical assistants go from the externship into their job,” said Fischer, who oversees nine MAs at North Sound.
The programs at both WCC and SVC are accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP). After completing the academic requirements and the externship, students are encouraged to take a national certification exam, which is offered thrice yearly. Passing the exam is not a legal requirement to work in the field, but it makes one significantly more marketable, Dahl said.
Opportunities for advancement within the field are plentiful.
“Eventually, I would like to get more into the management part of it,” Hicks said. “Being a medical assistant is kind of a stepping stone for a physician’s assistant or a nurse practitioner.” Either of those occupations would require additional education.
“Our training is broad enough that if we choose to go to a specialty office that we would be trained for that. If we wanted to work in a lab or do more of the administrative part of it, we would have all that basic training.”
Another benefit medical assistants enjoy is portability.
“Medical assistants come out of their program with skills that can work in any specialty,” Fischer said. “It’s a skill that you can take anywhere.”

Entering the electronic age
One of the biggest changes in recent years has been the conversion from paper files to electronic medical records.
“When I graduated from the medical assisting program, we didn’t have a computer,” said Nancy Hill, a WCC grad who has spent the past 18 years as an MA at North Sound. “The first few months you kind of fight it.”
Hicks, who got her first job in 2001, also had to make the transition from paper to electronic records, but sees the benefits. “I think it makes it a lot easier to be organized with the computer now, instead of searching through charts and paperwork,” she said.
One of the most widely-used programs throughout Washington is called Centricity. It allows a patient’s medical records to be shared among multiple physicians and also is used for billing and insurance purposes. The program also automatically keeps track of preventative care measures such as shots.
“Electronic medical records are going to be the key to managing records across a discipline,” Dahl said. “Centricity is an amazing program and we love it.”
General Electric recently made a donation that allowed WCC to purchase the Centricity software for use in its curriculum. SVC also incorporates electronic record keeping in its program.
“The knowledge base expected has increased remarkably,” Hemming said. “You’re going to have to know how to work with electronic records.”
One thing the computers haven’t changed, however, is the demand for a personal touch. Medical assistants often spend as much, if not more, time with a patient than the doctors themselves.
“I would definitely say you have to be a people person for this job,” Hicks said. “If you’re not good at communicating and you don’t like people, I wouldn’t suggest this as a good career.”
“You have to have really good communication skills, written and verbal, because you liaison between the doctor and the patient,” Dahl added.
For those who master the knowledge base, the communication and computer skills, medical assisting offers a bright career future.

Whatcom Community College medical assistant students Pamela Letterman, left, and Sandra Stoner gain experience on an electronic medical record-keeping system called Centricity.




Instructor Jacqueline Cavanaugh, left, and chair Barbara Dahl are former practicing CMAs who bring experience from the field to the classroom at Whatcom Community College.




Denise Fischer, right, practice manager at North Sound Family Medicine, looks for CMAs with a variety of clerical and clinical skills.