(This article is based on an oral presentation AAMA Executive Director Balasa gave at a meeting of the Health Professions Network.)

Medical assistants may be defined as allied health professionals who work primarily in outpatient or ambulatory health care delivery settings, most often under direct physician supervision, and who are able to be delegated both back-office clinical procedures as well as front-office administrative responsibilities. Supervision requirements vary somewhat from state to state. However, “direct supervision” is usually defined as the delegating/supervising/overseeing physician(s) being on the premises and reasonably available (although not necessarily in the same room) when the medical assistants are performing clinical duties other than the most basic ones (e.g., taking vital signs, rooming patients, and collecting certain specimens).

According to the United States Bureau of Labor Statistics (BLS), the medical assisting profession continues to be one of the fastest growing employment categories. The BLS projects that the number of medical assistants will grow by 34 percent from 2008 to 2018—from 483,600 to 647,500—much faster than the average for all occupations. What are the reasons for this high rate of growth for the medical assisting profession? There are many, but three of the most significant ones are as follows:

  1. The growing recognition in all segments of the U.S. health care system that medical assistants—especially CMAs (AAMA)—are the ideal allied health professionals for all types of outpatient settings
  2. The increasing demand for health care in general
  3. The fact that more health care is being provided on an outpatient basis

Accreditation of programs

Before discussing accreditation of medical assisting academic programs, it is necessary to define and distinguish institutional and programmatic (also known as specialized) accreditation. According to published, generally accepted standards, they may be defined as follows:

  1. Institutional accreditation is the process by which a school as a whole is evaluated.
  2. Programmatic accreditation is the process by which a specific program within a school is evaluated.

There are two bodies that accredit postsecondary medical assisting programs:

  1. The Commission on Accreditation of Allied Health Education Programs (CAAHEP)
  2. The Accrediting Bureau of Health Education Schools (ABHES)

The programs that CAAHEP and ABHES accredit are either one-year certificate or diploma programs, or two-year associate degree programs. Most of these programs are located in community colleges or vocational/technical schools. To be accredited by CAAHEP or ABHES, a postsecondary medical assisting program must teach students the knowledge, competencies, and professional attitudes required by the accreditation standards of CAAHEP or ABHES. These accreditation standards encompass the back-office clinical dimensions of medical assisting, the front-office administrative dimensions, and patient communication and other aspects of medical assisting that are necessary for competent and effective performance in clinical, administrative, and other domains.

There are many varieties of medical assisting educational programs throughout the United States. As indicated above, CAAHEP and ABHES only accredit medical assisting programs at the postsecondary level. However, there are medical assisting programs that are taught at the secondary (high school) level. Furthermore, some educational programs at the secondary and postsecondary level only teach the administrative aspects of medical assisting, and some programs only teach the clinical aspects of medical assisting. Finally, there are some postsecondary medical assisting programs that are not accredited by CAAHEP or ABHES, but are situated in postsecondary schools that are institutionally accredited.

As we turn our attention to medical assisting credentials, it is important to keep in mind that only graduates of CAAHEP or ABHES accredited medical assisting programs are eligible to take the CMA (AAMA) Certification Examination and become CMAs (AAMA).

Medical assisting credentials

As is the case with medical assisting academic programs, there are many different medical assisting credentials.  Some medical assisting tests and credentials are exclusively or primarily administrative, and some are exclusively or primarily clinical. There are several medical assisting examinations that try to evaluate both administrative and clinical knowledge, but these tests vary greatly in the depth and breadth of knowledge they attempt to measure.

A comparison of four medical assisting credentials is presented in “How the CMA (AAMA) Stands Apart.”1 The following summarizes the main points addressed in that article:

  1. The CMA (AAMA) is the only medical assisting certification program that requires candidates to graduate from a medical assisting education program.
  2. Only graduates of CAAHEP or ABHES accredited programs are eligible for the CMA (AAMA) Certification Examination.
  3. The CMA (AAMA) is the only medical assisting certification that requires proof of current certification in CPR as a requirement for initial certification and recertification.
  4. The CMA (AAMA) is the only certification that uses the National Board of Medical Examiners as test consultant.
  5. The CMA (AAMA) is the only medical assisting credential that requires proof of continuing education in the general, administrative, and clinical categories as a condition for recertifying by continuing education.

As discussed in “Your Office Staff Can Get You Sued,”2 an increasing number of employers are insisting that their medical assistants have the CMA (AAMA) designation, and that they keep it current by recertifying every 60 months. This is due to the fact that hiring a medical assistant who has graduated from an accredited academic program and who holds a current CMA (AAMA) credential is evidence that the employer is exercising a high degree of care and diligence in its medical assisting employment procedures.

Meeting new staffing demands

With the American health care delivery system changing at a dizzying rate, partly because of actions by all three branches of the federal government, it is time to take a fresh look at how CMAs (AAMA) can help physicians and other providers adjust to the new staffing configurations that are needed. Cost factors are influencing staffing decisions in all health delivery settings. Allied health professionals who are narrowly educated and unwilling to take on additional responsibilities outside of their traditional scopes of practice will find it more difficult to thrive in the new environment. In contrast, CMAs (AAMA) are being recognized as the allied health professionals of choice for all different varieties of outpatient delivery settings because of their broad-based education and their readiness to employ their critical thinking skills in adapting to novel approaches to health care delivery.

One of the most important of these new models for providing outpatient care is the Patient-Centered Medical Home (PCMH). Note the following definition of the PCMH:

The Patient-Centered Medical Home (PCMH) is an approach to providing comprehensive primary care for children, youth, and adults. The PCMH is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family.3

The partnerships between physicians, patients, and allied health professionals that are so essential for establishing a successful Patient-Centered Medical Home cannot be created without skilled communication. A CMA (AAMA) is the ideal allied health professional to “build the communication bridges” between physicians, patients, and the families of patients. Note the following elements of the Core Curriculum of the CAAHEP Standards and Guidelines for the Accreditation of Educational Programs in Medical Assisting:

  • Apply active listening skills.
  • Demonstrate empathy in communicating with patients, family, and staff.
  • Demonstrate respect for diversity in approaching patients and families.4

Allied health professionals must do more than foster communication between patients and physicians. In some instances, they must play a proactive role in presenting patients’ concerns and questions to physicians. The Core Curriculum acknowledges this fact by requiring medical assisting students to “recognize the role of patient advocacy in the practice of medical assisting, and advocate on behalf of patients.”

These are just a few of the ways in which CMAs (AAMA) can help physicians adjust to the new dynamics of U.S. health care. More specific information and breaking news about CMAs (AAMA) and their value to physicians and patients can be found on the AAMA website, Legal Eye blog, and future issues of CMA Today.

Questions? Contact Donald A. Balasa, JD, MBA, at dbalasa@aama-ntl.org or 800/228-2262.