1. The Medical Assistant & The Healthcare Team
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2. The History of Medicine
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The History of Medicine
Medical Pioneers & Their Achievements
Name
Achievement
Andreas Versalius ( )
Father of modern anatomy; wrote first anatomy book
William Harvey ( )
Discovered the circulatory system
Anton van Leeuwenhoek ( )
First to observe microbes through a lens; developed the first microscope
John Hunter ( )
Founder of scientific surgery

3. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Edward Jenner ( )
Developed smallpox vaccine
Ignaz Semmelweis ( )
First physician to recommend hand washing to prevent puerperal fever; believed there was a connection between performing autopsies & then delivering babies that caused puerperal fever in new mothers

4. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Florence Nightingale ( )
Founder of nursing
Clara Barton ( )
Established the American Red Cross
Elizabeth Blackwell ( )
First woman in the United States to earn a Doctor of Medicine degree

5. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Louis Pasteur ( )
Father of bacteriology & preventative medicine; developed pasteurization & established the connection between germs & disease
Joseph Lister ( )
Father of sterile surgery; developed antiseptic method for surgery

6. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Robert Koch ( )
Developed Koch's postulates, a theory of causative agents for disease; discovered the cause of cholera
William Roentgen ( )
Discovered the x-ray

7. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Walter Reed ( )
Proved that yellow fever was transmitted by mosquito bites while in the U.S. Army serving in Cuba
Paul Ehrlich ( )
Injected chemicals for the first time to treat disease (syphilis)
Marie Curie ( )
Discovered radium & polonium

8. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Alexander Fleming ( )
Discovered penicillin
Albert Sabin ( )
Developed the oral live-virus vaccine for polio 10 years after Salk developed the first injected vaccine

9. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Virginia Apgar ( )
Founded neonatology; developed the Apgar score, which assesses the status of newborns
Jonas Salk ( )
Developed the first safe & effective injectable vaccine for polio
Christian Barnard ( )
Performed the first human heart transplant

10. The History of Medicine: Cont.
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The History of Medicine: Cont.
Medical Pioneers & Their Achievements
Name
Achievement
Edwin Carl Wood ( )
Pioneered the technique of in vitro fertilization (IVF)
David Ho (1952- )
Research pioneer in acquired immunodeficiency syndrome (AIDS)

11. National Departments & Agencies That Focus on Health
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National Departments & Agencies That Focus on Health
Department of Health & Human Services (HHS): Responsible for providing essential human services & protecting the health of all Americans.
Centers for Disease Control & Prevention (CDC): Agency concerned with health.
National Institutes of Health (NIH): part of the HHS & seeks to improve health.
Occupational Safety & Health Administration (OSHA): responsible for establishing & enforcing regulations to protect individuals in the workplace.
Department of Health & Human Services (HHS): The principal U.S. department for providing essential human services & protecting the health of all Americans, especially those unable to help themselves. The HHS is made up of more than immunizations; financial assistance for low-income families; programs for the elderly; & oversight of Medicare & Medicaid programs.
Centers for Disease Control & Prevention (CDC): The principal U.S. federal agency concerned with health. It conducts research on health-related issues & serves as a clearinghouse for information & statistics associated with healthcare. The divisions of the CDC focus on specific health-related issues; some of these divisions are the National Center for HIV, STD, & TB Prevention; the Public Health Practice Program Office; the National Center on Birth Defects & Development Disabilities; & the National Center for Health Statistics. The CDC establishes regulations that affect all healthcare facilities.
National Institutes of Health (NIH): The NIH is part of the HHS & seeks to improve the health of the American people. It supports & conducts biomedical research into the causes & prevention of diseases & uses a modern communications system to furnish biomedical information to the healthcare professions. It consists of 27 different institutes & centers, in addition to the National Library of Medicine. Thousands of research projects are under way in NIH laboratories & clinics at any given time. The NIH also provides funding for research projects conducted at universities, medical schools, & hospitals.
Occupational Safety & Health Administration (OSHA): An agency if the Department of Labor responsible for establishing & enforcing regulations to protect individuals in the workplace. OSHA’s influence in the healthcare setting is far-reaching, especially in the areas of infection control & development of the Bloodborne Pathogens Standard to protect healthcare workers & patients from contracting infectious diseases in a healthcare setting.

12. Professional Medical Assisting Organizations
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Professional Medical Assisting Organizations
American Association of Medical Assistants (AAMA) formed in 1956, devoted exclusively to the medical assisting profession.
Commission on Accreditation of Allied Health Education Programs (CAAHEP) formed in 1993, in charge of the accreditation process
Accrediting Bureau of Health Education Schools (ABHES) in charge of the accreditation process
National Certification Examination

13. Professional Medical Assisting Organizations: Cont.
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Professional Medical Assisting Organizations: Cont.
American Medical Technologists (AMT) formed in 1939, certification agency for multiple allied health professionals.
National Commission for Certifying Agencies (NCCA). Accredits the AMT.
The National Healthcare Association (NHA) formed in 1990, offers certification examination in a number of allied health programs;
American Medical Technologists (AMT) formed in 1939, certification agency for multiple allied health professionals, including Medical Laboratory Technician (MLT), Phlebotomy Technician (RPT), Medical Assistant (RMA), Medical Administrative Specialist (CMAS), & Dental Assistant (RDA). The AMT certification examinations are developed, administered, & analyzed by a committee of subject matter experts. Once certification has been granted, applicants automatically become members of the AMT & earn the credential RMA.
The National Healthcare Association (NHA) formed in 1990, offers certification examination in a number of allied health programs; for example, certification is granted for pharmacy, phlebotomy, & electrocardiography (ECG) technicians. The NHA also offers two different medical assisting certifications: Certified Clinical Medical Assistant (CCMA) & Certified Medical Administrative Assistant (CMAA).

14. Medical Assisting Job Description
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Medical Assisting Job Description
Medical assistants are the only allied health professionals specifically trained to work in ambulatory care settings, such as physician’s offices, clinics, & group practices.
The skills performed by an entry-level medical assistant depend on his or her place of employment, but all graduates of accredited programs are taught a similar skill set.
The training includes both clinical & administrative skills, covering a multitude of medical practice needs.

15. Medical Assisting Job Description: Cont.
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Medical Assisting Job Description: Cont.
Clinical Skills Include:
Assisting during physical examinations
Performing patient screening procedures
Assisting with minor surgical procedures, including sterilization procedures
Performing electrocardiograms (ECGs)
Obtaining & recording vital signs & medical histories
Performing first aid procedures as needed

16. Medical Assisting Job Description: Cont.
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Medical Assisting Job Description: Cont.
Preforming phlebotomy
Performing tests permitted by the Clinical Laboratory Improvement Amendments (i.e., CLIA-waived tests)
Collecting & managing laboratory specimens
Following OSHA regulations on infection control
Administering vaccinations & medications as ordered by the practitioner
Performing infection control procedures

17. Medical Assisting Job Description: Cont.
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Medical Assisting Job Description: Cont.
Performing patient education & coaching initiatives within the scope of practice
Documenting accurately in a paper record or an EHR
Applying therapeutic communication techniques
Acting within legal & ethical boundaries
Adapting to the special needs of a patient based on his or her developmental life stage, cultural diversity, & individual communication barriers

18. Medical Assisting Job Description: Cont.
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Medical Assisting Job Description: Cont.
Acting as a patient advocate or navigator, including referring patients to community resources
Administrative skills include:
Answering telephones
Managing patient scheduling
Creating & maintaining patient health records
Documenting accurately in a paper record & an EHR

19. Medical Assisting Job Description: Cont.
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Medical Assisting Job Description: Cont.
Performing routine maintenance of facility equipment
Performing basic practice finance procedures
Coordinating third-party reimbursement
Performing procedural & diagnostic coding
Communicating professionally with patients, family members, practitioners, peers, & the public
Managing facility correspondence

20. Medical Assisting Job Description: Cont.
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Medical Assisting Job Description: Cont.
Performing patient education & coaching initiatives within the scope of practice
Following legal & ethical principles
Complying with facility safety practices

21. Allied Health Professionals
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Allied Health Professionals
Allied health professionals – those who can act only under the authority of a licensed medical practitioner (e.g., MD, DO, optometrist, dentist, pharmacist, podiatrist, or chiropractor)
The term “allied health” is used to identify a cluster of healthcare professional, encompassing as many as 200 careers.
Allied health professionals include respiratory therapists, radiation therapists, occupational therapists, physical therapists, technologist of various types, dental hygienists, medical assistant, phlebotomist, pharmacy technicians, & other professionals who do not independently diagnose & prescribe treatment, but perform diagnostic procedures, therapeutic services, & provide care.
Technicians:
Trained to preform procedures (less than 2 years)
Require to work under the supervision of medical providers or licensed therapists.
Therapists:
Require state-issued license & an advanced degree

22. Medical Professionals
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Medical Professionals
Primary care providers (PCPs) are often referred to as “gatekeepers,” because most insurance policies require that patients first must be assessed &, if possible, treated by the PCP before they are referred to a specialist for more advanced assessment & care.
Doctors of Medicine
Medical doctors (MDs) are considered allopathic physicians. They are the most widely recognized type of physician. They diagnose illness & prescribe treatment for their patients.
MDs have a wide variety of rights, including writing prescriptions, performing surgery, offering wellness advice, & performing preventative medicine procedures. Becoming an MD requires 4 years of undergraduate university training (premed) & 4 years of medical school. Regardless of where premed students attend college, a national standard of course work is required to apply to medical school. They must take entry & advanced levels of biology, physics, organic & inorganic chemistry, mathematics, English, humanities, & social sciences. The US has approximately 125 allopathic medical schools. After medical school, the student faces 3 to 8 years of residency programs, depending on the medical specialty he or she pursues.

23. Medical Professionals: Cont.
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Medical Professionals: Cont.
Doctors of Osteopathy
Osteopathic physicians (DOs) complete requirements similar to those of MDs to graduate & practice medicine. Osteopaths use medicine & surgery, in addition to the osteopathic manipulative therapy(OMT), in treating their patients. Dos stress preventive medicine & holistic patient care, in addition to a special focus on the musculoskeletal system & OMT.
Few differences between MDs & DOs today

24. Medical Professionals: Cont.
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Medical Professionals: Cont.
Doctors of Chiropractic
Chiropractic Doctors(DCs) typically are thought of as “bone doctors,” but they actually focus on the nervous system to help patients live healthier lives. The intention of the chiropractic adjustment is to remove any disruptions or distortions of the nervous system that may be caused by slight misalignments.
The nervous system is the master system of the body, controlling & coordinating all the other systems. Information from the environment, both internal & external, moves through the spinal cord to get to the brain, & in the same manner, information from the brain moves through the spinal cord to reach the body in a two-way flow of communication.

25. Medical Professionals: Cont.
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Medical Professionals: Cont.
Hospitalists
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Most hospitalists are employed by the healthcare facility instead of having individual freestanding offices in which patients are seen & treated. Hospitalists work a specific, set number of hours each week & receive a set salary from their employers.
In addition, most institutions that employ hospitalists cover these physicians with blanket malpractice insurance, saving the practitioner the expense of costly premiums. Although the hospitalist is in charge of the patient while the person is in the hospital, if the patient has a PCP, he or she may still visit the patient. Of course, the patient is not required to use the services of a hospitalists & may be cared for by the attending physician of his or her choice. The hospitalist would still refer the patient to medical specialists as needed for more advanced care.

26. Medical Professionals: Cont.
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Medical Professionals: Cont.
Dentists
There is no difference in training between dentists with a “DDS” or a “DMD.” The two degrees mean the same thing: the dentist graduated from an accredited dental school. DDS stands for Doctor of Dental Surgery, & DMD stands for Doctor of Medicine in Dentistry or Doctor of Dental Medicine.
The university where each dental school is based determines the degree in dentistry that is awarded.
The level of education & clinical training required to earn a dental degree are similar to those expected by medical schools. Upon completion of general dentistry training, additional postgraduate training is required to become a dental specialist, such as an orthodontist or periodontists

27. Medical Professionals: Cont.
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Medical Professionals: Cont.
Optometrists
The optometrist (OD) is trained & licensed to examine the eyes, to test visual acuity, & to treat vision defects by prescribing correctional lenses & other optical aids.
Podiatrists
Podiatrists (Doctors of Podiatric Medicine [DPMs]) are educated in the care of the feet, including surgical treatment. Podiatrists are trained to find pressure points & weight-distribution problems.
Optometrists study at accredited schools of optometry for 4 years after completing undergraduate studies in the sciences, mathematics, & English. They must be licensed in the state in which they practice. Optometrists should not be confused with ophthalmologist, who are licensed MDs.
These physicians must complete an undergraduate bachelor’s degree in addition to 4 years of training in a podiatric medical school & 3 years of hospital residency training. The training is similar to that of other doctors.

28. Medical Professionals: Cont.
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Medical Professionals: Cont.
Nurse Practitioners
Nurse practitioner (NPs) provide basic patient care services, including diagnosing & prescribing medications for common illnesses, or they may have additional training & expertise in a specialty area of medicine.
These professionals must have advanced academic training beyond the registered nurse (RN) degree & also have vast clinical experience. An NP is licensed by individual states & can practice independently or as a part of a team of healthcare professionals.

29. Medical Professionals: Cont.
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Medical Professionals: Cont.
Nurse Anesthetists
Nurse anesthetists are registered nurses (RNs) who administer anesthetics to patients during surgical or inpatient diagnostic procedures. They practice in many different healthcare settings, including hospital surgical areas, labor, & delivery units, ophthalmology offices, plastic surgery offices, & many others.
Certified Registered Nurse Anesthetist (CRNA) must have a Bachelor of Science in Nursing (BSN) or other appropriate baccalaureate degree; a current license as a registered nurse; & at least 1 year’s experience in an acute care nursing setting. They also must have graduated from an accredited graduate school of nurse anesthesia program, which can range from 24 to 36 months, & must pass a national certification examination after graduation.

30. Medical Professionals: Cont.
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Medical Professionals: Cont.
Physician Assistants
A physician assistant (PA) is a certified healthcare professional who provides diagnostic, therapeutic, & preventive healthcare services under the supervision of a medical doctor.
Physician assistants must be licensed, which requires completion of a physician assistant program that is typically at the master’s degree level. Physician assistant must pass the Physician Assistant National Certifying Examination to practice in any state. They may also complete advanced training to focus on a particular specially practice.

31. Types of Healthcare Facilities
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Types of Healthcare Facilities
Hospitals
Hospitals are classified according to the type of care & services they provide to patients & by the type of ownership. There are three different levels of hospitalized care, which are interconnected.
Primary Level of Care
Smaller city or community hospitals
Usually serve as the first level of contact between the community members & the hospital setting

32. Types of Healthcare Facilities: Cont.
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Types of Healthcare Facilities: Cont.
Secondary Level of Care
Both PCPs & specialists provide care
Larger municipal or district hospitals that provide a wider variety of specialty care & departments
Tertiary Level of Care
Referral system for primary or secondary care facilities
Provide care for complicated cases & trauma
Medical centers, regional & specialty hospitals

33. Types of Healthcare Facilities: Cont.
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Types of Healthcare Facilities: Cont.
Private hospitals are run by a corporation or other organization & usually are designed to produce a profit for the owners or stockholders.
Nonprofit hospitals exist to serve the community in which they are located & are normally run by a board of directors. The term nonprofit sometimes is misleading, because “profit” is different from “making money.” A nonprofit hospital or organization may make money in a campaign or fundraiser, but all of the money is returned to the organization.
Nonprofit hospital & organizations must follow strict guidelines in the area of finance & must account to the government for the money brought in & the purposes for which it is used.

34. Types of Healthcare Facilities: Cont.
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Types of Healthcare Facilities: Cont.
A hospital system is a group of facilities that are affiliated & work toward a common goal. Many hospital systems are designed as integrated health delivery systems.
An integrate delivery system (IDS) is a network of healthcare providers & organizations that provides or arranges to provide a coordinated continuum of services to a defined population & is willing to be held clinically & fiscally accountable for the clinical outcomes & health status of the population served.
Hospital systems may include a hospital & a cancer center in a small community or may consist of a group of separate hospitals in a specific geographic region.
An IDS may own or could be closely aligned with an insurance product, such as a type of insurance policy. Services provided by an IDS can include a fully equipped community &/or tertiary hospital, home healthcare & hospice services, primary & specialty outpatient care & surgery, social services, rehabilitation, preventive care, health education & financing, & community provider offices. An IDS can also be a training location for health professional students, including physicians, nurses, & allied health professionals.

35. Types of Healthcare Facilities: Cont.
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Types of Healthcare Facilities: Cont.
Accreditation is considered the highest form of recognition for the quality of care a facility or organization provides. Not only does it indicate to the public that the facility is concerned with providing high-quality care, it also provides professional liability insurance benefits & plays a role in regulatory agency re-licensure & certification efforts.
Hospitals & other healthcare facilities are accredited by The Joint Commission, an organization that promotes & evaluates the quality of care in healthcare facilities. Standards or indicators have been developed that help determine when patients are receiving high-quality care. The term quality refers to much more than whether the patient liked the food served or had to wait to have a procedure or test performed.
Categories of compliance include:
Assessment & care of patients
Use of medication
Plant, technology, & safety management
Orientation, education, & training of staff
Medical staff qualifications
Patients’ rights

36. Types of Healthcare Facilities: Cont.
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Types of Healthcare Facilities: Cont.
Ambulatory Care
Ambulatory care centers include a wide range of facilities that offer healthcare services to patients who seek outpatient health services. Physician’s offices, group practices, & multispecialty group practices are common types of ambulatory care facilities, & medical assistance can be employed in all of these practices.

37. Types of Healthcare Facilities: Cont.
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Types of Healthcare Facilities: Cont.
Other Healthcare Facilities
Diagnostic laboratories offer testing services for patients referred by their provides.
Home health agencies or hospital-affiliated home healthcare organizations provide crucial services to patients who require medical follow-up but are not in a hospital setting. Home healthcare includes therapy services, administration of & assistance with medications, wound care, & other services so that the patient can remain at home, yet still obtain consistent medical attention.

38. Types of Healthcare Facilities: Cont.
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Types of Healthcare Facilities: Cont.
The Patient-Centered Medical Home
According to the Agency for Healthcare Research & Quality (AHRQ), the patient-centered medical home has five core functions and attributes:
Comprehensive care
Patient-centered care
Coordinated care
Accessible services
Quality & safety
According to the Agency for Healthcare Research & Quality (AHRQ), which is part of the HSS, “The patient-centered medical home is a way of organizing primary care that emphasizes care coordination & communication to transform primary care into what patients want it to be.”
Comprehensive care – the primary care practice has the potential to provide physical & mental healthcare, prevention & wellness, acute care, & chronic care to all patients in the practice. However, comprehensive care cannot be provided by only the practicing physician. It requires a team of care providers. The healthcare team for a PCMH includes physicians, nurse practitioners, physician assistants, nurses, pharmacists, nutritionists, social workers, educators, & medical assistants. If these specialty individuals are not readily available to smaller physician practices, virtual teams can be created online to link providers & patients to services in their communities.
Patient-centered care – The PCMH provides primary healthcare that is holistic & relationship-based, always considering the individual patient & all facets of his or her life. However, establishing a partnership with patients & their families requires understanding & respect of each patient’s unique needs, culture, values, & preferences. Medical assistants are trained to provide respectful patient care regardless of individual patient factors. The goal of PCMH is to encourage & support patients in learning how to manage & organize their own care. Patients & families are recognized as core members of the care team.
Coordinated care – The PCMH coordinates care access all parts of the healthcare system, including specialty care, hospitals, home healthcare, & community services. Coordination is especially important when patients are transitioning from one site of care to another, such as from hospital to home. The PCMH works at creating & maintaining open communication among patients & families, the medical home, & members of the broader healthcare team.
Accessible services – The PCMH is designed to deliver accessible care. This is achieved through establishing policies that create shorter wait times for urgent needs, more office hours, around- the-clock telephone or electronic access to a member of the care team, & alternative methods of communication, such as e- mail & telephone care.
Quality & safety – The PCMH is committed to delivering quality healthcare by providing evidence-based medicine & shared decision making with patients & families; assessing practice performance & working on improvements; collecting safety data; & measuring & responding to patients’ experiences & satisfaction. All of this information is made public to allow an open assessment of the practice & suggestion for possible methods of improvement.

39. Scope of Practice & Standards of Care for Medical Assistants
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Scope of Practice & Standards of Care for Medical Assistants
Scope of practice is defined as the range of responsibilities & practice guidelines that determine the boundaries within which a healthcare worker practices.
Make sure you are aware of your states’ rules governing medical assistant scope of practice.

40. Scope of Practice & Standards of Care for Medical Assistants
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Scope of Practice & Standards of Care for Medical Assistants
Specific task that are beyond the scope of practice for medical assistants:
Performing telephone or in-person triage; medical assistants are not legally authorized to assess or diagnose symptoms
Prescribing medications or making recommendations about over-the-counter drugs & remedies
Giving out drug samples without provider permission

41. Scope of Practice & Standards of Care for Medical Assistants
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Scope of Practice & Standards of Care for Medical Assistants
Automatically submitting refill prescription requests without provider orders
Administering intravenous (IV) medications & starting, flushing, or removing IV lines unless permitted by state law
Analyzing or interpreting test results
Operating laser equipment

42. Scope of Practice & Standards of Care for Medical Assistants
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Scope of Practice & Standards of Care for Medical Assistants
Standard of care is a legal term that refers to whether the level & quality of patient service provided is the same as what another healthcare worker with similar training & experience in a similar situation would provide.
Medical assistants not meeting the expected standard of care may be charged with professional negligence
We will cover negligence later in the term.

43. Page 29
Closing Comments
A crucial role of medical assistants is to act as the patient’s navigator; that is, to help patients understand & comply with complex care issues.
Medical assistant practice must align with state & regional scope of practice laws & must meet expected standards of care.
Medical assistants must always act under the direction of a physician or provider; they cannot diagnose, prescribe, or treat patients independently.

44. Closing Comments Page 29 Patient Education
Some patients have very little knowledge about the healthcare industry & may need instruction & explanations about details important to their healthcare. They often call the healthcare facility with questions; therefore, MAs must understand the wide variety of healthcare facilities & medical resources available in the community. Become familiar with community resources to make provider-approved referrals for patients who need help from various sources.
If a patient seems to have a need, speak with him or her privately & determine whether any agency or organization might help with the issues at hand.
The patient-centered medical home model relies on all healthcare workers to participate in the care of patients.

45. Closing Comments Page 30 Legal & Ethical Issues
MAs are responsible for understanding & following the scope of practice in their communities & for always meeting the expected standards of care. Not meeting these responsibilities can result in serious liability for themselves & their employers.
You must know the limitations placed on you practice by the state in which you live or by the facility or provider who employs you.
Remember, the MA must act under the direct supervision of a physician or licensed provider.
There is nothing more important than patient safety, so always act within the guidelines of the law & according to the policies & procedures of the facility where you work. MAs are multi-skilled healthcare workers who can have a lasting positive effect on patient outcomes. However, never forget that you do not have the authority or education to diagnose, prescribe, or treat patient clinical problems.