Medical Assisting: An Overview of the Profession & Results

Office of the University Dean for Health and Human Services

101 West 31st Street, 14th Floor, New York, NY 10001 • Phone: (646) 344-7315 • Fax: (646) 344-7319 http://web.cuny.edu/administration/hhs.html

Medical Assisting: An Overview of the Profession

& Results of the Survey of Graduates (1999-2000 to 2009-2010)

Summary Report

February 2012

CUNY: Overview of the Medical Assisting Profession & Survey of Graduates (1999-2000 to 2009-2010) February 2012

Office of the University Dean for Health and Human Services, CUNY 1

Table of Contents

I INTRODUCTION............................................................................................................. 3

Overview of the Medical Assisting Profession ......................................................................... 3

Challenges Facing the Medical Assisting Profession ................................................................ 4

Healthcare Reform and the Evolving Medical Assistant Role .................................................. 5

Utilization of Medical Assistants in Community-Based, Primary Care Settings ...................... 6

Preparing the Medical Assistant of the Future: Public Education’s Role ............................... 11

II METHODOLOGY ......................................................................................................... 12

Sample Selection and Response Rate ...................................................................................... 12

Survey Weights ....................................................................................................................... 13

Survey Design ......................................................................................................................... 13

Research Team and Acknowledgements ................................................................................. 13

III DESCRIPTION OF GRADUATES .............................................................................. 14

Graduate Demographics .......................................................................................................... 14

IV MEDICAL ASSISTANT EDUCATION ...................................................................... 18

Perceptions of CUNY Medical Assistant Education ............................................................... 18

Additional Degrees .................................................................................................................. 19

Further Education .................................................................................................................... 20

V INCUMBENT WORKERS ............................................................................................ 22

CUNY Medical Assistant Students as Incumbent Workers .................................................... 22

VI TRANSITION FROM CUNY ....................................................................................... 23

Internships ............................................................................................................................... 23

Certification ............................................................................................................................. 25

Job Search and Working as a Medical Assistant ..................................................................... 26

VII CAREER PATHS ........................................................................................................... 28

Work Settings .......................................................................................................................... 28

First Medical Assistant Job Tenure ......................................................................................... 30

Salaries .................................................................................................................................... 31

Characteristics of Current/Most Recent Medical Assistant Job .............................................. 32

Job Satisfaction and Benefits: Current/Most Recent Medical Assistant Job ........................... 34

Graduates Not Currently Working as Medical Assistants ....................................................... 37

Career Plans ............................................................................................................................. 39

VIII CONCLUDING COMMENTS ...................................................................................... 40

IX REFERENCES ................................................................................................................ 42



List of Tables

Table 1. Total Population of CUNY Medical Assistant Graduates, 1999-2000 to 2009-2010. ............ 15

Table 2. Respondents to the Survey of CUNY Medical Assistant Graduates, 1999-2000 to 2009-2010 ................................................................................................................................................. 16

Table 3. Demographics of CUNY Medical Assistant Graduates .......................................................... 17

Table 4. Perceptions of CUNY Medical Assistant Program ................................................................. 18

Table 5. Overall Educational Attainment .............................................................................................. 19

Table 6. Further Education .................................................................................................................... 21

Table 7. Incumbent Workers ................................................................................................................. 22

Table 8. Internships ............................................................................................................................... 24

Table 9. Certification ............................................................................................................................. 25

Table 10. Job Search ............................................................................................................................... 27

Table 11. Work Experience as a Medical Assistant ................................................................................ 27

Table 12. First and Current/Most Recent Medical Assistant Job Setting ................................................ 29

Table 13. First Medical Assistant Job ..................................................................................................... 30

Table 14. Salaries .................................................................................................................................... 31

Table 15. Clinical vs. Administrative Duties .......................................................................................... 32

Table 16. Electronic Health Records ....................................................................................................... 33

Table 17. Benefits and Rewards at Current/Most Recent Medical Assistant Job ................................... 35

Table 18. Health Insurance Benefits ....................................................................................................... 36

Table 19. Graduates Not Currently Working as Medical Assistants ....................................................... 38

Table 20. Career Plans: All Graduates .................................................................................................... 39



I INTRODUCTION

Overview of the Medical Assisting Profession As defined by the Bureau of Labor Statistics (BLS, 2010) and the American Association of

Medical Assistants (AAMA, 2003; AAMA, 2010), medical assistants (MAs) are healthcare

personnel who ensure the smooth operations of physician’s offices (primarily) and other

healthcare facilities, by performing a variety of administrative and clinical tasks. Administrative,

or “front office,” tasks performed by MAs include billing and coding, patient registration and

scheduling appointments, among others. Clinical functions, also known as “back office” tasks,

include phlebotomy, electrocardiography (EKG) and exam room preparation, among others. The

MA profession developed during World War II, at a time when nurses migrated in large numbers

from physician’s offices to short-staffed hospitals. To bridge the resulting gap, physicians

retrained medical secretaries to take on clinical duties in addition to their administrative role,

leading to the unique administrative/clinical balance still found in the MA profession (Taché &

Chapman, 2004).

The BLS estimates that there were approximately 483,600 MAs in the workforce in 2008, with

the majority (62%) working in physician’s offices and small percentages working in other

settings such as hospitals (13%) and the offices of non-physician providers (11%). The median

annual salary for medical assistants was $28,300 in 2008, among the lowest wages for non-

physician personnel who perform many of the same functions. For example, median wages in

2008 for licensed practical/vocational nurses (LPNs/LVNs), medical secretaries, and medical

records/health information technicians were $39,030, $29, 680, and $30, 610, respectively.

Nationally, the MA workforce is predominantly female and mostly Caucasian, although the

racial/ethnic composition of the workforce differs dramatically based upon locale (e.g., 54% of

MAs working in California are non-White; Taché & Chapman, 2004).

The BLS projects that medical assistants will be in demand in the coming years, with “much

faster than average” growth expected from 2008-2018. In addition to being one of the fastest

growing healthcare sectors, medical assistants are the largest group of healthcare personnel

present in ambulatory care settings (Taché & Hill-Sakurai, 2010). MAs have been described as



“linchpins of the healthcare system,” (Balasa, 2009), “the glue of the healthcare system,” (Taché

& Hill-Sakurai, 2010) and “an important human resource” (Ferrer, Mody-Bailey, Jaén, Gott &

Arujo, 2009), in addition to being touted as a cost-effective answer for primary care providers

seeking to improve efficiency and patient flow within their practices (e.g., Taché & Chapman,

2005). MAs themselves also recognize the value of their work as patient flow managers,

liaisons, and educators in the primary care setting (Palmer & Midgette, 2008; Taché & Hill-

Sakurai, 2010).

Challenges Facing the Medical Assisting Profession As it continues to grow in size and importance within the healthcare landscape, the medical

assisting field faces a number of challenges (Taché & Chapman, 2004, 2006). These challenges

include:

• Lack of a standard scope of work: Medical assistants have varied scopes of work depending

upon the state in which they practice, the physician they work under, and their work setting.

Medical assistants who work in short-staffed areas of the country and/or small medical

practices tend to perform more functions than those who work within large, fully-staffed

facilities that have more defined roles and restricted scopes of practice. MAs are not licensed

in most states, but states such as New York have recently responded to the growing

utilization of MAs by officially delineating the tasks that can and cannot be delegated to

MAs (NYSED Office of the Professions, 2010).

• Lack of consistent entry requirements: Medical assistant training is currently delivered

through a wide variety of channels, including on-the-job training (which might not be

transferrable between settings); non-credit educational programs of varying lengths; 6- to 12-

month credit certificate programs; and 2-year associate degree programs that vary in their

mix of administrative and clinical training. This wide range of training options has

implications for the skill level of the workforce and quality of care.

• Undefined career ladders: Professions such as nursing have clearly outlined careers paths

(e.g., certified nurse’s aide (CNA)�licensed practical/vocational nurse (LPN/LVN) �

registered nurse (RN)�nurse practitioner (NP) and beyond) that are missing from the

medical assisting field. Innovative organizations (including those outlined later in this

review) create internal pathways for advancement that allow MAs to take on greater



responsibility, perform in more varied roles and earn higher pay. Without these defined

opportunities for advancement, the field may face difficulties with recruiting and retaining its

workforce.

• Lack of regulation/lack of consensus on the value of certification: Two MA credentials are

currently offered, the Certified Medical Assistant (CMA) credential governed by the

American Association of Medical Assistants and the Registered Medical Assistant (RMA)

credential governed by American Medical Technologists (AMT). Most states and employers

do not require certification for employment. Although certification does translate into higher

salaries, only ~15% of MAs in the United States hold either the CMA or RMA credential.

• Lack of oversight/standardization for educational programs: Two accrediting bodies are

recognized by the field- the Commission on Accreditation of Allied Health Education

Programs (CAAHEP) and the Accrediting Bureau of Health Education Schools (ABHES).

Although the number of accredited programs is on the rise, there are large numbers of

unaccredited programs. Given that graduation from an accredited program is not required for

practice, many programs have little impetus to pursue the costly and time-intensive

accreditation process.

• Low pay relative to other allied health professions: Given that the profession is loosely

regulated and unlicensed, MAs receive lower pay as compared to LPNs/LVNs,

medical/clinical laboratory technicians, radiology technologists/technicians, medical

secretaries and medical records/health information technicians, all professionals who perform

functions similar to those performed by medical assistants.

A systematic, profession-wide response to these issues will be critical to the profession’s success

as it expands in the coming years (Chapman, Marks & Chan, 2010).

Healthcare Reform and the Evolving Medical Assistant Role The healthcare system of the future, as dictated by the ongoing healthcare reform movement, will

focus on chronic care and prevention (rather than the historical focus on acute care), shift the

locus of care from the hospital setting to the community setting, enhance patients’ involvement

in their care, and seek to improve efficiency and continuity of care. National reports and

initiatives (Martin et al., 2004; Cifuentes et al., 2005; Cohen, Tallia, Crabtree & Young, 2005;

Institute of Medicine, 2001) highlight the importance of primary care in the future healthcare



system, the pressing need for preventive services and the value of interdisciplinary teams that

utilize non-physician personnel (including MAs) within the full scope of their practice and

capabilities. The flexibility of the MA role (a corollary to the lack of standardization described

as a challenge above) makes it a natural choice for reconfiguration to fit the needs of the

emerging healthcare system.

Utilization of Medical Assistants in Community-Based, Primary Care Settings Bates and Chapman (2009, 2010) conducted a two-part examination of the utilization of allied

health personnel in California’s Federally Qualified Health Centers (FQHCs; i.e., clinics funded

by federal grants governed by Section 330 of the Public Health Act), FQHC Look-Alikes

(similar to FQHCs, but not funded via the Public Health Act), Free Clinics (clinics that are

operated primarily with private funding and do not charge patients for care) and other

independent, non-profit clinics.

The first phase of their investigation focused on the utilization of MAs in particular. The

community-based clinics surveyed have increased significantly in number and patient caseload

in recent years, with most of this growth occurring at FQHC and FQHC Look-Alikes. As these

clinics have proliferated, so has their utilization of MAs. In 2007 (the most recent year reported

on), more than 70% of the surveyed clinics used MAs, including 80% of the largest clinics (those

completing >40,000 patient visits every year). In the second, comparative phase of their

investigation, Bates and Chapman (2010) highlighted a trend towards clinics using MAs in lieu

of other types of allied health staff. Of the clinics reporting use of MAs in 2008, 35% reported

using MAs exclusively, in lieu of registered nurses (RNs) and licensed vocational/practical

nurses (LVNs/LPNs). In general, staffing patterns incorporating MAs (whether alone or in

combination with nurses) were more common than nurse-only staffing patterns, with the RN-MA

pairing being the most commonly used. These data lend credence to the notion that MAs will be

a vital cog in emerging healthcare settings.

Two emergent care delivery models, the “teamlet” model and the Ambulatory Intensive Caring

Unit (A-ICU) model, propose innovative approaches for utilizing medical assistants in primary

care settings. Both approaches are in the spirit of the Patient-Centered Medical Home (PCMH)



model (Robert Graham Center, 2007) that is a cornerstone of the ongoing healthcare reform

movement.

Bodenheimer and Laing (2007) describe a “teamlet model of primary care” that hinges on

retraining medical assistants and other allied health personnel as health coaches. Health coaches

conduct “previsits” with all patients (priority setting for the visit, history taking, etc.), provide

assistance during the clinical encounter as needed, and conduct “postvisits” for complex cases (to

reinforce the clinician’s advice, help patients develop behavioral change action plans, etc.).

Between visits, health coaches follow-up with patients by phone or e-mail to reinforce

information discussed during the previous visit and troubleshoot any issues. This model has

demonstrated success in the treatment of chronic illnesses such as diabetes and hypertension

(Chen et al., 2010), although implementation has not occurred without challenges (Laing, Ward,

Yeh, Chen & Bodenheimer, 2008; Ngo, Hammer & Bodenheimer, 2010).

The A-ICU model of care (Blash, Chapman & Dower, 2010a, b; Renaissance Health, 2006) calls

for providers to target clinical resources to the sickest patients, to actively engage patients in self-

care management, and to utilize allied health personnel such as medical assistants as health

educators. A-ICU conceptualizes care as occurring on three metaphorical “floors.” On the first

“floor,” medical assistants and other non-physician staff work with patients to enhance their

ability to manage their existing illnesses. On the second “floor,” primary care visits (with

clinicians such as physicians or nurse practitioners) are supported by health information

technology resources and continued involvement of frontline workers, with the goal of making

visits as efficient and effective as possible. The focus of the third “floor” is to provide cost-

effective specialist referrals and other services (e.g., pharmacy) via partnerships with large

insurers.

An ongoing series entitled Innovative Workforce Models in Health Care presents case studies of

health facilities that have implemented the A-ICU model and components of the teamlet model

of care. The first article of the series describes the experience of New York City’s UNITE

HERE Health Center (UHC), the oldest health center in the United States developed to serve the

health needs of union members (Blash, Chapman & Dower, 2010a; Nelson, Pitaro, Tzellas &

Lum, 2010). The Center used existing bilingual/bicultural medical assistants to assume the



responsibilities outlined in the A-ICU model’s first floor. Following successful completion of

training, MAs become health coaches, working closely with patients (in person and by

telephone) on self-management of chronic illness. Health coaches also often serve as floor

coordinators, charged with maintaining a smooth flow of patients and teamwork. Adoption of

the A-ICU model began at one center, spread throughout UHC’s network of clinics, and helped

UHC achieve PCMH designation.

The series goes on to describe similar initiatives implemented at sites across the country,

including:

• An Atlantic City, NJ clinic that provides care for low-income, immigrant casino workers.

Implementation followed a course similar to the experience at UHC, except that this clinic

hired new bilingual/bicultural MAs and LPNs to fulfill the health coach role (Blash,

Chapman & Dower, 2010b).

• Kaiser Permanente, which implemented a technology-based support tool and team-based

patient visits to close gaps in the delivery of screenings/other preventive services and

streamline primary care (Blash, Chapman & Dower, 2010c).

• A rural, five-site Colorado FQHC, where all allied health personnel (MAs, nurses, medical

secretaries, etc.) are cross-trained as “patient facilitators.” Patient Facilitators can then

complete additional training to advance to the health coach role. These professionals work

alongside a patient navigator and community health worker to improve the patient experience

and continuity of care (Blash, Dower & Chapman, 2010a).

• A rural, four-site West Virginia FQHC that implemented an MA-based model of care (using

existing, experienced MAs in expanded roles. The goal of this initiative was to deliver

quality care to older adults, in both the home setting and the clinic setting (Blash, Dower &

Chapman, 2010b).

• A network of 11 community-based clinics operated by the University of Utah, which

developed and implemented a “care by design” model. The hallmarks of this model include

a high MA-to-provider ratio, as well as thoughtful and intentional expansion of the MA role.

This model also involved developing relationships with the local community/technical

college, which retrained incumbent workers as MAs (Blash, Dower & Chapman, 2011a).



• A Sacramento, CA family medicine residency practice that implemented Utah’s “care by

design” model in its quest for PCMH designation (Blash, Dower & Chapman, 2011b).

• A Eugene, OR healthcare organization piloting the patient centered medical home model.

MAs were used in expanded roles, including administering immunizations; administering

depression screening inventories; performing medication reconciliations and providing

prescription refills per protocol; and serving as health coaches, providing health promotion

and patient education services per protocol (Blash, Dower & Chapman, 2011c).

• A university-affiliated, primary care medical group operating 16 clinics in the greater

Chicago area. This group implemented a three-level MA career ladder, including promotion

and salary incentives. With supervision, MAs devise and implement projects intended to

improve clinic processes; participate in training to enhance customer service and other skills;

and have the opportunity to expand their role/responsibilities (Blash, Chapman & Dower,

2011a).

• A San Antonio, TX based medical group that serves primarily Medicare patients. This

organization also operates an on-site medical assistant training school, in conjunction with a

local community college. MAs in this organization perform expanded functions, including

performing injections, administering medications and reconciling medications (Blash,

Chapman & Dower, 2011b).

• A rural Maine federally qualified health center (FQHC). Given the shortage of nurses in the

area, MAs play an important role in patient care and quality improvement initiatives. MAs

working in this center administer immunizations; perform depression, smoking status and

chronic illness screenings; assist patients with setting goals for self-management of care; and

participate actively in quality improvement. MAs may also be promoted to the Team Lead

role, with responsibility for workflow delegation and communication with administration

(Blash, Chapman & Dower, 2011c).

• A Baltimore, MD hospital-owned ambulatory care clinic and residency site, which developed

a career advancement opportunity (via creation of a Lead CMA role), implemented to retain

and expand the functions of talented CMAs. Competency assessment and training/

continuing education opportunities for new and incumbent CMAs were also implemented,

including the use of simulation for assessment and training exercises (Blash, Dower &

Chapman, 2011d).



• A Worchester, MA community health center and residency site, which incorporated multiple

training opportunities (medical interpretation, patient navigation/community health work,

supervisor/mentor, clinical skills) along with career advancement opportunities (Blash,

Chapman & Dower, 2011d).

Although diverse, the sites highlighted in the Innovative Workforce Models of Care series faced

many similar challenges, and enjoyed many similar successes. Challenges included:

• Difficulty eliciting buy-in from staff members who were skeptical and/or resentful of the

changes; high staff turnover early in the implementation process

• Significant financial and time-related costs of training and implementation

• Patient confusion and/or discomfort surrounding the redesign; and

• Changes in the target patient population (e.g., demographics, insurance coverage,

employment status).

Despite these challenges, implementation of these innovative models led to many positive

outcomes, including:

• Decreases in wait times, no-show rates, and unscheduled visits

• Decreased care costs, including costs related to ER visits and hospitalizations

• Improved clinical outcomes (e.g., A1c levels, blood pressure, LDL levels, smoking rates) and

rates of preventive screening (e.g., colonoscopy, mammography)

• Decreased staff turnover

• Increased clinic productivity/patient volume

• Improved patient satisfaction

• Improved patient safety

MAs and other allied health personnel involved in these innovative models reported feeling more

confident, satisfied, engaged and skilled in their professional roles. Many have also taken

advantage of opportunities and benefits geared towards educational advancement. Concrete and

attainable career ladders were created/reinforced within these organizations, and each facility

made significant use of technology (e.g., electronic health records, simulation) to streamline care

delivery and documentation. A number of sites also achieved Patient Cantered Medical Home

(PCMH) designation as a result of their successful redesign initiatives.



Other collaborative models not included as part of the “Innovative Workforce Models in Health

Care” series have demonstrated that interdisciplinary care involving medical assistants in central

roles can improve patient referrals to, and attendance at, behavioral interventions (Ferrer, Mody-

Bailey, Jaén, Gott & Araujo, 2009); self-management of care among diabetics (Robert Wood

Johnson Foundation, 2006; Ruggerio et al., 2010); consistency of smoking status documentation

(Spencer, Swanson, Hueston and Edberg, 1999); delivery of smoking cessation services (Katz,

Muehlenbruch, Brown, Fiore & Baker, 2004); and mammography screening rates (McCarthy et

al., 1997).

Preparing the Medical Assistant of the Future: Public Education’s Role The medical assisting profession is poised to continue its trajectory of dynamic growth and

reinvention in the coming years. Educational programs training medical assistants are key

partners in the profession’s future. Given that the workforce is relatively low-wage, public

universities offering affordable tuition will be critical to the profession’s success. Public

universities such as the City University of New York, which offer affordable programs and

maintain ties to the healthcare industry, will be particularly relevant to this movement.

Supporting and strengthening CUNY’s medical assistant programs is a goal for the University’s

Office of the University Dean for Health and Human Services. As a first step, the Office

commissioned a survey of graduates from CUNY’s medical assistant graduates over the past

decade (from the 1999-2000 academic year to the 2009-2010 academic year).



II METHODOLOGY

The Survey of CUNY Medical Assistant Graduates was conducted by the Office of the

University Dean for Health and Human Services. Respondents completed interviews between

September 2010 and December 2010.

Sample Selection and Response Rate Our sample was the 239 students who graduated from CUNY medical assistant programs

between the 1999-2000 and 2009-2010 academic years, including four programs: 1) a Medical

Assistant AAS degree program at Bronx Community College, 2) a Medical Office Manager AAS

degree program at Hostos Community College, 3) a Medical Office Manager Certificate program

at Hostos Community College, and 4) a Medical Office Assistant Certificate program at

Queensborough Community College. The AAS degree and Certificate programs at Hostos

Community College had only 22 graduates and one graduate over the study period, respectively,

and were included in the survey sample, but not in the analysis, because of low sample size.

The entire population of 239 individuals was provided to Cornell University’s Survey Research

Institute (SRI), which administered the survey. Potential respondents were sent an alert letter and

were subsequently contacted by SRI to set up a time to participate in a 10-minute telephone

survey. We offered a $10 incentive for survey participation. A total of 39 percent of telephone

numbers were wrong numbers or no longer in service. Among eligible phone numbers, we

achieved a 79 percent contact rate and an overall response rate of 67 percent (calculated using

the American Association for Public Opinion Research contact rate 3 and response rate 4

formulae). We obtained 90 completed interviews, comprising 38 percent of the entire population

of CUNY’s medical assistant program graduates during the 11-year period. Eighty-three of the

completed surveys came from the two programs (Bronx AAS and the Queensborough

Certificate) included in the analysis, which also comprise 38% of the population of 216

graduates from those two programs.



Survey Weights

We applied population weights to the sample using data from CUNY’s Institutional Research

Database (IRDB). Weighting was a two-step process. First, post-stratification weights were

assigned according to location in one of 20 strata, representing college program, whether the

degree was from the last five years or earlier, and race and ethnicity. Next, we used a raking

procedure, also known as sample balancing, to adjust the post-stratification weights to enhance

sample representativeness of the original survey population. This procedure helps correct for

both intentional oversampling and potential differences in non-response rates across population

subgroups, and it also allows for weighting by variables not in our original strata. Categories

used in the raking procedure included college program, specific academic year, age category,

ethnicity, and gender. The raking procedure was executed using the enhanced IHB Raking

Macro in SAS 9.13.

Survey Design Questions in the survey were designed specifically for CUNY medical assistant graduates.

Existing surveys and literature on both the medical assisting and general workforce informed the

development process. The survey sample selection and instrument design allow for exploration

of differences between medical assisting graduates from the AAS and Certificate programs.

Research Team and Acknowledgements William Ebenstein, University Dean for Health and Human Services, secured public and private

funding to develop and conduct the survey. Shana Lassiter, Director of Health Professions

Initiatives, facilitated survey design and implementation, conducted the literature review, and led

the report writing/coordination process. Erin Croke, Senior Director of Program Development &

Evaluation at the time of the study, facilitated survey design and implementation efforts. Travis

Dale, Senior Research Associate, provided expertise in survey design/methodology, data analysis

and report writing.



III DESCRIPTION OF GRADUATES

A total of 216 individuals graduated with an AAS or credit certificate (or both) in medical

assisting from CUNY between the 1999-2000 and 2009-2010 academic years. The 83

respondents to the 2010 survey were generally similar to the overall population of CUNY

medical assistant graduates, although the sample of respondents included a higher proportion of

White graduates (34.0%) than the total population of medical assistant graduates (24.6%).

Graduate Demographics CUNY medical assistant graduates were predominately women, consistent with the national

profile of medical assistants. AAS and Certificate graduates reported significant family

responsibilities, although AAS graduates were more likely to be primary caretakers. The

majority of respondents are from racial/ethnic minority groups, but there were differences

between the AAS and Certificate samples with respect to country of origin. The majority of

respondents have at least one parent who was born outside of the United States.

• Between the 1999-2000 and 2009-2010 academic years, 94 percent of AAS graduates and 98

percent of Certificate graduates were women.

• Approximately 94 percent of AAS graduates and 66 percent of Certificate graduates were

Black, Hispanic, Asian or American Indian.

• Forty-seven percent of AAS graduates and 68% of Certificate graduates were not born in the

US.

• Approximately 64 percent of AAS graduates and 31 percent of Certificate graduates reported

being the primary caretaker for a child under the age of 18.

• More than one-quarter of AAS and RN to BS completion graduates were primary caregivers

for one or more dependent adults.

• The average age at the date of graduation of an AAS graduate was 29.5; the average age of a

Certificate graduate was 26.8.



Table 1. Total Population of CUNY Medical Assistant Graduates, 1999-2000 to 2009-2010

Bronx AAS QCC Cert

N % N %

All Graduates 86 130

Academic Year Graduated

1999-2000 7 8.1% 5 3.8%

2000-2001 11 12.8% 21 16.2%

2001-2002 13 15.1% 15 11.5%

2002-2003 5 5.8% 14 10.8%

2003-2004 3 3.5% 10 7.7%

2004-2005 10 11.6% 10 7.7%

2005-2006 9 10.5% 13 10.0%

2006-2007 12 14.0% 6 4.6%

2007-2008 7 8.1% 19 14.6%

2008-2009 4 4.7% 12 9.2%

2009-2010 5 5.8% 5 3.8%

Gender

Men 4 4.7% 3 2.3%

Women 82 95.3% 127 97.7%

Ethnicity

American Indian 1 1.2% 1 0.8%

Asian/Pacific Islander 4 4.7% 31 23.8%

Black 32 37.2% 39 30.0%

Hispanic 46 53.5% 27 20.8%

White 3 3.5% 32 24.6%

SOURCE: CUNY Institutional Research Database (IRDB)



Table 2. Respondents to the Survey of CUNY Medical Assistant Graduates, 1999-2000 to 2009-2010

Bronx AAS QCC Cert

N % N %

All Graduates 33 50

Academic Year Graduated

1999-2000 2 6.1% 2 4.0%

2000-2001 4 12.1% 7 14.0%

2001-2002 3 9.1% 5 10.0%

2002-2003 1 3.0% 7 14.0%

2003-2004 2 6.1% 4 8.0%

2004-2005 3 9.1% 1 2.0%

2005-2006 6 18.2% 3 6.0%

2006-2007 2 6.1% 3 6.0%

2007-2008 3 9.1% 9 18.0%

2008-2009 3 9.1% 8 16.0%

2009-2010 4 12.1% 1 2.0%

Gender

Men 2 6.1% 1 2.0%

Women 31 93.9% 49 98.0%

Ethnicity

American Indian 0 0.0% 1 2.0%

Asian/Pacific Islander 2 6.1% 10 20.0%

Black 11 33.3% 13 26.0%

Hispanic 18 54.5% 9 18.0%

White 2 6.1% 17 34.0%

SOURCE: CUNY Institutional Research Database (IRDB)



Table 3. Demographics of CUNY Medical Assistant Graduates

Bronx AAS QCC Cert

Marital status

Never married or single 60.7% 67.5%

Married 30.0% 29.5%

In married-like relationship 0.0% 0.0%

Widowed 0.0% 0.0%

Divorced 9.3% 0.0%

Separated 0.0% 3.0%

Primary caretaker for child under 18 63.9% 30.5%

Born in the United States 53.4% 31.6%

Parents' origin

Both parents born in the Unites States 26.3% 12.6%

One parent born in the United States 9.3% 0.0%

Neither parent born in the United States 64.4% 87.5%

Average Age at Graduation 29.5 26.8

SOURCE: 2010 Survey of CUNY Medical Assistant Graduates



IV MEDICAL ASSISTANT EDUCATION

Perceptions of CUNY Medical Assistant Education Overall, graduates of CUNY medical assistant programs thought highly of the preparation they

received to become an MA. Many graduates earned additional degrees before and/or after

earning their CUNY medical assisting degree. More than 70 percent were already enrolled or

planning to enroll in further education.

• Approximately 74 percent of graduates from the AAS program and 64 percent of graduates

from the Certificate program reported that overall, their CUNY education prepared them

“well” or “very well” to practice as an MA.

• Ten percent of AAS graduates and approximately 15 percent of Certificate graduates

reported that their CUNY education “adequately” prepared them to practice as an MA.

• Certificate graduates had less favorable views about the preparation they received to practice

as an MA, compared to AAS graduates.

Table 4. Perceptions of CUNY Medical Assistant Program

Bronx AAS QCC Cert

Overall, how did your education prepare you to work as a Medical Assistant?

Well or Very Well 73.6% 63.8%

Adequately 10.0% 14.5%

Poorly or Very Poorly 16.4% 21.7%




Additional Degrees Many graduates have gone on to earn a higher credential after completing their CUNY AAS or

Certificate program in medical assisting. It should be noted that, since the survey sample

consisted of those that earned a medical assisting degree or certificate between 1999 and 2010,

the more recent graduates may have not yet had time to complete subsequent credentials.

• Of those who earned an AAS degree in medical assisting, 35 percent have subsequently

earned a baccalaureate degree and 5 percent have earned a Master’s degree.

• Fifty-one percent of Certificate graduates have earned a subsequent associate degree and 19

percent have earned a baccalaureate degree.

Table 5. Overall Educational Attainment

Bronx AAS QCC Cert

Earned other degree or certificate 55.4% 55.1%

Most recently earned degree or certificate

Certificate 36.1% 25.7%

Associate 21.8% 50.9%

Baccalaureate 34.8% 19.0%

Master's 4.7% 0.0%

Other type of degree 2.6% 4.4%




Further Education

• At the time of the survey, 11 percent of AAS graduates and 32 percent of Certificate

graduates were enrolled in a further educational program. In addition, 63 percent of AAS

graduates and 38 percent of Certificate graduates had plans to enroll in further education.

Thus, approximately 74 percent of AAS graduates and 70 percent of Certificate graduates

were already enrolled or planning to enroll in further education.

• Approximately 49 percent of AAS graduates enrolled in a further educational program were

enrolled in a program leading to a higher degree (baccalaureate or above). Thirty-six percent

were enrolled in another associate degree program and 13 percent were enrolled in a

certificate program. Eighty-five percent of Certificate graduates enrolled in a further

educational program were enrolled in a program leading to a higher credential (associate

degree or higher). Fifteen percent were enrolled in another certificate program.

• Ninety percent of AAS graduates who planned to enroll in a further educational program

were planning to enroll in a baccalaureate or higher degree program. Ninety-six percent of

Certificate graduates who planned to enroll in a further educational program were planning to

enroll in an associate or higher degree program.



Table 6. Further Education

Bronx AAS QCC Cert

Plans for further education

Currently Enrolled 10.7% 32.3%

Plan to enroll in next year 32.0% 14.2%

Plan to enroll in the future 31.2% 24.0%

No plans for further education 26.1% 29.5%

Of those currently enrolled in a program:

Type of degree program




Master's 37.8% 4.4%

Of those who plan to enroll in a program:

Type of degree program planning to attend




Master's 16.5% 18.3%

Doctorate 4.9% 0.0%




V INCUMBENT WORKERS

CUNY Medical Assistant Students as Incumbent Workers The majority of medical assistant graduates were new to the healthcare arena when they were

enrolled in CUNY, and were not working in the healthcare field while enrolled at CUNY.

Certificate graduates were more likely to be incumbent workers during their time at CUNY than

AAS graduates.

• Approximately 39 percent of AAS graduates worked in healthcare at some point before

finishing their initial MA education program.

• Of those with previous healthcare experience, 32 percent of AAS graduates and 67 percent of

Certificate graduates worked in healthcare while attending their initial MA education

program.

Table 7. Incumbent Workers

Bronx AAS QCC Cert

Did you work in healthcare at any time before you finished your initial MA education program?

Yes 39.4% 23.0%

No 60.6% 77.0%

If yes, were you working in healthcare while you attended your initial MA education program?

Yes 32.2% 67.0%

No 67.8% 33.0%




VI TRANSITION FROM CUNY

Internships A significant number of AAS graduates reported not completing a formal internship. The

majority of graduates who reported completing a formal internship received their college’s help

with finding a placement. Although most MAs in the workforce are currently employed in

physician’s offices, most graduates reported completing internships in hospital outpatient and

community-based clinic settings. Few graduates received job offers from their internship

organizations, although Certificate graduates were more successful in this regard.


completing a formal internship.

• All AAS graduates who reported completing an internship obtained their internship with their

college’s help. Fifty-five percent of Certificate graduates who reported completing an

internship reported obtaining their internship with help from their college.

• All of the AAS graduates who reported completing an internship did so in a (hospital

outpatient or community-based) clinic setting. Forty-seven percent of Certificate graduates

who reported completing an internship did so in a clinic setting; forty-two percent of

Certificate graduates completed internships in a physician’s office.

• None of the AAS graduates who reported completing an internship and twenty-six percent of

Certificate graduates who reported completing an internship received job offers from the

organization where they completed an internship. More than three-quarters (78 percent) of

those who received such job offers accepted them.



Table 8. Internships

Bronx AAS QCC Cert

Did you complete a formal internship?

Yes 16.3% 69.3%

No 83.7% 30.7%

How did you obtain your internship?

You were working for an employer that was able to provide an internship

0.0% 4.5%

Your college helped you find the internship 100.0% 54.7%

You found the internship on your own 0.0% 40.0%

Some other way 0.0% 0.8%

Setting of internship

Physician's Office 0.0% 42.3%

Hospital Outpatient Clinic 63.3% 43.5%

Community-based Clinic 36.7% 3.5%

Something else 0.0% 10.7%

Received job offer from internship organization

Yes 0.0% 26.2%

No 100.0% 73.8%

If yes, accepted job offer

Yes n/a 78.0%

No n/a 22.0%




Certification

Certification statistics for CUNY Certificate graduates compare favorably with national trends.

• None of the AAS graduates surveyed reported holding a professional medical office

certification.

• Approximately 21 percent of Certificate graduates hold the Certified Medical Assistant

(CMA) credential and another 3 percent hold the Registered Medical Assistant (RMA)

credential. In total, nearly one-quarter (24 percent) of CUNY Certificate graduates hold

either the CMA or RMA credential, as compared to an estimated 15% of the national medical

assisting workforce.

Table 9. Certification

QCC Cert

Do you hold a professional medical office certification?

Yes, Certified Medical Assistant (CMA) 20.6%

Yes, Registered Medical Assistant (RMA) 2.8%

Yes, Some other certification 1.4%

No 75.3%




Job Search and Working as a Medical Assistant The majority of AAS and Certificate graduates have searched for a medical assisting position,

with Certificate graduates reporting more success. A weak job market and low pay were

common barriers reported by graduates. The majority of graduates report never working as a

medical assistant.


searching for a job as a medical assistant.

• The vast majority (85 percent) of AAS graduates who reported searching for a job

encountered difficulty finding a desirable job. Forty-six percent of those individuals

attributed that difficulty to an overall lack of jobs or inadequate salary/compensation.

• Approximately 50% of Certificate graduates who searched for a medical assistant job

encountered difficulty finding a desirable job. Sixty-four percent of those individuals

attributed that difficulty to an overall lack of jobs or inadequate salary/compensation.

• Eighty-nine percent (89%) of AAS graduates and 65% of Certificate graduates have never

worked as medical assistants. Only 3 percent of AAS graduates and approximately one

quarter (24 percent) of Certificate graduates are currently working as a medical assistant.

• Fifty-five (55) graduates reported never working as a medical assistant or not currently

working as a medical assistant. These graduates reported a variety of titles for their current,

main paid job. The majority (64%; n=35) are working in non-healthcare positions, primarily

as administrative support personnel. Thirty-six percent (36%; n=20) reported currently

working in the healthcare arena, including 8 healthcare support workers/technicians (e.g.,

nursing assistant, pharmacy technician, physical therapy assistant); 3 nurses; and 9 graduates

working as administrative support personnel in a healthcare setting (e.g., medical secretary,

medical biller).



Table 10. Job Search

Bronx AAS QCC Cert

Did you search for a job as a Medical Assistant?

Yes 65.7% 73.2%

No 34.3% 26.9%

Did you have difficulty finding a job?

Yes 84.8% 49.5%

No 15.2% 50.5%

Main reason for difficulty

Overall lack of jobs 27.4% 38.8%

Lack of jobs in desired location 5.8% 0.0%

Lack of jobs in desired settings 0.0% 3.7%

Inadequate salary/compensation 18.9% 25.1%

Other 47.9% 32.4%


Table 11. Work Experience as a Medical Assistant

Bronx AAS QCC Cert

Have you ever worked as a Medical Assistant?

Yes 11.2% 34.9%

No 88.8% 65.1%

Are you currently working as an Medical Assistant?

Yes 2.5% 23.5%

No 97.5% 76.6%




VII CAREER PATHS

The Survey of CUNY Medical Assistant Graduates reveals that most graduates do not obtain

employment as medical assistants. The numbers of AAS graduates who have worked as medical

assistants was particularly low, so the following statistics focus on CUNY’s Certificate

graduates. Survey respondents may have held more than one medical assisting job at a time, but

were asked to report about their main jobs in medical assisting, that is, the jobs where they spent

most of their time. Graduates who were no longer working as a medical assistant were asked to

report about the medical assisting job they held most recently.

Work Settings

• Eighty-five percent of Certificate graduates first worked as an MA in a physician’s office.

The remaining 15 percent first worked in a clinic setting- approximately 10 percent in a

hospital outpatient clinic and approximately 6 percent in a community-based clinic.

• Similarly, eighty-five percent of Certificate graduates reported that their current or most

recent job was in a physician’s office, and 15 percent reported that their current or most

recent job was in a clinic setting (all in hospital based clinics).

These statistics are in line with national trends, which indicate that physician’s offices are

currently the most common work setting for medical assistants.



Table 12. First and Current/Most Recent Medical Assistant Job Setting

QCC Cert

Setting of first medical assistant job

Physician's Office 84.6%

Hospital Outpatient Clinic 9.6%

Community-based Clinic 5.8%

Something else 0.0%

Setting of current/most recent medical assistant job

Physician's Office 84.7%

Hospital Outpatient Clinic 15.3%

Community-based Clinic 0.0%

Something else 0.0%

Note: If a respondant only reported one Medical Assistant job, the setting is counted as both the first and the current/most recent setting.




First Medical Assistant Job Tenure

• Approximately 31 percent of Certificate graduates between the 1999-2000 and 2009-2010

academic years were still working in their first medical assistant jobs.

• Thirty-nine percent of Certificate graduates remained in their first job for two years or less,

including 33 percent who stayed in their first job for less than one year.

• Conversely, thirty percent of Certificate graduates remained in their first job for three or

more years, including 22 percent who stayed for five or more years.

Table 13. First Medical Assistant Job

QCC Cert

How many years did you stay at your first medical assistant job?

Still working in first medical assistant job 30.8%

Less than one year 33.2%

1 to 2 years 5.7%

3 to 4 years 8.4%

5 or more years 21.9%




Salaries

• The average salary of surveyed graduates working as MAs was $31,671 for those who

reported annual wages and $14.50/hour for those who reported hourly wages. Median

salaries for medical assistants were $31,000 (annual) and $12.00 (hourly).

• The average salary of surveyed graduates not working as MAs was $45,158 for those who

reported annual wages and $14.48 for those who reported hourly wages. Median salaries for

graduates not working as medical assistants were $42,000 (annual) and $13.00 (hourly).

• In general, Certificate graduates who were not working as medical assistants earned the

highest wages.

Table 14. Salaries

All Medical Assistants N Mean Median Min Max

Annual 5 $31,671 $31,000 $18,000 $39,500

Hourly 15 $14.50 $12.00 $8.00 $35.00

All Non Medical Assistants N Mean Median Min Max

Annual 24 $45,158 $42,000 $19,000 $150,000

Hourly 26 $14.48 $13.00 $8.00 $33.00

All Non Medical Assistants: By Program N Mean Median Min Max

Annual Bronx AAS 15 $37,924 $35,000 $19,000 $75,000

QCC Cert 9 $58,574 $55,000 $23,000 $150,000

Hourly Bronx AAS 10 $11.79 $13.00 $8.00 $17.00

QCC Cert 14 $16.91 $15.00 $8.00 $33.00



Characteristics of Current/Most Recent Medical Assistant Job

Survey respondents were asked to report about their current medical assistant job or, if not

currently working as an MA, their most recent medical assistant job. Most respondents reported

spending more than half of their time performing clinical duties, and using an Electronic Health

Record System (EHR) in the course of their work.

• Seventy-four percent of Certificate graduates reported spending more than half of their time

at their current or most recent medial assistant job performing clinical duties. Approximately

21 percent spent all of their time on clinical tasks.

• Thirty-nine percent of Certificate graduates reported spending more than half of their time at

their current or most recent medial assistant job performing administrative duties.

Approximately 10 percent spent all of their time on administrative tasks.

• Most Certificate graduates (61 percent) have used an Electronic Health System in the course

of their current or most recent job. The vast majority of those individuals (81 percent)

reported that they were trained to use the system on-the-job.

Table 15. Clinical vs. Administrative Duties

QCC Cert

What proportion time spent performing clinical duties

None 14.0%

Less than half 12.4%

More than half 52.6%

All 20.9%

What proportion time spent performing administrative duties

None 5.7%

Less than half 55.1%

More than half 29.4%

All 9.8%




Table 16. Electronic Health Records

QCC Cert

Used an Electronic Health Records System in current/most recent job

Yes 60.6%

No 39.4%

Which of the following best describes how you were trained to use the Electronic Health Records system?

Through CUNY coursework 0.0%

Employer-sponsored course or training 18.8%

On-the-job 81.2%




Job Satisfaction and Benefits: Current/Most Recent Medical Assistant Job

• All Certificate graduates indicated they were very or somewhat satisfied with their current or

most recent medical assistant job.

• The vast majority of Certificate graduates who worked as a medical assistant indicated that

they had the chance to gain new skills and knowledge (100 percent agreed or strongly

agreed), and had opportunities to get better job within their organization (94.5 percent agreed

or strongly agreed.

• Seventy-three percent reported actively seeking career advancement or promotion.

• Approximately 76 percent of Certificate graduates who worked as an MA were eligible for

health insurance through their current/most recent employer. Sixty-nine percent of those

individuals were enrolled in health insurance plans through their current/most recent

employer.

• Thirty percent of those who were eligible for insurance through their current or most recent

employer were uninsured or insured through a public program.



Table 17. Benefits and Rewards at Current/Most Recent Medical Assistant Job

QCC Cert

Overall satisfaction with current/most recent Medical Assistant job

Very satisfied 54.1%

Somewhat satisfied 45.9%

Neither satisfied nor dissatisfied 0.0%

Somewhat dissatisfied 0.0%

Very dissatisfied 0.0%

You had the chance to gain new skills and knowledge

Strongly agree 47.9%

Agree 52.1%

Disagree 0.0%

Strongly disagree 0.0%

You had opportunities to get a better job in the organization


Agree 77.9%

Disagree 5.5%


You actively seek advancement or promotion in your career


Agree 43.2%

Disagree 23.2%





Table 18. Health Insurance Benefits

QCC Cert

Eligible for health insurance in current/most recent job

Yes 76.1%

No 23.9%

While working in current/most recent job, did you have health insurance?

Yes, through employer 68.0%

Yes, through spouse, partner or parent's employer 1.6%

Yes, through public program 21.8%

No, cost is too high 3.1%

No, some other reason 5.5%




Graduates Not Currently Working as Medical Assistants The vast majority of AAS and Certificate graduates (98 percent and 77 percent, respectively)

reported that they are not currently working as a medical assistant. The majority of these

graduates were working in non-medical assistant jobs, and reported feeling satisfied in those

jobs. Difficulty finding a desirable job was cited most often as the reason for not currently

working as a medical assistant. These graduates tended to envision themselves working in

healthcare in the next five years, but not as medical assistants.

• Eighty-one percent of AAS graduates not currently working as medical assistants reported

that they were working for pay at the time of the survey. Seventy-four percent of Certificate

graduates not working as medical assistants reported the same.

• Certificate graduates not working as medical assistants were more likely to be working in

other healthcare fields. Sixty-two percent of Certificate graduates not working as medical

assistants reported working in another healthcare profession, as compared to 37% of AAS

graduates not currently working as medical assistants.

• Graduates were generally satisfied with their non-medical assistant jobs. Eighty-seven

percent of AAS graduates and 79 percent of Certificate graduates who were not working as

medical assistants reported feeling somewhat satisfied or very satisfied with their current

jobs.

• Fifty-two percent of AAS graduates cited the inability to find a desirable medical assistant

job as the reason for not currently working in the field. Forty-two percent of Certificate

graduates similarly cited an inability to find a desirable medical assisting job, and an

additional 31 percent of Certificate graduates reported earning more money in another

position as the primary reason.



Table 19. Graduates Not Currently Working as Medical Assistants

Bronx AAS QCC Cert

Currently working for pay

Yes 80.9% 74.2%

No 19.1% 25.8%

If yes, are you working in the healthcare field?

Yes 37.4% 61.7%

No 62.6% 38.3%

Overall satisfaction with current job

Very satisfied 43.2% 21.0%

Somewhat satisfied 43.7% 58.2%

Neither satisfied nor dissatisfied 4.5% 1.0%

Somewhat dissatisfied 2.5% 18.6%

Very dissatisfied 6.1% 1.2%

Primary reason for not currently working as a Medical Assistant

Unable to find a desirable medical assistant position

51.8% 42.2%

Earn more money working in another position 6.5% 30.5%

Other position more satisfying 9.6% 7.7%

Not currently working due to family obligations 7.2% 0.0%

Other reason 25.0% 19.7%




Career Plans All graduates were asked to envision their careers in five years. A majority of graduates

envisioned themselves working in healthcare, although few saw themselves working as a

medical assistant in five years.

• Fifty-two percent of AAS graduates and 77 percent of Certificate graduates see themselves

working primarily in healthcare in the five years.

• Eleven percent of AAS graduates envision themselves working as medical assistants in five

years. Nineteen percent of Certificate graduates shared that sentiment.

Table 20. Career Plans: All Graduates

Bronx AAS QCC Cert

In what primary position do you see yourself in five years?

Working as a medical assistant 10.5% 18.9%

Working in another healthcare position 41.0% 57.7%

Working in a position outside of healthcare 27.4% 3.8%

Taking care of children or other family members 0.0% 1.6%

Pursuing further education 16.9% 6.2%

Doing something else 4.3% 11.8%




VIII CONCLUDING COMMENTS

Passage of the Patient Protection and Affordable Care Act (ACA) is accelerating ongoing

changes in the healthcare delivery system including trends toward community-based services,

patient-centered medical homes, care coordination among multiple providers, a multi-

disciplinary team approach, incorporation of new technologies such as electronic health records,

and accountability for the total care of the patient. In general, the future healthcare delivery

system will be more focused on primary and preventive care and will emphasize effective

management of chronic diseases. These trends are emerging within Federally Qualified Health

Centers, patient centered medical homes, hospital-affiliated ambulatory care clinics,

“accountable care organizations” and other service settings.

Regardless of the venue or service delivery model the success of these reforms will ultimately

depend on the quality of the workforce. Federally funded reimbursement innovations such as

“bundled payments” are accelerating reform efforts by aligning payments for services delivered

across an episode of care rather than paying for services separately. Thus, new reimbursement

methodologies are encouraging coordination of care among providers, promoting workforce

flexibility, and creating financial incentives to develop new career ladders for frontline workers.

Community health centers (CHCs) and hospital affiliated ambulatory clinics are integral parts of

the primary care delivery system. The Community Health Center Workforce in New York study,

conducted by the Center for Health Workforce Studies (McGinnis, Martiniano & Moore, 2011),

showed that MAs are the critical frontline workers within the community health center (CHC)

model. Among the key findings was that the health care workers employed in the greatest

numbers by CHCs were MAs, but they were also among the most difficult personnel to retain. A

lack of career ladder opportunities contributes to their high turnover. With funding through the

ACA, CHCs are expected to expand and they anticipate hiring increasing numbers of MAs.

These findings corroborate the existing literature on the medical assisting workforce, detailed in

the introduction of the current report.

MAs are employed in large numbers across all ambulatory care settings. According to the

CHWS’ Supply of and Demand for Medical Assistants in New York City report (Moore &



Langelier, 2011), based on data drawn from the American Community Survey, although 35% of

all MAs in NYC are employed in physician offices, 30% are employed by hospitals. MAs are not

licensed in any states but recently our SED Office of the Professions responded to their creeping

scope of practice by officially listing tasks that they should not perform without proper

supervision (NYSED, 2010). At the same time the role of MAs continues to evolve as health

reform provides incentives to use allied health personnel on multi-disciplinary teams to deliver

culturally competent primary and preventive care. The diversity of the medical assisting

workforce in NYC-36% are Latino and 31% are Black-is viewed as an asset by providers who

serve racially and ethnically diverse populations.

Career ladder models for MAs are proliferating, as demonstrated by the 2010-2011 Innovative

Workforce Models in Health Care series of case studies conducted by the University of

California-San Francisco’s Center for the Health Professions (Blash, Chapman, & Dower, 2010

a-c, 2011 a-d; Blash, Dower & Chapman, 2010a, 2010b, 2011a-c). Implementation of these

redesigns has led to positive outcomes including decreases in wait times, no-show rates, re-

hospitalizations and staff turnover. The MAs involved in these pilots reported feeling more

confident, satisfied, engaged and skilled in their roles. There is a shortage of experienced and

trained MAs to meet the significant changes in job requirements that are needed for improved

patient care management at CHCs and ambulatory clinics. Many of the changes require a more

sophisticated frontline worker with a broader scope of responsibility and practice. MAs are

increasingly working as health coaches and community educators, as partners with patients and

their families, as members of multi-disciplinary teams and as active users of electronic health

records. As a consequence of these dramatic reforms and the concurrent organizational

restructuring and job redesigns, frontline workers who do not have the increased knowledge and

competencies to make the transition to the new service paradigm are more likely to be at risk of

losing their jobs.

CUNY has designed a credited, college-level certificate to train incumbent medical assistants as

health coaches. The training program enhances workers’ job skills and expands their knowledge

base. It also provides an opportunity for upgrading and career mobility which will help to retain

this important cadre of frontline workers.



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Documents

Medical Assisting: An Overview of the Profession & Results