Featured topic and speakers
Interview with James Jerzak, MD, and Christine Dzoga, BS, CMA (AAMA), on finding and keeping the right medical assistants for your team. To learn more on this topic, review the related toolkit.
- James Jerzak, MD; Family Medicine, Bellin Health Systems
- Christine Dzoga, BS, CMA (AAMA); Medical Assisting Program Coordinator, Malcom X College
- Jill Jin, MD, MPH; Senior Physician Advisor, American Medical Association
Listen to the episode on the go on Apple Podcasts, Spotify or anywhere podcasts are available.
Speaker: Hello and welcome to the AMA STEPS Forward® podcast series. We'll hear from health care leaders nationwide about real-world solutions to the challenges that practices are confronting today. Solutions that help put the joy back into medicine. AMA STEPS Forward® program is open access and free to all at stepsforward.org.
Dr. Jin: Hi everyone, welcome. I'm Jill Jin, senior physician advisor and STEPS Forward® editor at the AMA. Today, we will be discussing our latest module called Medical Assistant Recruitment and Retention: Find and Keep the Right Medical Assistant for your Practice. And I'm so thrilled to have with me two of the authors of the module, Dr. Jim Jerzak and Christine Dzoga. Thank you both for being with me today.
Dr. Jerzak: My pleasure. Thanks for having us.
Dzoga: My pleasure, thank you.
Dr. Jin: So why don't you guys go ahead and introduce yourselves to the audience?
Dr. Jerzak: Jim Jerzak, family doctor here in Green Bay. I've been actually practicing since ‘86 in Green Bay with Bellin Health since ‘96, and I've been a full-time practicing family physician. In 2016, we started our team-based care transformation. So, I've been a physician lead for team-based care here at Bellin. And I'm sure get into that a little bit here as far as what that means for the MA role, but I'm glad to be with you, it's exciting.
Dzoga: Christine Dzoga. I have been a medical assistant since 1990. I've worked in a variety of roles, including practice manager. Currently I am running the medical assisting program for City Colleges of Chicago at Malcolm X College.
Dr. Jin: Let's dive right in, and first things first, can you define for our audience what a medical assistant is and the various pathways one can take to become a medical assistant?
Dzoga: So a medical assistant is a cross-trained employee in administrative and clinical skills and a variety of skills. When you are looking at a medical assistant, they have a very broad range of training and the training that they receive, I can tell you, they will never fully utilize in one practice. There are several pathways to becoming a medical assistant. There is a military pathway, if you had medical training through the military, you can have graduated from a medical assisting training program. And then there is the apprenticeship model, which is a medical assistant who has worked in the field for five years, five consecutive years, and can have a physician attest to their skill set.
Dr. Jin: The MA role is not very well defined. And of course, it varies so widely depending on your practice, depending on the patient population, depending on your practice size, your needs. So, it's very difficult to recruit and train MAs in a way that's standardized, but also unique and a well fit for the specific practice. How could this process be optimized?
Dr. Jerzak: There's a big movement to team-based care across the country. And one of the key features of that is really an up-trained role for the medical assistants. They become key members of the team and through a lot of the EHR, we're getting involved with, quality measure improvement and population health work and documentation.
So, when the requirements for MA is actually the numbers are quite high now. There's a shortage of MAs and people going into team-based care, because of the enhanced support, we often need more than one MA per provider per physician in busy practices. So there's a quite a demand on the MAs. So, recruitment is a big issue for us and for systems we've talked to across the country.
The other thing we found out is when you look at training of medical assistants, they're really not trained, to large extent, for the things they're going to be doing in team-based care. So, what that means is systems just have to be prepared to train internally to some extent. For example, how to document and note, you know, they come in and, and they're not even clear, you know, difference between an HPI and review systems, and that all has to be trained. Fortunately it's doable and the end result is really great, but it has been a challenge in terms of recruiting adequate numbers and then training them internally.
Dzoga: The recruitment angle of it, the job description should really be detailed to what your needs are. Most of the time you see these very generic job descriptions, but understand that medical assistants with their, if they're experienced medical assistants, they may have worked in primary care and they're now going into say a specialty office. It's going to be a very different feel and look to what they, what the expectation is. And so, it really should be detailed on what you're really looking for.
The other thing is that you really want to determine the pace of your practice. So, I can say when I was my very last position before this, when I was working in a very fast-paced environment, when we had people join the team who were very slow paced, it wasn't a good fit for us. We had way too many patients, we were moving fast. You kind of want to get that feel for, if it is, you know, what their pace is. And I would say that working with schools that are around your organization really should look into newly trained medical assistants. They are the most open to being trained the way you want them so you can form them.
Dr. Jerzak: The adage of hire for personality and train for skills, I think is really applicable in this role.
Dr. Jin: One other issue I did want to touch upon is the issue of equity or health equity, which is of course so important in this day and age, and the idea that hiring MAs, kind of what you were saying, Christine, from your community or from your local school or those familiar, those coming from the same community and background as your patients might be coming from, seems to be beneficial just because patients tend to have a more trusting and close relationship with health care professionals they feel they can relate to in that manner. Do you have any personal experience with this or any stories to share?
Dzoga: We have done quite extensive recruitment in different areas of the city for students, from those areas where we have determined there are health care disparities. And then we work with the organizations in those, we partner very closely with the organizations and those communities to then attempt to transition those students into positions in those areas. It helps the organization and also we're fulfilling one of our mission statements.
Dr. Jerzak: The minority population here is, is small but growing. And one thing that we've done with one of we have about 31 ambulatory clinics. And for one of our clinics, we've converted that into a bilingual clinic management clinic. I was talking to the lead of that last night and it was really interesting. She was saying, they just don't want people to be bilingual. They want them to be bicultural. She said that makes a big difference in trying to communicate with people and understand where they're coming from.
So, this clinic has really been doing well and talking to her last night, she said in their quality data, the Spanish-speaking patients actually have a better quality of data than the non-Spanish speaking ones. And that's in that clinic. I think partly she attributes that to the bicultural type aspect they bring to that. It was really interesting.
Dr. Jin: Once recruited and trained, of course, retention of medical assistance is critical for our practice to thrive. So how can practices retain their top MA talent?
Dr. Jerzak: So, we've worked with our our system try to enhance that a bit for these people, especially as they're taking on more advanced roles. We're talking about considering quality bonuses based on quality measures since they're doing much of the work in that area. And that may help, but ultimately, it's got to be a fulfilling job role. Once they're established in this role and they're having relationships with patients and the physicians working with them, empower them to do the more advanced things in their practice. That I think ultimately is what keeps them part of a team culture. They feel part of a team, they're empowered, the patients look to them for questions and things like that. That's really been helpful for us.
Dzoga: Professional development is huge. Just not feeling stagnant in that role and feeling like they they're contributing something to the team.
Dr. Jin: What tips do you have for physicians who wish to build a trusting and fulfilling relationship in a long-term relationship with their medical assistant?
Dr. Jerzak: Well, number one, they have to be trained well. And number two, you have to empower them to do things. Now, when, when you're starting with the documentation piece in team-based care, they are extremely vulnerable because they're very unsure of themselves and and just don't have a lot of confidence in that. So we really stress with our physicians you have to be very careful with your feedback, and giving constructive criticism and positive feedback. You have to stay away from negative feedback, because that is very harmful at that time.
But then, and even with all the different things that the MAs are doing, in the in-basket in team-based care, you just have to trust them to be able to do the thing that they're being asked to do. And you're always going to be able to have oversight. You're still going to have to sign off on things and things like that, but the feedback is just so important. It's a team and they become valuable members of the team and you have to make sure they realize that they are valuable members. The research on enhancing the roles of the MAs is leading to decreased provider burnout too. So there there's a win-win situation here and we've got to do all we can to foster that type of approach.
Dr. Jin: Well, I think that is a good note to end on. Thank you both for taking the time to speak with me today. We so appreciate your expertise in this very important topic.
Speaker: Thank you for listening to this episode from the AMA STEPS Forward® podcast series. AMA’s STEPS Forward® program is open access and free to all at stepsforward.org. STEPS Forward® can help put the joy back into medicine by offering real world solutions to the challenges that your practice is confronting today. We look forward to you joining us next time on the AMA STEPS Forward® podcast series, stepsforward.org.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.