microsoft word - medical assistant report draft final revision ii

MEDICAL ASSISTANTCAREER LATTICE

PROJECT

A REGIONAL FOUR COUNTY STUDYFOCUSED ON EDUCATIONAL LATTICES,

RETENTION AND TRAINING OFMEDICAL ASSISTANTS

M E R C E D C O U N T Y D E P A R T M E N T

O F

W O R K F O R C E I N V E S T M E N T

2 0 0 7

M E R C E D ▪ S A N T A C L A R A ▪ S A N T A C R U Z ▪ S T A N I S L A U S

Medical Assistant Career LatticeProject

2007 Merced County Department of WorkforceInvestment

Executive Summary

On March 1, 2005, Merced CountyDepartment of Workforce Investment (WI)received funding though the WorkforceInvestment Act 15 Percent (Governor’sDiscretionary) funding for the MedicalAssistant Lattice Project. This projectaddresses issues related to an educationallattice, retention and training for MedicalAssistants by conducting a regional study. Thestudy gathered information that determinedMedical Assistant training qualifications andretention needs and determined the feasibilityof developing an educational lattice fromMedical Assistant curriculum to local nursingprograms.

The results of the study reinforced the need forbuilding an educational/career lattice betweenthe Medical Assistant and nursing programs,identified ways to improve the retention ratefor Medical Assistants, and addressed needsfor improvements in the educational trainingprograms for Medical Assistants.

In order to provide continuing opportunities tofront-line medical workers, the need for acomprehensive framework to enable upwardmobility is imperative. Currently, a modeldoes not exist that purposely and successfullyguides Medical Assistants to continue theirupward progress. As part of the study, theMerced County Department of WorkforceInvestment organized focus groups, one format

included Medical Assistants and the other,employers of Medical Assistants.

Using a focused conversation format, thegroups discussed career lattices, training,retention and other related topics. Thefollowing conclusions and recommendationswere made after a careful examination of theresponses provided by the focus groups. Incentives such as the 20/40 Nursing

Program (employee enrolled in nursingprogram for 20 hours and employed for20 hours and gets wages for 40 hourstotal) should be expanded for MedicalAssistants to successfully complete anytype of continued training.

Similar career lattices established forC.N.A.s should be duplicated forMedical Assistants.

Back office or “clinical” pathways needdevelopment for ease of access modeledafter office or “administrative” careerchoices.

Eighty percent of employers reportproblems with retention.

Increasing opportunities within theirown organization, employers can createtheir own pipeline thus stabilizingretention.

Employers can use more “recognitiontechniques” and increased “schedulingflexibility” if monetary incentives arenot available to increase retention.

A good work environment and jobsecurity were reported as most importantto MAs. Employers should focus theirretention strategies to include theseareas as well.

Over fifty percent of MAs reported thattheir externship was NOT long enoughto prepare them for their profession.

Inconsistencies in training programsstem in part to the lack of State andFederal regulations as well as theabsence of mandatory certifications.

Workforce Investment April 2007Medical Assistant Lattice, Retention & Training

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California Certified Skill Standards arecurrently not being addressed.

Portable and recognized skills setswithin the MA profession do not exist.

Introduction

According to EDD reports, Medical Assistantswill have the 34th largest number of jobopenings in the State from 2000 to 2010 andwill have the 11th fastest growth rate. ManyCalifornia counties have a moderately difficulttime in recruiting entry-level MedicalAssistants.1

The Center for the Health Professions atUniversity of California, San Franciscocompleted a report that summarizes pertinentareas of interest for the “Medical Assistants inCalifornia”. The critical issues and policyconcerns addressed included difficulty inrecruiting, turnover rates, workforce shortages,lack of consistency in requirements, scope ofpractice, lack of career path, and futuredirections in training. Similar articles voice thesame concerns facing this health careprofession.2

Medical Assistants have been identified ascritical front-line workers to explore in thehealth field. Exploration on the issues andchallenges facing Medical Assistants,employers and training providers, has clearlybeen established and documented, but many ofthe proposed solutions are still in the planningstages. Career lattices are recommended as aviable solution for many of the projectedhealth care worker shortages.

Medical Assistants are exposed to many otheroccupations in the health care industry. Theskills, knowledge, and work activities requiredof Medical Assistants (see Appendix A) makethem a potential pool to recruit and train fornursing professions. According to theOccupational Information Network (O*NET)

ratings, Medical Assistants are the closestmatch to Registered Nurses (RNs) in abilitiesas compared to other health care occupations.3

The benefits for developing career lattices andpathways have been substantiated by manystudies. Some of the benefits for employersinclude greater competency of employees,greater employee retention, lower investmentin recruitment and improved quality of patientcare. For the employee, some benefits includereceiving nationally recognized credentials andpositions, increased wages tied tocompetencies, identifiable career pathways,and improved self-esteem.4

Developing well-defined career paths, ladders,and lattices with the healthcare servicesrequires collaborative and coordinated effortsbetween many entities: health care serviceorganizations, educational facilities,professional associations, labor unions,workforce development agencies, governmentlicensing, certifying and policy-makingagencies. Coordination and collaboration arekey components for any successful project.The direct collaboration between employers,employees, training providers, and othergroups have been increasing, but have a shorthistory.5

Reports have been published as occupationalresource tools designed to assist inimprovement of recruitment and retention inthe health care industry. There are severalexamples of health care career ladderprograms that have had measurable success.To date, Medical Assistant lattice programshave not been located for review or research.We currently have samples of career latticesbut we cannot find programs.

The Robert Wood Johnson Foundation(RWJF) approached their “Defining theFrontline Workforce” study with the point ofview that frontline workers, such as Medical


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Assistants, have been “understudied and arefacing key challenges that may obstruct theirability to work effectively, contribute at theirmaximum potential and enhance their ownwork experience and career advancementopportunities.”6 The study further shows apreliminary analysis revealing that theworkforce is “lacking a viable, skilledemerging working population to adequatelyfill the projected shortages.”7

The RWJF recommends that strategicinitiatives may be most effective by “targetedoutreach and training opportunities along withcareer advancement pathways in order toadvance entry into frontline workforceoccupations and to strengthen existingoccupations frameworks” to address thenursing shortage. Collaboration andcoordination are strongly recommended in thereport. RWJF also stresses “employer-provided” education in which work-basedlearning is key to enhancing the healthcareindustry and recognizes the education value ofexperience in practice.

This “Medical Assistant Lattice Project” studywill be a forerunner in providing valuableinput from the employers and MedicalAssistants’ perspectives.

Planned Approach and Expected Outcomes

The approach was to address the issuesidentified with Medical Assistant educationallattice, retention and training, included thefollowing. WI:

1. Hosted a four-county action-planningmeeting with Santa Cruz, Santa Clara(Silicon Valley Workforce InvestmentNetwork, SVWIN replaced SanMateo), and Stanislaus Counties todevelop a regional study.

2. Developed a survey and held focusgroups to gain data from currentMedical Assistants regarding the

feasibility of advancement to nursingprograms, job retention issues, andtraining qualifications for theworkplace.

3. Developed a survey and held employerfocus groups to determine employerneeds, appropriate skill levels andconsistency of training that MedicalAssistants need to be successful in theworkplace.

4. Analyzed current training MedicalAssistants receive and addressinconsistencies, employer’s needs, andretention issues for Medical Assistantgraduation from these programs.

5. Created a report from this regionalstudy that can be used both locally andstatewide to address the feasibility ofcreating Medical Assistant to nursingprogram lattice, training, and retentionstrategies.

Methodology

The Project Objective was to address issuesrelated to the creation of an educational latticefor Medical Assistants, training, and retention.The Merced County Department of WorkforceInvestment conducted a regional studybetween June 2006 and October 2006. Thestudy gathered information to determinecurrent Medical Assistant training,qualification and retention needs, anddetermined the feasibility of developing aneducational lattice from Medical Assistantcurriculum to the local nursing program.

This project addressed health related industryissues: 1) the possibility of creating a MedicalAssistant program to nursing program lattice,2) addressing retention issues and 3) reportedinconsistencies in Medical Assistant training.The career lattice process for MedicalAssistants to continue their education and beable to transfer credits from their MedicalAssistant training toward credits in the


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Licensed Vocational Nursing (LVN) programwas explored. In Merced County, no part ofMedical Assistant training is counted towardsthe LVN program and employees andemployers who wish to expand their staffcapacity must start from scratch. Employersalso reported difficulty in retention of MedicalAssistants statewide. Retention issues may bedue in part to:

limited career lattices for MedicalAssistants;

a statewide inconsistency in trainingprograms producing adequately trainedMAs ready to meet the needs of theiremployers.

The project studied the problem of MedicalAssistant retention and explored the idea ofbuilding an educational/career lattice betweenthe Medical Assistant training programs andLVN programs. Because these issues have abroader impact than just Merced County, WIinvited three diverse central Californiacounties to participate in this study. The goalswere to identify how to: a) Examine thepipeline into the nursing field for MedicalAssistants, b) improve the retention of MedicalAssistants for employers, and c) address needsfor improvements in the educational programsfor Medical Assistants. The results andrecommended actions are included in thisreport and will be published for statewidedissemination.

Focus groups were held for Medical Assistantsin Merced, Santa Clara County/SVWIN, SantaCruz County, and Stanislaus Counties. A totalof 52 Medical Assistants attended the focusgroups and were asked nine questions(Appendix C). The focus group sessions are asfollows:

Merced County- 23 MA in attendanceheld on June 15 and June 22, 2006

Santa Clara County - 11 MA inattendance held on September 15, 2006

Stanislaus County-13 MA inattendance held on September 20, 2006

Santa Cruz County- 5 in attendanceheld on October 18, 2006

Focus groups were also held for providers whoemploy Medical Assistants in Merced, SantaClara, Santa Cruz, and Stanislaus Counties. Atotal of 28 providers attended the focus groups.The focus groups sessions are as follows:

Merced County-4 providers inattendance held on 6/22/06 and6/27/06.

Santa Clara County-12 providers inattendance held on 9/15/06.

Santa Cruz County-6 providers inattendance held on 10/18/06.

Stanislaus County- 6 providers inattendance held on 9/20/06.

Each employer focus group was asked torespond to twelve questions (Appendix C).

Findings - Career LatticeSeveral inconsistencies in Medical Assistanttraining need to be addressed in order to createa sustainable Medical Assistant to nursingprogram lattice. Almost eighty-five percent ofMAs surveyed stated that the job requiredskills that were not included in their training.The highest rated skills missing from MAtraining centered around “front office” duties,including computer input, scheduling,paperwork and referrals (Figure 1). Over sixtypercent of Medical Assistants reported trainingon equipment such as EKG and computers tobe outdated by the time they enteredemployment (Figure 2).

Of great interest are reasons why MAs wouldleave the medical profession. Almost 50% ofthe respondents felt that pay, benefits andreceiving no recognition would cause them toleave the MA profession (Figure 5).Additionally, advancement on the job was


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reported as limited due to lack of educationand money. When asked if there were anyincentives for furthering their education or inobtaining a National Certification, the majorityof MAs reported they were “unsure” and didnot know about employer incentives. Only13% of the respondents knew of incentives tofurther their education (Figure 8b). Pay andAdvancement was also reported by employersas reasons why MAs leave their positions(Figure 18).

Many Medical Assistants must work full-timewhile attending school in order to survive.This creates difficulties in completing any typeof career lattice program, unless, the employeris willing to provide exceptional incentives.The 20/40 Nursing program offered in severalcounties is a model that can be followed. Theemployer is willing to pay the MedicalAssistant for 40 hours of employment but onlyrequire them to work 20 hours per week andthe other 20 hours are spent in an upgradetraining (usually RN Program).

Kaiser Permanente and Memorial Hospital(Sutter Affiliate) provide 20/40 Nursingprograms. Currently, career lattices are onlybeing implemented by larger medicalestablishments (Appendix F). Smaller officestend not to have a pipeline due to staffingresources. Larger facilities also encouragetheir Medical Assistants to enter an RNprogram rather than any other medicalposition. But, overall, Medical Assistantscurrently plan their career paths by themselvesand do not have access to medical careerprofessionals who can guide them through theprocess.

The efforts of smaller employers can besummarized by both tangible and intangibleincentives. Smaller employers tend to offereducational allowances in the form of tuitionreimbursement as well as intangible incentivessuch as flexibility in work schedules. An

employer in Santa Clara County added thattheir Medical Assistants can have up to a 20%work reduction with manager approval, andnot lose any of their current employee benefits.

Of special note is that currently there arenumerous career lattices offered to CertifiedNursing Assistants (CNA) to become LicensedVocational Nurses (LVN) (see Appendix D).The same opportunities do not exist forMedical Assistants. Furthermore, Santa CruzCounty (see Appendix E) reported careergrowth opportunities for Medical Assistantswho follow both an administrative or clinicalpath but, does not delineate the proper stepsinto either an LVN or RN position.

This implies that the emphasis has traditionallybeen placed for Medical Assistants to continuetheir path in their “administrative roles” inorder to promote within an organization, thustaking the path of least resistance.8 Back officeor “clinical” pathways require much moreemphasis on pre-requisites and they haveextensive waiting lists in order to enter anursing program. For example, Santa CruzCounty has a four-year waiting list for theNursing Program.

Lifelong Learning Accounts (LiLAs) can beused by employers and offered as an additionto the benefits package. LiLAs will increaseopportunities of continuous life-long learningby sharing the responsibility between the MAand the employer.

In order to provide opportunities for continuedMA skill upgrades, smaller offices can pooltheir training, thus allowing for morescheduling flexibility for both MAs andemployers.

Another Career Lattice option would be to setup a Licensed Practical Nurse Program whichhas been recognized as an “ApprenticeableMedical Occupation” by the Department of


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Labor (DOL), requiring 2000 hours (DOT orO*Net Code 079.374-014). An interesting sidenote is that DOL also has Medical AssistantApprenticeship but entails 4000 hours tocomplete. Currently there is only one in theState ETPL at San Bernardino Adult School.

Findings – RetentionThe study found that only 20% of employersfelt that they did not have any problems withretention. Not being able to pay higher wagesand advancement accounted for almost 50% ofretention problems. Advancement usuallymeant MAs enrolling into a Nursing Program(Figure 16).

Employers were asked what they were doingto retain their MAs. Team Building andFlexibility accounted for 36% of specificactivities employers engage in to deal withretention issues. What was interesting to notewas that the four counties differed greatly inhow they handled retention issues. OnlyStanislaus County and Santa Cruz Countyoverlapped in “flexible” as a way to ensureretention was being met. By flexible, theymeant flexibility in scheduling toaccommodate child care needs ortransportation.

Conversely, if we look at what keeps MAs intheir line of work, fresh challenges and careergrowth within the employer were reported byMAs as methods to address retention issues. Ifemployers promote from within, by increasingopportunities, they will create their ownpipeline and allow others to fill the spacesbeing vacated. This is a win-win situation forboth employers and Medical Assistants.

Employers and MAs agreed that Pay is thenumber one reason that MAs leave theirpositions. Employers are losing MAs to otheroffices for sometimes as little as 50 cents anhour. Further, MAs ranked not having benefitsand receiving no recognition as the second and

third most important reason why they leave(Figure 5). Employers reported MAsadvancing and entering nursing programs asthe second and third reasons why MAs leavein addition to pay. Paradoxically, what ishelping solve one problem (nursing shortagealleviated by increased MA enrollment) is infact affecting retention issues for employerswho hire MAs.

Forty percent of MAs reported Good WorkEnvironment and Job Security as being mostimportant to them in the profession.Employers can focus on these two areas inorder to increase the retention of their MAs.Employers can promote a team atmosphere,make MAs feel valued, important andempowered, especially when financial rewardsare not available (Figure 6b and 17).Flexibility with time is considered to be aneffective retention strategy by StanislausCounty employers.

Findings – TrainingOver half of the MAs reported that theirexternship was not long enough to preparethem for the profession. A study by theUniversity of California, San Francisco,Center for the Health Professions, cited that“minimal State and Federal regulations and theabsence of mandatory certifications forMedical Assistants” has created a lack ofconsistencies in requirements for MAs9.

The study goes on to state that large managedcare organizations develop their own standardsfor hiring and retaining their MAs. This studyfound that such large organizations alsorequire their MAs to be certified (Figure 20).Based on input from all four counties, “soft”skills, primarily customer service skills, needto be incorporated into the Medical Assistantcurriculum. There currently are 464 MAprograms on the Eligible Training ProviderList (ETPL). They range from no cost to$30,000.00 and from no credit courses up to


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98 quarter units (equivalent to AS degree).Additionally, many community colleges do nothave their MA program in the ETPL.

A Medical Assistant shall receive training, asnecessary, in the judgment of the supervisingphysician, podiatrist, or instructor to assure theMA is competent to perform that service at theappropriate standard of care.10 The MAs had agood understanding of the basics, but statedthat they had a better handle on back officeduties and less focus was made on front officeduties. 44/52 Medical Assistants felt that thejob definitely required other skills not includedin their training.

It is this inconsistency that leads to employersnot being able to depend upon continuous skillquality from trained MAs. Recruitment alsoposes problems and some employers evenrecommended specific training providers beingfavored over others due to the quality MA theyare known for providing.

Skill standards provide advantages to bothemployers and MAs in the form of workersknowing exactly what skills and knowledgethey need to acquire to move ahead. Workersare less likely to waste time or be discouragedby taking trainings not based on skillstandards. Additionally, workers have skillsthat are nationally recognized and portableacross geographic areas.11

In order to establish skill standards, theCalifornia Certified Skill Standards could beused as a guide to develop recognized skillstandards within an industry and are portablefrom employer to employer and acrossgeographic boundaries.

Some of the goals of the California CertifiedMedical Assistant (CCMA) are to upgrade theMA profession standards and professionalcompetence, with the underlying goal toupdate the MA profession. Since medical

offices are open Monday through Friday, 8:00a.m. to 5:00 p.m., the need for schooling to beavailable in the evenings and weekends isparamount to giving individuals anopportunity to enter a career lattice.

The focus group also revealed an increasedneed for translation services. Eighty-eightpercent of employers responded in theaffirmative to needing bilingual staff, withSpanish ranked first as language needed butinterestingly, American Sign Language wasranked second (Figure 13).

Conclusion

These are the conclusions that were drawnfrom the analysis of the responses that couldcreate a sustained career lattice program,address retention and training strategies. It would benefit smaller and medium

sized organizations to support“exceptional incentive” programs. The20/40 Nursing Program could bemodeled and incorporated as part of thelonger-term planning goals to combatretention while simultaneously creatinga career lattice.

By creating an internal “pipeline”through the use of a career lattice, bothMAs and employers will mutuallybenefit by maintaining the employee andincreasing opportunities for new MAs.

Employers should focus on using“recognition techniques” to create ateam environment and implementingmethods to empower MAs.

Employers would benefit fromexercising “scheduling flexibility” as anincentive for MAs entering a careerlattice, especially when monetaryincentives are not available.


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It is imperative that training providersfocus on “portability” of skill sets byusing the California Certified MedicalAssistant (CCMA) standards or anotherrecognized standard.

Medical terminology for propertranslation and increased patient careshould be strongly encouraged forbilingual MAs.

The length of externships should beincreased to a minimum of 400 hourswith increased exposure to variedspecialties.

There will be an increased demand forAmerican Sign Language translators.

There exists a need for standardizationof the MA curriculum. A State Boardcertificate would ensure minimalcompetencies are being achieved andprovide stability in the MA arena.

Next Steps

Provide this report to educators andencourage changes in MA training. Thefollowing should be included indiscussions with educators and trainingproviders.

o Medical Assistant courses need tomeet the pre-requisite requirementsfor nursing or other medicalprofessions, especially in medicalterminology and anatomy.

o Extend the length of time forexternships and place students inmedical settings that are morecomprehensive versus specializedfields.

o Non-traditional trainingopportunities such as LifelongLearning Accounts (LiLAs) and MAPooling should be explored due tothe various financial, family, andscheduling needs of medicalassistants.

o Incorporate more soft-skills traininginto the MA curriculum whichemployer input indicated as criticalto retention.

Provide this report to policy makers andadvocate for standardization of MedicalAssistant curriculums.

Contact Information

Merced CountyDepartment of Workforce Investment1880 W. Wardrobe AvenueMerced, CA 95340http://web.co.merced.ca.us/wi/wib/wib.html

Santa Clara County/SVWINwork2future1290 Parkmoor AvenueSan Jose, CA 95126www.work2future.biz/Library.html

Workforce Investment Board ofSanta Cruz County1040 Emeline AvenueSanta Cruz, CA 95060www.santacruzwib.com

Stanislaus CountyAlliance WorknetP.O. Box 3389251 E. Hackett Rd. C-2Modesto, CA 95353-3389www.allianceworknet.com


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Appendix A – LMI

LABOR MARKET INFORMATIONCOMPARISON

WI completed a comparison of MedicalAssistants from each of the four regionalcounties based on the 2005 California LaborMarket Department Surveys.12 The similaritiesbetween the counties were in the areas of jobdescription, career options, and sourcesavailable for additional information. Thedifferences centered on working locations,salaries, benefits and job outlook.

MEDICAL ASSISTANTS (MA)Merced CountySanta Cruz County*Santa Clara CountyStanislaus County* LMI for Santa Cruz includes Monterey and

San Benito Counties as well.

What do Medical Assistants do?The information is the same for all fourcounties.Medical Assistants perform administrative andcertain clinical duties under the direction ofphysicians. Administrative duties may includescheduling appointments, maintaining medicalrecords, billing, and coding for insurancepurposes. Clinical duties may include takingand recording vital signs and medical histories,preparing patients for examination, andadministering medications as directed byphysician.(Source SOC 31-9092-see Sources Page)

What are the work activities and tasks?The information is the same for all fourcounties.Listed below are the top 10 work activities andtasks that Medical Assistants perform. (SourceO*NET-see Notes Page).

Interview patients to obtain medicalinformation

Prepare patients for examinations andtreatments

Record patients’ medical information andvital signs

Prepare and administer medications asdirected by physicians

Collect laboratory specimens and preparethem for testing

Explain treatment and physicians’instructions to patients

Help physicians examine and treat patients Authorize drug refills and provide

prescription information Prepare treatment rooms for patient

examinations Clean instruments and dispose of

contaminated supplies

What working conditions can I expect?The information is the same for all fourcounties.Medical Assistants work in well-lighted, cleanenvironments. They constantly interact withother people and may have to handle severalresponsibilities at once. Most full-timeMedical Assistants work a regular 40-hourweek. Some work part-time, evenings, orweekends.(Source: Occupational Outlook Handbook-seeSources Page)

Where do Medical Assistants work?Merced County-survey informationrepresents 24 firms that employ 159 MA.Most MA work in doctors’ offices and clinicsand a few work in laboratories, outpatient carecenters, hospital and mental health facilities.

Doctors’ offices and clinics 71%Hospitals 4%Laboratories 13%Mental Health Facilities 4%Outpatient Care Centers 8%


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Santa Cruz County-survey informationrepresents 59 firms that employ 337 MA inMonterey, Santa Cruz, and San BenitoCounties. Almost all MA work in doctors’offices and clinics and a few work in publicadministration, outpatient care centers, mentalhealth facilities and hospitals.

Doctors’ offices and clinics 83%Mental Health Facilities 3%Public Administration 8%Hospitals 2%Outpatient Care Centers 4%Santa Clara County-survey informationrepresents 19 firms that employ 708 MA.Many MA work in doctors’ offices and clinics.Some work in hospitals, and a few work inother areas.

Doctors’ offices and clinics 48%Other 10%Hospitals 30%Mental health Facilities 3%Outpatient care centers 16%

Stanislaus County-survey informationrepresents 15 firms that employ 256 MA.Most MA work in doctors’ offices and clinics.

Doctors offices and clinics 78%Mental health facilities 3%Hospitals 12%Other 2%Outpatient care centers 5%

* LMI for Santa Cruz includes Monterey andSan Benito Counties as well.

How much can I expect to earn?This occupation does not pay as well whencompared to other occupations that requiresimilar levels of education. Wages for full-time for hourly/annual are as follows:

Merced/ Santa Cruz/Santa Clara Stanislaus

Low $ 9.40/$ 19,538 $ 12.34/$ 25,674

$ 13.53/$ 28,132 $ 11.48/$ 23,888

Median $ 11.31/$ 23,537 $ 14.38/$ 29,909

$ 15.97/$ 33,222 $ 13.30/$ 27,651

High $ 12.87/$ 26,779 $ 16.82/$ 34,979

$ 18.15/$ 37,743 $ 15.50/$ 32,743

What percent of medical insurance doemployers pay?

Of the Merced County employers whoprovide medical insurance, all reported thatthey pay for half or more of the cost ofmedical insurance for full-time, and most payfor half or more of the cost for part-time.

Of the Monterey, Santa Cruz, and San BenitoCounties employers who provide medicalinsurance, almost all reported that they pay forhalf of more of the cost of medical insurancefor full-time and part-time.

Of the Santa Clara County employers whoprovide medical benefits, almost all reportedthat they pay for half or more of the cost ofmedical insurance for full-time, and mostreported that they pay for half or more of thecost of medical insurance for part-time.

Of the Stanislaus County employers whoprovide medical benefits, almost all reportedthat they pay for half or more of the cost ofmedical insurance for full-time MedicalAssistants.

What benefits can I expect to receive?

MercedSantaCruz

SantaClara Stanislaus

Medical 67% 92% 100% 87%13% 19% 42% 20%

Dental 42% 47% 79% 47%8% 8% 32% 3%

Vision 25% 34% 42% 47%4% 8% 32% 0%

Life 33% 29% 53% 13%8% 5% 21% 0%

Disability 21% 15% 53% 20%


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8% 2% 32% 07%Vacation 83% 80% 74% 80%

29% 37% 21% 27%SickLeave

75% 71% 58% 73%

29% 27% 21% 20%Paid TimeOff Bank

21% 36% 42% 13%

13% 27% 32% 13%RetirementPlan

71% 76% 89% 53%

17% 39% 37% 3%

Full-time WorkPart-time Work

What education, training, and experience do Ineed?

Education/training requirementsThe information is the same for all fourcounties.Formal training in medical assisting isgenerally preferred but is not always requried.Applicants usually need a high school diplomaor the equivalent.Medical Assistants are not licensed, certified,or registered by the State of California.However, most employers prefer graduates offormal programs in medical assisting.

Medical programs are offered in vocational-technical high schools, postsecondaryvocational school, and community or juniorcolleges.

The training institutions or instructors certifystudents who complete the required trainingsatisfactorily. Each employer retains a copy ofthe certificate as a record.

Recommended High School courses:mathematics, health, biology, typing,bookkeeping, computers, and office skills.

Schools that offer trainingThe information is the same of all fourcounties.

To find training programs, refer to theEmployment Development Department’sLabor Market Information Web site.(Source: LaborMarketInfo-see Sources Page)Note: Contact the schools that you are interested into learn about the availability of classes and anyprerequisite course work.

Licensing RequirementsLicensing is not required in any of the fourcounties.

ExperienceMost of the employers in Merced Countyrequire new hires to have prior experienceworking as a Medical Assistant. Mostemployers will not accept experience in relatedoccupations and many employers will notaccept training in place of experience.

Most employers in Monterey, Santa Cruz andSan Benito Counties require new hires to haveprior experience working as a MedicalAssistant. Many employers reported notaccepting experience in related occupations,but most employers will accept training inplace of experience.Almost all employers in Santa Clara Countyrequire new hires to have prior experienceworking as a Medical Assistant. Mostemployers do not accept experience in relatedoccupations, and many do not accept trainingin place of experience.

Most employers in Stanislaus County requirenew hires to have prior experience working asa Medical Assistant. Many employers acceptexperience in related occupations but do notaccept training in place of experience.

Employers requiring work experience as aMedical Assistant.


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MercedSantaCruz


Required Experience79% 73% 84% 67%

More than 1 year0% 28% 31% 10%

7-12 months61% 53% 31% 40%

4-6 months33% 16% 31% 50%

1-3 months6% 3% 7% 0%

Not required21% 27% 16% 33%

Employers accepting work experience inrelated occupations.

MercedSantaCruz


Accept related experience37% 49% 26% 53%


7-12 months46% 48% 50% 63%

4-6 months33% 22% 25% 25%

1-3 months22% 15% 25% 12%

Not accepting experience63% 51% 74% 47%

Employers accepting training in place ofexperience.

MercedSantaCruz


Accept Training42% 68% 42% 47%


7-12 months30% 38% 50% 57%

4-6 months40% 24% 25% 29%

1-3 months30% 27% 12% 0%

Not accepting experience

58% 32% 58% 53%What skills, abilities, and knowledge areneeded?

The information is the same for all counties.

Skills: Skills are the use of knowledgerequired to perform a job. Skills are developedthrough practical experience and training. Thetop five skills that are very important toemployers are Active Listening (87), Speaking(79), Social Perceptiveness (79), Instructing(78), and Reading Comprehension (75).

Abilities: Abilities are the capacity to performvarious tasks related to a job based on skillsand knowledge. The top five abilitiesimportant to employers are OralComprehension (88), Oral Expression (85),Speech Clarity (78), Near Vision (72), andProblem Sensitivity (69).

Knowledge: Knowledge is the understandingof facts or principles relating to a particularsubject area. The top five knowledge areas areEnglish Language (75), Customer andPersonal Services (69), Medicine andDentistry (64), Clerical (56), and Therapy &Counseling (47).Numeric scores represent the degree ofimportance in performing this job.75-100 = Very Important25-49 = Somewhat Important50-74 = Important

0-24 = Not ImportantStudents considering employmentopportunities as Medical Assistants candetermine whether they have the interest andbackground that make a good fit for thisoccupation.

Medical Assistants are expected to activelyhelp people, and therefore they must be neatand well groomed, courteous, and pleasant.Medical Assistants must be able to put patientsat ease, explain physicians’ instructions, andrespect the confidential nature of medical


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information. They are also required to have areasonable level of manual dexterity and visualacuity to perform clinical duties.

Note: Information provided about skills,abilities, and knowledge applies to thisoccupation on a national level.

What if I am considering educationalopportunities in this occupation?The information is the same for all fourcounties.

Medical Assistants must be knowledgeableand have a good understanding of the Englishlanguage. Other helpful courses are:mathematics, health, biology, computers, andoffice skills.

What is the job outlook?

Current Employment:250 Medical Assistants are employed inMerced County.1100 Medical Assistants are employed inMonterey, Santa Cruz, and San BenitoCounties.2490 Medical Assistants are employed inSanta Clara County.1520 Medical Assistants are employed inStanislaus County.

Employment Forecast:The number of Medical Assistant jobs inMerced County is projected to grow by33.3% between 2001 and 2008. The jobgrowth rate is much faster than the projectedgrowth rate of 15.7% for all jobs in MercedCounty.

The number of Medical Assistant jobs inSanta Cruz County is projected to grow by21.4% between 2001 and 2008. This jobgrowth rate is faster than the projected growthrate of 11.5% for all jobs in the counties.

The number of Medical Assistant jobs inSanta Clara County is projected to grow by23.7% between 2001 and 2008. The jobgrowth rate is much faster than the projectedgrowth rate of 7.6% for all jobs in Santa ClaraCounty.

The number of Medical Assistant jobs inStanislaus County is projected to grow by22.2% between 2001 and 2008. The jobgrowth rate is faster than the projected growthrate of 15.3% for all jobs in Stanislaus County.

All of the Counties job growth rates forMedical Assistants are much slower that thejob growth rate of 46% for Medical Assistantsin all of California.

Number of Medical Assistants

MercedSantaCruz


Estimated 2001 Employment210 980 2190 1350

Estimated 2008 Employment280 1190 2710 1650

Are qualified applicants available?

Many employers in Merced and Santa CruzCounties find it somewhat difficult to findexperienced applicants and not difficult to findinexperienced applicants for MedicalAssistants vacancies.

Most employers in Santa Clara County findit “somewhat” to “not difficult” to findexperienced applicants, and many find it notdifficult to find inexperienced applicants forMedical Assistants vacancies.

Many employers in Stanislaus County find itnot difficult to find experienced applicants andmost find it not difficult to find inexperiencedapplicants for Medical Assistants vacancies.


14

What does this mean to me?Experienced applicants may need to spendmore time looking for available positions andinexperienced applicants may find there aremore applicants than positions when lookingor work as Medical Assistants in Merced,Santa Cruz, and Santa Clara Counties.

Experienced and inexperienced applicants mayfind there are more applicants than positionswhen looking for work as Medical Assistantsin Stanislaus County.

Medical Assistants will be in high demand inCalifornia and most of the nation for the next 7years or more. The needs of a growingpopulation and technological advances inmedicine will ensure the availability of workfor Medical Assistants for many years tocome.

Where can job seeker find a job?Most Medical Assistants work in Doctors’Offices and Clinics in Merced and StanislausCounties.

Many Medical Assistants in Santa ClaraCounty work in Doctors’ Offices and Clinics.

Almost all Medical Assistants in Santa CruzCounty work in Doctors’ Offices.

What are job seekers’ career options?The information is the same for all fourcounties.

There are many occupations in the health carefield that are related to Medical Assistants.These related careers can be grouped by theamount of education they require, rangingfrom 30 days of on-the-job training (OJT) topostsecondary and vocational education, toadvanced professional degrees.

Related careers are occupations withcharacteristics such as skills, abilities,knowledge, or general work activities that aresimilar to those required of MedicalAssistants.

What sources are available for additionalinformation?The information is the same for all fourcounties.

In addition to the information displayed in thisreport, other sources are available withadditional information. These sources areexplained below with links that will connectyou to the appropriate website.

Job DescriptionSOC Code (Standard Occupationalclassification)


15

A universal occupational classification systemproduced by the U.S. Department of Labor,Bureau of Labor Statistics (BLS).http://www.bls.gov/soc

Work Activities and TasksO*NET Center (Occupational InformationNetwork)Detailed information on work activities andtasks. Click on Find Occupations, type in theoccupation title and click Go. Click onoccupation and then Details. Scroll down toneeded information,http://online.onetcenter.org

Working ConditionsOOH (Occupational Outlook Handbook),Bureau of Labor Statistics

Enter the title of the occupation and clickSearch. Select the occupation title and doubleclick. Select Working Conditions and doubleclick.http://www.bls.gov/search/ooh

Wages and BenefitsWages are from the EmploymentDevelopment Department, OccupationalEmployment Statistics (OES). Select theGeographic Area, Year, and type of file youwould like to see. Scroll down to theappropriate SOC code.http://www.calmis.ca.gov/file/occup$/oes$.htm

Education and TrainingEDD, Labor Market Information Division,Find Training Programs

Enter a Keyword under Program Name andthen select county. Click on Search and thenselect a program to view the schools.http://www.labormarketinfo.edd.ca.gov/cqi/databrowsing

Licensing requirementsNone required for Medical Assistants. Go toCalifornia Board of Register Nursing foradditional career opportunities.http://www.rn.ca.gov/

Skills, abilities and KnowledgeO*NET Center (Occupational InformationNetwork)An expanded list of skills, abilities andknowledge. See instructions under Work,Activities and Tasks (left-hand column).http://online.onetcenter.org

Job OutlookEDD, Labor Market Information divisionsProjections

Long-term projections for occupations. Typein title of occupation, select an area, and thenclick on Search. Scroll to desired projectionsinformation.http://www.labormarketinfor.edd.ca.gov

Supply and DemandAmerica’s Job Bank

Find job openings in your designated area.Enter the occupation and location then clickSearch Now.http://www.jobsearch.org/seeker/jobsearch/quick

One Stop Career Center

Allows you to search for the nearest CareerCenter. Enter the location and your servicerequirements and click on GO.http://www.servicelocator.org/


16

Appendix BMEDICAL ASSISTANT FOCUS GROUP - DATA TABLES

1) Did the job require other skills that were not included in the Medical Assistant training? Ifso, what were they?

ResponseSome of the Medical Assistants felt that they had a good understanding of the basics, but were betterprepared for the back office instead of the front office. A general consensus was that they learnbasically what is needed to perform the duties in the classroom, but things are done differently on thejob. There were 44 of the 52 MAs surveyed (84.6%) felt that the job definitely required other skillsthat were not included in their training. The two highest responses were in front office, includingcomputer, scheduling, referrals and paperwork and equipment. There were only 8 of the 52 (15.4%)who felt that they learned the skills necessary in training. The MAs who felt they had sufficienttraining due to having On the Job Training (OJT) or attending a 2 year community college.

Figure 1) Did the job require other skills that were not included in the medical assistant

training?

0

2

4

6

8

10

Front

office N

o

Equipm

ent

Vacin

nes/T

BTest

/Dra

wing

Blood

Pedia

trics

Back

offic

e

Eyeca

re/ Ear

care

Treat

men

ts

Triage

Trans

latin

g

Mixi

ng/M

easu

ring

Med

icatio

n

Sutur

ing

and

stap

ling

rem

ovals

Multi-

task

ing

Merced Santa Clara Santa Cruz Stanislaus Total

Note: Front office includes computer, scheduling, referrals, and paperwork. Treatments include O2 Stat, Nebulizer, and pulmonary function.


17

2) Was any of the training outdated? If so, what?

ResponseThe primary reasons the training were outdated was due to equipment and computers being too oldand the educational providers not keeping up with technological medical advances and programs. TheEKG machine was specifically named as the primary outdated piece of equipment. Santa CruzCounty MAs noted training for computers was not relevant.

Figure 2) Was any training outdated?

0

2

4

6

8

10

12

Com

pute

rs

EKG

Equ

ipm

ent

No

Res

pons

e

Oka

y

Teach

erIssu

es

Tem

pera

ture

Immun

izat

ions

Merced Santa Clara Santa Cruz Stanislaus Combined Total

3) How long was the externship and was it long enough?

ResponseThe externship ranged from 90 hours up to 3840 hours.

Figure 3) Wast the externship long enough?

02468

101214

90

16

0

18

0

20

0

24

0

28

0

40

0

48

0

64

0

96

0

28

80

38

40

Tim

eN

ot

Sp

ec

ifie

d

Number of Externship Hours



18

Long enough?

Figure 3) Part II - Was the Externership Long Enough?

0

5

10

15

20

25

Yes No Didn't have one

4) What keeps you in this line of work?

Figure 4) What keeps you in this line of work?

0

5

10

15

20

25

30

Helpin

gPeop

le

Co-work

ers

Mon

ey

Conveni

ent

Advanc

emen

t

Lear

ning

newth

ings

Love

sw

orki

ngwith

babi

es

Want

sto

leav

e

Retirem

ent


19

5) What would cause you to leave the Medical Assistant profession?

Figure 5) What would cause you to leave the Medical Assistant Profession?

0

2

4

6

8

10

12

14

16

Pay

Benefits

No

Recognitio

n

Conflic

tw

ith

Insura

nce

Co.

BetterP

atie

nt

Care

Nurs

ing

LVN

Lack

ofte

am

work

Would

notle

ave

Retire

ment

Lack

of

Pro

fessio

nal

Advance

ment

BetterC

are

er

Opportunity

School/E

ducation

Furt

hering

Care

er

Gettin

gin

to

busin

ess

Would

NotLeave

Merced Santa Clara Santa Cruz Stanis laus Combined Total

Figure 5b) What would cause you to leave the MA profession?

Combined Totals

0

2

4

6

8

10

12

14

16

Pay

Benefit

s

No

Recognition

Conflictw

ith

Insura

nce

Co.

BetterPatie

nt

Care

Nurs

ing

LVN

Lack

of

team

work

Would

notle

ave

Retir

em

ent

Lack

of

Pro

fessio

nal

Advancem

ent

BetterC

are

er

Opportunity

School/E

ducatio

n

Furthering

Care

er

Gettin

gin

to

busin

ess

Would

NotLeave

6) What is most important to you as a Medical Assistant? What are the two most important?

Figure 6) What is most important to you as a Medical Assistant?

0

2

4

6

8

10

12

Patient Care Good

Environment

Job Security Benefits Wage/Pay Continued

Learning

Flexibility

Merced Santa Clara Santa Cruz Stanislaus


20

Figure 6b) What is most important to you as a Medical Assistant?

0

5

10

15

20

25

30

Patient Care Good

Environment

Job Security Benefits Wage/Pay Continued

Learning

Flexibility

7) What are the barriers to advancement in your job?

Figure 7) What are the barriers to advancement in your job?

0

1

23

4

5

6

78

9

10

Educa

tion

Mon

ey

Family

Advan

cem

ent n

otpo

ssib

le

Not

Bilin

gual

-Spa

nish

Not

Sur

e

Lim

ited

optio

ns

Mus

t be

C.N

.A. t

oen

ter LV

N

Waitin

gfo

r peop

leto

retir

e

Non

e

Not

Bilin

gual

-Vietn

ames

e

Who

you

know

Mor

eTra

inin

g

Flexibi

lity


Figure 7b) What are the barriers to advancement in your job?

Combined Total

0123456789

10

Educatio

n

Mone

y

Family

Advance

men

t not po

ssib

le

Not

Bilingu

al-Spa

nish

Not

Sure

Limite

dopt

ions

Must

beC.N

.A. to

enter

LVN

Waiti

ngfo

r peopl

eto

retir

e

Non

e

Not

Bilingu

al-Vie

tnam

ese

Who

you

know

More

Trainin

g

Flexib

ility


21

8) Are there any incentives for furthering your education or in obtaining NationalCertification? If so, what are they?

Figure 8) Are there any incentives for furthering your education or in

obtaining National Certification? If so, what are they?

02468

101214161820

Un

su

re No

Ye

s

Ed

uc

atio

n

Re

imb

urs

em

en

t

Em

plo

ye

rw

ou

ld

co

ns

ide

rif

ce

rtifi

ed

Fle

xib

leh

ou

rs

Dis

co

ura

ge

d/h

ou

rs

co

nfli

ct

Cla

ss

es

Off

ere

d

Pa

y

Pe

rso

na

lGo

als

Be

ne

fits

CM

Aa

lre

ad

y-

rec

om

me

nd

sit


Figure 8b) Incentives for furthering education for MAs

Combined Totals

02468

101214161820

Unsure NoYes

Education Reim

bursement

Employer wouldconsider if certif

ied

Flexiblehours

Discouraged/hoursconflic

t

Classes Offere

d Pay

Personal Goals

Benefits

CMAalre

ady-recommends it


22

9) Are you interested in becoming a LVN/RN or in other promotional opportunities?

Figure 9) Are you interested in becoming an LVN/RN or in other

promotional opportunities?

0

5

10

15

20

RN

Not

interested

LVN

Proba

blyor

may

be

Prerequ

isite

sCha

ngingProfess

ion

Nurse

Practito

ner


FOCUS GROUPS EMPLOYER RESPONSES – DATA TABLES

Focus groups were held for the business group providers who employ medical assistants in Merced,Santa Clara, Santa Cruz, and Stanislaus Counties. A total of 28 providers attended the focus groups.The focus groups sessions were as follows:

Merced County - 4 providers in attendance held on 6/22/06 and 6/27/06. Santa Clara County - 12 providers in attendance held on 9/15/06. Santa Cruz County - 6 providers in attendance held on10/18/06. Stanislaus County - 6 providers in attendance held on 9/20/06.

Each employer focus group was asked to respond to twelve questions. The results are as follows:

10) Have Medical Assistant duties changed or expanded over the years? If so, how?There were not clear answers to this question since doctors have medical assistants perform dutiesoutside an MA’s scope of practice while working. One Merced County employer felt that the medicalassistants were not prepared to do billing and office work while another felt that they do more now


23

than before. In Santa Clara County, many of the providers felt that the common duties have remainedthe same. Medical assistants can no longer perform phlebotomy. MAs who work for smaller doctoroffices reported increased duties when compared to MAs employed in larger organizations. Most ofthe providers agreed that medical assistants do more than in previous years. All of the providersagreed that there have been definite changes for medical assistants.

Figure 10) Duties expanded over the years in the MA field.

0

1

2

3

4

5

Du

tie

so

uts

ide

of

sc

op

eo

fp

rac

tic

e

Mo

res

kill

sa

nd

kn

ole

dg

en

ee

de

d

Fro

nt

off

ice

Ph

leb

oto

my

He

igh

t/W

eig

ht/

BM

I

Cri

tic

al

thin

kin

g

Sh

rin

kin

gs

co

pe

of

pra

cti

ce


11) What training is still needed for a “new hire” medical assistant?

Figure 11) Training still needed for "new hire" MA.

0

2

4

6

8

10

12

Cu

sto

me

r

Se

rvic

e

Asse

ssm

en

t

Va

rie

tyo

f

skill

s

Ag

en

cy

spe

cific

s

Pa

tien

tC

are

/

Ed

uca

tion

Inje

ctio

ns

Fro

nt

Off

ice

Skill

s

Ca

lcu

latio

ns

Wri

tin

ga

nd

gra

mm

ar

Co

mp

ete

ncie

s

Pa

pe

rwo

rk/

Insu

ran

ce

Pe

dia

tiric

s

He

ari

ng

/Vis

ion

PT

D

Me

dic

al

term

ino

log

y

OB

-GY

N

Die

tary

EK

G

Fin

an

cia

l

Pre

scri

ptio

ns

Ste

riliz

atio

ns

Te

ach

ing

me

tho

do

log

y



24

Figure 11b) Combined training for new hires.

0

2

4

6

8

10

Cus

tom

erSer

vice

Asses

smen

t

Varie

tyof

skills

Agenc

ysp

ecifics

Patient

Car

e/Educ

atio

n

Inje

ctio

ns

Front

Offi

ceSkil

ls

Cal

cula

tions

Writ

ing

and

gram

mar

Com

pete

ncie

s

Paper

wor

k/In

sura

nce

Pedia

tiric

s

Hea

ring/

Vision

PTD

Med

ical

term

inolo

gy

OB-G

YN

Dieta

ryEKG

Finan

cial

Presc

riptio

ns

Steril

izat

ions

Teachin

gm

ethod

ology

12) What additional training do you provide to medical assistants?

Figure 12) Additional Training do Employers provide to MAs.

0

5

10

15

20

25

30

Orie

nta tio

ns

Comput

er

Custom

erSer

vice

Billing

/Rec

ords/

Insu

ranc

e

Infe

ctio

usco

ntro

l

Inje

ctio

ns

Depe

nds

onSpe

cialty

HAHCO

/HEPA

Proce

dure

s

Qua

lityco

ntro

l chec

ks

Man

datory

repo

rting

Urgen

t care

-min

i ER

Resp

irato

ryth

erap

y

Surgic

alPack

s

DH-E

PIC

Inve

ntor

y/ s

upp lie

s

Patie

ntEdu

catio

n


Note: Orientation is 3 weeks to 3 months. Customer Service includes conflict resolution

13) Do you need bilingual staff? If so, what languages?

Merced County employers uniformly responded yes to this question but added that they have accessto the AT&T translation service. Employers reported that bilingual MAs are extremely beneficial andaids (MAs) in hiring decisions. Many of the doctors are hired from outside of the United States andspeak other languages. Santa Clara County employers stated that there is access to all languagesthrough other services. One Stanislaus County provider does not allow MAs to interpret since they donot know medical terminology in Spanish.


25

Figure 13) Need for bilingual staff

0

1

2

3

4

5

6

7

8

9

10

Spanish Sign

Language

Hmong Portuguese Punjabi Vietnamese Hindi


14) Have you encountered problems with bilingual staff translating medical terminologyaccurately? If so, what problems?

In Merced County, a local hospital requires their bilingual staff to be certified in order to translate.Many patients do not understand medical terminology in general, so additional problems can resultwith another language. Santa Clara County employers stated that having bilingual staff is not a majorissue for them. Additionally, Santa Clara bilingual staff have to be certified and/or take a test forbilingual pay. The sentiment in Santa Cruz County was that medical terminology is a language initself, which can create difficulties in communication. Stanislaus County employers stated thattranslating has not been too much of a problem for any of them. They added that they have access tothe language line (AT&T).

Figure 14) Problems with medical translation.

0

2

4

6

8

10

12


Yes

No


26

15) What training needs do you have that you cannot resolve?

In Merced County, the issues centered more on the nursing shortage and they felt that most trainingissues can be resolved normally. Time constraints to allow for role-playing and increase customerservice skills were stressed as the most important issue they are having difficulty resolving. SantaClara County added that soft skills were a common theme along with grammar skills, attendance,punctuality, critical thinking skills and common sense skills. Santa Cruz County employers stated thattime constraints hinder much needed training and would like to add calculations training, criticalthinking skills, immunizations and most importantly, they are having difficulty finding suitabletrainers. Stanislaus County employers felt that of all new hires, the “Generation X-ers” lackedworkplace basics and soft skills. The soft skills included work ethics, accountability, professionalism,reliability, respect, and proper cell phone and computer usage, personal grooming and interviewingskills.

Figure 15) Employer Training Needs

0

2

4

6

8

10

12

Custo

mer

serv

ice

skill

s

Tim

e

constrain

tsfo

r

role

-pla

yin

g

Critical

thin

kin

gskill

s

Too

much

train

ing

for

new

MA

-2

Gra

mm

ar

skill

s

Com

mon

sense

Calc

ula

tions

Imm

uniz

ations

Tra

iners

16) What problems do you have in retaining medical assistants?

Merced County employers felt that from the corporate perspective, there is no concept of what aMedical Assistant actually does. Santa Clara County felt that retention is not an issue if the salary iscompetitive. Santa Clara employers felt that the cost of living in their county is very high, which is afactor in the number of transfers and relocations they deal with. Stanislaus County employersreported that pay is a major issue, especially with Kaiser Permanente expanding their services in thelocal area.


27

Figure 16) Retention Problems

0

1

2

3

4

5

6

7

Pay

Tra

nsfe

rs

No

pro

ble

ms

Advancem

ent

(RN

)

Work

Eth

ic

Work

ing

on

nurs

ing

pre

requis

ites

Work

load


17) What are you doing to retain medical assistants?

Merced County reported that having a good working environment is important in retention. SantaClara employers felt that having MAs feel that they are an important part of the team and are valuedare stressed and added that retention strategies ranged from tangible and intangible techniques. SantaCruz employers stressed the importance of empowering their staff and valuing the important roleseach MA plays in their offices, while Stanislaus County employers reported “flexibility” with time astheir main retention strategy.

Figure 17) Employer Retention Strategies

01234567

Team

build

ing

Foste

ring

growth

Flexib

ility

Empo

wermen

t

Comm

unica

tions

Gre

atbe

nefit

s,re

tirem

ent

Tuitio

nre

imbu

rsem

ent

Educa

tiona

l leav

e

Mor

alebui

ldin

g

Belon

ging/

owne

rshi

p

Family

atm

osphe

re

Goo

dPay

Goo

den

vironm

ent

Three

leve

l appr

oach

Not sure


Note: Three level approach is defined as having a three-tiered MA system.


28

18) What are the reasons for medical assistants leaving?

Merced County reported pay, advancement, family and education as primary reasons why MAsleave. Santa Clara County reported that the aging of the workforce is a factor for leaving since manyMAs are retiring.

Figure 18) Reasons why MAs leave.

01234567

Pay

Adv

ance

men

t

Ent

ernu

rsing

prog

ram

Ret

irem

ent

Reloc

ation

Cha

lleng

eof

new

job

Term

inat

ion

Fam

ily

Late

ral tra

nsfe

rs

Job

Bur

nout


19) What is the pay range for medical assistants?

The Merced County employers’ pay range is lower than other counties. The providers who attendedwere from large medical facilities and smaller doctors’ offices. The range in Merced was from $9.44to $13.00 per hour. Santa Clara employers stressed that “Mom and Pop” doctors are lower and thatthis is not a normal sample. All are per hour. Santa Clara pay range is $11.00 to $19.00, if certifiedMA then the rate is $18.00 to $23.00 per hour. The cost of living is a major factor in the starting payfor Santa Cruz County. Their MAs start at $13.00 per hour to $25.00. The providers in attendancewere from smaller offices or clinics in Stanislaus County and their wages ranged from $9.10 per hourto $17.00 per hour.

County Merced Santa Clara Santa Cruz Stanislaus

$ 25.00$ 24.00$ 23.00$ 22.00$ 21.00$ 20.00$ 19.00$ 18.00$ 17.00$ 16.00$ 15.00$ 14.00$ 13.00$ 12.00$ 11.00$ 10.00$ 9.00

Figure 19


29

20) Are there any incentives, financial or professional, if a medical assistant is registered,certified or has the National Certification through he American Association of MedicalAssistants (AMMA)? If so, please, describe.

Employers from Merced County stated that being certified is not a requirement. Santa Clara Countyemployers felt that certification is a “plus” in the hiring process, but not a requirement. Only oneemployer from Santa Clara stated that it was required within 18 months of their hire date. In sharpcontrast, Santa Cruz County employers require certification as a hiring requirement for most of theproviders. In Stanislaus County, the scope of practice remains the same whether certified or not.

Figure 20) Incentives for certification

0

2

4

6

8

10

12

14

No

Incentive

Reim

burs

em

ent

Required

Plus

inhiring

pro

cess

Encoura

ged

to

obta

in

Paid

tim

e

pro

vided

Required

within

18

month

sof

hire


21) What would be the steps for a medical assistant to advance to a LVN within yourorganization?

Merced County employers reported that there is no pipeline for advancement but advancement is acommonly encouraged practice. Santa Clara employers encourage their Medical Assistants to enterthe RN program and place very little emphasis on the LVN program. Santa Cruz County employersstated that LVNs are needed for nursing homes primarily. One of the Santa Cruz clinics employsMAs exclusively, while others want staff to pursue the RN program. They added that currently thereis a 4-year waiting list for nursing school. One of the facilities in Stanislaus County no longer hiresLVNs. Sutter Hospital has a 20/40 program available where staff can work 20 hours, but get paid for40 hours while in the nursing program.

Figure 21) MA to LVN Steps

0

2

4

6

8

10

12

14

16

Flexibility in

time

Educational

Allowance

Do it on your

own

None Provide

tuition

Provide

training

Challenge

the LVN test



30

Appendix C

FOCUS GROUP QUESTIONING GUIDE

9 Questions asked to Medical Assistants

1. Did the job require other skills that were not included in the Medical Assistant training? If so,

what were they?

2. Was any of the training outdated? If so, what?

3. How long was the externship and was it long enough? Why?

4. What keeps you in this line of work?

5. What would cause you to leave the Medical Assistant profession?

6. What is most important to you as a Medical Assistant? What are the two most important?

7. What are the barriers to advancement in your job?

8. Are there any incentives for furthering your education or in obtaining National Certification? If

so, what are they?

9. Are you interested in becoming a LVN/RN or in other promotional opportunities?

12 Questions asked to Employers of Medical Assistants

10. Have Medical Assistant duties changed or expanded over the years? If so, how?

11. What training is still needed for a “new hire” Medical Assistant?

12. What additional training do you provide to Medical Assistants?

13. Do you need bilingual staff? If so, what languages?

14. Have you encountered problems with bilingual staff translating medical terminology accurately?

If so, what problems?

15. What training needs do you have that you cannot resolve?

16. What problems do you have in retaining Medical Assistants?

17. What are you doing to retain Medical Assistants?

18. What are the reasons for Medical Assistants leaving?

19. What is the pay range for Medical Assistants?

20. Are there any incentives, financial or professional, if a Medical Assistant is registered, certified or

has the National Certification through the American Association of medical Assistants (AMMA)?

If so, please describe.

21. What would be the steps for a Medical Assistant to advance to an LVN within your organization?


31

Appendix D

TREE FORMAT C.N.A. CAREER LATTICE

“Tree” representation developed by the California Association of Heath Facilities to illustrate nurseaides and certified nursing assistants (C.N.A.) as a start to other health careers (July 2000).


32

Appendix E

STEP FORMAT


33

Appendix F

MODEL FOR MA


34

Notes

1 Employment Development Department, Labor Market Information Division, CaliforniaOccupational Guide, July 2005.

2 Center for the Health Professions, Allied Health 1970s-2000s: A Review of Key Reports, Universityof California, San Francisco, 2005.

3 Employment Development Department, Labor Market Information Division, Health Care Careers,May 2005.

4 Council for Adult and Experiential Learning (CAEL), Employee Development, A Prescription forBetter Healthcare, 2005.

5 Employment Development Department, Labor Market Information Division, Careers UnderConstruction: Models for Developing Career Ladders, May 2005.

6 Robert Wood Johnson Foundation, Defining the Frontline Workforce, September 2005

7 Robert Wood Johnson Foundation, Frontline Workforce Development: Promoting Partnerships andEmerging Practices in Health and Health Care, September 22, 2005.

8 UCSF Center for the Health Professions, Medical Assistants in California, May 2004.

9 UCSF Center for the Health Professions, Medical Assistants in California, page.6, May 2004.

10 Medical Board of California, Medical Assistants. Retrieved from the World Wide Web atwww.medbd.ca.gov/MA_FAQ.htm.

11 Employment Development Department, Labor Market Information Division, Careers UnderConstruction: Models for Developing Career Ladders, May 2005.

12 Employment Development Department EDD, Labor Market Information, Select Careers. Retrievedfrom the World Wide Web at:http://www.calmis.ca.gov/selectcareers/.

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