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    Delegating tasks to practice staff enhances team-based care

    Physicians sharing responsibilities with their teams can lead to better patient care

    physicians paperworkPhysician practice owners carry much more responsibility than they did in previous years. In fact, an avalanche of administrative requirements required to succeed, even survive, in healthcare is placing an even greater toll on morale. According to a Medical Economics web poll in December 2013, 41.9% of physicians say that administrative hassles threaten their relationships with patients. And while the challenges have been well documented, the solutions require a new approach to delegation and teamwork, experts say.

    Related: 4 ways to manage practice productivity and organize your staff

     “The notion of what it means to lead has shifted. We are moving to a team-based model of care—and it’s not just doctors,” says Andrew Morris-Singer, MD, president and founder of Primary Care Progress, a nonprofit organization that develops leadership practices amongst an interprofessional group of medical professionals. “There are different levels of credentials, expertise and diversity in the doctor’s practice right now. And we never taught physicians how to be on a team and lead a team that’s not all physicians.”

    Morris-Singer adds that physicians no longer can have the mentality that they have all of the answers—and this is a good thing. Because of the increased complexity of patient care, especially surrounding chronic disease, it will be important for physicians to build a staff that can manage all areas of a patient’s needs.

    The need for appropriate delegation can save a team time. According to a Health Affairs study primary care physicians could save 30 minutes per day by delegating routine functions to staff members. While it’s not a lot of time, it is a start.

    “We aren’t able to know the exact answers anymore in terms of care delivery,” he says, adding that different staff members can assist physicians with getting patients to adhere to prescriptions and other guidelines.

    “We have to work in a team with a unique, complementary set of skills. This is not substituting the doctor. There’s no one on the team who knows complex diagnoses and can build a therapeutic alliance better than the physician. But that’s not the only thing a patient needs.”

    Next: Giving up responsibilities

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    • Anonymous
      This article was very interesting. I agree 100% the right staff should be hired to perform the responsibilities they excel at. I also agree cross training is needed and to give additional responsibilities to staff where appropriate. What I have a hard time agreeing with are medical assistants given additional duties beyond their scope of practice. They do not have a license and work under the direct supervision of the physician. They are limited at to what they can and cannot do. To give medical assistants additional responsibilities that the physician should be is wrong is wrong; i.e. refilling Rx's. Yes, they can call the Rx into the pharmacy, but what if the MD was thinking about changing the dose or medication, but was waiting until the patient was done with their current bottle of meds? The MA would not know that, plus the MA should not just automatically refill without consulting the MD in regards to the refill request. MA's are not allowed to practice medicine. They cannot use their own judgment to access, evaluate or interpret tests results. The majority of states under the State Board of Healing Arts states the following: Licensed professional healthcare workers who have "unlicensed" staff working under their license cannot delegate any act that requires the use of judgment" I'm sure many MDs forget the rules/guidelines they need to following when hiring MA's. They hire MA's due to a lower pay scale. The majority of MA's do not have the education to have patients lives in their hands, giving additional duties to take care of them when it's the MDs responsibility. Lawsuits are waiting to happen if MDs begin to allow their medical assistants (who are trained to do repetitive tasks) to take are of patients on their own. In most, if not all states, the MA's can only take vitals, collect urine and sputum, without an MD in the office. MD's are supposed to be supervising (watching) MA's perform their duties. Plus, you are forgetting that "maybe patients want their MD to take care of them and not someone they hired off the street". "maybe patients have questions when calling in refills, wanting to speak with their MD in regards to side effects, etc." Many conversations have been misinterpreted with a patient "having" to ask the MA to ask the MD. MA's don't always understand the question the patient is asking. MA's are NOT nurses! MA's did not go 4 years of college to learn nursing. They went to a trade school and was certified/trained to do repetitive tasks. Unfortunately, 80% of patients don't know that the person who escorts them to the exam room, takes their vitals, returns their calls is not a NURSE (most of the time). It's a false misrepresentation of the office --- patients think they are nurses and they are not. Hospitals don't recognize LPN's and they are requiring RN's to go back to school to get their BSN degree. Yet, MA's are popular with doctor's offices due to their low pay. MA's should not be given the additional responsibility you are speaking about in this article.
    • Anonymous
      This article was very interesting. I agree 100% the right staff should be hired to perform the responsibilities they excel at. I also agree cross training is needed and to give additional responsibilities to staff where appropriate. What I have a hard time agreeing with are medical assistants given additional duties beyond their scope of practice. They do not have a license and work under the direct supervision of the physician. They are limited at to what they can and cannot do. To give medical assistants additional responsibilities that the physician should be is wrong is wrong; i.e. refilling Rx's. Yes, they can call the Rx into the pharmacy, but what if the MD was thinking about changing the dose or medication, but was waiting until the patient was done with their current bottle of meds? The MA would not know that, plus the MA should not just automatically refill without consulting the MD in regards to the refill request. MA's are not allowed to practice medicine. They cannot use their own judgment to access, evaluate or interpret tests results. The majority of states under the State Board of Healing Arts states the following: Licensed professional healthcare workers who have "unlicensed" staff working under their license cannot delegate any act that requires the use of judgment" I'm sure many MDs forget the rules/guidelines they need to following when hiring MA's. They hire MA's due to a lower pay scale. The majority of MA's do not have the education to have patients lives in their hands, giving additional duties to take care of them when it's the MDs responsibility. Lawsuits are waiting to happen if MDs begin to allow their medical assistants (who are trained to do repetitive tasks) to take are of patients on their own. In most, if not all states, the MA's can only take vitals, collect urine and sputum, without an MD in the office. MD's are supposed to be supervising (watching) MA's perform their duties. Plus, you are forgetting that "maybe patients want their MD to take care of them and not someone they hired off the street". "maybe patients have questions when calling in refills, wanting to speak with their MD in regards to side effects, etc." Many conversations have been misinterpreted with a patient "having" to ask the MA to ask the MD. MA's don't always understand the question the patient is asking. MA's are NOT nurses! MA's did not go 4 years of college to learn nursing. They went to a trade school and was certified/trained to do repetitive tasks. Unfortunately, 80% of patients don't know that the person who escorts them to the exam room, takes their vitals, returns their calls is not a NURSE (most of the time). It's a false misrepresentation of the office --- patients think they are nurses and they are not. Hospitals don't recognize LPN's and they are requiring RN's to go back to school to get their BSN degree. Yet, MA's are popular with doctor's offices due to their low pay. MA's should not be given the additional responsibility you are speaking about in this article.
    • Anonymous
      This article was very interesting. I agree 100% the right staff should be hired to perform the responsibilities they excel at. I also agree cross training is needed and to give additional responsibilities to staff where appropriate. What I have a hard time agreeing with are medical assistants given additional duties beyond their scope of practice. They do not have a license and work under the direct supervision of the physician. They are limited at to what they can and cannot do. To give medical assistants additional responsibilities that the physician should be is wrong is wrong; i.e. refilling Rx's. Yes, they can call the Rx into the pharmacy, but what if the MD was thinking about changing the dose or medication, but was waiting until the patient was done with their current bottle of meds? The MA would not know that, plus the MA should not just automatically refill without consulting the MD in regards to the refill request. MA's are not allowed to practice medicine. They cannot use their own judgment to access, evaluate or interpret tests results. The majority of states under the State Board of Healing Arts states the following: Licensed professional healthcare workers who have "unlicensed" staff working under their license cannot delegate any act that requires the use of judgment" I'm sure many MDs forget the rules/guidelines they need to following when hiring MA's. They hire MA's due to a lower pay scale. The majority of MA's do not have the education to have patients lives in their hands, giving additional duties to take care of them when it's the MDs responsibility. Lawsuits are waiting to happen if MDs begin to allow their medical assistants (who are trained to do repetitive tasks) to take are of patients on their own. In most, if not all states, the MA's can only take vitals, collect urine and sputum, without an MD in the office. MD's are supposed to be supervising (watching) MA's perform their duties. Plus, you are forgetting that "maybe patients want their MD to take care of them and not someone they hired off the street". "maybe patients have questions when calling in refills, wanting to speak with their MD in regards to side effects, etc." Many conversations have been misinterpreted with a patient "having" to ask the MA to ask the MD. MA's don't always understand the question the patient is asking. MA's are NOT nurses! MA's did not go 4 years of college to learn nursing. They went to a trade school and was certified/trained to do repetitive tasks. Unfortunately, 80% of patients don't know that the person who escorts them to the exam room, takes their vitals, returns their calls is not a NURSE (most of the time). It's a false misrepresentation of the office --- patients think they are nurses and they are not. Hospitals don't recognize LPN's and they are requiring RN's to go back to school to get their BSN degree. Yet, MA's are popular with doctor's offices due to their low pay. MA's should not be given the additional responsibility you are speaking about in this article.

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