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Our clinic (i.e. outpatient primary care, attached to large, urban nonprofit hospital) is perpetually short on medical assistants.  I started in November, and still do not have a specific person assigned to me.  About one fifth of my work days, I do not have a medical assistant at all.  

Without a medical assistant, I spend at least an extra hour charting, because that time is lost during the day, trying to get help with injections, ear washes or other tasks (or sometimes getting the equipment myself and doing the tasks).  

At first, I was told that MAs are prioritized to physicians because they are paid on RVUs, and I am not.  I complained, and this practice was stopped.  However, we have continued to lose about 2 per month, and cannot hire and train them fast enough.  Although the MA absences are now shared equally among all providers, I am not getting the help I need.  My supervisors are sympathetic, but they simply cannot fill the MA slots quickly enough.

As primary care PAs, do you experience the same situation?  How is your MA coverage (and where are you located)?  Do your physician counterparts have MAs more often than you do?  Do you have tips on how to handle this?

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I'm not sure it compares well but something similar happened here (east Texas) recently. I work in an urgent care for a huge faith based organization and they are forever trying to magically divine staffing levels on a shifting basis so as to not spend a dollar they don't have to. As most anyone could predict it doesn't work because there is no way to guess day to day what the patient load might be.

A couple of weeks ago I was doing a weekend shift..2 providers and one MA and she got sick. First her boss was trying to find a replacement (and told her to stay until she could) but my MA was vomiting in a trash can and I told her to go home. Then I called the medical director and told him what happened. He told me I would need to room patients. I said no. It isn't my job, he wouldn't do it under the same circumstances, and quite frankly admin needed to feel the pain of their foolishness otherwise they would never fix anything. So for 3 hours 2 of us sat here with the front desk redirecting everyone who walked in to a different UC 10 miles away. They finally found an MA and we continued to the end of the day.

So the point(s) of that wandering story is 1) I expect to be treated like every other provider, physician or not, and if the medical director wouldn't do it don't expect me to and 2) if admin doesn't feel some sting they will not react. If you kill yourself plugging the hole that will create an expectation and remove any sense of urgency.

I used to work for a community health center that couldn't keep MAs because they paid 2-3$/hr less than any other employer in the area and no matter how long an MA was there they never got a raise because "we are a community health center. We don't do that." I didn't finish out my contract.

I can't really suggest what you should do but it seems you have 2 choices. Do the MA work and slow your productivity down to reflect the time you are wasting or tell them you can't see patients without someone to help you. well I guess door number 3 is do all the work yourself but that way lies madness.

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In my area and especially my practice, we actually have TOO MANY MAs.

 

And there seems to be MA schools in every mall and business park in every city here. Schools with "old" sounding names like "Blake Austin" and "Carrington" "Universities" they are called.

 

I just realized I didn't help with your situation... Sorry about that. Are there hiring restrictions with your place like requirement of "Certified" MAs? That could be a hurdle. Or are there just not enough MAs in the area?

 

Sent from my SAMSUNG-SM-G891A using Tapatalk

 

 

 

 

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The most likely reason they are losing MAs is that they are not paying enough. So there are 4 options.

Complain until it gets fixed.

Find a new job (make sure to let them know why you are leaving).

Pay for an MA out of your salary. 

Or as SAS8514 said, refuse to see patients without an MA. They will either fix it or fire you.

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I can say my office struggles with hiring MAs.  Thankfully we don't lose them that often, but I do know that there are vacancies in other offices in our practice and they had to increase the salary just to get people to come in for an interview (and no, that is not hyperbole, not a single person applied for the MA openings for 2 months).

The bottom line - the salary is often stingy and a lot of docs will complain about the "tight profit margin," while they are making $300K+ a year - after malpractice, practice costs, etc.

I have an inside way to see books at the place where I work, and personally know for a FACT that if I saw an average of 10 patients per day I would more than pay for my own salary, benefits, MA+benefits, etc.  (in other words be PROFITABLE).  I was told not 10 days ago that I am barely profitable - and I see on average 18 patients per day.  I'm not complaining, I like my job and the people I work for/with, but it's annoying when the "bosses" mess with the numbers to make it look like we're hurting for profits, while the docs are in the process of opening up three more buildings over the next 18 months - which will make then at least $50K more per year just from the rent money from PT/lab/radiology moving in.

The funny thing is, I guarantee that if they increased MA salaries to a more stable wage, the lack of turnover and therefore greater efficiency would more than pay for itself.

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