I'm an MA - Is my job considered PCE?

[KH21444]

Hello! I hope someone can help!! I am so confused in regards to if a medical assistant is considered PCE or HCE for CASPA. I've been an MA for 3 years, this past year I've been working in an Urgent Care. However, the two years prior is what I'm worried about. I do feel it's considered PCE based on what I did/level of responsibility, but the way CASPA describes it is freaking me out a bit. This might be a long post but I hope even just 1 person can give me some insight!!

CASPA states:

"Patient Care Experience

Experiences in which you are directly responsible for a patient's care. For example, prescribing medication, performing procedures, directing a course of treatment, designing a treatment regimen, actively working on patients as a nurse, paramedic, EMT, CNA, phlebotomist, physical therapist, dental hygienist, etc.

Healthcare Experience

Both paid and unpaid work in a health or health-related field where you are not directly responsible for a patient's care, but may still have patient interaction; for example, filling prescriptions, performing clerical work, delivering patient food, cleaning patients and/or their rooms, administering food or medication, taking vitals or other record keeping information, working as a scribe, CNA (depending on job description), medical assistant, etc."

 

My Experience:

I've been a Medical Assistant since 2018, right when I graduated I got a job through my MA externship to work in a GI/Colorectal surgery clinic inside a local hospital. The office had 4 GI Drs, 3 colorectal surgeons, 1 hepatologist & had 2 PAs/1 NP (one for each field). I worked with 3-4 other medical assistants and we did everything. We roomed patients (some days seeing 90-100 patients), covered for surgical schedulers if needed, covered for the front desk if needed. On top of doing out our own job! We were assigned physicians we would personally work with to delegate where patient calls/messages would go. For the first year, I was the MA for 1 gastroenterologist. The second year, I was promoted to working with the colorectal surgery team. I then worked with 3 surgeons (with 1 other MA), 1 was the chief of colorectal surgery for the hospital - I became one of his personal scribes who would go in while seeing patients and do his note/visit summaries, we would see around 20-30 patients when he was in clinic.

Day to day duties consisted of prioritizing/answering messages/calls from patients in a timely manner, either helping them if we can ourselves or passing on the message to the appropriate physician where we would call the patient with their response. We would prescribe medications based on what the provider wanted, meaning: they would tell us what to prescribe and we would propose the orders for them so they didn't have to. Assisting in in-office procedures. It's important to add that I did too have a handful of administrative duties like scanning in medical records, refill requests, scheduling appointments, prior authorizations through insurance companies. (Even these I would think should be considered PCE based on the responsibility factor).

Long story short, I did A LOT of work that I feel is considered Patient Care Experience, regardless of it's considered administrative or clinical. Meaning, I felt that I was directly responsible for the care of patients, under the supervision of the physicians. If I did call back to explain a treatment plan (made by the physician), then the patient would never get called. If I didn't call to schedule their surgery and make sure they have everything they need to prepare for a colonoscopy or colon resection, it would be my fault.

In August of 2020 I transferred to an Urgent Care as I begun my prerequisite PA courses that needed to be on campus (or so I thought bc of COVID). Anyways, I am getting (official) back office MA experience now. However, I am terrified that my 2 years (4,000 hrs+) of GI/Colorectal surgery experience will be deemed as Healthcare experience rather than Patient care experience, which I feel would hurt my chances of getting into PA school.  Even the thought of dividing it half and half between PCE & HCE doesn't make me happy, but I rather do that then consider all this time HCE.

I'm sorry for this long post, maybe I'm being ridiculous and overthinking this - but if anyone can share their insight or personal experience that would be highly appreciated!!

Thank you

Edited March 28, 2021 by KH21444

[UGoLong]

The interpretation probably varies by PA program; some for example, some count scribing as PCE and some don't.  This leaves it up to you to properly put your experience in the "right" category. 

What I might consider in your case is for you first to develop an estimate by percentages of what your experience was like. If you were working with patients in accordance with the CASPA definitions, (or working closely with a provider by scribing, etc,) I'd probably call that PCE. The other stuff: HCE. Second, write a separate job description for each of the two roles, multiply the percentages times your total MA hours and list each part of the job in the appropriate category on your application.

That's just my take but it sounds like one of those areas of life where there aren't hard and fast rules and you just have to have a system for answering as honestly as you can.

Good luck!

[KH21444]

2 hours ago, UGoLong said:

The interpretation probably varies by PA program; some for example, some count scribing as PCE and some don't.  This leaves it up to you to properly put your experience in the "right" category. 

What I might consider in your case is for you first to develop an estimate by percentages of what your experience was like. If you were working with patients in accordance with the CASPA definitions, (or working closely with a provider by scribing, etc,) I'd probably call that PCE. The other stuff: HCE. Second, write a separate job description for each of the two roles, multiply the percentages times your total MA hours and list each part of the job in the appropriate category on your application.

That's just my take but it sounds like one of those areas of life where there aren't hard and fast rules and you just have to have a system for answering as honestly as you can.

Good luck!

Ahhhh I see, thank you! But still I wonder, when CASPA says "directly responsible for patient's care" - does this mean without the direction of a physician? Like responsibility solely on our own? Like I said, I feel like I had direct responsibility for the care of patients, however, it was mostly under the direction of a physician.

But I hear what you're saying - this is one of those things where it's up for interpretation. Just need to stick with the definition of PCE & HCE as much as I can. I definitely feel like dividing up my hours is fair - 50/50 seems like a bit much, maybe 60/40, 60 being PCE & 40 being HCE.

Going to spend some more time thinking about this! Thank you for your help!!

[UGoLong]

2 hours ago, KH21444 said:

Ahhhh I see, thank you! But still I wonder, when CASPA says "directly responsible for patient's care" - does this mean without the direction of a physician? Like responsibility solely on our own? Like I said, I feel like I had direct responsibility for the care of patients, however, it was mostly under the direction of a physician.

But I hear what you're saying - this is one of those things where it's up for interpretation. Just need to stick with the definition of PCE & HCE as much as I can. I definitely feel like dividing up my hours is fair - 50/50 seems like a bit much, maybe 60/40, 60 being PCE & 40 being HCE.

Going to spend some more time thinking about this! Thank you for your help!!

No one is every COMPLETELY responsible for patient care except usually a physician. I think by "direct" they imply you are working directly with the patient and personally handling some aspect of their medical care. Not changing sheets, cleaning their room, setting up appointments, etc. Instead, you are directly in the pathway of their care, from taking vitals, to drawing blood, giving injections, etc.

[greenmood]

On 3/28/2021 at 4:59 PM, KH21444 said:

roomed patients HCE

covered for surgical schedulers HCE

covered for the front desk HCE

delegate where patient calls/messages would go HCE

personal scribes who would go in while seeing patients and do his note/visit summaries This depends on what you did in the room, and how closely you worked with this physician. Scribing isn't PCE by CASPA definition if all you are doing is literally typing notes and entering orders for the providers.

prioritizing/answering messages/calls from patients in a timely manner, either helping them if we can ourselves or passing on the message to the appropriate physician where we would call the patient with their response I think you could make a good case for PCE.

prescribe medications based on what the provider wanted, meaning: they would tell us what to prescribe and we would propose the orders for them so they didn't have to This is HCE, and if you try to pass this off as PCE I think you will run into trouble. I find it borderline unethical.

Assisting in in-office procedures Depends on what this involved. If administering medication prescribed by someone else is considered HCE, then you need to be careful about what "assistance" you call PCE.

scanning in medical records, refill requests, scheduling appointments, prior authorizations through insurance companies HCE

See my bolded responses above. HCE isn't less important than PCE. It's a different kind of care. I like UGoLong's suggestion of dividing some of this up into almost separate job descriptions. You did a lot of stuff. The thing is... I know you don't like the idea that this doesn't count towards some CASPA definition, but it's still impressive experience. I don't think you're going to do yourself any favors by trying to pass it off as something it isn't. Admissions committee members can read a job description. They know what PCE is. So regardless of how you categorize it for CASPA, someone with a brain and experience is still going to look at this and understand what you did as a medical assistant.

[KH21444]

18 hours ago, greenmood said:

See my bolded responses above. HCE isn't less important than PCE. It's a different kind of care. I like UGoLong's suggestion of dividing some of this up into almost separate job descriptions. You did a lot of stuff. The thing is... I know you don't like the idea that this doesn't count towards some CASPA definition, but it's still impressive experience. I don't think you're going to do yourself any favors by trying to pass it off as something it isn't. Admissions committee members can read a job description. They know what PCE is. So regardless of how you categorize it for CASPA, someone with a brain and experience is still going to look at this and understand what you did as a medical assistant.

Thank you so much for taking the time to go through everything!! As far as medications go, we had a list of standing orders - for example if we scheduled a patient for an abdominal surgery, we can prescribe the pre-surgery antibiotics, which is co-signed by the physician. I worded it wrong lol - not prescribing in that way, but prescribing on behalf of the physician based on our standing orders.

Anyways, thank you too for saying HCE isn't less important! I was reading an article about this and they said "it's better to undersell yourself than oversell yourself, and be wrong about it" meaning it's better to give yourself more HCE than PCE if you're not 100% sure and let the PA school admissions decide for themselves.

Definitely going to combine UGoLong's & your advice together and find an appropriate way to split it up. I was thinking to just do 50/50 but now that I think about it maybe it's more HCE than PCE. My only argument for thinking it's more PCE is that generally if I wasn't scribing, my whole day was spent primarily on the phone with patients, hearing their symptoms and relaying it to physicians and calling patients back to go over treatment plans. When I had free time, then all the other HCE tasks came into play.

Sorry for the long messages, you & UGoLong have helped a lot to organize my mind on this topic, thank you again!! :)

[KH21444]

21 hours ago, UGoLong said:

No one is every COMPLETELY responsible for patient care except usually a physician. I think by "direct" they imply you are working directly with the patient and personally handling some aspect of their medical care. Not changing sheets, cleaning their room, setting up appointments, etc. Instead, you are directly in the pathway of their care, from taking vitals, to drawing blood, giving injections, etc.

Ahhhhh that makes much more sense! Would you consider communicating between the patients and physicians to relay information about patient symptoms or treatment plans/care to be considered "direct"? The only reason I want to say yes is because, for example, if the patient was having some sort of bleeding/serious symptom and needed medical attention right away and I didn't prioritize reaching out to the physician to see what should be done, it would be my fault.

Point being, I feel like I had a decent bit of responsibility for facilitating their care - but not in the way that the patient is in the hospital and I'm caring for them - if that makes sense!

Again, thank you for all your help!

[UGoLong]

2 hours ago, KH21444 said:

Ahhhhh that makes much more sense! Would you consider communicating between the patients and physicians to relay information about patient symptoms or treatment plans/care to be considered "direct"? The only reason I want to say yes is because, for example, if the patient was having some sort of bleeding/serious symptom and needed medical attention right away and I didn't prioritize reaching out to the physician to see what should be done, it would be my fault.

Point being, I feel like I had a decent bit of responsibility for facilitating their care - but not in the way that the patient is in the hospital and I'm caring for them - if that makes sense!

Again, thank you for all your help!

From my perspective:

If you are taking patent history and making decisions on that basis, then it probably could be considered PCE. It would mean that you learned of a sign or symptom and decided to escalate it to the doc. As a PA, you will take lots of histories (and learn to do physicals) and make decisions based on the outcome.

That doesn't mean the patient asked to see a doc so you merely "relayed" the patient's request to the doc (that would just be HCE in my world).