RT Journal Article
SR Electronic
T1 Patterns of Relating Between Physicians and Medical Assistants in Small Family Medicine Offices
JF The Annals of Family Medicine
JO Ann Fam Med
FD American Academy of Family Physicians
SP 150
OP 157
DO 10.1370/afm.1581
VO 12
IS 2
A1 Nancy C. Elder
A1 C. Jeffrey Jacobson
A1 Shannon K. Bolon
A1 Joseph Fixler
A1 Harini Pallerla
A1 Christina Busick
A1 Erica Gerrety
A1 Dee Kinney
A1 Saundra Regan
A1 Michael Pugnale
YR 2014
UL http://www.annfammed.org/content/12/2/150.abstract
AB PURPOSE The clinician-colleague relationship is a cornerstone of relationship-centered care (RCC); in small family medicine offices, the clinician–medical assistant (MA) relationship is especially important. We sought to better understand the relationship between MA roles and the clinician-MA relationship within the RCC framework. METHODS We conducted an ethnographic study of 5 small family medicine offices (having <5 clinicians) in the Cincinnati Area Research and Improvement Group (CARInG) Network using interviews, surveys, and observations. We interviewed 19 MAs and supervisors and 11 clinicians (9 family physicians and 2 nurse practitioners) and observed 15 MAs in practice. Qualitative analysis used the editing style. RESULTS MAs’ roles in small family medicine offices were determined by MA career motivations and clinician-MA relationships. MA career motivations comprised interest in health care, easy training/workload, and customer service orientation. Clinician-MA relationships were influenced by how MAs and clinicians respond to their perceptions of MA clinical competence (illustrated predominantly by comparing MAs with nurses) and organizational structure. We propose a model, trust and verify, to describe the structure of the clinician-MA relationship. This model is informed by clinicians’ roles in hiring and managing MAs and the social familiarity of MAs and clinicians. Within the RCC framework, these findings can be seen as previously undefined constraints and freedoms in what is known as the Complex Responsive Process of Relating between clinicians and MAs. CONCLUSIONS Improved understanding of clinician-MA relationships will allow a better appreciation of how clinicians and MAs function in family medicine teams. Our findings may assist small offices undergoing practice transformation and guide future research to improve the education, training, and use of MAs in the family medicine setting.