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Patterns of relating between physicians and medical assistants in small family medicine offices.
MedLine Citation:
PMID:  24615311     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Nancy C Elder; C Jeffrey Jacobson; Shannon K Bolon; Joseph Fixler; Harini Pallerla; Christina Busick; Erica Gerrety; Dee Kinney; Saundra Regan; Michael Pugnale
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of family medicine     Volume:  12     ISSN:  1544-1717     ISO Abbreviation:  Ann Fam Med     Publication Date:    2014 Mar-Apr
Date Detail:
Created Date:  2014-03-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101167762     Medline TA:  Ann Fam Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  150-7     Citation Subset:  IM    
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