Open Forum

Hello!

I was wondering if the medical assistants in other clinics roll up into nursing or if they roll up to practice managers?

currently at our ambulatory clinics they report into business operations and have a "dotted" line to nursing. We are looking to get an understanding of what others do.

Thanks!

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Alaina Filiau PhD, RN

Clinical Nursing Director

Tufts Medical Center
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Hi Alaina,

Our reporting structure recently changed this year. MAs are now reporting to LVN Supervisor who reports to the practice manager. Previous both MAs and LVN Supervisor reported to a RN Manager. 

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Briana Gonzalez
Venice Family Clinic
Torrance CA
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It seems that having medical assistants reporting to nursing leadership is the most common reporting structure for medical assistants based on the responses in this thread. In the state of California, our Medical Board states that medical assistants must be supervised by a physician, surgeon, or podiatrist, (or, as delegated in writing, by a PA, or NP).  Curious how others, particularly those in California, with nursing leadership structures are managing this. Do you have organizational policy language that speaks to the supervision required for medical assistants?

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Sierra Kane, MSN, RN, CNL, AMB-BC, DNC
Director of Ambulatory Nursing – Nursing Administration
Stanford Health Care
skane@stanfordhealthcare.org
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Original Message:
Sent: 10-04-2023 01:23
From: Briana Gonzalez
Subject: Medical Assistant reporting structure

Hi Alaina,

Our reporting structure recently changed this year. MAs are now reporting to LVN Supervisor who reports to the practice manager. Previous both MAs and LVN Supervisor reported to a RN Manager. 

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Briana Gonzalez
Venice Family Clinic
Torrance CA
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Original Message:
Sent: 10/9/2023 3:02:00 PM
From: Sierra Kane
Subject: RE: Medical Assistant reporting structure

It seems that having medical assistants reporting to nursing leadership is the most common reporting structure for medical assistants based on the responses in this thread. In the state of California, our Medical Board states that medical assistants must be supervised by a physician, surgeon, or podiatrist, (or, as delegated in writing, by a PA, or NP).  Curious how others, particularly those in California, with nursing leadership structures are managing this. Do you have organizational policy language that speaks to the supervision required for medical assistants?

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Sierra Kane, MSN, RN, CNL, AMB-BC, DNC
Director of Ambulatory Nursing – Nursing Administration
Stanford Health Care
skane@stanfordhealthcare.org
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Concur with Aleesa Mobley. 

The Medical Practice Act allows physicians to delegate patient care to UAP.  When the physician delegates to the UAP, he/she assumes responsibility/accountability for the UAP actions and for patient outcomes. Nursing roles when the physician delegates activities to unlicensed assistive personnel are limited by the Nursing Practice Act and related rules.  ANA & NCSBN released a joint statement on delegation that also is helpful to review: ana-ncsbn-joint-statement-on-delegation.pdf (nursingworld.org)

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Jami Falk MS RN-BSN CNML
VHA OPC PCMO Chief Nurse
VHA
Bismarck ND
(701)367-5431
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Original Message:
Sent: 10-10-2023 11:51
From: Aleesa Mobley
Subject: Medical Assistant reporting structure

When the medical assistants report to the nursing structure, they are perceived as unlicensed personnel and should be utilized in this manner. It is difficult in large organizations to find  or convince a  Medical Director willing to take responsibility and accountability for oversight of the medical assistant role per the states' BOM statutes.  

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Aleesa M Mobley PhD APN  (she/her/hers) Why Pronouns Matter

Assistant Professor - Clerkship Director [Pain Management/Substance Use Disorder]

Physical Medicine & Rehabilitation - Neuro Musculoskeletal Institute 

Lippincott Procedures: Subject Matter Expert - Wolters Kluwer Publishing

Rowan Medicine Bldg., 42 E. Laurel Rd, Ste 1700, Stratford New Jersey 08084 

T: 856-566-7010 | F: 856-566-6956| C: 856-230-1229 

mobley@rowan.edu | som.rowan.edu 

Learning is not attained by chance, it must be sought for with ardor and attended to with diligence [Abigail Adams (1744 - 1818), 1780].

Original Message:
Sent: 10/9/2023 3:02:00 PM
From: Sierra Kane
Subject: RE: Medical Assistant reporting structure

It seems that having medical assistants reporting to nursing leadership is the most common reporting structure for medical assistants based on the responses in this thread. In the state of California, our Medical Board states that medical assistants must be supervised by a physician, surgeon, or podiatrist, (or, as delegated in writing, by a PA, or NP).  Curious how others, particularly those in California, with nursing leadership structures are managing this. Do you have organizational policy language that speaks to the supervision required for medical assistants?

------------------------------
Sierra Kane, MSN, RN, CNL, AMB-BC, DNC
Director of Ambulatory Nursing – Nursing Administration
Stanford Health Care
skane@stanfordhealthcare.org
------------------------------


Original Message:
Sent: 10-04-2023 01:23
From: Briana Gonzalez
Subject: Medical Assistant reporting structure

Hi Alaina,

Our reporting structure recently changed this year. MAs are now reporting to LVN Supervisor who reports to the practice manager. Previous both MAs and LVN Supervisor reported to a RN Manager. 

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Briana Gonzalez
Venice Family Clinic
Torrance CA

We do it both ways depending on the clinic and if a nurse (clinical) manager is present. For all clinics that have nurse managers they roll up to them; for those clinics that do not have a nurse manger they roll up to practice manager. At the end of the day though they report to nursing (me as the CNO).  

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Patricia Hughes DNP RN NE-BC
Chief Nursing Officer, Ambulatory
UK HealthCare
Lexington KY
(859)323-4413
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In most areas we have MA's report to charge nurses or nurse admins in the clinics and it works very well. 

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Michelle Lynn COO
SIU Healthcare
Springfield IL
(217)545-3653
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Hi Alaina, 

Our MAs report to our practice managers but we changed my title to Director of Nursing and Clinical Services so that I could have the MA program underneath me.  I also hired an MA Program Manager that will report to me.  She is an MA, and while the position is new, I am hoping it will help give the MAs a voice and structure the work better.  She will not have direct reports but ultimately, anything clinical will route through her to me. 

Angela

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Angela Hall MN RN
Director of Nursing and Clinical Services
Neighborhood Health Center
Portland OR
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Our MAs report up to an assistant clinical nurse manager which is in every clinic. 

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Quiere Robinson MSN RN AMB-BC
Ambulatory Nurse Clinician
VCU Health
Richmond VA
(804)570-8620
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Good day to All. We are at a CHC- FQHC in PA & our MA's are all certified & report up through nursing.  Clinicians are all aware that MAs function under his/ her license, are unlicensed themselves, and require supervision. They perform clinical support duties & so to not have them reporting as such feels odd, to be honest. 

Melissa Miranda, RN CEO 

Neighborhood Health Centers of the Lehigh Valley, PA

Www.nhclv.org

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Melissa Miranda CEO
Neighborhood Hlth Ctrs of the Lehigh Valley
Bethlehem PA
(610)820-7605 (2302)
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