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Study: Could Medical Assistants Transform Chronic Care?

Most providers in the field know and already use the strategy of employing physician extenders like PAs, and NPs, to expand their patient care. Using extenders to take care of simple, frontline primary care is a great way to provide cost-effective healthcare, and make full use of your practice staff. In that scenario, everyone is working at the top of their license, and making the most of their billable hours.

But what if you also made use of medical assistants for simple patient care and health management tasks? What if you actually trained MAs as health coaches for your patients with chronic care?

That’s the subject of a recent study published in the Annals of Family Medicine. Could training medical assistants as health coaches be an effective strategy for reigning in our exorbitant spending on chronic care management? And would this strategy of using assistants with little rigorous medical training for healthcare be amenable to clinicians?

What the study found is a promising insight into how we could simply and cost-effectively improve chronic care management in the U.S.

Researchers at the University of San Francisco recruited 441 low-income patients with chronic conditions like diabetes and hypertension, and split them into two groups. The control group received usual care. In this case, usual care included access to appointments with their physicians, chronic care nurses, and health educators, and even health education classes. The experimental group, on the other hand, received support from three coaches, all of whom had completed MA education programs, but did not have undergraduate or post-graduate degrees.

Patients in each group worked toward set clinical goals, such as achieving and maintaining certain hemoglobin or systolic blood pressure levels.

In the coaching intervention, patients met with their health coaches before and after their doctor’s visits. Coaches attended the doctor’s appointments as well, and then closely reviewed care plans afterwards to answer any questions, and make sure the patient fully understood the physician’s instructions. The MA coaches also scheduled their own appointments with the patients every three months and checked-in with patients between visits to see if they needed anything.

Though the addition of these coaching sessions was a relatively simple intervention, the experimenters saw substantial effects. 46% of patients who received coaching met at least one clinical goal – 12% more than those patients in the control group. Specifically, 49% of patients who received coaching met their goal for hemoglobin A1c levels, compared to only 28% of control patients.

The results are an encouraging sign of how medical assistants could improve our healthcare system and reign in this country’s ballooning chronic care costs. And, as a profession projected to grow rapidly in common years, medical assistants will be in high supply and able to help relieve the overburdened primary care profession.

Coupled with the rise in telemedicine solutions that let health professionals counsel and treat patients remotely, this simple coaching intervention could be a powerful way to expand access to low-cost health support. Especially in remote, rural, or high-risk areas where finding or just getting into the office to see a doctor prevent many chronic care patients from getting care as frequently as they need, telemedicine coupled with MA guidance could improve the quality of life for entire communities.

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