Self Care And Burnout For Medical Assistants

Most people are drawn to the health care professions because of a combined interest in medicine and a desire to help others and to make a difference in the world. This desire will serve them well in their careers but can also be their undoing because caregivers sometimes have a tendency to take good care of everyone but themselves. Ignoring their needs can eventually put them at great risk of burnout, a syndrome in which an individual feels physical, emotional, or mental exhaustion caused by ongoing intensive demands without sufficient physical or emotional rest. New medical assistants are usually so enthusiastic about their careers that they find it difficult to imagine themselves ever feeling burned out.

However, no one is immune. Furthermore, burnout rarely occurs suddenly. Rather, it usually develops slowly over a period of time and may become profound before an individual is fully aware. Therefore, all new medical assistants should develop a plan now to avoid burnout later. Many factors contribute to burnout but a key factor is the neglect of self-care. Self-care is any activity that supports and nurtures an individual’s physical, mental, spiritual, or emotional health and well-being. Providing effective self care entails taking full responsibility for nurturing and keeping oneself physically, emotionally, and mentally healthy. Some people have a hard time doing this and feel guilty when they spend time on themselves. Yet they may find themselves feeling needy and resentful when their needs go unmet and may even begin to feel resentful of others for failing to meet their needs. This has a negative impact on their relationships. Such individuals are at high risk for eventual burnout. To avoid this risk, they must learn to grant themselves permission to provide self-care, understanding that caring for oneself is a critical first step in being able to effectively care for others. A key principle in self-care is finding ways to create balance among work, play, rest, family obligations, and self-care needs. Medical assistants who develop and consistently use a plan of self-care find their effectiveness in their professional and personal lives is enhanced.

Symptoms Of Burnout

Medical Practice Acts and Medical Assistant's Role

Each state has medical practice acts that regulate the practice of medicine with the intent of protecting its citizens from harm. These statutes, or laws, govern licensure, standards of care, professional liability and negligence, confidentiality, and torts. Some states also regulate personnel who may be employed in the ambulatory care setting. For example, some states require that medical assistants be licensed or certified to be able to perform any invasive procedures. Other states require additional training in radiology for the medical assistant to be able to take X-rays. Further, some states are so strict in their regulations that medical assistants perform mostly clerical functions. Certainly, medical assistants desiring to utilize their skills must be aware of state regulations and always perform only within the scope of those regulations.

The Patient's Bill of Rights was developed by the American Hospital Association in 1973 to establish more effective patient care and greater satisfaction for patient, physician, and hospital. While this Bill of Rights was written with the hospital patient in mind, patients in ambulatory care settings should be accorded the same rights. Although no list of rights can guarantee the kind of treatment patients have a right to expect, medical assistants should make every effort to conduct activities with the concern of the patient in mind. here are a number of ways in which the law governs physicians and their employees. Some of these issues are particularly pertinent to the ambulatory care setting and the medical assistants who work in these health care environments.

Rights Of Patients According to AMERICAN HOSPITAL ASSOCIATION'S PATIENT'S BILL OF RIGHTS (1973) are,

a) The patient has the right to considerate and respectful care.
b) The patient has the right to obtain from his physician complete current information concerning his diagnosis, treatment, and prognosis in terms the patient can be reasonably expected to understand.
c) The patient has the right to receive from his physician information necessary to give informed consent prior to the start of any procedure and/or treatment. Except in emergencies, such information for informed consent should include but not necessarily be limited to the specific procedure and/or treatment, the medically significant risks involved, and the probable duration of incapacitation.
d) The patient has the right to refuse treatment to the extent permitted by law, and to be informed of the medical consequences of his action.    
e) The patient has the right to every consideration of his privacy concerning his own medical care program. Case discussion, consultation, examination, and treatment are confidential and should be conducted discreetly. Those not directly involved in his care must have the permission of the patient to be present.    
f) The patient has the right to expect that all communications and records pertaining to his care should be treated as confidential.
g) The patient has the right to examine and receive an explanation of his bill regardless of source of payment.
h) The patient has the right to know what hospital rules and regulations apply to his conduct as a patient.

AMA Ethical Guidelines

The American Medical Association and its nine-member Judicial Council publish a guide for ethical behavior for physicians that is beneficial to medical assistants who act in concert with their physician/employer. The guidelines are based on the publication Code of Medical Ethics Current Opinions of the Council on Ethical and Judicial Affairs of the American Medical Association, 1992. Information shared here is not meant to be exhaustive; however, physicians and their employees will find it helpful to consider information on the following topics, which was summarized from this publication. The complete guide can be purchased from AMA office in Chicago, IL. See Appendix A for the address and phone number.    

Advertising
Physicians and professional people have traditionally not advertised; however, it is not illegal to do so if claims made are truthful and not misleading. Advertisements may include credentials of physicians and a description of the practice and kinds of services rendered. Testimonials from patients are best avoided. Indeed, most physicians discover that word-of-mouth advertisement from patients is the best source of advertisement for their practice.    

Media Relations
Physicians and all of their employees are not allowed to discuss a patient's medical condition with any member of the media without the patient's expressed approval. This does not apply to informa-tion that is considered ''public domain," which includes births, deaths, accidents, and police records.While more hospitals than ambulatory care settings will be involved in media relations, the following is an example of information released that is considered public domain and does not require the patient's consent.

Confidentiality
Physicians must not reveal confidential information about patients without their consent unless they are otherwise required to do so by law. Confidentiality must be protected so that patients will feel comfortable and safe in revealing information about themselves that may be important to their health care. The following list contains examples of the kinds of reports that allow or require health professionals to report a confidence.    
       
1) A patient threatens another person and there is reason to believe that the threat may be carried out.    
2) Reportable injuries and illnesses must be reported. They include injuries such as knife and gunshot wounds, wounds that may be from suspected child abuse, and communicable diseases such as influenza, AIDS, and sexually transmitted diseases.    
3) Information that may have been subpoenaed for testimony in a court of law.    
When in doubt, it is always recommended that a physician have the patient's permission to reveal any confidential information.

Medical Records
The medical chart and the information in it are the property of the physician and the patient. No information should be revealed without the patient's consent unless required by law. The record is confidential. Physicians should not refuse to provide a copy of the record to another physician treating the patient so long as proper authorization has been received from the patient. A record cannot be withheld because of an unpaid bill.    
Upon a physician's retirement or death, or when a practice is sold, patients should be notified and given ample time to have their records transferred to another physician of their choice.

Professional Fees and Charges
Illegal or excessive fees should not be charged. Fees should be based on those customary to the locale and should reflect the difficulty of services and the quality of performance rendered. Fee splitting (a physician splits the fee with another physician for services rendered with or without the patient's knowledge) in any form is unethical. Physicians may charge for missed appointments (if patients have first been notified of the practice) and may charge for multiple or very complex insurance forms. Physicians and their employees must be diligent to assure that only the services actually rendered are charged or indicated on the insurance claim. Only what is documented in the patient's chart is to be billed.