When Wake Forest Health Network in North Carolina transitioned to a value-based health care model a decade ago, they realized the additional work that would be required and decided to use the 2-to-1 ratio of certified medical assistants (CMA) to physicians in more of its practices.
They called it their “Encounter Specialist” program. As part of this model, the CMA starts following a patient before a visit to ensure laboratory tests are done in advance and to note issues that need to be addressed at the visit. The CMA then accompanies the patient during check-in and rooming activities. When the physician is in the room, the CMA acts as a scribe. When the physician leaves, the CMA provides the necessary patient education and reiterates any instructions the physician may have given during the visit.
The physician is free to move on to the next patient waiting with the second CMA.
“The Encounter Specialist program was proven to enhance both physician and staff satisfaction, improve documentation, close gaps in care to achieve quality goals and increase productivity,” says an AMA STEPS Forward™ success story profiling the effort.
Committed to making physician burnout a thing of the past, the AMA has studied, and is currently addressing, issues causing and fueling physician burnout—including time constraints, technology and regulations—to better understand and reduce the challenges physicians face.
By focusing on factors causing burnout at the system level, the AMA assesses an organization’s well-being and offers guidance and targeted solutions to support physician well-being and satisfaction.
Eye toward program expansion
About 15% of primary care physicians in the Wake Forest Health Network, part of Wake Forest Baptist Health, use Encounter Specialists. The CMAs go through a formal training program to help ensure appropriate attestation is included in the record and to provide clarity for CMAs and physicians about their roles during the patient encounter and documentation process.
Wake Forest Baptist Health recently entered a strategic combination with Atrium Health, and the goal is to evaluate further expansion in adult primary care practices and consider how other specialties could benefit from the program.
An otolaryngology single-physician practice has already seen the benefits of having two certified MAs. Patients seeking appointments had long wait times between when they called and the next available appointment.
The volume wasn’t quite high enough for the otolaryngologist to justify adding another doctor, even though there were patient access challenges. So, the physician implemented a pilot Encounter Specialist program. That move enabled the practice to increase the volume of patients the physician could see, resolving the patient backlog, says the STEPS Forward success story.
Read more about how to free up three hours doctors’ time daily with smart use of MAs.
Finding joy in medicine again
For one family physician frustrated because she went home each night with several hours of charting still to do, adding two certified MAs brought her back from the verge of complete doctor burnout.
Her practice decided to test the Encounter Specialist model to support the physician. The result: By day’s end, all visit notes were complete and the practice opened up an additional half-day per week to see more patients. After six months, the family doctor who was on the verge of total burnout reported that she was as happy as she had ever been in practice.
The AMA STEPS Forward open-access toolkits offer innovative strategies that allow physicians and their staff to thrive in the new health care environment. These courses can help you prevent physician burnout, create the organizational foundation for joy in medicine and improve practice efficiency. One CME module specifically addresses how to improve efficiency, workflow and patient care with team documentation another helps you recruit and retain medical assistants.
STEPS Forward is part of the AMA Ed Hub™, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content from trusted sources, all in one place—with activities relevant to you, automated credit tracking and reporting for some states and specialty boards.
Learn more about AMA CME accreditation.
