Wearing Many Hats The Skills a CA Could/Should Possess

Every Chiropractic Assistant (CA) is different. In some offices the title may be given to an employee who answers the phone and schedules appointments. In other offices the CA may greet patients and apply modali­ties such as electric muscle stimulation or ultrasound. Yet other offices may expand the role to include taking pre­liminary histories, or measurements and vitals like height, weight, temperature and blood pressures of a patient. In the realm of Chiropractic Assistants, there are also specialty subsets such as the Chiropractic Technician (CT). CTs are specifically trained to aid in shooting x-rays. Of­fices also need coding and billing expertise that may fall into the CA toolbox, or be hired out. To perform coding and billing effectively additional training in those specific areas is crucial. So What Skill Sets DOES a CA Need? Certainly the answer to that question is dependent on what duties a specific office may ask you to perform. We know that educational levels of CAs can vary; some CAs have obtained an Associate's Degree, some have a Bach­elor's, and many others secured their job after graduating high school. Many have become proficient from years of learning on the job. In the opinion of this author, there are a few funda­mental skill requirements that are needed to be an ef­fective CA: 1. Excellent Communication Skills: CAs are the first impression patients and other prof \es- sionals get of an office and can "make or break" a patient's impression. Competition in healthcare is fierce, and patients will go where they feel welcomed and valued. Other professional offices will migrate toward partners (referrals) who present a professional atmosphere. A great CA will know how to communicate in a professional and friendly manner to patients, fellow staff members, insur­ance companies and other professionals. Using proper grammar in written and verbal communications falls under this category, as does using medical abbreviations correctly. Understanding appropriate communications/ behaviors also includes discretion. That is, knowing what information can and should be shared, how it should be shared, and with whom. The image that a CA projects with their communications style, friendliness, and attitude is very important. 2. Organization: In a busy office, organization, time management and the ability to multi-task and prioritize tasks correctly are skills that make a CA indispensable. Understanding what yourdoctor needs, and when they need it for good office flow is greatly appreciated. The CA may be answering the phone, greeting patients, pulling files, performing back office tasks like height and weight, showing patients to treatment rooms, checking people out, applying e-stim, entering charges in the computer, and trying call patients on the schedule to remind them of their appointments. A competent CA will know what needs to be done "now," what can wait until later, and what should take precedence at any given time. Keep in mind that all of this juggling must be accom- plished while maintaining a great attitude toward people around you. This goes back to item #1... keeping a friendly peaceful demeanor toward your patients while you are performing several tasks at once is difficult for some peo­ple, but a skill that must be mastered for the sake of the office. If you are a person that is easily frustrated and gets "short and irritated" if you have multiple things to accom­plish and a patient walks in the door... then the front desk/ working with patients is not a good place for you right now. 3. Competence: Whatever duties that are performed, they must be per­formed correctly. Competence is key in all areas: to avoid pa­tient injury when performing modalities (and thus an office lawsuit); to avoid improper bill­ing (and things like Medicare/ insurance audits); to avoid putting the wrong file in the treatment room for the doctor; or giving the patient the wrong appointment time reminder. Documentation must be cor­rect, performing procedures safely and correctly is crucial, maintaining HIPAA compliance is required by law. The list goes on. Mindfulness in the job that you are doing in a healthcare office is a required skill. 4. Desire to Learn: Doctors need their CAs to have a desire to learn new things. The more knowledge a CA has about how the office works the more valuable you are to the office. A business owner can always find some­one to answer the phone. However, finding someone who answers the phone "the right way" and can handle filing, office flow, take blood pressures, and apply modali- ties to a patient is another skill set entirely. Most Doctors appreciate and reward their employees that can bring more to the table. From my experience, I've also found that the more my assistants "know" the better they communicate with me and our patients. As a general rule, understanding "why" you are doing something provides more confidence and competence. A well-trained CA understands the modality being used (physics of e-stim or ultrasound for example) and has a general understanding of the doctor's diagnosis. If a CA can describe to a patient what they are doing during a modality, the confidence that patients have in their care increases. More important, the risk of injury to the patient from CA application of modalities greatly decreases. This is being recognized on the national and state levels with increasing requirements for CA educational training. The Federation of Chiropractic Licensing Boards (FCLB) now has minimum guidelines in place for CA training and a national exam that can be taken to earn Certified Chiro­practic Clinical Assistant (CCCA) status. This is a huge step in validating the important role that our CAs perform in the office! At www.fclb.org you can learn more about the national CCCA credential and process. Training Is Key Baseline knowledge is always beneficial to have if you work in a healthcare profession. Tell your DC that you'd like to go through some additional training. This could be anything from communication skills and office organiza­tion to being more thoroughly trained in modality use (the focus of FCLB's programming guidelines), or could be focused on more specialty areas like taking x-rays or coding/billing procedures. Find out what your office needs and fill the void. Speaking on behalf of offices that perform passive care modalities like electric muscle stimulation, ultrasound, cold laser and the like (and my own past practice), I would rec­ommend that the best place to start for training would be to earn the national FCLB CCCA certification. The programs associated with this training include basic foundational study of documentation, professional boundaries and of- fice safety, as well as anatomy and common conditions/ diagnosis, but then train heavily on the use of the office modalities and even back office/taking vitals. The information below will tell you about a program focused on general CCCAand modality training that makes your next step easy and convenient! Distance Learning Makes Training Convenient Online training programs in particular make high quality training affordable and convenient and can be taken any timeofday.Atwww.CCCAonline.com learners can engage in a streamlined 24-hour training program that meets or exceeds FCLB guidelines in every area of study. DCs will often pay for their employees to train. Full price for this training is an affordable $339 for the entire 24-hour program. However, www.CCCAonline.com also has special discount programs available for COCSA State Association members, participating colleges and other organizations. Ask your State Association for your specific discount code. Not a member? If you are receiving this article through the American Chiropractor Magazine, you can still enjoy a discount. Use AMCHIRO as your discount code. When this code is entered during the registration process it will automatically provide a $15 discount off the regular price of the program. This is the program that gives back to the profession. Learners can expect text, images/schematics, dynamic video lectures, and robust customized experiential inter­activities in a thorough 19-module program. Plus an extensive note-packet of nearly 200 pages is included and can be downloaded, printed, and studied off line. Learners work at their own pace and can conveniently take programming around work hours to avoid disruption in the office. Questions? Visit our website or send us an email at [email protected] Laurie Mueller, DC sen>ed in private practice in San Diego, California. She was the post-graduate director at Palmer College from 2000-2010; served as the ACC Post Graduate subcommittee chair for 6 years; peer reviewed for the Research Agenda Con- ference, and wrote the informal role determination study that aided in the development of FCLB's guidelines for chiropractic assistants. Dr. Mueller currently works as a private eLearning consultant with a focus on healthcare topics and functional medicine through her company, Impact Writing Solution and subsidiary www.CCCAonline.com. She is a clinician, an educa­tor and an expert in online educational pedagogy. You can also contact me at drmuelleronlmedyalioo.com