Five stars

Issue: BCMJ, vol. 46, No. 5, June 2004, Page 213 Editorials

The health care field has recently focused its attention mainly on health authority budgets and cutbacks to resources, wait lists, physicians’ wages, laboratory reform, private clinics, and the HEU strike. Yet medical office assistants—an integral part of the health care team—have received little or no attention. I would like to commend these individuals who work tirelessly for us to make our days run more smoothly.

I am in full-time private office practice but have regular contact with hospital-based medical office assistants (MOA/secretaries). Although the salary arrangements differ, I feel that the observations I have made do apply to both groups.

When interviewing candidates for our office MOA position, we stress that patients (as consumers) are always right, and all efforts must be made to satisfy them, even if there is a conflict. We also say that at times they may feel they are being treated as “hired help,” and that patients may be abrupt, even dismissive, because of fear and anxiety. Essentially, they are being asked to handle all the daily activities required to run a successful office practice and to protect us from having to deal with things they feel are trivial that we should not need to be bothered with. We stress that working in a private doctor’s office is different than in some other lines of business in that some flexibility needs to be built in for work hours. It is not always possible to leave at the planned time if urgent tests need booking, or if patients are still waiting to be seen or they walk in or phone demanding attention. As well, although vacation time should be flexible, we ask that they take vacations when we do. Although the Labour Relations Board states that 1 day a month is allowed for sick leave, we may fly into a tizzy when illness strikes. I’m amazed sick days aren’t increasing.

Given the growing abuse they are taking because of the chaos in our health care system, the MOAs are who patients turn to for answers regarding surgical wait lists, missed medical tests, and appointment backlogs and rebookings; the problems are endless. They are also who patients turn to for comfort and counsel. I have observed a distressing increase over the past few years in situations that put MOAs in untenable positions. Trying to be helpful and sympathetic, they sometimes feel inadequate, frustrated, and angry because they are not allowed to let their emotions surface or lose their patience. It has come to a point that some MOAs use codes on files of patients to remind them of what to expect and be prepared for. Believe me, a five-star patient is not analogous to a brilliant movie or hotel. I see mornings where MOAs wax poetic about the number of five-star patients they have appeased, knowing all the while that the patients’ demanding behavior will vanish once the all-knowing physician greets them in the examination room. Not fair! MOAs provide the first line of defence, they do a wonderful job, and while our workload has become more cumbersome, so has theirs.

Hats off to them; they are worth their weight in gold!


Susan E. Haigh, MD. Five stars. BCMJ, Vol. 46, No. 5, June, 2004, Page(s) 213 - Editorials.

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