Study to ask whether medical assistants are the right fit to keep us fit


A two-year, $296,000 grant awarded this summer by the Robert Wood Johnson Foundation (RWJF) will enable physicians at the Health Science Center and University Health System to study a way to change four of our worst habits – smoking, lack of exercise, unhealthy eating and alcohol consumption.

Robert L. Ferrer, M.D., M.P.H., associate professor of family and community medicine at the Health Science Center, and his colleagues will explore whether primary care practices can improve the health of patients by expanding the role of medical assistants. The grant is part of Prescription for Health: Promoting Health Behaviors in Primary Care Research Networks, a program of the RWJF and the U.S. Agency for Healthcare Research and Quality (AHRQ).

Dr. Ferrer’s group is part of a nationwide network aimed at developing effective, practical strategies for changing Americans’ unhealthy behaviors through primary care.

At the time of enrollment in the San Antonio study, patients will be asked to complete a “Healthy Hints” computer touch-screen questionnaire that addresses their health behaviors, including the four topics. Afterward, the medical assistants will sit down with the patients to review the printed responses on the four behaviors. Based on the answers, they will offer patients appropriate interventions such as smoking-cessation or healthy-walking programs.

Patients will complete the questionnaire again in six to nine months, and the second set of responses about the four topics will be compared with the first set to provide a measurement of effectiveness.

A medical assistant is a professional with a certificate from an accredited vocational school. The San Antonio work force includes a fair number, Dr. Ferrer said. “Currently, they take blood pressures and put people in exam rooms,” he said. “Expanding their duties is a way of extending the primary care team to help our patients lead healthier lives.”

Cancer and heart disease are the leading killers in the U.S., but underlying them are the four unhealthy behaviors the project seeks to address. “Until you address those, you don’t really solve the problem,” Dr. Ferrer said.

Medical assistants almost certainly will have more time to interact with patients on these fundamental issues than physicians who are busy managing acute symptoms or chronic diseases.

Priti Mody-Bailey, M.D., a family physician in the University Health System, coordinated the design of Healthy Hints. Patients complete the questionnaire at computer kiosks in University Health System and University Physicians Group clinics.

Most of the questions are based on the U.S. Preventive Services Task Force program called Put Prevention into Practice. The task force is under the auspices of the AHRQ.

The San Antonio project is one of 10 around the country that seek to change behavior but in slightly different ways. “Doctors want to help patients change unhealthy behaviors, but we’re often frustrated because it is difficult and time-consuming,” Dr. Ferrer said. “We trust that our project, along with the other nine nationwide, will show us how to enhance primary care throughout America.”

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