Medical Assisting Administrative and Clinical Procedures 7E Jan 6 2020 - 1259608549 - Mcgraw Hill 7Th Edition Booth Full Chapter

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CLINICAL
PROCEDURES
for Medical Assisting SEVENTH
EDITION
Kathryn A. Booth Leesa G. Whicker Terri D. Wyman

RN-BSN, RMA (AMT), BA, CMA (AAMA) CPC, CMRS,
RPT, CPhT, MS CMCS, AS
ISTUDY
SEVENTH EDITION
CLINICAL
PROCEDURES FOR
MEDICAL ASSISTING
Kathryn A. Booth, RN-BSN, RMA (AMT), RPT, EFR, CPhT, MS
Total Care Programming, Inc.
Palm Coast, Florida
Leesa G. Whicker, BA, CMA (AAMA)

Central Piedmont Community College—Retired
Charlotte, North Carolina
Terri D. Wyman, CPC, CMRS, CMCS, AS

Baystate Wing Hospital
Palmer, Massachusetts
ISTUDY
Final PDF to printer
CLINICAL PROCEDURES FOR MEDICAL ASSISTING
Published by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121. Copyright © 2021 by McGraw-Hill
Education. All rights reserved. Printed in the United States of America. Previous editions © 2017, 2014, and
2011. No part of this publication may be reproduced or distributed in any form or by any means, or stored in a
database or retrieval system, without the prior written consent of McGraw-Hill Education, including, but not
limited to, in any network or other electronic storage or transmission, or broadcast for distance learning.
Some ancillaries, including electronic and print components, may not be available to customers outside the
United States.
This book is printed on acid-free paper.
1 2 3 4 5 6 7 8 9 LWI 21 20
ISBN 978-1-260-56657-4
MHID 1-260-56657-9
Cover Image: Pefkos/Shutterstock
All credits appearing on page are considered to be an extension of the copyright page.
WARNING NOTICE: The clinical procedures, medicines, dosages, and other matters described in this
publication are based upon research of current literature and consultation with knowledgeable persons in the
field. The procedures and matters described in this text reflect currently accepted clinical practice. However,
this information cannot and should not be relied upon as necessarily applicable to a given individual’s case.
Accordingly, each person must be separately diagnosed to discern the patient’s unique circumstances. Likewise,
the manufacturer’s package insert for current drug product information should be consulted before administering
any drug. Publisher disclaims all liability for any inaccuracies, omissions, misuse, or misunderstanding of the
information contained in this publication. Publisher cautions that this publication is not intended as a substitute
for the professional judgment of trained medical personnel.
The Internet addresses listed in the text were accurate at the time of publication. The inclusion of a website does
not indicate an endorsement by the authors or McGraw-Hill Education, and McGraw-Hill Education does not
guarantee the accuracy of the information presented at these sites.
mheducation.com/highered
ISTUDY boo66579_fm_ISE.indd ii 11/05/19 05:03 PM

About the Authors
Kathryn A. Booth, RN-BSN, RMA (AMT), RPT, EFR, CPhT, MS is a medical assistant (RMA) who started her career
as a nurse (RN). She has a master’s degree in education as well as certifications as a pharmacy technician and in phlebotomy
and medical assisting. She is a certified emergency first responder and rescue scuba diver. Kathryn is an author, an educator,
and a consultant for Total Care Programming, Inc. She has over 35 years of teaching, nursing, and healthcare experience that
spans five states. As an educator, Kathy has been awarded the teacher of the year in three states where she taught various health
sciences, including medical assisting in both a classroom and an online capacity. Kathy serves on the AMT Examinations,
Qualifications, and Standards Committee and the Cardiac Credentialing International CRAT Exam Committee, as well as on the
advisory board of two educational institutions. She stays current through volunteer employment and obtaining and maintaining
certifications. Her goal is to develop up-to-date, dynamic healthcare educational materials to assist her and other educators and
to promote healthcare professions especially medical assisting. Kathy values the medical assisting profession, recognizing that
the diverse and dynamic professionals in it are essential to the future of our healthcare system.
Leesa G. Whicker, BA, CMA (AAMA) is a Certified Medical Assistant with a BA in art with a concentration in art history. She
is an educator with more than 20 years of experience in the classroom. With 35 years of experience in the healthcare field as a
medical assistant, a research specialist in molecular pathogenesis and infectious disease, and a medical assisting program direc-
tor and instructor, she brought a broad background of knowledge and experience to the classroom. As a curriculum expert, she
served on several committees, including the Writing Team for the Common Course Library for the North Carolina Community
College System and the Curriculum Committee at Central Piedmont Community College. Leesa was among the first instructors
to develop online courses at Central Piedmont Community College. She has presented Methods of Active and Collaborative
Learning on the national level. She recently retired from Central Piedmont Community College in Charlotte, North Carolina.
Though retired from teaching, she continues searching for novel and varied ways to reach the ever-changing learning styles of
today’s students.
Terri D. Wyman, AS, CPC, CMRS, CMCS has 35 years of experience in the healthcare field, first as a CMA specializing in
hematology/oncology and homecare and then in the medical billing and coding field. At the suggestion of a coworker, she began
her career in education as instructor and program director for both medical assisting and medical billing and coding programs
for several technical schools in New England. Currently, Terri is the revenue management coordinator for the Baystate Health
System’s Eastern Region, where her love of teaching continues in the hospital setting. She is active with her local AAPC chapter
and is on the National Advisory Board for the American Medical Billing Association (AMBA) and the executive advisory board
for the Massachusetts Association of Patient Account Management. She provides continuing education opportunities for AMBA
members by writing numerous billing and coding courses for them and speaking at their national conferences on medical coding
and revenue management topics. In the rapidly changing world of healthcare billing and coding, she is excited to continue shar-
ing the language of billing and coding with instructors, students, and career professionals. Terri sends special thanks to Dale for
his unending support and to Francis Stein, MD, whose patience with a new medical assistant years ago showed her the joy of
learning and education.
iii
ISTUDY
Brief Contents
Procedures xvii UNIT SIX: Clinical Practices
Digital Exercises and Activities xix 35 Infection Control Practices 442
A Closer Look xxii
A Guided Tour xxv 36 Patient Interview and History 465
Digital Materials for Medical Assisting xxviii 37 Vital Signs and Measurements 487
Connect: Required=Results xxx 38 Assisting with a General Physical Examination 508
Additional Supplementary Materials xxxii 39 Assisting in Reproductive and Urinary Specialties 528
Acknowledgments xxxiv 40 Assisting in Pediatrics 551
41 Assisting in Geriatrics 583
UNIT ONE: Medical Assisting as a Career 42 Assisting in Other Medical Specialties 599
1 Introduction to Medical Assisting 1 43 Assisting with Eye and Ear Care 621
3 Professionalism and Success 13 44 Assisting with Minor Surgery 649
4 Interpersonal Communication 28 UNIT SEVEN: Assisting with Diagnostics
5 Legal and Ethical Issues 48 45 Orientation to the Lab 676
46 Microbiology and Disease 697
UNIT TWO: Safety and the Environment 47 Collecting, Processing, and Testing Urine and
6 Infection Control Fundamentals 81 Stool Specimens 728
7 Safety and Patient Reception 98 48 Collecting, Processing, and Testing Blood
9 Examination and Treatment Areas 127 Specimens 757
49 Electrocardiography and Pulmonary Function
UNIT THREE: Communication Testing 793
12 Electronic Health Records 142
50 Diagnostic Imaging 822
14 Telephone Techniques 160 UNIT EIGHT: Assisting in Therapeutics
15 Patient Education 184 51 Principles of Pharmacology 843
52 Dosage Calculations 867
UNIT FIVE: Applied Anatomy and Physiology 53 Medication Administration 880
21 Organization of the Body 206 54 Physical Therapy and Rehabilitation 912
22 The Integumentary System 229 55 Nutrition and Health 935
23 The Skeletal System 245
24 The Muscular System 264 UNIT NINE: Medical Assisting Practice
25 The Cardiovascular System 281 57 Emergency Preparedness 964
26 The Blood 300 58 Preparing for the World of Work 995
27 The Lymphatic and Immune Systems 312 APPENDIXES
28 The Respiratory System 326 I Diseases and Disorders A-1
29 The Nervous System 342 II Prefixes, Suffixes, and Word Roots in Commonly
30 The Urinary System 361 Used Medical Terms A-19
31 The Reproductive Systems 372 III Abbreviations and Symbols Commonly Used in
32 The Digestive System 396 Medical Notations A-23
33 The Endocrine System 412 Glossary G-1
34 Special Senses 426 Index I-1
iv
ISTUDY
Contents
Procedures xvii 4.6 Communicating in Special Circumstances 37
Digital Exercises and Activities xix SKILLS VIDEO: Communicating with the Anxious Patient 38
A Closer Look xxii
SKILLS VIDEO: Communicating Effectively with Patients from
A Guided Tour xxv
Digital Materials for Medical Assisting xxviii Other Cultures and Meeting Their Needs for Privacy 39
Connect: Required=Results xxx 4.7 Communicating with Coworkers 41
Additional Supplementary Materials xxxii PROCEDURE 4-1: Communicating with the Anxious
Acknowledgments xxxiv Patient 43
PROCEDURE 4-2: Communicating with the Angry Patient 43
U N I T O N E PROCEDURE 4-3: Communicating with the Assistance of an
Interpreter 44
Medical Assisting as a Career PRACTICE MEDICAL OFFICE: Admin Check In: Interactions 47
C H A P T E R 1 C H A P T E R 5
Introduction to Medical Assisting 1 Legal and Ethical Issues 48
Introduction 2 Introduction 50
1.1 Responsibilities of the Medical Assistant 2 5.1 Laws and Ethics 50
1.2 Medical Assisting Organizations 4 5.2 The Physician-Patient Contract 52
1.3 Medical Assistant Credentials 5 5.3 Preventing Malpractice Claims 55
5.4 Administrative Procedures and the Law 59
1.4 Training Programs 7
5.5 Federal Legislation Affecting Healthcare 63
1.5 Professional Development 8
5.6 Confidentiality Issues and Mandatory Disclosure 70
PROCEDURE 1-1: Obtaining Certification/Registration
Information Through the Internet 9
5.7 Ethics 72
5.8 Legal Medical Practice Models 75
PROCEDURE 1-2: Locating Your State’s Legal Scope
of Practice 10 PROCEDURE 5-1: Obtaining Signature for Notice of Privacy
Practices and Acknowledgment 75
PROCEDURE 5-2: Completing a Privacy Violation Complaint
C H A P T E R 3
Form 76
Professionalism and Success 13

PROCEDURE 5-3: Obtaining Authorization to Release Health
Information 76
Introduction 14 ELECTRONIC HEALTH RECORDS: 5.01 Add an
3.1 Professionalism in Medical Assisting 14 Acknowledgement of Receipt of NPP to a Patient’s EHR 79
3.2 Professional Behaviors 15 ELECTRONIC HEALTH RECORDS: 5.02 Add an Authorization
3.3 Strategies for Success 20 to Release Health Information to a Patient’s EHR 79
PROCEDURE 3-1: Self-Evaluation of Professional Behaviors 24 PRACTICE MEDICAL OFFICE: Admin Check In: Privacy and
PRACTICE MEDICAL OFFICE: Admin Check Liability 80
In: Interactions 27
U N I T T WO
C H A P T E R 4
Safety and the Environment
Interpersonal Communication 28
Introduction 29 C H A P T E R 6
4.1 Elements of Communication 30
4.2 Human Behavior and Needs 31 Infection Control Fundamentals 81
4.3 Types of Communication 33 Introduction 82

4.4 Improving Your Communication Skills 34 6.1 Occupational Safety and Health Administration 82
4.5 Therapeutic Communication Skills 36 6.2 The Cycle of Infection 83
v
ISTUDY
SKILLS VIDEO: Aseptic Hand Hygiene 86 9.4 Room Temperature, Lighting, and Ventilation 135
6.3 OSHA Bloodborne Pathogens Standard and Universal 9.5 Medical Instruments and Supplies 135
Precautions 86 PROCEDURE 9-1: Performing Sanitization with an Ultrasonic
6.4 Transmission-Based Precautions 91 Cleaner 138
6.5 OSHA-Required Education and Training 92 PROCEDURE 9-2: Guidelines for Disinfecting Exam Room
PROCEDURE 6-1: Aseptic Handwashing 93 Surfaces 139
PROCEDURE 6-2: Using an Alcohol-Based Hand PRACTICE MEDICAL OFFICE: Clinical: Office
Disinfectant 94 Operations 141
PROCEDURE 6-3: Using a Biohazardous Sharps Container 94
PROCEDURE 6-4: Disposing of Biohazardous Waste 94 U N I T T H R E E
ELECTRONIC HEALTH RECORDS: 6.01 Add a Note to a
Patient’s EHR 96 Communication
PRACTICE MEDICAL OFFICE: Admin Check In: Office
Operations 97
C H A P T E R 1 2
C H A P T E R 7 Electronic Health Records 142
Safety and Patient Reception 98

Introduction 143
12.1 A Brief History of Electronic Medical Records 143
Introduction 99
12.2 Electronic Records 144
7.1 The Medical Office Safety Plan 100
12.3 Meaningful Use and the EHR 145
7.2 OSHA Hazard Communication Standard 100
12.4 Advantages and Disadvantages of EHR Programs 147
7.3 Electrical Safety 101
12.5 Working with an Electronic Health Record 147
7.4 Fire Safety 102
12.6 Other Functions of EHR Programs 148
7.5 Chemical Safety 104
12.7 Security and Confidentiality and EHR 152
7.6 Ergonomics and Physical Safety 105
SKILLS VIDEO: PHI Authorization to Release Health
7.7 Preventing Injury in the Front Office 107 Information 152
7.8 Design of the Reception Area 109 PROCEDURE 12-1: Creating a New Patient Record Using EHR
7.9 The Importance of Cleanliness 113 Software 153
7.10 Office Access for All 114 PROCEDURE 12-2: Checking in and Rooming a Patient Using
7.11 Functions of the Reception Staff 117 an Electronic Health Record 153
7.12 Opening and Closing the Office 119 PROCEDURE 12-3: Creating an Appointment Matrix for an
PROCEDURE 7-1: Handling a Fire Emergency 120 Electronic Scheduling System 154
PROCEDURE 7-2: Maintaining and Using an Eyewash PROCEDURE 12-4: Scheduling a Patient Appointment Using
Station 121 an Electronic Scheduler 154
PROCEDURE 7-3: Creating a Pediatric Reception Area 122 ELECTRONIC HEALTH RECORDS: EHR practice, see the
PROCEDURE 7-4: Creating a Reception Area Accessible to EHRClinic table of contents for the list of exercises. 157
Patients with Special Needs 122 PRACTICE MEDICAL OFFICE: Admin Check Out: Privacy and
PROCEDURE 7-5: Opening and Closing the Medical Office 123 Liability 158
PRACTICE MEDICAL OFFICE: Admin Check In: Work Task
Proficiencies 126 C H A P T E R 1 4
C H A P T E R 9
Telephone Techniques 160
Introduction 161
Examination and Treatment Areas 127 14.1 Telecommunications Equipment 161
Introduction 128 14.2 Effective Telephone Communication 164
9.1 The Exam Room 128 14.3 Telephone Etiquette 165

9.2 Sanitization and Disinfection 129 14.4 Types of Incoming Calls 167
SKILLS VIDEO: Guidelines for Disinfecting Exam Room SKILLS VIDEO: Managing a Prescription Refill 169
Surfaces 131 14.5 Managing Incoming Calls 172
9.3 Preparation of the Exam and Treatment Areas 131 14.6 Taking Complete and Accurate Phone Messages 174
vi CONTENTS
ISTUDY
14.7 Placing Outgoing Calls 175 BODY ANIMAT3D: Homeostasis 208
PROCEDURE 14-1: Using a Video Relay Service with an 21.2 Structural Organization of the Body 208
American Sign Language Interpreter 177 21.3 Major Tissue Types 208
PROCEDURE 14-2: Renewing a Prescription by 21.4 Body Organs and Systems 210
Telephone 178
21.5 Understanding Medical Terminology 211
PROCEDURE 14-3: Screening and Routing Telephone Calls 179
21.6 Anatomical Terminology 211
PROCEDURE 14-4: Handling Emergency Calls 179
21.7 Body Cavities and Abdominal Regions 214
PROCEDURE 14-5: Retrieving Messages from an Answering
21.8 Chemistry of Life 216
Service or System 180
BODY ANIMAT3D: Basic Chemistry (Organic Molecules) 216
ELECTRONIC HEALTH RECORDS: 14.01 Create an Electronic
BODY ANIMAT3D: Fluid and Electrolyte Imbalances 218
Telephone Encounter 183
21.9 Cell Characteristics 219
ELECTRONIC HEALTH RECORDS: 14.02 Create an Urgent
Electronic Telephone Encounter 183 BODY ANIMAT3D: Cells and Tissues 221
ELECTRONIC HEALTH RECORDS: 14.03 Complete a 21.10 Movement Through Cell Membranes 221
Prescription Refill Request 183 21.11 Cell Division 221
PRACTICE MEDICAL OFFICE: Admin Check In: Office BODY ANIMAT3D: Meiosis vs. Mitosis 222
Operations 183 21.12 Genetic Techniques 222
21.13 Heredity and Common Genetic Disorders 223
C H A P T E R 1 5 21.14 Pathophysiology: Common Genetic Disorders 224
Patient Education 184

C H A P T E R 2 2
Introduction 185
15.1 The Educated Patient 185 The Integumentary System 229
15.2 Learning and Teaching 186
Introduction 230
15.3 Teaching Techniques 186
22.1 Functions of the Integumentary System 230
15.4 Patient Education Materials 187
22.2 Skin Structure 230
15.5 Promoting Health and Wellness Through Education 191
22.3 Skin Color 231
15.6 The Patient Information Packet 193
22.4 Skin Lesions 232
15.7 Patient Education Prior to Surgery 196
22.5 Accessory Organs 233
PROCEDURE 15-1: Creating Electronic Patient Instructions 199
22.6 Skin Healing 234
PROCEDURE 15-2: Identifying Community Resources 200
BODY ANIMAT3D: Inflammation 234
PROCEDURE 15-3: Locating Credible Patient Education
22.7 Pathophysiology: Common Diseases and Disorders of
Information on the Internet 200
the Skin 235
PROCEDURE 15-4: Developing a Patient Education Plan 201
BODY ANIMAT3D: Burns 237
PROCEDURE 15-5: Outpatient Surgery Teaching 201
ELECTRONIC HEALTH RECORDS: 15.01 Document
Administration of Patient Education 204 C H A P T E R 2 3
Administration of Pre- and Post-Operative Instructions 204 The Skeletal System 245
PRACTICE MEDICAL OFFICE: Admin Check Out: Interactions 204
Introduction 246
23.1 Bone Structure 246
U N I T F I V E 23.2 Functions of Bones 248
23.3 Bone Growth 249
Applied Anatomy and Physiology 23.4 Bony Structures 250
23.5 The Skull 250
C H A P T E R 2 1 23.6 The Spinal Column 252
23.7 The Rib Cage 253
Organization of the Body 206 23.8 Bones of the Shoulders, Arms, and Hands 254
Introduction 207 23.9 Bones of the Hips, Legs, and Feet 254
21.1 The Study of the Body 207 23.10 Joints 256
CONTENTS vii
ISTUDY
C H A P T E R 2 7
the Skeletal System 257
BODY ANIMAT3D: Osteoarthritis vs. Rheumatoid Arthritis 257 The Lymphatic and Immune
BODY ANIMAT3D: Osteoporosis 260
Systems 312
Introduction 313
C H A P T E R 2 4 27.1 The Lymphatic System 313
BODY ANIMAT3D: Lymph and Lymph Node Circulation 314
The Muscular System 264
27.2 Defenses Against Disease 316
Introduction 265 27.3 Antibodies 318
24.1 Functions of Muscle 265 27.4 Immune Responses and Acquired Immunities 319
BODY ANIMAT3D: Muscle Contraction 265 27.5 Pathophysiology: Common Diseases and Disorders of
24.2 Muscle Cells and Tissue 266 the Immune System 321
24.3 Production of Energy for Muscle 267 BODY ANIMAT3D: Immune Response: Hypersensitivity 322
24.4 Structure of Skeletal Muscles 268 BODY ANIMAT3D: Inflammation 325
24.5 Attachments and Actions of Skeletal Muscles 268
24.6 Major Skeletal Muscles 269
24.7 Aging and the Musculoskeletal System 274 C H A P T E R 2 8
24.8 Pathophysiology: Common Diseases and Disorders
of the Muscular System 275 The Respiratory System 326
Introduction 327
C H A P T E R 2 5 28.1 Organs of the Respiratory System 327
28.2 The Mechanisms of Breathing 330
The Cardiovascular System 281 BODY ANIMAT3D: Acid-Base Balance: Acidosis and Acid-Base
Introduction 282 Balance: Alkalosis 331
25.1 The Heart 282 28.3 The Transport of Oxygen and Carbon Dioxide in the
25.2 Cardiac Cycle 284 Blood 331
BODY ANIMAT3D: Cardiac Cycle 285 BODY ANIMAT3D: Oxygen Transport and Gas Exchange 331
25.3 Blood Vessels 286 28.4 Respiratory Volumes 332
25.4 Circulation 289 28.5 Pathophysiology: Common Diseases and Disorders of
25.5 Blood Pressure 291 the Respiratory System 333
25.6 Pathophysiology: Common Diseases and Disorders of BODY ANIMAT3D: Asthma 333
the Cardiovascular System 292 BODY ANIMAT3D: COPD 334
BODY ANIMAT3D: Hypertension 292 BODY ANIMAT3D: Respiratory Tract Infections 334
BODY ANIMAT3D: Coronary Artery Disease (CAD) 293 BODY ANIMAT3D: Respiratory Failure 334
BODY ANIMAT3D: Heart Failure Overview, Left-Side Heart
Failure, and Right-Side Heart Failure 295
C H A P T E R 2 9
C H A P T E R 2 6
The Nervous System 342
The Blood 300 Introduction 343

Introduction 301 29.1 General Functions of the Nervous System 343
26.1 Components of Blood 301 29.2 Neuron Structure 344

26.2 Bleeding Control 304 29.3 Nerve Impulse and Synapse 344
BODY ANIMAT3D: Strokes 305 BODY ANIMAT3D: Nerve Impulse 344
26.3 ABO Blood Types 305 29.4 Central Nervous System 345
26.4 The Rh Factor 307 29.5 Peripheral Nervous System 349
26.5 Pathophysiology: Common Diseases and Disorders of BODY ANIMAT3D: Spinal Cord Injury 349
the Blood System 308 29.6 Neurologic Testing 352
viii CONTENTS
ISTUDY
C H A P T E R 3 3
the Nervous System 354
BODY ANIMAT3D: Alzheimer’s Disease 354 The Endocrine System 412
BODY ANIMAT3D: Strokes 359
Introduction 413
33.1 Hormones 413
C H A P T E R 3 0 33.2 Hormone Production 415
33.3 The Stress Response 418
The Urinary System 361 33.4 Pathophysiology: Common Diseases and Disorders of
Introduction 362 the Endocrine System 418
30.1 The Kidneys 362 BODY ANIMAT3D: Type 1 Diabetes 421
30.2 Urine Formation 365 BODY ANIMAT3D: Type 2 Diabetes 421
30.3 The Ureters, Urinary Bladder, and Urethra 365 BODY ANIMAT3D: Hyperthyroidism 422
30.4 Pathophysiology: Common Diseases and Disorders
of the Urinary System 367
C H A P T E R 3 4
BODY ANIMAT3D: Renal Function 367
Special Senses 426
C H A P T E R 3 1 Introduction 427
34.1 The Nose and the Sense of Smell 427
The Reproductive Systems 372 34.2 The Tongue and the Sense of Taste 428
Introduction 373 34.3 The Eye and the Sense of Sight 429
31.1 The Male Reproductive System 373 34.4 Visual Pathways 431
31.2 Pathophysiology: Common Diseases and Disorders of 34.5 Pathophysiology: Common Diseases and Disorders of
the Male Reproductive System 378 the Eyes 433
BODY ANIMAT3D: Prostate Cancer 378 34.6 The Ear and the Senses of Hearing and Equilibrium 435
31.3 The Female Reproductive System 379 34.7 The Hearing Process 436
31.4 Pathophysiology: Common Diseases and Disorders of BODY ANIMAT3D: Hearing Loss: Sensorineural 437
the Female Reproductive System 383 34.8 Pathophysiology: Common Diseases and Disorders of
BODY ANIMAT3D: Breast Cancer 383 the Ears 437
31.5 Pregnancy 385
BODY ANIMAT3D: Meiosis vs. Mitosis 386
31.6 The Birth Process 387 U N I T S I X
31.7 Contraception 389
31.8 Infertility 390
Clinical Practices
31.9 Pathophysiology: Sexually Transmitted Infections
C H A P T E R 3 5
Occurring in Both Sexes 391
Infection Control Practices 442
C H A P T E R 3 2 Introduction 443
35.1 Healthcare-Associated Infections 443
The Digestive System 396 35.2 Infection Control Methods 445
Introduction 397 SKILLS VIDEO: Applying Standard Precautions 448
32.1 Characteristics of the Alimentary Canal 397 35.3 Safe Injection Practices and Sharps Safety 448
32.2 Characteristics of the Digestive Accessory 35.4 Respiratory Hygiene/Cough Etiquette Practices 449
Organs 403 35.5 Infection Control Practices with Medical
32.3 The Absorption of Nutrients 404 Equipment 451
BODY ANIMAT3D: Food Absorption 404 35.6 Surgical Site Infections (SSIs) 451
32.4 Pathophysiology: Common Diseases and Disorders of 35.7 Sterilization 452
the Digestive System 406 SKILLS VIDEO: Wrapping and Labeling Instruments for
BODY ANIMAT3D: Liver Failure 406 Sterilization in the Autoclave 453
CONTENTS ix
ISTUDY
35.8 Reporting Guidelines for Infectious Diseases 456 SKILLS VIDEO: Measuring Adults and Children 499
PROCEDURE 35-1: Removing Contaminated Gloves 458 PROCEDURE 37-1: Measuring and Recording
PROCEDURE 35-2: Removing a Contaminated Gown 458 Temperature 500
PROCEDURE 35-3: Wrapping and Labeling Instruments for PROCEDURE 37-2: Measuring and Recording Pulse and
Sterilization in the Autoclave 458 Respirations 501
PROCEDURE 35-4: Running a Load Through the PROCEDURE 37-3: Obtaining a Pulse Oximetry Reading 502
Autoclave 460 PROCEDURE 37-4: Taking the Blood Pressure of Adults and
PROCEDURE 35-5: Notifying State and County Agencies Older Children 502
About Reportable Diseases 460 PROCEDURE 37-5: Measuring Adults and Children 503
PRACTICE MEDICAL OFFICE: Admin Check Out: Privacy and ELECTRONIC HEALTH RECORDS: 37.01 Record a Patient’s
Liability 464 Vital Signs and Measurements - A 506
ELECTRONIC HEALTH RECORDS: 37.02 Record a Patient’s
Vital Signs and Measurements - B 506
C H A P T E R 3 6 BODY ANIMAT3D: Hypertension 506
PRACTICE MEDICAL OFFICE: Clinical: Office
Patient Interview and History 465
Operations 507
Introduction 466
36.1 The Patient Interview and History 466
SKILLS VIDEO: Using Critical Thinking Skills During an C H A P T E R 3 8
Interview 470
36.2 Your Role as an Observer 470 Assisting with a General
36.3 Documenting Patient Information 473
Physical Examination 508
36.4 Recording the Patient’s Medical History 477
Introduction 509
SKILLS VIDEO: Obtaining a Medical History 480
38.1 The Purpose of a General Physical Exam 509
PROCEDURE 36-1: Using Critical Thinking Skills During an
Interview 483 38.2 The Role of the Medical Assistant 510
PROCEDURE 36-2: Using a Progress Note 484 38.3 Safety Precautions 510
PROCEDURE 36-3: Obtaining a Medical History 485 38.4 Preparing the Patient for an Exam 510
ELECTRONIC HEALTH RECORDS: 36.01 Record a Patient’s 38.5 Positioning and Draping 511
Interview and History in an EHR 486 SKILLS VIDEO: Positioning the Patient for an Exam 514
ELECTRONIC HEALTH RECORDS: 36.02 Record a Patient’s 38.6 Special Patient Considerations 514
Review of Systems (ROS) in an EHR 486 SKILLS VIDEO: Transferring a Patient in a Wheelchair for an
PRACTICE MEDICAL OFFICE: Clinical: Interactions 486 Exam 514
38.7 Exam Methods 514
38.8 Components of a General Physical Exam 515
C H A P T E R 3 7
SKILLS VIDEO: Assisting with a General Physical Exam 516
38.9 After the Exam
Vital Signs and Measurements 487
519
PROCEDURE 38-1: Practicing Good Body Mechanics 520
Introduction 488
PROCEDURE 38-2: Positioning a Patient for an Exam 521
37.1 Vital Signs 488
PROCEDURE 38-3: Communicating Effectively with Patients
37.2 Temperature 489 from Other Cultures and Meeting Their Needs for
SKILLS VIDEO: Measuring and Recording Temperature 492 Privacy 522
37.3 Pulse and Respiration 492 PROCEDURE 38-4: Transferring a Patient in a Wheelchair for
SKILLS VIDEO: Obtaining a Pulse Oximetry Reading 494 an Exam 523
SKILLS VIDEO: Measuring and Recording Pulse and PROCEDURE 38-5: Assisting with a General Physical Exam 524
Respirations 495 SKILLS VIDEO: Communicating Effectively with Patients from
37.4 Blood Pressure 495 Other Cultures and Meeting Their Needs for Privacy 527
SKILLS VIDEO: Taking the Blood Pressure of Adults and Older ELECTRONIC HEALTH RECORDS: 38.01 Record a Patient’s
Children 497 Physical Exam (PE) in an EHR 527
37.5 Body Measurements 498 PRACTICE MEDICAL OFFICE: Clinical: Interactions 527
x CONTENTS
ISTUDY
C H A P T E R 3 9 ELECTRONIC HEALTH RECORDS: 40.3 Document
Administration of Patient Education for Infants and Toddlers 581
Assisting in Reproductive and ELECTRONIC HEALTH RECORDS: 40.4 Record the
Administration of a Pediatric Immunization 581
Urinary Specialties 528 PRACTICE MEDICAL OFFICE: Clinical: Interactions 582
Introduction 529
39.1 Assisting with the Gynecologic Patient 529
C H A P T E R 4 1
SKILLS VIDEO: Assisting with a Gynecological
Exam 532 Assisting in Geriatrics 583
39.2 Assisting with the Obstetric Patient 533
Introduction 584
39.3 OB/GYN Diagnostic and Therapeutic Tests and
Procedures 535 41.1 The Geriatric Patient 584
SKILLS VIDEO: Pregnancy Testing Using
41.2 Diseases and Disorders of Geriatric Patients 587
the EIA Method 536 41.3 Assisting with Geriatric Care 587
39.4 Assisting in Urology 541 SKILLS VIDEO: Obtaining Information from a Geriatric
Patient 587
39.5 Urologic Diagnostic Tests and Procedures 541
39.6 Diseases and Disorders of the Reproductive and 41.4 Geriatric Patient Special Concerns 592
Urinary Systems 542 PROCEDURE 41-1: Coaching and Communicating with

Geriatric Patients 594
PROCEDURE 39-1: Assisting with a Gynecologic Exam 545
PROCEDURE 41-2: E ducating Adult Patients About Daily
PROCEDURE 39-2: Assisting During the Exam of a Pregnant
Water Requirements 595
Patient 547
PROCEDURE 39-3: Assisting with a Cervical Biopsy 547
Administration of Patient Education for Fall Prevention 598
ELECTRONIC HEALTH RECORDS: 39.01 Record a
Gynecologic Exam in a Patient’s EHR 550
Administration of Patient Education for Daily Water Intake 598
ELECTRONIC HEALTH RECORDS: 39.02 Add Test Results to
PRACTICE MEDICAL OFFICE: Clinical: Interactions 598
a Patient’s EHR 550
ELECTRONIC HEALTH RECORDS: 39.03 Document Patient
Education for Testicular Self-Exam 550 C H A P T E R 4 2
PRACTICE MEDICAL OFFICE: Clinical: Interactions 550
Assisting in Other Medical Specialties 599
Introduction 600
C H A P T E R 4 0
42.1 Working in Other Medical Specialties 600
Assisting in Pediatrics 551 42.2 Diseases and Disorders of Medical Specialties 604
42.3 Exams and Procedures in Medical Specialties 608
Introduction 552
PROCEDURE 42-1: Assisting with a Scratch Test
40.1 Developmental Stages and Care 553
Examination 617
40.2 Pediatric Examinations 561
PROCEDURE 42-2: Assisting with a Sigmoidoscopy 618
40.3 Pediatric Immunizations 562
PROCEDURE 42-3: Assisting with a Needle Biopsy 618
40.4 Pediatric Screening and Diagnostic Tests 566
ELECTRONIC HEALTH RECORDS: 42.01 Document Scratch
SKILLS VIDEO: Measuring Infants 568 Test Results 620
40.5 Pediatric Diseases and Disorders 570 PRACTICE MEDICAL OFFICE: Clinical: Interactions 620
40.6 Pediatric Patient Special Concerns 574
PROCEDURE 40-1: Measuring Infants 576
C H A P T E R 4 3
PROCEDURE 40-2: Maintaining Growth Charts 577
PROCEDURE 40-3: Collecting a Urine Specimen from a Assisting with Eye and Ear Care 621
Pediatric Patient 579
ELECTRONIC HEALTH RECORDS: 40.01 Record Pediatric Introduction 622
Vital Signs and Measurement 581 43.1 Ophthalmology 623
ELECTRONIC HEALTH RECORDS: 40.02 Review a Pediatric 43.2 Eye Diseases and Disorders 623
Growth Chart in an EHR 581 43.3 Ophthalmic Exams 626
CONTENTS xi
ISTUDY
SKILLS VIDEO: Performing Vision Screening Tests 628 PROCEDURE 44-6: Assisting After Minor Surgical
43.4 Ophthalmologic Procedures and Treatments 628 Procedures 671
43.5 Otology 629 PROCEDURE 44-7: Suture Removal 672
43.6 Ear Diseases and Disorders 629 ELECTRONIC HEALTH RECORDS: 44.01 Document a
SKILLS VIDEO: Obtaining Information from a Patient with a Patient’s Informed Consent 675
Hearing Aid 633 ELECTRONIC HEALTH RECORDS: 44.02 Document Patient
43.7 Hearing and Other Diagnostic Ear Tests 633 Education - Wound Care after Mole Removal 675
PRACTICE MEDICAL OFFICE: Clinical: Work Task
SKILLS VIDEO: Measuring Auditory Acuity 634
Proficiencies 675
43.8 Ear Treatments and Procedures 634
SKILLS VIDEO: Performing Ear Irrigation 635
PROCEDURE 43-1: Preparing the Ophthalmoscope U N I T S E V E N
for Use 637
PROCEDURE 43-2: Performing Vision Screening Tests 637 Assisting with Diagnostics
PROCEDURE 43-3: Administering Eye Medications 640
PROCEDURE 43-4: Performing Eye Irrigation 642 C H A P T E R 4 5
PROCEDURE 43-5: Measuring Auditory Acuity 643
PROCEDURE 43-6: Administering Eardrops 644
Orientation to the Lab 676
PROCEDURE 43-7: Performing Ear Irrigation 645 Introduction 677

ELECTRONIC HEALTH RECORDS: 43.01 Record Vision Test 45.1 The Role of Laboratory Testing in Patient Care 677
(Snellen) Results 648 45.2 The Medical Assistant’s Role 679
ELECTRONIC HEALTH RECORDS: 43.02 Document Results 45.3 Use of Laboratory Equipment 679
of an Auditory Acuity Test 648 SKILLS VIDEO: Using a Microscope 681
PRACTICE MEDICAL OFFICE: Clinical: Interactions 648 45.4 Safety in the Laboratory 682
45.5 Quality Assurance Programs 683
45.6 Communicating with the Patient 690
C H A P T E R 4 4
45.7 Recordkeeping 691
Assisting with Minor Surgery 649 PROCEDURE 45-1: Using a Microscope 693
ELECTRONIC HEALTH RECORDS: 45.01 Order a Patient’s
Introduction 650
Labs 696
44.1 The Medical Assistant’s Role in Minor Surgery 650
ELECTRONIC HEALTH RECORDS: 45.02 Record a Patient’s
44.2 Surgery in the Physician’s Office 650 Lab Results 696
BODY ANIMAT3D: Wound Healing 652 PRACTICE MEDICAL OFFICE: Clinical: Privacy and
44.3 Instruments Used in Minor Surgery 653 Liability 696
44.4 Asepsis 658
SKILLS VIDEO: Creating a Sterile Field 660
C H A P T E R 4 6
SKILLS VIDEO: Performing a Surgical Scrub and Donning
Sterile Gloves 661
Microbiology and Disease 697
44.5 Preoperative Procedures 661
44.6 Intraoperative Procedures 663 Introduction 698
44.7 Postoperative Procedures 666 46.1 Microbiology and the Role of the Medical Assistant 698
SKILLS VIDEO: Assisting after Minor Surgical Procedures 667 46.2 How Microorganisms Cause Disease 698
SKILLS VIDEO: Suture Removal 667 46.3 Classification and Naming of Microorganisms 699
PROCEDURE 44-1: Creating a Sterile Field 667 46.4 Viruses 700
PROCEDURE 44-2: Performing a Surgical Scrub 668 46.5 Bacteria 703
PROCEDURE 44-3: Donning Sterile Gloves 669 46.6 Protozoans 707
PROCEDURE 44-4: Assisting as a Floater (Unsterile 46.7 Fungi 707
Assistant) During Minor Surgical Procedures 670 46.8 Multicellular Parasites 709
PROCEDURE 44-5: Assisting as a Sterile Scrub Assistant 46.9 How Infections Are Diagnosed 711
During Minor Surgical Procedures 671 46.10 Specimen Collection 713
xii CONTENTS
ISTUDY
SKILLS VIDEO: Obtaining a Throat Culture Specimen 715 ELECTRONIC HEALTH RECORDS: 47.02 Document Release
46.11 Transporting Specimens to an Outside Laboratory 715 of Urine Specimen for Chain of Custody 756
46.12 Direct Examination of Specimens 716 PRACTICE MEDICAL OFFICE: Clinical: Interactions 756
46.13 Preparation and Examination of Stained Specimens 716
46.14 Culturing Specimens in the Medical Office 717
PROCEDURE 46-1: Obtaining a Throat Culture Specimen 720 C H A P T E R 4 8
PROCEDURE 46-2: Performing a Quick Strep A Test on a
Throat Specimen 721
Collecting, Processing, and
PROCEDURE 46-3: Preparing Microbiologic Specimens for Testing Blood Specimens 757
Transport to an Outside Laboratory 722
Introduction 758
PROCEDURE 46-4: Preparing a Microbiologic Specimen
48.1 The Role of the Medical Assistant 758
Smear 722
48.2 Preparation for Collecting Blood Specimens 759
PROCEDURE 46-5: Performing a Gram Stain 723
SKILLS VIDEO: Quality Control Procedures for Blood Specimen
ELECTRONIC HEALTH RECORDS: 46.01 Order a Strep Test
Collection 759
for a Patient 727
48.3 Patient Preparation and Communication 766
ELECTRONIC HEALTH RECORDS: 46.02 Record Strep Test
48.4 Performing Blood Collection 768
Results for a Patient 727
48.5 Performing Common Blood Tests 770
PRACTICE MEDICAL OFFICE: Admin Check Out: Privacy and
Liability 727 SKILLS VIDEO: Preparing a Blood Smear Slide 777
SKILLS VIDEO: Measuring Hematocrit Percentage after
Centrifuge 778
C H A P T E R 4 7 SKILLS VIDEO: Measuring Blood Glucose Using a Handheld
Glucometer 781
Collecting, Processing, and Testing PROCEDURE 48-1: Quality Control Procedures for Blood
Urine and Stool Specimens 728 Specimen Collection 782
PROCEDURE 48-2: Performing Venipuncture Using an
Introduction 729
Evacuated System 783
47.1 The Role of the Medical Assistant 729
PROCEDURE 48-3: Performing Capillary Puncture 785
47.2 Obtaining Urine Specimens 730
PROCEDURE 48-4: Preparing a Blood Smear Slide 786
SKILLS VIDEO: Collecting a Clean-Catch Midstream Urine
Specimen 731 PROCEDURE 48-5: Measuring Hematocrit Percentage after
Centrifuge 788
47.3 Urinalysis 735
PROCEDURE 48-6: Measuring Blood Glucose Using a
SKILLS VIDEO: Performing a Reagent Strip Test 739
Handheld Glucometer 789
SKILLS VIDEO: Pregnancy Testing Using the EIA Method 741
PROCEDURE 48-7: Performing a Rapid Infectious
47.4 Collecting and Processing Stool Specimens 744
Mononucleosis Test 790
PROCEDURE 47-1: Collecting a Clean-Catch Midstream Urine
ELECTRONIC HEALTH RECORDS: 48.01 Order Bloodwork
Specimen 746
for a Patient 792
PROCEDURE 47-2: Collecting a 24-Hour Urine
ELECTRONIC HEALTH RECORDS: 48.02 Record Glucose
Specimen 747
Test Results 792
PROCEDURE 47-3: Establishing Chain of Custody for a Urine PRACTICE MEDICAL OFFICE: Clinical: Work Task
Specimen 748 Proficiencies 792
PROCEDURE 47-4: Measuring Specific Gravity with a
Refractometer 749
PROCEDURE 47-5: Performing a Reagent Strip Test 749 C H A P T E R 4 9
PROCEDURE 47-6: Pregnancy Testing Using the EIA
Method 750 Electrocardiography and Pulmonary
PROCEDURE 47-7: Processing a Urine Specimen for
Microscopic Examination of Sediment 751
Function Testing 793
PROCEDURE 47-8: Fecal Occult Blood Testing Using the Introduction 794
Guaiac Testing Method 753 49.1 The Medical Assistant’s Role in Electrocardiography
ELECTRONIC HEALTH RECORDS: 47.01 Record Urine and Pulmonary Function Testing 794
Dipstick Results 756 49.2 Basic Principles of Electrocardiography 794
CONTENTS xiii
ISTUDY
49.3 The Electrocardiograph 795 51.1 The Medical Assistant’s Role in Pharmacology 844
49.4 Performing an ECG 799 51.2 Pharmacology 845
SKILLS VIDEO: Obtaining an ECG 807 BODY ANIMAT3D: Pharmacokinetics vs.
49.5 Exercise Electrocardiography (Stress Testing) and Pharmacodynamics 846
Echocardiography 808 BODY ANIMAT3D: Medication Absorption, Medication
49.6 Ambulatory Electrocardiography (Holter Monitoring) 809 Distribution, Medication Metabolism, and Medication Excretion 846
SKILLS VIDEO: Holter Monitoring 810 51.3 Drug Names and Categories 848
49.7 Pulmonary Function Testing 810 51.4 FDA Regulation and Drugs 852
SKILLS VIDEO: Measuring Forced Vital Capacity Using 51.5 Sources of Drug Information 853
Spirometry 813 51.6 Controlled Substances 857
SKILLS VIDEO: Peak Expiratory Flow Rate 813 51.7 Prescriptions 859
PROCEDURE 49-1: Obtaining an ECG 814 SKILLS VIDEO: Interpreting a Prescription 860
PROCEDURE 49-2: Ambulatory Monitoring 815 51.8 Nonpharmacologic Pain Management 862
PROCEDURE 49-3: Measuring Forced Vital Capacity Using 51.9 Vaccines 862
Spirometry 816 PROCEDURE 51-1: Helping the Licensed Practitioner Comply
PROCEDURE 49-4: Obtaining a Peak Expiratory Flow Rate 817 with the Controlled Substances Act of 1970 863
ELECTRONIC HEALTH RECORDS: 49.01 Order an ECG for a PROCEDURE 51-2: Interpreting a Prescription 864
Patient 820 ELECTRONIC HEALTH RECORDS: 51.01 Record
ELECTRONIC HEALTH RECORDS: 49.02 Upload an ECG Administration of a Vaccine 866
Tracing to a Patient’s EHR 820 ELECTRONIC HEALTH RECORDS: 51.02 Record Medications
PRACTICE MEDICAL OFFICE: Clinical: Work Task in a Patient’s EHR 866
Proficiencies 821 ELECTRONIC HEALTH RECORDS: 51.03 Create a
Prescription Refill Request 866
C H A P T E R 5 0 PRACTICE MEDICAL OFFICE: Clinical: Privacy and Liability 866
Diagnostic Imaging 822
Introduction 823 C H A P T E R 5 2
50.1 Brief History of the X-ray 823

Dosage Calculations 867
50.2 Diagnostic Radiology 823
50.3 The Medical Assistant’s Role in Diagnostic Radiology 824 Introduction 868
50.4 Common Diagnostic Radiologic Tests 826 52.1 Ensuring Safe Dosage Calculations 868
50.5 Common Therapeutic Uses of Radiation 835 52.2 Measurement Systems 869
50.6 Radiation Safety and Dose 835 52.3 Conversions Within and Between Measurement Systems 870
50.7 Electronic Medicine 837 52.4 Dosage Calculations 872

PROCEDURE 50-1: Assisting with an X-ray Examination 838 52.5 Body Weight and Body Surface Area Calculations 875
PROCEDURE 50-2: Documentation and Filing Techniques for PRACTICE MEDICAL OFFICE: Clinical: Privacy and
X-rays 839 Liability 879

Administration of Patient Education - Mammography 842 C H A P T E R 5 3
ELECTRONIC HEALTH RECORDS: 50.02 Upload
Mammogram Results to a Patient’s EHR 842 Medication Administration 880
PRACTICE MEDICAL OFFICE: Clinical: Interactions 842 Introduction 881

53.1 Preparing to Administer a Drug 881
U N I T E I G H T 53.2 Rights of Medication Administration 884
53.3 Drug Routes and Equipment 885
Assisting in Therapeutics 53.4 Medications by Mouth 887
SKILLS VIDEO: Administering Drugs by Mouth 888
C H A P T E R 5 1 53.5 Medications by Injection 888
SKILLS VIDEO: Drawing a Drug from an Ampule 890
Principles of Pharmacology 843
SKILLS VIDEO: Reconstituting and Drawing a Drug for
Introduction 844 Injection 890
xiv CONTENTS
ISTUDY
SKILLS VIDEO: Giving an Intradermal Injection 891 PROCEDURE 54-4: Teaching a Patient How to Use a Walker 931
SKILLS VIDEO: Giving a Subcutaneous Injection 891 PROCEDURE 54-5: Teaching a Patient How to Use
SKILLS VIDEO: Giving an Intramuscular Injection 891 Crutches 931
53.6 Other Medication Routes 893 ELECTRONIC HEALTH RECORDS: 54.01 Refer a Patient to
53.7 Special Considerations 893 Physical Therapy 934
53.8 Patient Education About Medications 895 PRACTICE MEDICAL OFFICE: Clinical: Work Task
Proficiencies 934
53.9 Charting Medications 897
PROCEDURE 53-1: Administering Oral Drugs 898
PROCEDURE 53-2: Administering Buccal or Sublingual C H A P T E R 5 5
Drugs 900
PROCEDURE 53-3: Drawing a Drug from an Ampule 901 Nutrition and Health 935
PROCEDURE 53-4: Reconstituting and Drawing a Drug for Introduction 936
Injection 901
55.1 Daily Energy Requirements 936
PROCEDURE 53-5: Giving an Intradermal (ID) Injection 902
55.2 Nutrients 937
PROCEDURE 53-6: Giving a Subcutaneous (Subcut)
BODY ANIMAT3D: Protein Synthesis 938
Injection 903
PROCEDURE 53-7: Giving an Intramuscular (IM) 55.3 Dietary Guidelines 944
Injection 904 55.4 Assessing Nutritional Levels 946
PROCEDURE 53-8: Administering Inhalation Therapy 905 55.5 Modified Diets 947
PROCEDURE 53-9: Administering and Removing a 55.6 Patients with Specific Nutritional Needs 948
Transdermal Patch 906 BODY ANIMAT3D: Digestion: Lactose Intolerance 952
PROCEDURE 53-10: Assisting with Administration of a BODY ANIMAT3D: Obesity 953
Urethral Drug 907 55.7 Eating Disorders 954
PROCEDURE 53-11: Administering a Vaginal Medication 907
55.8 Patient Education 956
PROCEDURE 53-12: Administering a Rectal Medication 908
PROCEDURE 55-1: Teaching Patients How to
ELECTRONIC HEALTH RECORDS: 53.01 Document Read Food Labels 957
Medication Administration 911
PROCEDURE 55-2: Alerting Patients with Food Allergies to
ELECTRONIC HEALTH RECORDS: 53.02 Record Medications the Dangers of Common Foods 959
in a Patient’s EHR 911
ELECTRONIC HEALTH RECORDS: 53.03 Document Allergies Administration of Patient Education for Nutrition 962
in a Patient’s EHR 911
ELECTRONIC HEALTH RECORDS: 55.02 Record Food
PRACTICE MEDICAL OFFICE: Clinical: Office
Allergies in a Patient’s EHR 962
Operations 911
PRACTICE MEDICAL OFFICE: Admin
Check In: Interactions 962
C H A P T E R 5 4
Physical Therapy and Rehabilitation 912 U N I T N I N E
Introduction 913
54.1 General Principles of Physical Therapy 913
Medical Assisting Practice
54.2 Cryotherapy and Thermotherapy 916
54.3 Hydrotherapy 919 C H A P T E R 5 7
54.4 Exercise Therapy 920
54.5 Massage 922
Emergency Preparedness 964
54.6 Traction 923 Introduction 965

54.7 Mobility Aids 923 57.1 Understanding Medical Emergencies 965
SKILLS VIDEO: Teaching a Patient How to Use Crutches 926 57.2 Preparing for Medical Emergencies 966
54.8 Referral to a Physical Therapist 928 SKILLS VIDEO: Performing an Emergency Assessment 968
PROCEDURE 54-1: Administering Cryotherapy 928 57.3 Accidental Injuries 968
PROCEDURE 54-2: Administering Thermotherapy 929 BODY ANIMAT3D: Concussions 971

PROCEDURE 54-3: Teaching a Patient How to Use a SKILLS VIDEO: Controlling Bleeding 971
Cane 930 SKILLS VIDEO: Cleaning Minor Wounds 975
CONTENTS xv
ISTUDY
57.4 Common Disorders 975
C H A P T E R 5 8
SKILLS VIDEO: Caring for a Patient Who Is Vomiting 978
57.5 Less Common Disorders 978 Preparing for the World of Work 995
SKILLS VIDEO: Performing Cardiopulmonary Resuscitation
Introduction 996
(CPR) 980
58.1 Training in Action 996
57.6 Common Psychosocial Emergencies 982
58.2 Obtaining Professional Certification 1000
57.7 The Patient Under Stress 982
58.3 Preparing to Find a Position 1001
57.8 Educating the Patient 983
58.4 Interviewing 1007
57.9 Disasters and Pandemics 983
58.5 On the Job 1011
57.10 Bioterrorism 984
PROCEDURE 58-1: Résumé Writing 1012
PROCEDURE 57-1: Stocking the Crash Cart 986
PRACTICE MEDICAL OFFICE: Admin Check Out: Work Task
PROCEDURE 57-2: Performing an Emergency
Proficiencies 1014
Assessment 987
PROCEDURE 57-3: Foreign Body Airway Obstruction in a
Responsive Adult or Child 987
A P P E N D I C E S
PROCEDURE 57-4: Foreign Body Airway Obstruction in a
Responsive Infant 989 I Diseases and Disorders A-1
PROCEDURE 57-5: Controlling Bleeding 990 II Prefixes, Suffixes, and Word Roots in Commonly Used
PROCEDURE 57-6: Cleaning Minor Wounds 990 Medical Terms A-19
PROCEDURE 57-7: Caring for a Patient Who Is Vomiting 991 III Abbreviations and Symbols Commonly Used in
PROCEDURE 57-8: Assisting During a Chemical Disaster 991 Medical Notations A-23
BODY ANIMAT3D: Burns 993 Glossary G-1
Index I-1
PRACTICE MEDICAL OFFICE: Clinical: Privacy and
Liability 994
xvi CONTENTS
ISTUDY
Procedures
PROCEDURE 1-1 Obtaining Certification/Registration PROCEDURE 15-2 Identifying Community Resources 200
Information Through the Internet 9 PROCEDURE 15-3 Locating Credible Patient Education
PROCEDURE 1-2 Locating Your State’s Legal Scope of Practice 10 Information on the Internet 200
PROCEDURE 3-1 Self-Evaluation of Professional Behaviors 24 PROCEDURE 15-4 Developing a Patient Education Plan 201
PROCEDURE 4-1 Communicating with the Anxious Patient 43 PROCEDURE 15-5 Outpatient Surgery Teaching 201
PROCEDURE 4-2 Communicating with the Angry Patient 43 PROCEDURE 35-1 Removing Contaminated Gloves 458
PROCEDURE 4-3 Communicating with the Assistance of an PROCEDURE 35-2 Removing a Contaminated Gown 458
Interpreter 44 PROCEDURE 35-3 Wrapping and Labeling Instruments for
PROCEDURE 5-1 Obtaining Signature for Notice of Privacy Sterilization in the Autoclave 458
Practices and Acknowledgment 75 PROCEDURE 35-4 Running a Load Through the Autoclave 460
PROCEDURE 5-2 Completing a Privacy Violation Complaint PROCEDURE 35-5 Notifying State and County Agencies About
Form 76 Reportable Diseases 460
PROCEDURE 5-3 Obtaining Authorization to Release Health
PROCEDURE 36-1 Using Critical Thinking Skills During an
Information 76
Interview 483
PROCEDURE 6-1 Aseptic Handwashing 93
PROCEDURE 36-2 Using a Progress Note 484
PROCEDURE 6-2 Using an Alcohol-Based Hand
PROCEDURE 36-3 Obtaining a Medical History 485
Disinfectant 94
PROCEDURE 37-1 Measuring and Recording Temperature 500
PROCEDURE 6-3 Using a Biohazardous Sharps Container 94
PROCEDURE 37-2 Measuring and Recording Pulse and
PROCEDURE 6-4 Disposing of Biohazardous Waste 94
Respirations 501
PROCEDURE 7-1 Handling a Fire Emergency 120
PROCEDURE 37-3 Obtaining a Pulse Oximetry Reading 502
PROCEDURE 7-2 Maintaining and Using an Eyewash
PROCEDURE 37-4 Taking the Blood Pressure of Adults and Older
Station 121
Children 502
PROCEDURE 7-3 Creating a Pediatric Reception Area 122
PROCEDURE 37-5 Measuring Adults and Children 503
PROCEDURE 7-4 Creating a Reception Area Accessible to
PROCEDURE 38-1 Practicing Good Body Mechanics 520
Patients with Special Needs 122
PROCEDURE 38-2 Positioning a Patient for an Exam 521
PROCEDURE 7-5 Opening and Closing the Medical Office 123
PROCEDURE 38-3 Communicating Effectively with Patients
PROCEDURE 9-1 Performing Sanitization with an Ultrasonic
from Other Cultures and Meeting Their Needs
Cleaner 138
for Privacy 522
PROCEDURE 9-2 Guidelines for Disinfecting Exam Room
Surfaces 139 PROCEDURE 38-4 Transferring a Patient in a Wheelchair for an
Exam 523
PROCEDURE 12-1* Creating a New Patient Record Using EHR
Software 153 PROCEDURE 38-5 Assisting with a General Physical Exam 524
PROCEDURE 12-2* Checking in and Rooming a Patient Using an PROCEDURE 39-1 Assisting with a Gynecologic Exam 545
Electronic Health Record 153 PROCEDURE 39-2 Assisting During the Exam of a Pregnant
PROCEDURE 12-3* Creating an Appointment Matrix for an Patient 547
Electronic Scheduling System 154 PROCEDURE 39-3 Assisting with a Cervical Biopsy 547
PROCEDURE 12-4* Scheduling a Patient Appointment Using an PROCEDURE 40-1 Measuring Infants 576
Electronic Scheduler 154 PROCEDURE 40-2 Maintaining Growth Charts 577
PROCEDURE 14-1 Using a Video Relay Service with an American PROCEDURE 40-3 Collecting a Urine Specimen from a Pediatric
Sign Language Interpreter 177 Patient 579
PROCEDURE 14-2 Renewing a Prescription by Telephone 178 PROCEDURE 41-1 Coaching and Communicating with Geriatric
PROCEDURE 14-3 Screening and Routing Telephone Calls 179 Patients 594
PROCEDURE 14-4 Handling Emergency Calls 179 PROCEDURE 41-2 E ducating Adult Patients About Daily Water
PROCEDURE 14-5 Retrieving Messages from an Answering Requirements 595
Service or System 180 PROCEDURE 42-1 Assisting with a Scratch Test Examination 617
PROCEDURE 15-1* Creating Electronic Patient Instructions 199 PROCEDURE 42-2 Assisting with a Sigmoidoscopy 618
xvii
ISTUDY
PROCEDURE 42-3 Assisting with a Needle Biopsy 618 PROCEDURE 48-7 Performing a Rapid Infectious Mononucleosis
PROCEDURE 43-1 Preparing the Ophthalmoscope for Use 637 Test 790
PROCEDURE 43-2 Performing Vision Screening Tests 637 PROCEDURE 49-1 Obtaining an ECG 814
PROCEDURE 43-3 Administering Eye Medications 640 PROCEDURE 49-2 Ambulatory Monitoring 815
PROCEDURE 43-4 Performing Eye Irrigation 642 PROCEDURE 49-3 Measuring Forced Vital Capacity Using
Spirometry 816
PROCEDURE 43-5 Measuring Auditory Acuity 643
PROCEDURE 49-4 Obtaining a Peak Expiratory Flow Rate 817
PROCEDURE 43-6 Administering Eardrops 644
PROCEDURE 50-1 Assisting with an X-ray Examination 838
PROCEDURE 43-7 Performing Ear Irrigation 645
PROCEDURE 50-2 Documentation and Filing Techniques for
PROCEDURE 44-1 Creating a Sterile Field 667
X-rays 839
PROCEDURE 44-2 Performing a Surgical Scrub 668
PROCEDURE 51-1 Helping the Licensed Practitioner Comply with
PROCEDURE 44-3 Donning Sterile Gloves 669 the Controlled Substances Act of 1970 863
PROCEDURE 44-4 Assisting as a Floater (Unsterile Assistant) PROCEDURE 51-2 Interpreting a Prescription 864
During Minor Surgical Procedures 670
PROCEDURE 53-1 Administering Oral Drugs 898
PROCEDURE 44-5 Assisting as a Sterile Scrub Assistant During PROCEDURE 53-2 Administering Buccal or Sublingual
Minor Surgical Procedures 671 Drugs 900
PROCEDURE 44-6 Assisting After Minor Surgical Procedures 671 PROCEDURE 53-3 Drawing a Drug from an Ampule 901
PROCEDURE 44-7 Suture Removal 672 PROCEDURE 53-4 Reconstituting and Drawing a Drug for
PROCEDURE 45-1 Using a Microscope 693 Injection 901
PROCEDURE 46-1 Obtaining a Throat Culture Specimen 720 PROCEDURE 53-5 Giving an Intradermal (ID) Injection 902
PROCEDURE 46-2 Performing a Quick Strep A Test on a Throat PROCEDURE 53-6 Giving a Subcutaneous (Subcut)
Specimen 721 Injection 903
PROCEDURE 46-3 Preparing Microbiologic Specimens for PROCEDURE 53-7 Giving an Intramuscular (IM) Injection 904
Transport to an Outside Laboratory 722 PROCEDURE 53-8 Administering Inhalation Therapy 905
PROCEDURE 46-4 Preparing a Microbiologic Specimen PROCEDURE 53-9 Administering and Removing a Transdermal
Smear 722 Patch 906
PROCEDURE 46-5 Performing a Gram Stain 723 PROCEDURE 53-10 Assisting with Administration of a Urethral
PROCEDURE 47-1 Collecting a Clean-Catch Midstream Urine Drug 907
Specimen 746 PROCEDURE 53-11 Administering a Vaginal Medication 907
PROCEDURE 47-2 Collecting a 24-Hour Urine Specimen 747 PROCEDURE 53-12 Administering a Rectal Medication 908
PROCEDURE 47-3 Establishing Chain of Custody for a Urine PROCEDURE 54-1 Administering Cryotherapy 928
Specimen 748
PROCEDURE 54-2 Administering Thermotherapy 929
PROCEDURE 47-4 Measuring Specific Gravity with a
PROCEDURE 54-3 Teaching a Patient How to Use a Cane 930
Refractometer 749
PROCEDURE 54-4 Teaching a Patient How to Use a Walker 931
PROCEDURE 47-5 Performing a Reagent Strip Test 749
PROCEDURE 54-5 Teaching a Patient How to Use Crutches 931
PROCEDURE 47-6 Pregnancy Testing Using the EIA Method 750
PROCEDURE 55-1 Teaching Patients How to Read Food Labels 957
PROCEDURE 47-7 Processing a Urine Specimen for Microscopic
PROCEDURE 55-2 Alerting Patients with Food Allergies to the
Examination of Sediment 751
Dangers of Common Foods 959
PROCEDURE 47-8 Fecal Occult Blood Testing Using the Guaiac
PROCEDURE 57-1 Stocking the Crash Cart 986
Testing Method 753
PROCEDURE 57-2 Performing an Emergency Assessment 987
PROCEDURE 48-1 Quality Control Procedures for Blood
Specimen Collection 782 PROCEDURE 57-3 Foreign Body Airway Obstruction in a
Responsive Adult or Child 987
PROCEDURE 48-2 Performing Venipuncture Using an Evacuated
System 783 PROCEDURE 57-4 Foreign Body Airway Obstruction in a
Responsive Infant 989
PROCEDURE 48-3 Performing Capillary Puncture 785
PROCEDURE 57-5 Controlling Bleeding 990
PROCEDURE 48-4 Preparing a Blood Smear Slide 786
PROCEDURE 57-6 Cleaning Minor Wounds 990
PROCEDURE 48-5 Measuring Hematocrit Percentage after
Centrifuge 788 PROCEDURE 57-7 Caring for a Patient Who Is Vomiting 991
PROCEDURE 48-6 Measuring Blood Glucose Using a Handheld PROCEDURE 57-8 Assisting During a Chemical Disaster 991
Glucometer 789 PROCEDURE 58-1 Résumé Writing 1012
*Indicates EHRClinic video
xviii PROCEDURES
ISTUDY
Digital Exercises and Activities
NEW! EHRclinic Exercises 45.01 Order a Patient’s Labs 696
45.02 Record a Patient’s Lab Results 696
5.01 Add an Acknowledgement of Receipt of NPP to a
46.01 Order a Strep Test for a Patient 727
Patient’s EHR 79
46.02 Record Strep Test Results for a Patient 727
5.02 Add an Authorization to Release Health Information
to a Patient’s EHR 79 47.01 Record Urine Dipstick Results 756
6.01 Add a Note to a Patient’s EHR 96 47.02 Document Release of Urine Specimen for Chain of
Custody 756
12.01 - 12.23 EHR review exercises 157
48.01 Order Bloodwork for a Patient 792
14.01 Create an Electronic Telephone Encounter 183
48.02 Record Glucose Test Results 792
14.02 Create an Urgent Electronic Telephone Encounter 183
49.01 Order an ECG for a Patient 820
14.03 Complete a Prescription Refill Request 183
49.02 Upload an ECG Tracing to a Patient’s EHR 820
15.01 Document Administration of Patient Education 204
50.01 Document Administration of Patient
15.02 Document Administration of Pre- and Post-Operative
Education - Mammography 842
Instructions 204
50.02 Upload Mammogram Results to a
36.01 Record a Patient’s Interview and History in an
Patient’s EHR 842
EHR 486
51.01 Record Administration of a Vaccine 866
36.02 Record a Patient’s Review of Systems (ROS) in an
EHR 486 51.02 Record Medications in a Patient’s EHR 866
37.01 Record a Patient’s Vital Signs and 51.03 Create a Prescription Refill Request 866
Measurements - A 506 53.01 Document Medication Administration 911
37.02 Record a Patient’s Vital Signs 53.02 Record Medications in a Patient’s EHR 911
and Measurements - B 506 53.03 Document Allergies in a Patient’s EHR 911
38.01 Record a Patient’s Physical Exam (PE) in an 54.01 Refer a Patient to Physical Therapy 934
EHR 527 55.01 Document Administration of Patient Education for
39.01 Record a Gynecologic Exam in a Patient’s Nutrition 962
EHR 550 55.02 Record Food Allergies in a Patient’s EHR 962
39.02 Add Test Results to a Patient’s EHR 550
39.03 Document Patient Education for Testicular
Self-Exam 550 Body Animat3D
40.01 Record Pediatric Vital Signs and Measurement 581
Homeostasis 208
40.02 Review a Pediatric Growth Chart in an EHR 581
Basic Chemistry (Organic Molecules) 216
40.03 Document Administration of Patient Education for
Fluid and Electrolyte Imbalances 218
Infants and Toddlers 581
Cells and Tissues 221
40.04 Record the Administration of a Pediatric
Immunization 581 Meiosis vs. Mitosis 222
41.01 Document Administration of Patient Education for Inflammation 234
Fall Prevention 598 Burns 237
41.02 Document Administration of Patient Education for Osteoarthritis vs. Rheumatoid Arthritis 257
Daily Water Intake 598 Osteoporosis 260
42.01 Document Scratch Test Results 620 Muscle Contraction 265
43.01 Record Vision Test (Snellen) Results 648 Cardiac Cycle 285
43.02 Document Results of an Auditory Acuity Test 648 Hypertension 292
44.01 Document a Patient’s Informed Consent 675 Coronary Artery Disease (CAD) 293
44.02 Document Patient Education - Wound Care after Mole Heart Failure Overview, Left-Side Heart Failure, and
Removal 675 Right-Side Heart Failure 295
xix
ISTUDY
Strokes 305 Using Critical Thinking Skills During an Interview 470
Lymph and Lymph Node Circulation 314 Obtaining a Medical History 480
Immune Response: Hypersensitivity 322 Measuring and Recording Temperature 492
Inflammation 325 Obtaining a Pulse Oximetry Reading 494
Acid-Base Balance: Acidosis and Acid-Base Balance: Measuring and Recording Pulse and Respirations 495
Alkalosis 331 Taking the Blood Pressure of Adults and Older
Oxygen Transport and Gas Exchange 331 Children 497
Asthma 333 Measuring Adults and Children 499
COPD 334 Positioning the Patient for an Exam 514
Respiratory Tract Infections 334 Transferring a Patient in a Wheelchair for an Exam 514
Respiratory Failure 334 Assisting with a General Physical Exam 516
Nerve Impulse 344 Communicating Effectively with Patients from Other Cultures
Spinal Cord Injury 349 and Meeting Their Needs for Privacy 527
Alzheimer’s Disease 354 Assisting with a Gynecological Exam 532
Strokes 359 Pregnancy Testing Using the EIA Method 536
Renal Function 367 Measuring Infants 546
Prostate Cancer 378 Obtaining Information from a Geriatric Patient 587
Breast Cancer 383 Performing Vision Screening Tests 628
Meiosis vs. Mitosis 386 Obtaining Information from a Patient with a Hearing Aid 633
Food Absorption 404 Measuring Auditory Acuity 634
Liver Failure 406 Performing Ear Irrigation 635
Type 1 Diabetes 421 Creating a Sterile Field 660
Type 2 Diabetes 421 Performing a Surgical Scrub and Donning Sterile Gloves 661
Hyperthyroidism 422 Assisting after Minor Surgical Procedures 667
Hearing Loss: Sensorineural 437 Suture Removal 667
Hypertension 506 Using a Microscope 681
Wound Healing 652 Obtaining a Throat Culture Specimen 715
Pharmacokinetics vs. Pharmacodynamics 846 Collecting a Clean-Catch Midstream Urine Specimen 731
Medication Absorption, Medication Distribution, Medication Performing a Reagent Strip Test 739
Metabolism, and Medication Excretion 846 Pregnancy Testing Using the EIA Method 741
Protein Synthesis 938 Quality Control Procedures for Blood Specimen
Digestion: Lactose Intolerance 952 Collection 759
Obesity 953 Preparing a Blood Smear Slide 777
Concussions 971 Measuring Hematocrit Percentage after Centrifuge 778
Burns 993 Measuring Blood Glucose Using a Handheld Glucometer 781
Obtaining an ECG 807
Holter Monitoring 810
Administrative and Measuring Forced Vital Capacity Using Spirometry 813
Clinical Skills Videos Peak Expiratory Flow Rate 813
Communicating with the Anxious Patient 38 Interpreting a Prescription 860
Communicating Effectively with Patients from Other Cultures Administering Drugs by Mouth 888
and Meeting Their Needs for Privacy 39 Drawing a Drug from an Ampule 890
Aseptic Hand Hygiene 86 Reconstituting and Drawing a Drug for Injection 890
Guidelines for Disinfecting Exam Room Surfaces 131 Giving an Intradermal Injection 891
PHI Authorization to Release Health Information 152 Giving an Intramuscular Injection 891
Managing a Prescription Refill 169 Giving a Subcutaneous Injection 891
Applying Standard Precautions 448 Teaching a Patient How to Use Crutches 926
Wrapping and Labeling Instruments for Sterilization in the Performing an Emergency Assessment 968
Autoclave 453 Controlling Bleeding 971
xx D I G I TA L E X E R C I S E S A N D AC T I V I T I E S
ISTUDY
Cleaning Minor Wounds 975 Clinical: Privacy and Liability 696, 866, 879, 994
Caring for a Patient Who Is Vomiting 978 Clinical: Work Task Proficiencies 648, 675, 934
Performing Cardiopulmonary Resuscitation (CPR) 980 SmartVideo: BPH vs Prostate Cancer
SmartVideo: The Prostate Gland
SmartVideo: The Mammary Gland
NEW! Application-Based SmartVideo: Breast Cancer
SmartVideo: Breast Cancer Treatment
Activities (ABAs) Including
SmartVideo: Food Absorption
Practice Medical Office (PMO) SmartVideo: Blood Pressure & Hypertension
Drawing Up an Injection SmartVideo: Hypertension Treatments
Obtaining a Pulse Oximetry Reading SmartVideo: The Liver – Anatomy and Function
Flu Shot Incident SmartVideo: Liver Failure and Treatment
Dealing with an Angry Parent SmartVideo: Liver Failure – Acetaminophen Overdose
Clean Catch Mid- Stream Urine Collection SmartVideo: Measuring Aduitory Acuity
Performing Venipuncture Using an Evacuated System SmartVideo: Measuring Blood Glucose Using a Handheld
Harassment in the Clinic Glucometer
Holter Monitor SmartVideo: Measuring Hematocrit Percentage after
Admin Check In: Interactions 27, 47, 962 Centrifuge
Admin Check In: Office Operations 97, 183, 307 SmartVideo: Meiosis
Admin Check In: Privacy and Liability 80 SmartVideo: Mitosis
Admin Check In: Work Task Proficiencies 126 SmartVideo: Obtaining Information from a Geriatric Patient
Admin Check Out: Interactions 204 SmartVideo: Performing Ear Irrigation
Admin Check Out: Office Operations 419 SmartVideo: Performing Vision Screening Tests
Admin Check Out: Privacy and Liability 158, 464, 727 SmartVideo: Preparing a Blood Smear
Admin Check Out: Work Task Proficiencies 1014
Clinical: Interactions 486, 527, 550, 582, 598, 620, 648, Find the complete list of of NEW! Application-Based
756, 842 Activities (ABAs) with the Instructor Resources on
Clinical: Office Operations 141, 507, 911 Connect.
D I G I TA L E X E R C I S E S A N D AC T I V I T I E S xxi
ISTUDY
A Closer Look
Medical assisting is a rock-solid career with a variety of essen- set of tools for individuals preparing to become medical assis-
tial tasks. These tasks are always expanding and changing as tants as well as the instructors helping them to accomplish
the healthcare environment changes. Learning these tasks and this task.
stacking them together can be a challenge. The seventh edi- When you begin the book, you will find it is not just
tion is updated to help students as well as instructors learn about rote memorization of concepts. Medical Assisting
these ever-changing tasks and stay current in the healthcare immerses you in the world of BWW Medical Associates,
environment. McGraw-Hill is committed to helping prepare where you learn as you confront new workplace challenges in
students to succeed in their educational program and career each chapter. All elements of the book—from the case studies
by providing a complete and easy set of solutions for the in each chapter and the Soft Skills Success exercises to the
educators of these programs. The following will give you a screenshots and other visuals—immerse the stu-
snapshot of some of the exciting solutions available with the dent in a realistic learning environment. Case studies are built
seventh edition of Medical Assisting: Clinical Procedures around a set of patients who regularly visit BWW Medical
with Anatomy and Physiology for your Medical Assisting Associates, and you will get to know these patients as well
course. Instructors across the country have told us how much as the employees of BWW Medical Associates as you move
preparation it takes to teach medical assisting. To help, we through the chapters and the accompanying EHR exercises.
have added more detailed information on how to organize and Within this framework, we have worked to provide the most
utilize the many available practice features and activities, as up-to-date information about all aspects of the medical assisting
well as a breakdown by Learning Outcomes for correspond- profession, with a focus on consistency, authenticity, and accu-
ing activities entitled the Comprehensive Asset Map, located racy. Along with thousands of minor tweaks and updates, Medi-
in the Instructor Resources portion of Connect. cal Assisting, seventh edition, incorporates the following:
• New! Over 100 electronic health record exer-
cises correlated to 34 chapters.
The Content—a Note from the Authors • New! A complete set of 23 exercises included
The seventh edition of Medical Assisting: Clinical Procedures with Chapter 12 Electronic Health Records that provides
with Anatomy and Physiology has many exciting and note- documentation of EHR proficiency and a “big picture”
worthy updates. With insightful feedback from our users and journey for the student.
reviewers, our experienced author team set out to create a one- • Dozens of BWW EHR documentation/progress note
of-a-kind, dynamic, practical, realistic, and comprehensive examples in both clinical and administrative chapters.
FIGURE FM-1 The new Practice Atlas.

©McGraw-Hill Education
xxii
ISTUDY
• Soft Skills Success exercises located with the Chapter Chapter 7 Computer Vision Syndrome, service dogs and
Review that test employability skills and link students to comfort animals, visual relay services
related modules in Practice Medical Office (PMO) and Chapter 9 Mixing 10% bleach solution; key terms
Application-Based Activities (ABAs). anoscope, examination light, laryngeal mirror,
• Over 30 screenshots throughout the nasal speculum, otoscope, penlight, reflex
text to showcase basic EHR skills in the context of the hammer
BWW Medical Associates. Chapter 12 Meaningful Use, expanded coverage of shared
• Case studies that are enhanced by the inclusion of more data, general guidelines for using an EHR
detailed clinical information and link to the new Soft Skills program, practice management systems,
Success activities where applicable. updated EHR content with new
• Coding content focusing on ICD-10-CM, including detailed program
1500 claim form instructions utilizing the 5010 updates to Chapter 14 Communicating with deaf, Uber, Lyft, and cell
make the form compliant with ICD-10 requirements phone use
• New! Thirteen math and dosage videos and questions Chapter 15 Electronic media use, defined modeling versus
located as assignments in Connect. return demonstration; sample e-newsletter,
• Inclusion of content and terminology related to all of the patient information form, and physician
current medical assisting standards to help ensure student information figures added
certification success. Chapter 21 New Medical Terminology focus feature and
• Brand new level heading in all of the anatomy and physiol- “Diagnostic Exams and Tests” heading under
ogy chapters titled “Diagnostic Exams and Test.” Pathophysiology section
• New! Medical Terminology Practice feature with the Chapter 22 Added melanin and modified burn and skin
anatomy and physiology chapters to bring further under- cancer sections, New Medical Terminology
standing of the power of the construction and deconstruc- focus feature and “Diagnostic Exams and
tion of medical terms, as well as corresponding practice Tests” heading under Pathophysiology
questions in the Chapter Review. section
• New! Corresponding practice of anatomy and physiology Chapter 23 New Medical Terminology focus feature and
with Practice Atlas on Connect. “Diagnostic Exams and Tests” heading under
A more detailed list of chapter changes is covered in the next Pathophysiology section
section. Chapter 24 New Medical Terminology focus feature and
“Diagnostic Exams and Tests” heading under
Pathophysiology section
Key Chapter-by-Chapter Changes
Chapter 25 Added interatrial and interventricular
The following chapter-by-chapter list includes the essential
as related to the septum and additional
changes and updates made to the book. A full list of changes
information about capillaries; new
is available in the transition guide provided in the Instructor
Medical Terminology focus feature and
Resources on Connect.
“Diagnostic Exams and Tests” heading under
Pathophysiology section
Chapter 1 The medical assistant as a patient navigator,
scope of practice procedure, standard of care, Chapter 26 New Medical Terminology focus feature and
and practice test provided by certification “Diagnostic Exams and Tests” heading under
organizations. A new procedure titled Locate Pathophysiology section
Your State’s Legal Scope of Practice Chapter 27 Removed HIV/AIDS section and revised
Chapter 3 Professional use of personal electronic Medical Terminology focus feature and
devices and social media, customer service “Diagnostic Exams and Tests” heading under
as professionalism, cultural diversity with Pathophysiology
co-workers Chapter 28 Added image of paranasal sinuses, new
Chapter 4 Introduction to Behavioral Health Issues, Medical Terminology focus feature and
Substance Abuse, and Gender Identity and “Diagnostic Exams and Tests” heading under
Sexuality and more detail about Roadblocks to Pathophysiology section
Effective Communication Chapter 29 New Medical Terminology focus feature and
Chapter 5 POLST, Advance Medical Directive, DNR, “Diagnostic Exams and Tests” heading under
and DNAR Pathophysiology section
Chapter 6 OPIM, transmission-based precautions, and Chapter 30 New Medical Terminology focus feature and
OSHA education and training requirements for “Diagnostic Exams and Tests” heading under
ambulatory care Pathophysiology section
A CLOSER LOOK xxiii
ISTUDY
Chapter 31 New Medical Terminology focus feature and Chapter 44 Added section about Point of Care tests
“Diagnostic Exams and Tests” heading under Chapter 45 Revised content about microscope, CLIA
Pathophysiology section Certificate of Waiver, and calibration and
Chapter 32 New Medical Terminology focus feature and control samples
“Diagnostic Exams and Tests” heading under Chapter 46 Added CDC’s “Be Antibiotics Aware”
Pathophysiology section information on antibiotic resistance avoidance
Chapter 33 New Medical Terminology focus feature and Chapter 47 Revised the text and illustrations for
“Diagnostic Exams and Tests” heading under clarity, and replaced some illustrations with
Pathophysiology section photographs; added new photos for bacteria,
Chapter 34 New Medical Terminology focus feature and yeast, and parasites
“Diagnostic Exams and Tests” heading under Chapter 48 Reorganized information for clarity and added
Pathophysiology section new learning outcome, new information about
Chapter 35 Updated CDC Reportable Diseases ESR, and performing blood collection; added
Chapter 36 Clarified communication with child, updated requisition form to chapter
tables Chapter 49 Moved Pulse Oximeter information to
Chapter 37 Updated normal vital signs measurements, added Chapter 37
Points on Practice for Body Measurements, Chapter 50 Added information about the problem with eye
moved Pulse Oximeter to this chapter. makeup causing MRI artifacts
Chapter 38 Added new Caution: Handle with Care feature Chapter 51 Updated drug names and addressed look-alike/
“Understanding Communication Barriers” sound-alike drugs
Chapter 39 New Figure 39-3 of mammogram Chapter 52 Added media resources to improve understanding
Chapter 40 Expanded the list of tests routinely performed Chapter 53 New images of calibrated spoons and oral
as part of neonatal screening to include cystic syringes; additional information about needle
fibrosis, biotinidase deficiency, galactosemia, selection
hypothyroidism, and sickle cell disease Chapter 54 New images of crutch gaits to improve
Chapter 41 Added more challenges faced by geriatric understanding
patients, updated hypertension per AHA Chapter 55 New images of nutrients; added celiac and
guidelines nonceliac gluten sensitivity, allergy treatments,
Chapter 42 Added chondrosarcomas to Table 42-1; preventing obesity
updated several images; added chemical and Chapter 57 Updated tourniquet usage, changed triage
nuclear stress tests information to prioritization protocols in Caution box:
Chapter 43 Revised types of vision test and included Planning and Implementing a Preparedness
contrast sensitivity and functional acuity tests; Plan for Pandemic Illness
added Weber and Rhine hearing tests with Chapter 58 Stressed leaving options open in the
images “Professional Objective” section of the résumé
xxiv A CLOSER LOOK
ISTUDY
A Guided Tour
Learning Outcomes, Key Terms, • ABHES (Accrediting Bureau of Health Education Schools)
Competencies and Curriculum
and Textbook Organization
• AAMA (American Association of Medical Assistants)
Every learning outcome in Medical Assisting, seventh edition,
CMA (Certified Medical Assistant) Occupational Analysis
is aligned with a level I heading. McGraw-Hill has made it even
easier for students and instructors to find, learn, and review • AMT (American Medical Technologists) RMA (Regis-
critical information. The chapter organization of the seventh tered Medical Assistant) Task List
edition is organized to promote learning based on what a medi- • AMT (American Medical Technologists) CMAS (Cer-
cal assistant does in practice. The chapters build on one another tified Medical Assistant Specialist) Competencies and
to ensure student understanding of the many tasks they will Examination Specifications
be expected to perform. The chapters can be easily grouped • NHA (National Healthcareer Association) Certified Clini-
together to create larger topics or units for the students to learn. cal Medical Assistant (CCMA)
For ease of understanding, content can be organized asConfirming
follows:
Pages • NHA (National Healthcareer Association) Certified Medi-
• Unit One, Medical Assisting as a Career—Chapters 1, 3, 4, 5 cal Administrative Assistant (CMAA)
• Unit Two, Safety and the Environment—Chapters 6, 7, 9 • CMA (AAMA) Certification Examination Content Outline
• Medical Records
Unit Three, Communication—Chapters 12, 14, 15 əə • NCCT (National Center for Competency Testing) National
Certified Medical Assistant (NCMA) Detailed Test Plan
• and Documentation
Unit Four, Administrative Practices—Chapters 15 to 20
• NAHP (National Association for Health Profession-
• Unit Five, Applied Anatomy and Physiology—Chapters 21
als) Nationally Registered Certified Medical Assistant
to 34
C A S E S T U D Y
for his rescue inhaler in (NRCMA) content outline
Unit Six, Clinical Practices—Chapters 35 to mother 44 has brought him
the last several days. His
• Patient Name DOB
to the appointment, but Allergies • NAHP (National Association for Health Professionals)
PAT I E N T I N F O R M AT I O N
• Unit Seven,
Mohammad
Nassar
Assisting
05/17/2005 NKA with Diagnostics—Chapters 45 to 50
Mohammad Nassar has
asked that she remain Nationally Registered Certified Administrative Health
Unit Eight, Assisting in Therapeutics—Chapters during his51 to 55
in the reception area
• appointment. Assistant (NRCAHA) content outline
Attending She does give you a list
MRN Other Information
• Unit Nine,
Elizabeth H. Medical Assisting Practice—Chapters
00-AA-007 56 to 58
of Mohammad’s current
asthma medications and • CAHIIM (Commission on Accreditation for Health Infor-
Williams, MD
matics and Information Management Education)
©David Sacks/Getty Images
the previously completed
Key terms are called out at the beginning of each chapter and
new patient documents.
Keep Mohammad Nassar (and his mother) in mind as
arepractice
set andincomesbold to the throughout
office today for an annual the
Mohammad Nassar is a teenage male who is new to the
physicaltext
of theto further promote the mas-
you study this chapter. There will be questions at the end
chapter based on the case study. The information in
• SCANS Correlation
examination. He has a known past medical history of asthma,
terywhich
of has learning
been relatively stableoutcomes.
until recently. He states when
he arrives that he has been experiencing an increasing need
the chapter will help you answer these questions.
Correlations to these are included with the instructor
resources located on Connect (see later pages for informa-
tion about Connect™). In addition, CAAHEP requires that all
L E A R N I N G O U T C O M E S K E Y T E R M S
After completing Chapter 11, you will be able to:
audit review of systems
medical assistants be proficient in the 71 entry-level areas of
11.1 Explain the importance of patient medical
records. CHEDDAR sign competence when they begin medical assisting work. ABHES
requires proficiency in the competences and curriculum con-
11.2 Identify the documents that constitute a patient demographic source-oriented medical
medical record. record (SOMR)
documentation
11.3 Compare SOMR, POMR, SOAP, and CHEDDAR
medical record formats.
noncompliant
subjective
Subjective, Objective, tent at a minimum. The opening pages of each chapter provide
Confirming Pages
a list of the areas of competence that are covered within the
objective Assessment, and Plan
11.4 Recall the six Cs of charting, giving an example of
each. patient record/chart (SOAP)
11.5 Describe the need for neatness, timeliness,
accuracy, and professional tone in patient
problem-oriented medical
record (POMR)
symptom
transcription
chapter.
records.
11.6 Illustrate the correct procedure for correcting and
updating a medical record. M E D I C A L A S S I S T I N G C O M P E T E N C I E S
11.7 Describe the steps in responding to a written CAAHEP ABHES
request for release of medical records.
V.P.1 Use feedback techniques to obtain patient 3. Medical Terminology
information including: d. Define and use medical abbreviations when
(a) reflection appropriate and acceptable
(b) restatement
4. Medical Law and Ethics
Content Correlations V.P.11
(c) clarification
Report relevant information concisely and
accurately
a. Follow documentation guidelines
b. Institute federal and state guidelines when:
Medical Assisting, seventh edition, also provides a correlation VI.C.4 Define types of information contained in the
patient’s medical record
(1) Releasing medical records or information
5. Human Relations
structure that will enhance its usefulness to both students and VI.C.5 Identify methods of organizing the patient’s h. Display effective interpersonal skills with patients
and health care team members
medical record based on:
instructors. We have been careful to ensure that the text and
boo08549_ch11_225-249.indd 225 05/30/19 06:43 PM (a) problem-oriented medical record (POMR)
(b) source-oriented medical record (SOMR)
7. Administrative Procedures
a. Gather and process documents
supplements provide coverage of topics crucial to all of the VI.C.6 Identify equipment and supplies needed for g. Display professionalism through written and
medical records in order to: verbal communications
following: (a) Create
(b) Maintain
(c) Store
• CAAHEP (Commission on Accreditation of Allied Health VI.P.3 Create a patient’s medical record
Education Programs) Standards and Guidelines for Medi- You will also find that each procedure is correlated to the
VI.P.4 Organize a patient’s medical record
X.C.3 Describe the components of the Health
cal Assisting Education Programs ABHES and CAAHEP competencies within the workbook on
Information Portability and Accountability Act
(HIPAA)
X.P.2 Apply HIPAA rules in regards to:
(a) privacy
X.P.3
(b) release of information
Document patient care accurately in the
xxv
medical record
X.A.2 Protect the integrity of the medical record
ISTUDY
Confirming Pages
the procedure sheets. These sheets can be easily pulled out P R O C E D U R E 1 2 - 1 Creating a New Patient
of the workbook and placed in the student file to document Record Using EHR Software
proficiency. Procedure Goal: To create a new patient record using EHR

software
RATIONALE: This is a legal record. The information must
be entered completely and correctly.
8. Any field marked with an * is a required field. For
OSHA Guidelines: This procedure does not involve exposure
instance, the patient’s address is a required field, as
Chapter Features
to blood, body fluids, or tissue.
is the identification number. The insurance name field
must be completed with the insurance company name.
Materials: Initial patient forms (patient information,
This field may also be used if the patient does not have
advance directives, physician notes, referrals, and laboratory
Each chapter opens with material that includes the Case orders)
insurance by entering “none” or used temporarily if
the patient has insurance that is new to the practice
Study, the learning outcomes, a list of key terms, the ABHES Method:
1. From the home screen, select “Tools” from
that must be entered into the system. In any case, the
insurance name field is required.
and CAAHEP medical assisting competencies covered in the

RATIONALE: A required field is considered essential
the left side of the screen. information by the practice, so the field cannot be
2. On this Administrative tools screen, under the skipped.
chapter, and an introduction. Since the learning outcomes Information Management window, click on the blue bar
labeled “Manage practice data.”
9. Continue entering the information in each field, and use
the scroll bar on the right-hand side of the screen to see
represent each of the level I headings in the chapter, they serve 3. At the next screen, Information Management List, choose
“Patient Information.” At the top of the Patient Listing,
all of the fields.
10. Inspect all information for accuracy. Once you are
as the chapter outline. Chapters are organized into topics that click the “Add New Patient” button.
4. The patient’s chart number will auto-populate on the
satisfied that all information is complete and accurate,
click the “Add Patient” button to save the patient
move from the general to the specific. Updated color photo- new patient screen.
5. If a patient photo is available, select the “Add image”
information.
RATIONALE: This information will become part of the
graphs, anatomical and technical drawings, tables, charts, and • Points on Practice feature boxes provide guidelines
button to upload the image.
6. Using the patient registration form completed by the
patient’s permanent medical record. Proofread all
information and verify accuracy before saving.
text features help educate the student about various aspects on keeping the medical office running smoothly and
patient, carefully enter information in each field for this
new patient.
11. At the confirmation box, which gives the patient’s
name and assigned chart or medical record number,
of medical assisting. The text features include the following: efficiently.

7. Some fields, such as gender and marital status, are
completed using a drop-down box obtained by clicking
click “OK.”
RATIONALE: The confirmation must be “okayed” or the
the arrow to the right of the field. patient’s record will not be saved.
• Case Studies are provided at the beginning of all chapters. • Educating the Patient feature boxes focus on ways to
P Rinstruct
OCEDURE patients about incaring
1 2 - 2 Checking for themselves
and Rooming a Patient Usingoutside an the
They represent situations similar to those that the medical Electronic Health Record
assistant may encounter in daily practice. The case studies medical office.
Procedure Goal: To follow standard procedures for check- 3. Scroll through the schedule to locate the desired patient,
include pictures of each of the patients who comeConfirming

to BWW Pages •ing inCaution: Handle
and rooming a patient using with
an electronic health recordCare and feature boxes cover the pre-
double-click the entry to open the appointment
information.
Medical Associates for care (and, where applicable, match- cautions
to blood, to be taken in certain“Check
body fluids, or tissue. situations
In” button at the or
bottomwhen perform-
4. On the open patient appointment screen, click the
Confirming
of the screen. Pages
ing avatars in the new and ABAs). Students are ingorcertain

information tasks.
Materials: Access to the patient’s EHR and other pertinent
documents containing the patient’s vital signs
RATIONALE: If the patient is not checked in to the
practice, no information can be added to the medical
əə
and measurements record.
Medical Records
encouraged to consider the case study as they read each chap-
ter. Case Study Questions in the end-of-chapter review check
Method:
1. Using
CA Uthe
from T Imenu
at the home screen, select “Schedules”
O Non: theHleftAsideND L Escreen.
of the
5. Complete the additional information related to
the patient’s appointment on the next screen.
This includes auto, employment, or other accident.
W I T H C A R E The default answer for each question is “No.”
and Documentation
students’ understanding and application of chapter content. 2. From the provider drop-down, choose the provider
Maintaining
today’s date.
Standards of Cleanliness
the patient is to see and verify that the default date is
Cleanliness is (and should be) one of a medical office’s hallmarks.
in Should the visit be related to one of these accident
thechange
types,
4. down
Reception
the entire
Spot-clean
Areato “Yes.” Scroll
the default answer
areasfield
that and enterdirty.
become any (Remove
additional scuffmarks.
Not RATIONALE: To locate
only is cleanliness the correct
required patient,
in the the correct
examination and testing information related
Clean upholstery to the patient’s appointment,
stains.)
Confirming Pages provider
rooms, andexpected
it is also the date ofinservice mustreception
the patient be chosen. area. A messy including the “Date of current illness, injury,
5. Disinfect areas of the reception area if they have been
patient reception area reflects badly on the practice. Patients exposed to body fluids. (Immediately clean and disinfect all
for his rescue inhaler in
may think, “If they don’t care about this, what else do they not
C A S E S T U D Y the last several days. His
care about?” Maintaining standards of cleanliness helps ensure
soiled areas.)
E L E C T R O N I C H E A LT H R E C O R D S 153
mother has brought him 6. Handle items with care. (Take precautions when carrying
Patient Name DOB Allergies
that the reception area is presentable and inviting at all times. potentially messy or breakable items. Do not carry too much
to the appointment, but
As a medical assistant, you may be involved—along with the
PAT I E N T I N F O R M AT I O N
Mohammad Nassar has at once.)

Mohammad 05/17/2005 NKA physician, office manager, and other staff members—in setting
O U TNassar
COME KEY POINTS
asked that she remain the office’s cleanliness standards. Standards are general guide- After the standards have been established, type and post
in the reception area lines. In addition to153 setting standards, you will need to specify the them in a prominent place for the office staff (but not the
boo7707X_ch12_142-159.indd 10/10/19 08:28 PM
11.6 Illustrate the correct procedure for correcting and The proper way to make corrections in aduringmedicalhis appointment.
record is to tasks required to meet each standard. You also may want to cre- patients) to see. The cleaning activities checklist may be posted,
updating a medicalMRN
Attending record. Other Information draw a single line through the error so thatShethedoes giveentry
original you a list ate a checklist of the tasks required to meet all of these standards. but the person responsible for cleaning the office also should
of as
is still legible. Make the correction as close Mohammad’s
possible to thecurrent The following list outlines standards you may want to con- keep a copy. It is everyone’s duty to keep the office looking
Elizabeth H. 00-AA-007 asthma medications
original entry, noting the reason for the correction, and initial theand clean and presentable.
Williams, MD sider. Specific housekeeping tasks for meeting those standards
correction. Any additions to a medical record also shouldcompleted
the previously be made A schedule of specific daily and weekly cleaning activities
©David Sacks/Getty Images are included in parentheses.
as soon as the need for the addition is noted, and thedocuments.
new patient reason for also should be posted. Less frequent housekeeping duties,
the addition or change should be clearly 1. Keep everything in its place. (Complete a daily visual check
Keep Mohammad Nassar (and documented.
his mother) in mind as such as laundering drapes, shampooing the carpet, and clean-
Mohammad Nassar is a teenage male who is new to the for out-of-place items. Return all magazines to racks. Push ing windows and blinds, can be noted in a tickler file so that
11.7 Describe
practice the steps
and comes in office
to the responding to aan
today for written
annualrequest
physical In you
orderstudy this chapter.
to release There medical
any confidential will be information,
questions atexpress
the end
chairs back into place.)
of thepermission
chapter based onpatient
the case they will be performed on a regular basis.
for release of medical records. written from the muststudy. The information
be received. Unless it in 2. Dispose of all trash. (Empty trash cans. Pick up trash on the
examination. He has a known past medical history of asthma, It is always a good idea to have a second staff member
is the chaptertowill
impossible help
do so, you should
copies answerbethese
madequestions.
and the originals floor or on furniture.)
which has been relatively stable until recently. He states when responsible for periodically working with the medical assis-
should remain in the office. If originals must be released, a
he arrives that he has been experiencing an increasing need 3. Prevent dust and dirt from accumulating on surfaces. tant on housekeeping responsibilities. That person also may
statement of responsibility should be signed by the receiver and
should be noted in the patient’s chart. Follow-up should take place (Wipe or dust furniture, lamps, and artificial plants. Polish be responsible for handling cleaning duties when the medical
until the original records are returned to the office and to the doorknobs. Clean mirrors, wall hangings, and pictures.) assistant is away from the office.
patient’s record. Only release records that are expressly requested
©David Sacks/Getty Images and authorized by the patient.
L E A R N I N G O U T C O M E S K E Y T E R M S waste, is waste that can be dangerous to those who handle Parking Arrangements
After completing Chapter 11, you will be able to: it or to the environment. Infectious waste includes human Although some patients walk to the medical office or take
• Pathophysiology is featuredpublic
inbytransportation,
each of thePatients
waste, human tissue, and body fluids such as blood and urine.
chapters on
audit review of systems the majority of patients will probably
11.1 Explain the importance of patient medical
CHEDDAR sign It also includes any potentially hazardous waste generated in
travel their personal vehicles. who drive to the
records.
the treatment of patients, such as needles, scalpels, cultures of
11.2 Identify the documents that constitute a patient
C A S E
medical record.
S T U D Y C R I T demographic
I C A L T
source-oriented medical
H Irecord
N (SOMR)
K I N G anatomy and physiology. These
human cells, and dressings. sections
office need a place to park.
provide students
The office can offer either on-street parking or a parking lot
documentation Although infectious waste is not commonly generated in
or parking garage. On-street parking requires patients to fend for
11.3 Compare SOMR,
medical record
POMR, SOAP,
Recall Mohammad
formats.
fromand CHEDDAR
the case study at the
subjective
physician? What documents should he have brought with
noncompliant
Subjective, Objective,
with details of the most common diseases and disorders of
the patient reception area, it can happen—for example, when
a patient vomits or bleeds on the rug or on furniture. If that
beginning of the chapter. Now that you have him, if available?
11.4 Recall the six Cs of charting,
completed giving
the chapter, an the
answer example of
following
objective Assessment, and Plan
2. Your office uses a SOAP format for medical records. After each body system and include information on the causes,
situation should occur, you must clean up the waste promptly.
Remember, infectious waste must be handled in accordance
each. questions regarding his case. patient
Dr. Williams completes her exam,(SOAP)
record/chart explain where each of the
11.5 Describe the 1. As a new
need for patient,
neatness,which documents
timeliness, new documents or pieces
problem-oriented medical of symptom
information obtained during common signs and symptoms, diagnostic exams and tests,
with federal law and following OSHA guidelines. Your office
may choose to purchase commercially prepared hazardous
accuracy, andshould be completed
professional tone inprior to
patient Mohammad’s
record (POMR) exam will be filed using the SOAP format.
transcription
records. Mohammad being seen by the treatment, and, where possible, the prevention
waste kits for use in cleaning up spills. After cleaning infec-
tious waste from the patient reception area, deposit it in a of each
Confirming Pages
11.6 Illustrate the correct procedure for correcting and
disease.
©David Sacks/Getty Images
biohazard container. Disinfect the site to eliminate possible
updating a medical record. contamination of other patients. Refer to the chapter Infection
11.7 Describe the steps in responding to a written Control Fundamentals to review OSHA guidelines and stan-
request for release of medical records. dard precautions.
©David Sacks/Getty Images PAT H O P H Y S I O L O G Y LO 23.11
E X A M P R E P A R A T I O N Q U E S T I O N S Office Access for All LO 7.10
1. (LO 11.1) The process of recording information in a 3. (LO 11.2) Which document serves as the “base” for the Common Diseases
The path patients must and Disorders
take to get from the parking area or
ofstreet
the toSkeletal
the office System
and then back out again is called the office
• Procedures give step-by-step instructions on how to per-
patient’s medical record is called
a. Auditing
patient medical record?
a. The registration form
access. Some offices have easier access than others, but ease
is isa important
general term
FIGURE 7-13 All patients should have access to ample parking and
Arthritis
of access to yourmeaning
patients,“joint inflammation.”
particularly those who easy access to the office.
form specific administrative or clinical tasks that a medical
b. SOAP
c. CHEDDAR
b. The patient medical history form
c. The physical examination form
Although
are olderthere are more than
or differently abled100 types
(see of arthritis,
Figure 7-13). we will dis-
cuss the two most common types: osteoarthritis and rheuma-
©McGraw-Hill Education/David Moyer, photographer
d. Documentation d. The patient demographic form

assistant will be required to perform. The procedures are
e. Demographics e. The patient review of systems
toid
130arthritis.
CHAPTER 7
2. (LO 11.1) Which of the following are possible uses for 4. (LO 11.2) Which of the following documents from other OSTEOARTHRITIS, also known as degenerative joint disease
referenced within the content when discussed and found in
patient medical records?
a. Research
sources frequently become part of a patient’s medical
record?
(DJD), is the most common type of joint disorder, affecting
nearly everyone to some degree by the age of 70. DJD primarily
their entirety at the end of the chapter. In the workbook, the
boo08549_ch11_225-249.indd 225 05/30/19 06:43 PM
b. Quality of care (quality control) a. X-rays, CT scan, and MRI results affects the weight-bearing joints of the hips and knees, and the
c. Patient education b. Lab results from private labs or hospitals cartilage between the 130
boo08549_ch07_114-142.indd bones and the bones themselves begin 05/30/19 05:49 PM
tearable procedure sheets mirror the exact procedures in

d. Quality of care (quality control) and patient education only
e. Research, quality of care (quality control), and patient
c. Hospital discharge summaries
d. Hospital operative notes
to break down.
Causes. Research points to inflammatory processes or
FIGURE 23-14 X-ray image of the Birmingham Hip Resurfacing
prosthesis of the left hip.
the book and allow for easy practice and assessment. Criti-
education e. All of these ©Total Care Programming, Inc.
metabolic disorders as the etiology of DJD.
Signs and Symptoms. These include joint stiffness, aching, Causes. RA is an autoimmune disease. The body’s immune
cal procedures also can be studied in Clinical or Admin-
248 CHAPTER 11 and pain, especially with weather changes. There is often fluid
around the joint and grating noises with joint movement. The
system attacks the synovium (lining) of the joints, triggering
inflammation.
istrative skills video exercises on Connect, as well as new grating noise is usually caused by bone-on-bone contact. Signs and Symptoms. In this disease, immune system attacks
Diagnostic Exams and Tests. X-rays of the affected joint are cause edema (swelling), tenderness, and warmth in and around
step-by-step videos of the procedures using the
boo08549_ch11_225-249.indd 248
. 05/30/19 06:43 PM
used to determine if osteoarthritis is present. Blood tests are
used to rule out rheumatoid arthritis.
the joints. Tissue becomes granular and thick, eventually
destroying the joint capsule and bone. Scar tissue forms, bones
Treatment. Anti-inflammatory drugs, including aspirin and atrophy, and visible deformities become apparent due to the
nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen bone malalignment and immobility. Patients also have moderate
to severe pain in the affected joints.
xxvi A GUIDED TOUR and Feldene®, may be used. Intra-articular steroid injections may
be tried for severe cases. In some cases, a series of injections Diagnostic Exams and Tests. Magnetic resonance imaging
of hyaluronic acid–containing medications is used when other (MRI) and X-rays in conjunction with blood tests are used to
treatments do not work. These injections serve as joint fluid diagnose RA.
replacement. Some success has been found with transplanting
ISTUDY harvested cartilage cells from the patient’s healthy knee
Treatment. Treatment includes anti-inflammatory drugs, exercise,
heat or cold treatments, and cortisone injections. Researchers are
cartilage, which are then grown in the lab and reinjected into working with genetic techniques to block the immune system
RATIONALE: This allows you to enter the name of a slot” button. engines.
new patient, or once you enter a few letters of an 7. (LO 15.6) Which of the following would least likely be
Use the From and To calendars at the top of the
existing patient, choose the correct patient from the in the patient information packet?
window to choose the desired date range.
drop-down list. a. Office policies and hours Go to CONNECT to complete the EHRclinic exercises:
Choose the appointment duration to change the 15.01 Document Administration of Patient Education
7. Verify the correct provider for this appointment is listed, b. Patient instruction sheet regarding common tests done
default duration time, if required. and 15.02 Document Administration of Pre- and
or select the correct provider. Select the appointment at the practice
type, either “New appointment” or “Follow up,” using the From the list produced, choose the requested time c. Patient instruction sheet about healthy living Post-Operative Instructions.
Each chapter closes with a summary of the Learning • Soft Skills Success practice scenarios emphasize employ-
drop-down arrow to the right of the field. slot and click “Select.” d. List of the physicians with their qualifications
RATIONALE: The visit type is required to give the provider If repeated appointments are required, use the e. Patient confidentiality statement
Outcomes. The summary is followed by an end-of-chapter

an idea of the type of visit scheduled.
8. Creating the appointment may be done in two ways:
repetition type required and the end date for the
repetitions. ability skills and critical thinking in complex situations.
8. (LO 15.7) What visual tool is especially helpful when
performing preoperative education?
review with questions related to the case study, as well as 10

RATIONALE: This makes it easier to complete multiple
using the Calendar or using the Find free slot option.
a. Using the Calendar option, select the date and time appointments for a patient at one time. These new exercise features are included in most non-A&P
a. Anatomical model
b. Printed information sheet
multiple-choice exam-style questions.

c. Line drawing
for the visit by clicking the current date and opening
9. Enter the reason for the appointment, verify that all
the calendar. Choose the date requested and then the
information is correct, and click “Schedule.” chapters and are correlated to Practice Medical Office and
d. Class or seminar
e. Sensory teaching
Application-Based Activities where applicable.
S U M M A R Y O F L E A R N I N G O U T C O M E S
OUTCOME KEY POINTS
12.1 List four medical mistakes that will be greatly Medical mistakes that will be greatly decreased or eliminated
decreased through the use of EHR. with EHR include lost or misfiled paper records, mishandled S O F T S K I L L S S U C C E S S
or “forgotten” patient messages, inaccurate or unreadable
information in a paper medical record, and mislabeled or A 35-year-old male patient is scheduled for a vasectomy
unreadable laboratory or prescription orders. tomorrow. It is within your scope of practice to provide
preoperative instruction, and you feel confident in performing
12.2 Differentiate among electronic medical records, The electronic medical record is an electronic record of health- this task. When you introduce yourself and explain what you
electronic health records, and personal health related information for an individual patient that is created, are going to do, the first words out of the patient’s mouth are, Go to PRACTICE MEDICAL OFFICE and complete
records. compiled, and managed by providers and staff members located “How do you know what this is all about? I am the one who the module Admin: Check Out - Interactions.
within a single healthcare organization. An electronic health is getting things cut!” How would you respond to this patient?
record is created, managed, and gathered in a manner that
conforms to nationally recognized interoperability standards,
so that members of more than one healthcare organization can
utilize it. A personal health record is an electronic version of the
comprehensive medical history and record of a patient’s lifelong
health that is collected and maintained by the individual patient.
12.3 Explain the concept of meaningful use, identifying at Meaningful use describes EHR as improving quality, safety,
The book also includes a glossary and three appendices
least two of its goals. and efficiency, and reducing health disparities. It engages the
patient and family as well as improves coordination of care for for328 use as reference tools. The glossary lists all the words
CHAPTER 15
population and public health. Maintenance of the privacy and

security of PHI also is required. The goals include better clinical presented as key terms in each chapter, along with a pronun-
outcomes, improved population health outcomes, increased
transparency and efficiency, empowered individuals, and more ciation guide and the definition of each term. The appendi-
robust research data on health systems. boo08549_ch15_308-328.indd 328 05/30/19 05:59 PM
ces present a list of common medical terminology, including

prefixes, root words, and suffixes, as well as medical abbre-
E L E C T R O N I C H E A LT H R E C O R D S 155
viations and symbols. A Diseases and Disorders appendix
• Medical Terminology practice exercises have been added provides a quick reference point for patient conditions that the
to all the anatomy and physiology chapters.
boo7707X_ch12_142-159.indd 155 10/10/19 08:28 PM
student may encounter.
A GUIDED TOUR xxvii
ISTUDY
Digital Materials for Medical Assisting
For the seventh edition, we enhanced the integration between • Medical Terminology Practice*
the textbook and our digital study materials and expanded ∘ A refresher area for the body systems chapters with
our offerings to better cover all aspects of medical assisting. Word Part exercises on select terms as well as audio
Links between the textbook and the key study resources are terms with associated spelling practice.
highlighted by eye-catching icons divided by resource type. • NEW! Math and dosage videos with questions that rein-
Digital study resources with icons include BodyANIMAT3D, force basic math needed by Medical Assistant students.
electronic health record exercises, and both Admin- • NEW! Practice Atlas exercises for all of the Anatomy and
istrative and Clinical Skills videos. Real-life practice opportu- Physiology chapters. The Practice Atlas for Anatomy &
nities include Practice Medical Office and Application-Based Physiology is an interactive tool that pairs images of com-
Activities, with icons at the end of the chapter. mon anatomical models with stunning cadaver photography,
which allows students to practice naming structures on both
models and human bodies. Additional multiple choice ques-
tions for practice are available as assignments in Connect.
• A completely revised and updated Test Bank (also avail-
Go to CONNECT to see a video exercise about
Establishing and Conducting the Supply
able through the Instructor Resources).
Inventory and Receiving Supplies. As part of Connect for Medical Assisting, we also offer Smart-
These different types of icons are then used to call out Book’s adaptive reading experience, which is powered by
specific activities and exercises by name. For example, above LearnSmart, the most widely used adaptive learning resource.
you can see an icon for Connect skills videos (the resource) For more information on Connect—the teaching and
about Establishing and Conducting Supply Inventory and learning platform used with all McGraw-Hill Education
Receiving Supplies (the exercise name). products—and SmartBook, look for the section Connect,
Required=Results.
McGraw-Hill Connect® Medical Assisting Simulations and Games for Medical Assisting
A number of our key resources for Medical Assisting, 7e—
, McGraw-Hill’s NEW electronic health record
including BodyANIMAT3D activities, skills video exercises,
tool, allows for the look and feel of a real electronic health
and electronic health records exercises—are part of
records system fully integrated with CONNECT.
our Connect offering for Medical Assisting.
provides over 101 exercises directly correlated to 34 chapters
Here is more on what you can expect to find in Connect for
of Booth Medical Assisting, 7e, with Chapter 12 Electronic
Medical Assisting, 7e, specifically:
Health Records being the most robust. These actionable exer-
• NEW! Exercises cises allow students to navigate the tool, provid-
∘ Over 101 electronic health record actionable exercises ing practical experience using electronic health records while
correlated to over 34 chapters of Booth Medical Assisting, they learn the tasks of a medical assistant. These simulated
7th edition. These simulated exercises allow students to exercises are assignable in Connect and are autograded.
navigate the tool while learning the tasks of a Chapter 12 includes 23 exercises that take the student through
Medical Assistant. the paces of electronic health records including administra-
• NEW! financial practice management exer- tive functions and financial management. Completion of these
cises designed to provide students with practical experi- exercises in total provides the basis for documenting elec-
ence with electronic billing, charge capture, payment tronic health record practical experience and gives the student
posting, and more. “the big picture.”
• Pre- and Post-Tests
• End-of-Chapter Exercises
• Interactive Exercises
• Administrative and Clinical Skills Video Exercises*
In Practice Medical Office (PMO), the student takes on
• BodyANIMAT3D Exercises*
the role of a new medical assistant in a 3D, immersive game
• ICD-10 Coding Exercises* focused on teaching the six key skills important to work-
∘ Utilizing scenarios developed by the authors, students ing in a medical office—professionalism, soft skills, office
can practice identifying and inputting the proper ICD- acumen, liability, medical knowledge, and privacy. Prac-
10 codes. tice Medical Office features 12 engaging and challenging
*in applicable chapters
xxviii
ISTUDY
FIGURE FM-2 The new
FIGURE FM-3 A new Application-Based Activity (ABA)

modules representing the functional areas of a medical prac- experience, with the ability to practice steps in key Proce-
tice: administrative check-in interactions, clinical interactions, dures outside a lab and “virtually” with an instructor. Along
and administrative check-out interactions. As the players with the Procedure ABAs, students will be able to practice
progress through each module, they will be faced with realis- real-life Scenario ABAs that call upon decision making
tic situations and learning events that will test their mastery of and application of medical assisting knowledge. Depending
critical job readiness skills in a fun, engaging learning expe- on the ABA, students will be graded on Objectives such as
rience. The PMO modules will be found together with the Clinical Skills, Administrative Skills, Interpersonal Skills,
Application-Based Activities described below. Communication, and more, all of which are aligned with
For a demo of Practice Medical Office, please go to http:// ABHES and CAAHEP standards in the instructor materials.
www.mhpractice.com/products/Practice_Medical_Office and Find a full list of the ABAs, as well as resources for how to
click on “Play the Demo.” An instructor’s manual for PMO, cor- incorporate in your course, in the Instructor Resources on
related to ABHES and CAAHEP standards by learning event, is Connect.
available in your Instructor Resources on Connect. On Connect, both the PMO modules and the ABAs can
For the NEW Application-Based Activities, or be found within the “Add Assignment” menu, under “MH
ABAs, the student is immersed in a brief, microsimulation Practice Activity” (title at publication).
D I G I TA L M AT E R I A L S F O R M E D I C A L A S S I S T I N G xxix
ISTUDY
FOR INSTRUCTORS
You’re in the driver’s seat.

Want to build your own course? No problem. Prefer to use our
turnkey, prebuilt course? Easy. Want to make changes throughout the
65%
semester? Sure. And you’ll save time with Connect’s auto-grading too. Less Time
Grading
They’ll thank you for it.

Adaptive study resources like SmartBook® 2.0 help
your students be better prepared in less time. You
can transform your class time from dull definitions to
dynamic debates. Find out more about the powerful
personalized learning experience available in
SmartBook 2.0 at www.mheducation.com/highered/
connect/smartbook
Laptop: McGraw-Hill; Woman/dog: George Doyle/Getty Images
Make it simple, Solutions for your

make it afiordable. challenges.
Connect makes it easy with seamless A product isn’t a solution. Real
integration using any of the major solutions are affordable, reliable,
Learning Management Systems— and come with training and
Blackboard®, Canvas, and D2L, among ongoing support when you need it
others—to let you organize your course and how you want it. Our Customer
in one convenient location. Give your Experience Group can also help
students access to digital materials at you troubleshoot tech problems—
a discount with our inclusive access although Connect’s 99% uptime
program. Ask your McGraw-Hill means you might not need to call
representative for more information. them. See for yourself at status.
mheducation.com
Padlock: Jobalou/Getty Images Checkmark: Jobalou/Getty Images
ISTUDY
FOR STUDENTS
Efiective, efficient studying.

Connect helps you be more productive with your study time and get better grades using tools like
SmartBook 2.0, which highlights key concepts and creates a personalized study plan. Connect sets you
up for success, so you walk into class with confidence and walk out with better grades.
Study anytime, anywhere. “I really liked this

Download the free ReadAnywhere app and access your app—it made it easy
online eBook or SmartBook 2.0 assignments when it’s to study when you
convenient, even if you’re offline. And since the app don't have your text-
automatically syncs with your eBook and SmartBook 2.0
assignments in Connect, all of your work is available book in front of you.”
every time you open it. Find out more at
www.mheducation.com/readanywhere - Jordan Cunningham,
Eastern Washington University
No surprises.
The Connect Calendar and Reports tools keep you on track with the
work you need to get done and your assignment scores. Life gets busy;
Connect tools help you keep learning through it all.
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Learning for everyone.

McGraw-Hill works directly with Accessibility Services
Departments and faculty to meet the learning needs
of all students. Please contact your Accessibility
Services office and ask them to email
[email protected], or visit
www.mheducation.com/about/accessibility
for more information.
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ISTUDY
Additional Supplementary Materials
Student Workbook for Use with you’ve come to expect, all of which can be found through the
Instructor Resources section in Connect.
Medical Assisting, 7e–in print and full
• An Instructor’s Manual that contains everything to orga-
color (ISBN: 978-1-260-47702-3) nize your course, complete with lecture outlines (with
The Student Workbook provides an opportunity for the student PowerPoint slide references), discussion points, learning
to review and practice the material and skills presented in the activities, and case studies. Also included are the answer
textbook. The workbook is divided into parts and presented keys to the book and workbook.
by chapter; the first part provides the following: • Correlation Guides map the standards of many accredi-
• Vocabulary review exercises, which test knowledge of key tation bureaus, including the Accrediting Bureau of
terms in the chapter Health Education Schools (ABHES) Medical A ssisting
• Content review exercises, which test the student’s knowl- competencies and curriculum; the Commission on
edge of key concepts in the chapter Accreditation of Allied Health Education Programs
• Critical thinking exercises, which test the student’s under- (CAAHEP) Standards and Guidelines for Medical Assist-
standing of key concepts in the chapter ing Education Programs competencies; American Asso-
• Application exercises, which include figures and practice ciation of Medical Assistants (AAMA) Occupational
forms and test mastery of specific skills Analysis; the Association of Medical Technologists
(AMT) Registered Medical Assistant (RMA) Certified
• Case studies, which apply the chapter material to real-life
Exam Topics; the National Healthcareer Association
situations or problems
(NHA) Medical Assisting Duty/Task List; the National
Each section, Clinical and/or Administrative, contains Association for Health Professionals (NAHP) Nationally
the appropriate procedures, presented in the order in which Registered Certified Medical Assistant (NRCMA) and
they are shown in the student textbook. These have been Nationally Registered Certified Administrative Health
revised for ease of use and include correlations to the ABHES Assistant (NRCAHA) content outlines; the Commission
and CAAHEP competencies mastered with the successful for Accreditation on Health Informatics and Information
completion of each procedure. Accompanying Work Product Management Education (CAHIIM); and the Secretary’s
Documentation (work/doc) provides blank forms for many Commission on Achieving Necessary Skills (SCANS)
of the procedures that require a specific type of document to areas of competence, as well as others.
complete the procedure. These documentation forms are used • PowerPoint Presentations have been fully updated to
when completing many of the application activities as well include the latest figures and content and to mirror the
as procedure competencies. Over 100 procedures as well as design of the book. Teaching notes offer suggestions—in
multiple application activities in the workbook include cor- addition to those in the Instructor’s Manual—to keep your
related work docs. class running smoothly. We also have taken steps to make
our PowerPoints more accessible, including adding alt tags
Pocket Guide for Use with Medical for images and tables and ensuring that our slides are orga-
Assisting, 7e (ISBN: 978-1-260-47700-9) nized to be easily read by screen readers.
• A Comprehensive Asset Map breaks down all of the
The Pocket Guide is a quick
resources available through the book and Connect by
and handy reference to use
chapter and by learning outcome to help you identify
while working as a medical
what you want to include in your course and where to
assistant or during training.
find it.
It includes critical proce-
dure steps, bulleted lists, and • New! Challenging Topics Asset Map uses Heat Map data
brief information all medical gathered from LearnSmart to determine the most challeng-
assistants should know. Infor- ing topics and Learning Objectives for students and then
mation is sorted by Adminis- gives direction as to what resources and practice activities
trative, Clinical, Laboratory, are available for those Learning Objectives, allowing the
and General content. instructor to focus lectures or group chats on areas most
needed.
Instructor Resources • A Transition Guide to help users of earlier editions make
Medical Assisting also comes the leap to this new edition, with thorough details outlined
with the instructor resources by the authors about changes big and small.
xxxii
ISTUDY
Test Builder in Connect Tegrity: Lectures 24/7
Available within Connect, Test Builder is a cloud-based tool Tegrity in Connect is a tool that makes class time available
that enables instructors to format tests that can be printed 24/7 by automatically cap¬turing every lecture. With a simple
or administered within a LMS. Test Builder offers a mod- one-click start-and-stop process, you capture all computer
ern, streamlined interface for easy content configuration that screens and corresponding audio in a format that is easy to
matches course needs, without requiring a download. search, frame by frame. Students can replay any part of any
Test Builder allows you to: class with easy-to-use, browser-based viewing on a PC, Mac,
iPod, or other mobile device.
• access all test bank content from a particular title.
Educators know that the more students can see, hear, and
• easily pinpoint the most relevant content through robust experience class resources, the better they learn. In fact, stud-
filtering options. ies prove it. Tegrity’s unique search feature helps students effi-
• manipulate the order of questions or scramble questions ciently find what they need, when they need it, across an entire
and/or answers. semester of class recordings. Help turn your students’ study
• pin questions to a specific location within a test. time into learning moments immediately supported by your lec-
• determine your preferred treatment of algorithmic questions. ture. With Tegrity, you also increase intent listening and class
• choose the layout and spacing. participation by easing students’ concerns about note-taking.
Using Tegrity in Connect will make it more likely you will see
• add instructions and configure default settings.
students’ faces, not the tops of their heads.
Test Builder provides a secure interface for better protection Check out the Instructor Resources area on Connect for
of content and allows for just-in-time updates to flow directly additional resources, including an image library, sample syllabi,
into assessments. printable procedure checklists and work documents, and more!
A D D I T I O N A L S U P P L E M E N TA R Y M AT E R I A L S xxxiii
ISTUDY
Acknowledgments
The task of putting together a textbook and all of its supple- Leesa and Terri would like to give a special thanks to
ments, both written and digital, takes a vast amount of cumu- Kathy Booth. Without her tireless work, team spirit, and dedi-
lative effort and coordination among multiple individuals cation to this project, we would not be able to “reach to new
and companies. To acknowledge each of them here individu- heights.” Her grasp of the big picture and her constant happy
ally would take far too long. However, we would like start by nature are an inspiration to us both. It is a pleasure and an
acknowledging McGraw-Hill and all of the individuals who are honor to work with her. Kathy gives many thanks back to
listed in the front of this book for their continued assistance, Terri and Leesa for some extra flying through this edition.
encouragement, and support. A special thanks for those who
are so close to this edition, including Bill Lawrensen, Chip-
per Scheid, Amy Ensign, Ann Courtney, Betsy Blumenthal, Contributors and Reviewers
Lori Hancock, Marlena Pechan, and Marilynn Taylor. Without We, along with McGraw-Hill, would like to thank the review-
McGraw-Hill and its valued employees and subcontractors, ers and contributors for their assistance in developing content,
there would be no need for this acknowledgment to be writ- offering suggestions, and shaping this revision. We appreciate
ten. We’d also like to give a special thank you to those that you. Many of the additions, improvements, and changes are
helped with supplement materials, and new digital tools on due directly to their feedback. We appreciate their insight and
Connect including our ABAs: Amy Ensign, Rhonda Harris- commitment to helping us provide information that is relevant
Scott, Ashita Patel, Tammy Vannatter, and Denise Pruitt. and valuable to medical assisting students.
7e Reviewers Kathy Gaeng, RMA, AHI Vatterott 6e Reviewers

Joseph Balatbat, MD, RMA, RPT, AHI Educational Centers Nick Davis Southern Careers Institute
(AMT), CPT Swedish Institute College of Stefanie Goodman Ivy Tech Community Karlene Jaggan, BIT, PN, NRCAHA
Health Sciences College – Marion Centura College
Tricia Berry, Ph.D Kaplan University Melissa Gauna, CMA South Texas College Shauna Phillips, RMA, CCMA, AHI Fortis
Melissa Bettigole, M.Ed, CMA EMTP Lisa Huehns Lakeshore Technical College College – Phoenix
Northwestern Connecticut Community Greg Klingler, MPAS, DHSc, PA-C David Martinez, MHSA, RMA Vista
College Brigham Young University – Idaho College
LeeAnn Bird, BA, CMA (AAMA) Ivy Tech Jodi Landfair, MS, RMA El Paso County Kristynna Foster, MA, LVN Charter College
Community College – Indianapolis Medical Society Wendy Schmerse, CPC-A, CMRS Southern
Sharon Breeding, MAE Bluegrass Marta Lopez, MD, RMA, BXMO Miami California Health Institute
Community and Technical College Dade College, Medical Campus Henry Gomez, MD ASA College
Mary Elizabeth Browder, M.Ed, CMA Barbara Parker, BSEd, CMA (AAMA), CPC Rebecca Ventura, RN, MSN, RMA
(AAMA) Cuyahoga Community College, Olympic College Davenport University – Saginaw
Metropolitan Campus Kimberly Poag, MHA Ed, CMA (AAMA) Stephanie Bernard, MBA, CMA Sanford-
Donna Carl, BA, BS, MLS Austin Baker College – Owosso Brown College
Community College Lori Rager, CMA (AAMA), CPC, Kristy Royea, MBA, BS, CMA (AAMA),
Denise DeDeaux, AA, BS, MBA Fayette- COC (AAPC) Utah State University EMT-B Mildred Elley College – Albany
ville Technical Community College Eastern Lisa Wright, CMA (AAMA), MT, SH
Jennifer Dietz, MS, CMA (AAMA), PBT Melanie Shearer, MS, MT (ASCP), PBTCM, Bristol Community College
(ASCP)CM Cuyahoga Community CMA (AAMA) Cuyahoga Community Barbara Marchelletta, CMA (AAMA),
College, Metropolitan Campus College, Metropolitan Campus RHIT, CPC, CPT, AHI Beal College
Laura Diggle, MS, CMA (AAMA), CCMA Paula Silver, BS Biology, PharmD College Marion Odom, RMA, NCMA, CPCT,
(NHA) Ivy Tech Community College of Health Science at ECPI University CPT, CEKG Illinois School of Health
– Anderson Jennifer Spencer, CMA (AAMA) Elmira Careers
Nancy Draper, CMA (AAMA), AAS Business Institute Melinda Wray, MA, CMA (AAMA), RMA
Chattanooga State Community College Francisco Velazquez, MD Southern ECPI University
Christine Dzoga, MA Program Director Technical College Gerry Gordon, BA, CPC, CPB Daytona
Malcolm X College – City College of Rebecca Voelker, AAS, BHSA, MBA Baker College
Chicago College Kathleen McCall, MLT (ASCP), NCMA
Melissa Edenburn, MS, RHIA, CCS Austin Amy Voytek, MBA/MHA, MT, CT, RMA DCI Career Institute
Community College Westmoreland County Community Laura Melendez, BS, RMA, RT, BMO
Rene Flemming, RN, ADN ATA College College Keiser University
Deborah Franklin, MSEd, CMRS Bryant & Melanie Zandi, BA, MA Jamestown Adrian Rios, EMT, RMA, NCMA, MA,
Stratton College Community College CPT-1 Newbridge College
xxxiv
ISTUDY
Marlene Schmidt, MT (ASCP), DVM Michael Melvin, RPh, BS Pharmacy Rhonda Harris-Scott BS, MEd The SAC:
Bryant & Stratton College Southern Crescent Technical Scott Academic Consulting
Marilyn Dalton, BS, RHIT, CCS-P, CPMSM College – Griffin Ashita Patel Wake Technical Community
Northeast Alabama Community College Helen Mills, RN, MSN, RMA, LXMO, AHI College
Mary Marks Mitchell Community College Keiser University Tammy Vannatter, BHSA, CMA (AAMA),
Angela LeuVoy, AASMA, CMA, CBCS, Joanitt Montano, MD Blue Cliff College RMA, CPC Baker College
CPT Fortis College Robyn Moore-Ball, RMA, AHI Everest
Luis Cedeno, BS, LPN, CPI Miami Dade College – Bedford Park EHRclinic Contributor
College Jennifer Morrill, CMA (AAMA), RMA Amy Ensign, MBA, CMA(AAMA)
Joshua Farquharson San Joaquin Valley North Central Michigan College RMA(AMT) Baker College
College – Visalia Kim Munson, MA, CMA (AAMA),
Marta Lopez, MD, RMA, BMO Miami RMA (AMT) International College of LearnSmart Contributors
Dade College – Medical Campus Business Ashita Patel Wake Technical Community
Michelle Crissman, JD, MS, RN, CMA Debra Paul, BA, CMA (AAMA) Ivy Tech College
(AAMA) Colorado Technical University Community College Rhonda Harris-Scott The SAC: Scott
Carrie Hammond, CMA (AAMA), RPT, Kathleen Michael J. Perrine, MHA, RMA, Academic Consulting
AAS Eagle Gate College – Murray NCMA, EMT National American Danielle Wilken, Ed.D, MT (ASCP)
Jennifer A. Leach, CCMA-NHA, BS, University Goodwin College
M.Ed McCann School of Business and Donna Riley, CMA (NCCT), AAS Elmira Tammy Vannatter, BHSA, CMA (AAMA),
Technology Business Institute RMA, CPC Baker College
Jean Mosley, BS, AAS, AAS, CMA Bruno Salazar-Perea, RMA, MD Kaplan
(AAMA) Surry Community College University Practice Medical Office Contributors
Jehad Ouri, CMA(AAMA) Ohio Business Jennifer Spencer, CMA (AAMA) Elmira Suzee G. Gay, LPN
College – Sheffield Village Business Institute Sue Coleman, LPN, AS, RMA (AMT)
Kaye Bathe, CMA, BSAH Tri-County Christina Steele, BS, AAGS, RMA Dorsey American National University
Technical College Business School Mario Cesar Villegas, MD Southwest
Karmon Kingsley, CMA (AAMA), BS Joseph H. Balatbat, MD, RMA, RPT, CPhT, University at El Paso
Cleveland State Community College AHI Swedish Institute College of Health David J Holden, CMA (AAMA), RN, MSN
Melinda Hughes-Parnell, MSN, RN Sciences Bryant & Stratton College
Northwest Louisiana Technical College Patti Finney, CMA (AAMA) Ridley Lowell Dr. Marta Lopez, MD, RMA, BMO
– Minden Business and Technical Institute Miami Dade College –Medical Campus
Stacey Wolfe, CMA Community Care Marissa M. Fordunski Plaza College Danielle Wilken, Ed.D, MT (ASCP)
College Rosemarie Scaringella, CBCS, CMAAC Goodwin College
Leeann Yurchenko, CMA (AAMA), RMA, Hunter Business College – Levittown William Hoover II, MD Bunker Hill
CPC Stautzenberger College – South Dawn Surridge, CMA (AAMA), AS, CPI Community College
Petra York, BS, CMA (AAMA), CPT, CET, (NCCT), CPT (NCCT) Ridley Lowell Lori Andrews, MSEd, RN, CMA (AAMA)
CMAA, AHI, CPhT Western Tech Business and Technical Institute Ivy Tech Community College – Indianapolis
Lori Andrews, MSEd, RN, CMA Telcida C. Dolcine, BBA, EMT-B, Daria M Garcia, AAS, RMA, NCMA
(AAMA) Ivy Tech Community College RMA, RPT New York Methodist Kaplan College
– Indianapolis Hospital – Center for Allied Health Helen Mills, RN, MSN, RMA, AHI, LXMO
Cherika de Jesus, CMA National American Education Keiser University
University Constantine Hatzis, MD Mildred Elley – Dr. Barbara Worley, BS, DPM, RMA
Leon Deutsch, MA Ed., RMA Keiser NYC Metro Campus (AMT) King’s College
University Muhammad Khan St. Paul’s School of
Joann Fisher, CMA (AAMA) Elmira Nursing – Queens Instructor’s Manual Contributor
Business Institute (Retired) Jodi Anderson, LVN Newbridge College Denise Pruitt, Ed.D New England Institute
Rachel Houston, CMA (AAMA), AS of Technology
Cabarrus College of Health Sciences Application-Based Activities
Beth Laurenz, BMA, BS, AAS, CMA Contributors Testbank Contributor
(AAMA) Valley View Medical Training Amy Ensign, MBA, CMA(AAMA) Rhonda Harris-Scott BS, MEd The SAC:
Center RMA(AMT) Baker College Scott Academic Consulting
Lynnae Lockett, RN, RMA, CMRS, MSN Jennifer Fendinger, MS, MSed, MT(ASCP),
Bryant & Stratton College RMA(AMT) PowerPoint Contributor
Pamela McNutt, MA, RMA National Deanna Schnebbe, CMA (AAMA) Ashita Patel Wake Technical Community
American University Kirkwood Community College College
ACKNOWLEDGMENTS xxxv
ISTUDY
UNIT ONE: MEDICAL ASSISTING AS A CAREER
Introduction to Medical 1
Assisting
long until he graduates and
C A S E S T U D Y needs to take the test to
become credentialed. He
Employee Name Position Credentials
E M P L O Y E E I N F O R M AT I O N
is nervous about the exam

Sandro Peso Student In Training but really wants to do well
to get the best job he can
to help support his family.
Keep Sandro Peso in
Supervisor Date of Hire Other Information mind as you study this
Malik Katahri, 10/11/2019 Assigned to Dr. Paul chapter. There will be
CMM F. Buckwalter questions at the end of the
chapter based on the case
study. The information in
©Ryan McVay/Getty Images the chapter will help you
Sandro Peso, a father of four in his mid-thirties, lost his job at answer these questions.
a local factory. He is now a medical assistant-in-training and is
currently working at BWW Medical Associates. He will be work-
ing in the administrative, clinical, and laboratory sections of the
office. He wants to decide which area he likes best and where
he might like to work when he finishes his training. It will not be
L E A R N I N G O U T C O M E S K E Y T E R M S
After completing Chapter 1, you will be able to:
accreditation continuing education
1.1 Recognize the duties and responsibilities of a
medical assistant. Accrediting Bureau of cross-training
Health Education Schools Health Insurance Portability
1.2 Distinguish various organizations related to the
(ABHES) and Accountability Act
medical assisting profession.
American Association (HIPAA)
1.3 Explain the need for and importance of the
of Medical Assistants licensed practitioner
medical assistant credentials.
(AAMA)
1.4 Identify the training needed to become a multiskilled healthcare
American Medical professional (MSHP)
professional medical assistant.
Technologists (AMT)
1.5 Discuss professional development as it relates to Occupational Safety and
certification Health Administration
medical assisting education.
Certified Medical Assistant (OSHA)
(CMA) patient navigator
Clinical Laboratory professional development
Improvement
Registered Medical
Amendments of 1988
Assistant (RMA)
(CLIA ’88)
registration
Commission on
Accreditation of Allied résumé
Health Education scope of practice
Programs (CAAHEP) standard of care
ISTUDY
M E D I C A L A S S I S T I N G C O M P E T E N C I E S
CAAHEP ABHES
V.C.12 Define patient navigator 1. General Orientation

V.C.13 Describe the role of the medical assistant as a a. Describe the current employment outlook for the
patient navigator medical assistant
X.C.1 Differentiate between scope of practice and c. Describe and comprehend medical assistant
standards of care for medical assistants credentialing requirements, the process to obtain the
X.C.5 Discuss licensure and certification as they apply credential and the importance of credentialing
to healthcare providers d. List the general responsibilities and skills of the
X.P.1 Locate a state’s legal scope of practice for medical assistant
medical assistants 4. Medical Law and Ethics
f. Comply with federal, state, and local health laws
and regulations as they relate to healthcare settings
(1) Define the scope of practice for the medical
assistant within the state that the medical
assistant is employed
(2) Describe what procedures can and cannot
be delegated to the medical assistant and by
whom within various employment settings
10. Career Development
b. Demonstrate professional behavior
c. Explain what continuing education is and how it is
acquired
Introduction medical assistants include working and communicating with

patients throughout the healthcare experience. In fact, medical
Healthcare is changing at a rapid rate. Advanced technology, assistants often perform the role of patient navigator. They
implementation of cost-effective medicine, and the aging popula- help patients find their way through the sometimes complex
tion are all factors that have caused growth in the healthcare ser- healthcare system, helping them overcome any barriers they
vices industry. As the healthcare services industry expands, the may encounter to help ensure that they get the diagnosis and
US Department of Labor projects that medical assisting will grow treatment they need in a timely manner.
29% between 2012 and 2022, which is much faster than the aver- Medical assistants work in an administrative, clinical,
age for all occupations. The growth in the number of physicians’ and/or laboratory capacity. As an administrative medical
group practices and other healthcare practices that use support per- assistant, you may handle the payroll for the office staff (or
sonnel such as medical assistants will in turn continue to drive up supervise a payroll service), obtain equipment and supplies,
demand for medical assistants. The multifunctional medical assis- and serve as the link between the physician or other licensed
tant is the perfect complement to the changing healthcare industry. practitioner and representatives of pharmaceutical and med-
Medical assistants have the training to perform a variety of ical supply companies. As a clinical medical assistant, you
duties, which qualify them to fill many different job openings in will be the physician’s or other licensed practitioner’s right
the healthcare industry. This chapter provides an introduction to arm by maintaining an efficient office, assisting the practitio-
the medical assisting profession. It presents a general description ner during examinations, and keeping examination rooms in
of your future duties, credentials, and needed training. Some order. Note that a licensed practitioner in healthcare means an
basic facts about professional associations, organizations, and individual other than a physician who is licensed or otherwise
development related to medical assisting also are discussed. All authorized by the state to provide healthcare services. Your
of this will help you understand the career of a medical assistant. laboratory duties as a medical assistant may include perform-
ing basic laboratory tests and maintaining laboratory equip-
Responsibilities of ment. In small practices, you may handle all duties. In larger
practices, you may specialize in a particular duty. As you
the Medical Assistant LO 1.1 grow in your profession, advanced duties may be required.
Your specific responsibilities as a medical assistant will The lists of duties in Table 1-1 are provided to help you bet-
depend on the type, location, and size of the facility, as well ter understand what you will be doing when you practice as a
as its medical specialties. General tasks performed by most medical assistant.
2 CHAPTER 1
ISTUDY
TABLE 1-1 Daily Duties of Medical Assistants
Duty Type Entry-Level Duties Advanced Duties
General • Recognizing and responding effectively to verbal, None
nonverbal, and written communications
• Explaining treatment procedures to patients
• Providing patient education within scope of practice
• Facilitating treatment for patients from diverse
cultural backgrounds and for patients with hearing or
vision impairments, or physical or mental disabilities
• Acting as a patient navigator and advocate
©monkeybusinessimages/
iStockphoto/Getty Images • Maintaining medical records
Administrative • Greeting patients • Developing and conducting public outreach programs to
• Handling correspondence market the licensed practitioner’s professional services
• Scheduling appointments • Negotiating leases of equipment and supply contracts
• Answering telephones • Negotiating nonrisk and risk managed care contracts
• Creating and maintaining patient medical records • Managing business and professional insurance
• Handling billing, bookkeeping, and insurance processing • Developing and maintaining fee schedules
• Performing medical transcription • Participating in practice analysis
©JGI/Daniel Grill/Blend • Arranging for hospital admissions • Coordinating plans for practice enhancement,
Images/Getty Images expansion, consolidation, and closure
• Performing as a HIPAA (Health Insurance Portability
and Accountability Act) compliance officer
• Providing personnel supervision and employment practices
• Providing information systems management
Clinical • Assisting the licensed practitioner during examinations • Initiating an IV and administering IV medications with
• Assisting with asepsis and infection control appropriate training and as permitted by state law
• Performing diagnostic tests, such as spirometry and • Reporting diagnostic study results
ECGs • Assisting patients in the completion of advance
• Giving injections, where allowed directives and living wills
• Phlebotomy, including venipuncture and capillary • Assisting with clinical trials
puncture
©VGstockstudio/Shutterstock • Disposing of soiled or stained supplies
• Performing first aid and cardiopulmonary
resuscitation (CPR)
• Preparing patients for examinations
• Preparing and administering medications as directed
by the licensed practitioner, and following state laws
for invasive procedures
• Recording vital signs and medical histories
• Removing sutures or changing dressings on wounds
• Sterilizing medical instruments
• Instructing patients about medication and special diets,
authorizing drug refills as directed by the licensed
practitioner, and calling pharmacies to order prescriptions
• Assisting with minor surgery
• Teaching patients about special procedures before
laboratory tests, surgery, X-rays, or ECGs
Laboratory • Performing Clinical Laboratory Improvement • Performing as an OSHA compliance officer
Amendments (CLIA)–waived tests, such as a urine • Performing moderately complex laboratory testing with
pregnancy test, on the premises appropriate training and certification
• Collecting, preparing, and transmitting laboratory
specimens
• Teaching patients to collect specific specimens properly
• Arranging laboratory services
• Meeting safety standards (OSHA guidelines) and fire
©Adam Gault/AGE Fotostock
protection mandates
INTRODUCTION TO MEDICAL ASSISTING 3
ISTUDY
You also may choose to specialize in a specific area of CMA (AAMA)”. In 2013, the study identified the 12 most
healthcare. For example, podiatric medical assistants make frequently performed responsibilities of medical assistants.
castings of feet, expose and develop X-rays, and assist podia- They are listed here in the order of most performed to least
trists in surgery. Ophthalmic medical assistants help ophthal- performed.
mologists (doctors who provide eye care) by administering
1. Abide by principles and laws related to confidentiality.
diagnostic tests, measuring and recording vision, testing the
functioning of eyes and eye muscles, and performing other 2. Adapt communications to an individual’s understanding.
duties. A discussion of medical specialties is found in the 3. Demonstrate respect for individual diversity (culture,
chapter Healthcare and the Healthcare Team. For specific ethnicity, gender, race, religion, age, economic status).
information about medical assistant duties within medical 4. Employ professional techniques during verbal, nonverbal,
specialty practice, refer to the following chapters: Assisting in and text-based interactions.
Reproductive and Urinary Specialties, Assisting in Pediatrics, 5. Comply with risk management and safety procedures.
Assisting in Geriatrics, Assisting in Other Medical Special- 6. Interact with staff and patients to optimize workflow
ties, and Assisting with Eye and Ear Care. efficiency.
7. Maintain patient records.
Medical Assisting Organizations LO 1.2 8. Provide care within legal and ethical boundaries.
Many organizations guide the profession of medical assisting. 9. Practice standard precautions.
These include professional associations such as the American 10. Document patient communication, observations, and
Association of Medical Assistants (AAMA), the American clinical treatments.
Medical Technologists (AMT), and National Healthcareer 11. Identify potential consequences of failing to operate
Association (NHA), as well as accrediting and register- within the scope of practice of a medical assistant.
ing organizations. As a future medical assistant, knowledge 12. Transmit information electronically.
of these organizations will help you make critical decisions
about your career.
Professional associations set high standards for quality and Professional Support for CMAs (AAMA) When you
performance in a profession. They define the tasks and func- become a member of the AAMA, you will have a large support
tions of an occupation, provide members with the opportunity group of active medical assistants. Membership benefits include:
to communicate and network with one another, as well as offer • Professional publications, such as CMA Today.
continuing education. Becoming a member of a professional
• A large variety of educational opportunities, such as
association helps you achieve career goals and furthers the
chapter-sponsored seminars and workshops about the

profession of medical assisting. Joining as a student is encour-
latest administrative, clinical, and management topics.
aged, and some associations even offer discounted rates to
students for a specified amount of time after graduation. • Group insurance.
• Legal information.
American Association of Medical Assistants • Local, state, and national activities that include profes-
The idea for a national association of medical assistants—later sional networking and multiple continuing education
to be called the American Association of Medical Assistants opportunities.
(AAMA)—was suggested at the 1955 annual state convention • Legislative monitoring to protect your right to practice as a
of the Kansas Medical Assistants Society. The next year, at an medical assistant.
American Medical Association (AMA) meeting, the AAMA • Access to the website at http://www.aama-ntl.org.
was officially created. In 1978, the US Department of Health,
Education, and Welfare declared medical assisting as an allied
health profession. American Medical Technologists (AMT)
American Medical Technologists (AMT) is a nonprofit
AAMA’s Purpose The AAMA works to raise standards certification agency and professional membership associa-
of medical assisting to a more professional level. It is the only tion representing over 45,000 individuals in allied healthcare.
professional association devoted exclusively to the medical Established in 1939, AMT began a program to register medi-
assisting profession. The AAMA provides the CMA (AAMA) cal assistants at accredited schools in the early 1970s. The
credential. AMT provides allied health professionals with professional
certification services and membership programs to enhance
AAMA Occupational Analysis In 1996, the AAMA their professional and personal growth. Upon certification,
formed a committee whose goal was to revise and update its individuals automatically become members of AMT and start
standards for the accreditation of programs that teach medi- to receive benefits. You will read more about the benefits of
cal assisting. The committee’s findings were published in joining a professional organization later in the chapter. The
1997 as the “AAMA Role Delineation Study: Occupational AMT provides many certifications, including the Registered
Analysis of the Medical Assistant Profession.” In 2009, it Medical Assistant RMA (AMT) credential and the Certified
was updated and named the “Occupational Analysis of the Medical Assistant Specialist CMAS (AMT) credential.
4 CHAPTER 1
ISTUDY
Professional Support for RMA (AMT) and CMAS obtainable goal for individuals who wish to show commit-
(AMT) The AMT offers many benefits. These include: ment to their chosen profession. Having multiple credentials
with one agency makes maintaining continuing education
• Professional publications. easier for practicing healthcare professionals. The NAHP
• Membership in the AMT Institute for Education. offers many credentials, including the Nationally Registered
• Group insurance programs—liability, health, and life. Certified Medical Assistant (NRCMA), the Nationally Regis-
• State chapter activities. tered Certified Coding Specialist (NRCCS), and the Nation-
ally Registered Certified Administrative Health Assistant
• Legal representation in health legislative matters.
(NRCAHA).
• Annual meetings and educational seminars. With the growth of the medical assisting field, new orga-
• Student membership. nizations have developed to serve professionals. For example,
• Access to the website at http://www.americanmedtech.org. the American Medical Certification Association (AMCA),
founded in 2010, provides certification for clinical and/or
National Healthcareer Association (NHA) administrative medical assistants. The American Registry of
The National Healthcareer Association (NHA) (http://www Medical Assistants (ARMA) is also one of many national cer-
.nhanow.com) was established in 1989 as an information tifying organizations that certify/register medical assistants.
resource and network for today’s active healthcare profes- Prospective medical assistants should be knowledgeable
sionals. NHA provides certification and continuing education about the agency they will use to obtain their medical assis-
services for healthcare professionals and curriculum develop- tant credential.
ment for educational institutions. It offers a variety of certifi-
cation exams, including Clinical Medical Assistant (CCMA),
Medical Administrative Assistant (CMAA), Billing and Cod-
Medical Assistant Credentials LO 1.3
ing Specialist (CBCS), and Electronic Health Records Spe- Certification is confirmation by an organization that an indi-
cialist (CEHRS). vidual is qualified to perform a job to professional standards.
Some of the NHA’s programs and services include: Registration, on the other hand, does not guarantee an indi-
vidual’s competence. Instead, registration is the granting of a
• Certification development and implementation.
title or license by a board that gives permission to practice in
• Continuing education curriculum development and a chosen profession. Once credentialed, you earn the right to
implementation. wear a pin that is obtained through the credentialing organiza-
• Program development for unions, hospitals, and schools. tion (Figure 1-1).
• Educational, career advancement, and networking services Medical assistant credentials such as certification and
for members. registration are not always required to practice as a medical
• Registry of certified professionals. assistant. However, employers today are aggressively recruit-
ing medical assistants who are credentialed in their field. As
Healthcare educators working in their various fields of discussed in the Medical Assisting Organizations, many cre-
study develop the National Healthcare Association certifica- dentials are available for medical assisting by various organi-
tion exams. The NHA is a member of the National Organiza- zations. Small physician practices are being consolidated or
tion of Competency Assurance (NOCA). merged into larger providers of healthcare, such as hospitals,
to decrease operating expenses. Human resource directors of
Other Medical Assistant Organizations
Other organizations assist potential and current medical
assisting professionals. These include the National Center for
Competency Testing (NCCT) and the National Association
for Health Professionals (NAHP).
The National Center for Competency Testing (NCCT)
(https://www.ncctinc.com) is an independent agency that cer-
tifies the validity of competency and knowledge of the medi-
cal profession through examination. Medical assistants and
medical office assistants receive the designation of National
Certified Medical Assistant (NCMA) and National Certified
Medical Office Assistant (NCMOA) after passing the certi-
fication examination. The NCCT avoids any allegiance to a
specific organization or association.
FIGURE 1-1 Wearing one of these pins indicates you have obtained
The National Association for Health Professionals a credential in medical assisting. Medical assistants registered by the
(NAHP) (http://www.nahpusa.com) offers multiple creden- American Medical Technologists must past the RMA exam to be certified
tials for healthcare professionals. The organization, which has and can wear the pin on the left. Members of the American Association of
been in existence for 30 years, prides itself in making the pro- Medical Assistants who pass the CMA exam wear the pin on the right.
cess of obtaining a credential an accessible, affordable, and ©Total Care Programming, Inc.
ISTUDY
these larger organizations place great importance on profes- groups. The AAMA also offers self-study courses through its
sional credentials for their employees. Hiring credentialed continuing education department.
medical assistants may lessen the likelihood of a legal chal- Only students who have completed medical assisting pro-
lenge. Common administrative and clinical certifications are grams accredited by CAAHEP and ABHES are eligible to
provided in Table 1-2. take the certification examination. The AAMA offers the
Candidate’s Guide to the Certification Examination to help
State and Federal Regulations applicants prepare for the examination. This guide explains
Certain provisions of the Occupational Safety and Health the test format and test-taking strategies. It also includes a
Administration (OSHA) and the Clinical Laboratory sample examination with answers and information about
Improvement Amendments of 1988 (CLIA ’88) are making study references. Some schools also have incorporated test
mandatory credentialing for medical assistants a logical step preparation reviews into their programs.
in the hiring process. OSHA and CLIA ’88 regulate health- The CMA (AAMA) examination is a computerized test
care but presently do not require that medical assistants be that may be taken any time at a designated testing site in your
credentialed. However, various components of these statutes area. You may search the Internet for an application and test
can be met by demonstrating that medical assistants are cer- review materials. Once you have successfully passed the CMA
tified. For example, some physician offices perform moder- (AAMA) examination, you have earned the right to add that cre-
ately complex laboratory testing onsite. The medical assistant dential to your name, such as Miguel A. Perez, CMA (AAMA).
can perform moderately complex tests if she or he has the
appropriate training and skills. AMT Credentials
The American Medical Technologists (AMT) organiza-
AAMA Credential tion credentials medical assistants as Registered Medical
The Certified Medical Assistant (CMA) credential is Assistants (RMA) or Certified Medical Assistant Specialists
awarded by the Certifying Board of the AAMA. The AAMA’s (CMAS). Although this section focuses on the RMA creden-
certification examination evaluates mastery of medical assist- tial, you can find more about the CMAS credential on the
ing competencies based on the Occupational Analysis of the AMT website at https://www.americanmedtech.org/.
CMA (AAMA), which is available at http://www.aama-ntl. Requirements for the RMA (AMT) credential include:
org/resources/library/OA.pdf. The National Board of Medi- • Graduation from a medical assistant program that is
cal Examiners (NBME) also provides technical assistance in accredited by ABHES or CAAHEP or is accredited by a
developing the tests. regional accrediting commission, by a national accrediting
CMAs (AAMA) must recertify the credential every organization approved by the US Department of Educa-
5 years. To be recertified as a CMA (AAMA), 60 contact tion, or by a formal medical services training program of
hours must be accumulated during the 5-year period: 10 in the US Armed Forces.
the administrative area, 10 in the clinical area, and 10 in the • Alternatively, employment in the medical assisting profes-
general area, with 30 additional hours in any of the three cat- sion for a minimum of 5 years, no more than 2 years of
egories. In addition, 30 of these contact hours must be from which may have been as an instructor in the postsecondary
an approved AAMA program. The AAMA also requires you medical assistant program.
to hold a current CPR card.
• Passing the AMT examination for RMA (AMT)
The recertification mandate requires you to learn about
certification.
new medical developments through education courses or par-
ticipation in an examination. Hundreds of continuing educa- RMAs (AMT) must accumulate 30 contact hours for con-
tion courses are sponsored by local, state, and national AAMA tinuing education units (CEUs) every 3 years if they were
TABLE 1-2 Medical Assisting Credentials

Type of Certification Certification Title Certifying Organization
Administrative and Clinical Certified Medical Assistant (CMA) AAMA
Administrative and Clinical Registered Medical Assistant (RMA) AMT AMT
Administrative and Clinical National Certified Medical Assistant (NCMA) NCCT
Administrative and Clinical Nationally Registered Certified Medical Assistant (NRCMA) NAHP
Clinical Certified Clinical Medical Assistant (CCMA) NHA
Administrative Medical Administrative Assistant (CMAA) NHA
Administrative Certified Medical Assistant Specialist (CMAS) AMT
Administrative National Certified Medical Office Assistant (NCMOA) NCCT
Administrative Nationally Registered Certified Administrative Health Assistant NAHP
(NRCAHA)
6 CHAPTER 1
ISTUDY
certified after 2006. RMAs (AMT) who were certified before Program Accreditation
this date are expected to keep abreast of all the changes and Accreditation is the process by which programs are officially
practices in their field through educational programs, work- authorized. The US Department of Education recognizes two
shops, or seminars. However, there are no specific continuing national entities that accredit medical assisting educational
education requirements. Once a medical assistant has passed programs:
the AMT exam, she has earned the right to add RMA (AMT)
to her name: Kaylyn R. Haddix, RMA (AMT). • Commission on Accreditation of Allied Health Edu-
cation Programs (CAAHEP). CAAHEP works directly
Credentialing Examinations with the Medical Assisting Educational Review Board
Credentialing examinations are rigorous. Participation in an (MAERB) of Medical Assistants Endowments to ensure
accredited program will help you learn what you need to know. that all accredited schools provide a competency-based
Each certification examination is based on a specific content education. CAAHEP accredits medical assisting pro-
outline created by the certifying organization. Most organiza- grams in both public and private postsecondary institutions
tions provide their content outline as well as practice examina- throughout the United States that prepare individuals for
tions for potential medical assistants to prepare. You should entry into the medical assisting profession.
research the Internet to gain additional information regarding • Accrediting Bureau of Health Education Schools
any of these certifications. See Procedure 1-1, Obtaining Cer- (ABHES). ABHES accredits private postsecondary insti-
tification/Registration Information Through the Internet. tutions and programs that prepare individuals for entry into
the medical assisting profession.
Training Programs LO 1.4 Accredited programs must cover the following topics:
With continuous changes in healthcare today, the role of the • Anatomy and physiology
medical assistant has become dynamic and wide-ranging. • Medical terminology
These changes have expanded the expectations for medical • Medical law and ethics
assistants. The knowledge base of the modern medical assis-
• Psychology
tant includes:
• Oral and written communications
• Administrative and clinical skills. • Laboratory procedures
• Patient insurance product knowledge (specific to the work- • Clinical and administrative procedures
ers’ geographic locations).
• Compliance with healthcare-regulating organizations. High school students may prepare for these courses by
studying mathematics, health, biology, office skills, book-
• Exceptional customer service.
keeping, and information technology. You may obtain current
• Practice management. information about accreditation standards for medical assist-
• Current patient treatments and education. ing programs from the AAMA.
The medical assisting profession requires a commitment to Medical assisting programs also must include a practi-
self-directed, lifelong learning. Healthcare is changing rapidly cum (externship) or work experience. This applied training
because of new technology, new healthcare delivery systems, is for a specified length of time in an ambulatory care set-
and new approaches to facilitating cost-efficient, high-quality ting, such as a physician’s office, hospital, or other healthcare
healthcare. A medical assistant who can adapt to change and facility. Additionally, the AAMA lists its minimum standards
is continually learning will be in high demand. for accredited programs. This list of standards ensures that all
Formal programs in medical assisting are offered in a vari- personnel—administrators and faculty alike—are qualified to
ety of educational settings, including vocational-technical perform their jobs. These standards also ensure that financial
high schools, postsecondary vocational schools, community and physical resources are available at accredited programs.
and junior colleges, and 4-year colleges and universities. Graduation from an accredited program helps your career
Vocational school programs usually last 9 months to 1 year in three ways. First, it shows that you have completed a pro-
and award a certificate or diploma. Community and junior gram that meets nationally accepted standards. Second, it
college programs are usually 2-year associate’s degree pro- provides recognition of your education by professional peers.
grams. Training can be obtained through traditional class- Third, it makes you eligible for registration or certification.
room as well as online settings. Students who graduate from an CAAHEP- or ABHES-
An accredited medical assisting program is competency accredited medical assisting program are eligible to take the
based; this means that standards are set by an accrediting CMA (AAMA) or RMA (AMT) immediately.
body for skill and proficiency in administrative and clinical
tasks. It is the educational institution’s duty to ensure that Work Experience
medical assisting students learn all medical assisting compe- Your practicum (externship) or work experience is manda-
tencies and that evidence is clearly documented for each stu- tory in accredited schools. The length of your experience will
dent. Periodic evaluations are performed by the accrediting vary, depending on your particular program, so familiarize
agencies to ensure the effectiveness of the program. yourself with the program requirements as soon as possible.
ISTUDY
Because this is a required part of the program, no matter how Multiskilled Healthcare Professionals
good your grades are in class, if the work experience is not Many hospitals and healthcare practices are embracing the
completed, you will not graduate from the program. idea of a multiskilled healthcare professional (MSHP). An
Your practicum (externship) or work experience is an MSHP is a cross-trained team member who is able to handle
extension of your classroom learning experience. You will many different duties.
apply skills learned in the classroom in an actual medical
office or other healthcare facility. You also earn the right to Reducing Healthcare Costs By hiring multiskilled
include this applied training experience on your résumé under healthcare professionals, healthcare organizations can reduce
job experience, as long as you title it as “Medical Assistant personnel costs. MSHPs can perform the functions of two or
Practicum, Externship, or Work Experience.” The Preparing more people, so they are cost-effective employees and are in
for the World of Work chapter will further explain your practi- high demand.
cal work experience.
Expanding Your Career Opportunities Career
Professional Development LO 1.5 opportunities are vast if you are self-motivated and willing
to learn new skills. Following are some examples of posi-
Professional development refers to skills and knowledge tions for medical assistants with additional experience and
attained for both personal development and career advance- certifications:
ment. During your training, you should strive to improve your
knowledge and skills. This will help you transition into your • Medical office manager
first job with ease. You also can gain valuable knowledge and • Medical biller and coder
skills through volunteering prior to or in addition to work • Medical assisting instructor (with a specified amount of
experience obtained as a student. experience and education)
Once you have entered the world of work as a medical • ECG technician
assistant, you will want to continue to develop in your pro-
• Sterilization technician
fession. You can do this through additional training, cross-
training, and other forms of continuing education. • Patient care technician
If you are multiskilled, you will have an advantage when
Volunteer Programs job hunting. Employers are eager to hire multiskilled medical
Volunteering is a rewarding experience. Before you even assistants and may even create positions for them.
begin a medical assisting program, you can gain experience in You can gain multiskill training by showing initiative and a
a healthcare profession through volunteer work. As a volun- willingness to learn every aspect of the medical facility in which
teer, you will get hands-on training and learn what it is like to you are working. When you begin working in a medical facility,
assist patients who are ill, disabled, or frightened. establish goals regarding your career path and discuss them with
You may volunteer as an aide in a hospital, clinic, nurs- your immediate supervisor. Indicate to your supervisor that you
ing home, or doctor’s office, or as a typist or filing clerk in a would like cross-training in every aspect of the medical facil-
medical office or medical record room. Some visiting nurse ity. Begin in the department in which you are currently work-
associations and hospices (homelike medical settings that ing and branch out to other departments once you master the
provide medical care and emotional support to terminally ill skills needed for your current position. This will demonstrate a
patients and their families) also offer volunteer opportunities. commitment to your profession and a strong work ethic. Cross-
These experiences may help you decide if you want to pursue training is a valuable marketing tool to include on your résumé.
a career as a medical assistant.
The American Red Cross also offers volunteer opportunities Scope of Practice
for student medical assistants. The Red Cross needs volunteers Professional development includes knowing your scope of
for its disaster relief programs locally, statewide, nationally, and practice and working within it. Medical assistants are not
abroad. As part of a disaster relief team at the site of a hurri- “licensed” healthcare professionals, and most often work
cane, tornado, storm, flood, earthquake, or fire, volunteers learn under a licensed healthcare provider, such as a nurse practitio-
first-aid and emergency triage skills. Red Cross volunteers gain ner or physician. Licensed healthcare professionals may del-
valuable work experience that may help them obtain a job. egate certain duties to a medical assistant, providing he or she
Because volunteers are not paid, it is usually easy to find has had the appropriate training through an accredited medi-
work opportunities. Just because you are not paid for volun- cal assisting program or through on-the-job training provided
teer work, however, does not mean the experience is not use- by the medical facility or physician.
ful for meeting your career goals. Questions often arise regarding the kinds of duties a medi-
Include information about any volunteer work on your cal assistant can perform. There is no universal answer to
résumé—a document that summarizes your employment and these questions. There is no single national definition of a
educational history. Be sure to note specific duties, responsi- medical assistant’s scope of practice, so the medical assistant
bilities, and skills you developed during the volunteer experi- must research the state in which he or she works to learn about
ence. Refer to the Preparing for the World of Work chapter for the scope of practice. You can find this information online by
examples of résumés. entering “medical assistant scope of practice” and the name
8 CHAPTER 1
ISTUDY
of your state in any major search engine. See Procedure 1-2, procedures that can be performed and the actions that can be
Locating Your State’s Legal Scope of Practice. In general, a taken under the terms of his or her professional license and
medical assistant may not perform procedures for which he or training. Standard of care is a legal term that refers to the
she was not educated or trained. Examples of procedures med- care that would ordinarily be provided by an average, prudent
ical assistants may not perform include administering intra- healthcare provider in a given situation.
venous medications (without advanced training), diagnosing
patients or informing patients of a diagnosis, and giving any Networking
advice to a patient unless permitted by a facility’s standard Networking is building alliances—socially and professionally. It
policies and procedures. The AAMA and AMT are good starts long before your job search. By attending professional asso-
resources to assist you in your research. The AAMA Occupa- ciation meetings, conferences, or other functions, m edical assis-
tional Analysis is also a helpful reference source that identifies tants generate opportunities for employment and personal and
the procedures that medical assistants are educated to perform. professional growth. Networking, through continuing education
Do not confuse the terms scope of practice and standard conferences throughout your career, keeps the doors open to
of care. A medical assistant’s scope of practice is the set of employment advancement.
P R O C E D U R E 1 - 1 Obtaining Certification/Registration
Information Through the Internet
Procedure Goal: To obtain information from the Internet • For other selected credentials navigate to the
regarding professional credentialing selected organization.
■ National Association for Health Professionals
(NAHP): http://nahpusa.com/
to blood, body fluids, or tissue.
■ National Center for Competency Testing (NCCT):
Materials: Computer with Internet access and printer https://www.ncctinc.com/
Method: ■ National Healthcareer Association (NHA):
1. Open your Internet browser and use a search engine to http://www.nhanow.com/
search for the credential you would like to pursue—for 3. Determine the steps you must take to obtain the selected
example, Certified Medical Assistant or Registered credential. You will need to navigate to the information
Medical Assistant. If you are unsure of the credential you about the requirements for eligibility, certification
would like to pursue, you may just want to search for standards, and the examination outline.
“Medical Assisting Credentials.” 4. Print or write down the qualifications you must obtain.
2. Select the site for the credential you are pursuing. RATIONALE: Maintaining a record of needed
Avoid sponsored links. These links are paid for and qualifications will be a reference as you pursue your
typically will not take you to the site of a credentialing chosen credential.
organization. 5. Once you have met the qualifications, you will need to
For example to navigate to the home page: apply for the examination or certification. Download the
• For the CMA (AAMA) credential, enter the site http:// application and the application instructions for the RMA
www.aama-ntl.org. (AMT) or the CMAS (AMT) or the candidate application
and handbook for the CMA (AAMA).
6. To view or print these instructions, you may need to
download Adobe Reader. You can click on a link to
download Adobe Reader after you click on the “Apply
Copyright © by American Association of Medical Assistants. All rights reserved. Online” link for AMT or “Apply for the Exam” for AAMA.
Used with permission.
7. Before or after you apply for the examination, you will need
• For the RMA (AMT) or CMAS (AMT) credential, enter to prepare for the examination. Select the link “Study for
the site http://www.americanmedtech.org. the Exam” on the AAMA site or the “Prepare for Exam” link
under the “Get Certified” drop-down menu on the AMT site.
8. Prepare for the exam by reviewing the content outline,
obtaining additional study resources, or taking a practice
exam online.
9. Print or save downloaded information in a file folder on your
desktop labeled “Credentials” or another name you can
Copyright © by American Medical Technologists. All rights reserved. Used with recognize. To print, click the printer icon found at the bottom
permission. of the web page or click the printer icon in your browser.
ISTUDY
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qualifications of a popular teacher. He would not have aspired to
finished eloquence of style: to the eloquence of gesture and of
manner, he was still more a stranger. But there is an eloquence of
physiognomy, which Mr. Rittenhouse most eminently possessed.
The modesty and amenity of his manner would have effected much,
whether his audience had been a class of philosophers, or an
assembly of ladies. Of his own discoveries, and opinions, and
theories, he would have always spoken with that sweet and modest
reserve, for which he was ever distinguished. He would have dwelt
with the most generous and ample enthusiasm upon the great
discoveries of Newton; and if, at any time, he could have forgotten
that impartial conduct, which it is the duty of the historian of a
science to observe, it would have been when he might have had
occasion to defend the theories of that great man, against the
objections of succeeding and minor philosophers.
In Physics, Newton was his favourite author. Of HIM he ever spoke

with a species of respect bordering upon veneration. He considered
him as one of those few great leaders in science whose discoveries
and services can never be forgotten: whose fame, instead of
diminishing, is destined to be augmented, with the progress of time. I
had many opportunities of being witness to the exalted opinion which
he entertained of the immortal British philosopher. He read Dr.
Bancroft’s objections to some parts of Sir Isaac’s theory of colours,
with a firm conviction, that the Newtonian principles were still
unshaken: and I well remember, that he once referred me to a paper
which he had published, in one of our magazines, in answer to some
objections which the late Dr. Witherspoon had urged against some of
the theories of Newton.
It has been observed by a celebrated writer, that mathematicians

in general read but little of each other’s works. This remark, if I
mistake not, is very strongly illustrated in Mr. Rittenhouse. However it
may have been in his earlier age, I am confident that during the last
thirteen years of his life, when my intercourse with him was great,
and indeed but little interrupted; I am confident, that at this matured
and auspicious era of his life, our friend was not a laborious student.
He looked into many books, and he often passed quickly from one
kind of reading to another: from philosophy to poetry; from poetry
perhaps to philosophy again. His reading may be said to have been
desultory. I have little doubt that this rather irregular manner of
reading was, in some measure, the result of his extreme delicacy of
constitution, which rendered a more unvaried application to any one
kind of reading, irksome and oppressive. Often have I seen him lay
down his book or pen, to recline upon his sopha, the circumscribed
flush upon his cheeks plainly indicating the physical state of his
feelings. A short repose would enable him to return to his studies
again.
Mr. Rittenhouse’s application to books, had, no doubt, been more

regular and constant in the earlier part of his life; before I knew him
well, or before I had accustomed myself to watch the progress of his
mind. He was, certainly, profoundly, acquainted with the Principia
and other writings of Newton, which he read partly in the original,
and partly through the medium of translation. And although, within
the period of my better acquaintance with him, his reading I have
said, was not intense, he suffered no important discovery in
philosophy to escape his notice. Although his own library was small,
he had ample opportunities, through the medium of the valuable
library belonging to the Philosophical Society, and other collections
in Philadelphia, of observing the progress of his favourite studies in
Europe. He took much interest in the discoveries of Mr. Herschel,
whose papers he eagerly read as they arrived from Europe: and I
well remember the time (in 1785) when he was engaged in reading
Scheel’s work on Fire, which had recently appeared, in an English
dress. He then assured me, that some of this great Swedish
philosopher’s notions concerning the nature and the laws of heat,
had long before suggested themselves to his mind.
The chemical discoveries of Crawford and Priestley solicited some

of Mr. Rittenhouse’s attention, about the year 1785-1786, and for
some time after. The brilliant discoveries of Priestley, in particular,
were not unknown to him. Upon the arrival of this illustrious
philosopher in Philadelphia, in 1794, Mr. Rittenhouse stood foremost
among the members of the Philosophical Society in publicly
welcoming the exiled philosopher to the country which he had
chosen as the asylum of his declining years; and in expressing his
high sense of his estimable character, and of the vast accessions
which he had brought to science. I often met Dr. Priestley at the
house of our friend. Their regard for each other was mutual. It is to
be regretted that their immediate intercourse with each other could
not be more frequent. Priestley had unfortunately chosen the
wilderness, instead of the capital or its vicinity, as his place of
residence: and Rittenhouse, alas! did not live two years after the
arrival of Priestley in America.
On the death of Mr. Rittenhouse, Dr. Priestley wrote me a letter of

condolence on the great loss which the publick had sustained; on the
irreparable loss which I, in particular, had suffered. When the Doctor
afterwards returned from Northumberland to Philadelphia, he
discovered much solicitude to know from me Mr. Rittenhouse’s
religious sentiments, and the manner and circumstances of his
death; and he evinced no small satisfaction in receiving from me that
relation which I have already given you, of the last hours, and of the
last words, of one of the best of men.
Mr. Rittenhouse had not studied natural history as a science: but

to some of the branches of this science he had paid particular
attention; and upon some of them he was capable of conversing with
the ablest, and the most experienced. In Botany, he was not
acquainted with the scientific or classical names: but the habits, and
in many instances, the properties of plants were known to him. I well
recollect how great were his pleasure and satisfaction, in
contemplating the Flora of the rich hills of Weeling, and other
branches of the Ohio, when I accompanied him into those parts of
our union, in the year 1785. In this wilderness, he first fostered my
love and zeal for natural history. Upon his return from the woods, in
the month of October, he brought with him, as ornaments to his
garden, many of the transmontain plants of the state of
Pennsylvania: and long before I knew that it grew wild in the vicinity
of Philadelphia, upon the banks of his native Schuylkill, he had
naturalized in his garden, the beautiful Silene virginica, which he
designated with the name of “Weeling Star.”
It is a fact, that in the last months of his life he devoted a good

deal of his time to an examination of the structure of the most
important organs of plants. Acquainted with that doctrine which
forms the basis of the sexual system, he was fond of examining
plants during the period of their inflorescence: and I remember, with
what apparent pleasure, he pointed out to me the tube in the styles
of some of the plants which grew in his garden.
He had made many observations upon the buds of trees, some of

which I think were new. I regret that the memorandums which he
kept of these observations have not been found among his papers.
Not fifteen days before his death, he had finished the perusal of a
German translation of Rousseau’s beautiful letters on Botany, which I
had put into his hands.
Mr. Rittenhouse, like Newton and many other men of great talents,
employed much of his time in the perusal of works on the subject of
natural and revealed religion. This was, I think, more especially the
case in the latter part of his life. Among other books which I could
mention, I well recollect that he read the Thoughts of the celebrated
French philosopher Pascall: and he acknowledged, that he read
them with pleasure. But that pleasure, he observed to me, was
diminished, when he learned, what was often the state of Pascall’s
mind:—a state of melancholy and gloom: and sometimes even of
mental derangement. At the time of his death, the American
Philosopher was engaged in the perusal of Mosheim’s Ecclesiastical
History: and he had just before finished the perusal of the
Meditations of the Emperor Marcus Antoninus; that excellent work,
replete with the sublimest morality, and with much of a sublime
religion.
About three weeks before his death, I had put into his hands the
first volume of Dr. Ferguson’s Elements of Moral and Political
Science. I took the liberty of particularly directing his attention to the
last chapter of the volume: the chapter on the future state. He read it
with so much satisfaction, that he afterwards sent it to his elder
daughter, with a request that she would peruse it.
The benevolent dispositions of our friend were well known to you.

You have, doubtless, done justice to this portion of his character; yet
permit me to mention a few detached facts, which have came under
my own immediate notice, and the relation of which may serve to
augment even your respect and veneration for Mr. Rittenhouse.
The year 1793 is memorable in the history of Philadelphia. During

the prevalence of the yellow fever, in the summer of that year, Mr.
Rittenhouse wrote to me a note requesting me to visit a number of
poor people, in his vicinity, labouring under the malignant fever; and
making it a condition of my attendance upon them, that I should
charge him for my services.
In the month of March of the same year, I had a good deal of

conversation with Mr. Rittenhouse, on the subject of penal laws. He
did not think that the late judge Bradford, whose essay on this
subject he greatly admired, and recommended to my perusal, was
too lenient in his views of the subject. He observed, that although he
had often served on juries, he thanked God, that he never had in any
case where life and death were immediately involved; observing, that
his conscience would ever reproach him, if he had, in any instance,
given his verdict for death. “Of all murders (he added) legal murders
are the most horrid.” He did not think that death ought to be the
punishment for any crime.
The union of sensibility with benevolence is frequently observed.

The sensibility of Rittenhouse was exquisitely nice; perhaps, I might
say, it was somewhat morbid. In a conversation which I had with him
on the subject of the analogies between animals and vegetables,
when I had observed to him, that the further we push our inquiries
into this interesting subject, the more reason we have for supposing,
that those two series of living beings constitute, as many eminent
naturalists have supposed, but one vast family, he said it appeared
so to him, but he hoped it would never be discovered that vegetables
are endowed with sensibility. “There is, he observed, already too
much of this in the world.”
His religion was sublime and pure. It had no tincture of superstition

or credulity. Accustomed, from an early period of his life, to
contemplate the largest and the smallest objects of Creation; and
with respect to the former to view their arrangement and harmony in
the construction of a system of immeasurable extent; in these
objects and in these places, he beheld one of the revelations of our
Creator. He could not be insensible of the ills, infirmities, and
miseries of human life, and even of the life of inferior animals. But
still he discovered, as he often observed to me, the existence and
even the dominion of much benevolence through the world. He was
wont to consider our benevolent dispositions, and our virtuous
affections, as among the strongest proofs of the existence of a
Creator. These dispositions, these affections, and our intellectual
powers, are the genuine emanations of a God.
Benjamin Smith Barton.
Philadelphia, December, 1813.
Letter from Lady Juliana Penn to the Rev. Peter Miller, Ephrata.
Septr. 29th. 1774.
Sir,
Your very respectable character would make me ashamed to

address you with words merely of form. I hope therefore you will not
suspect me of using any such, when I assure you I received the
favour of your letter with very great pleasure. And permit me, sir, to
join the thanks I owe to those worthy women, the holy sisters at
Ephrata, with those I now present to you, for the good opinion you,
and they, are pleased to have of me. I claim only that of respecting
merit, where I find it; and of wishing an increase in the world, of that
piety to the Almighty, and peace to our fellow-creatures, that I am
convinced is in your hearts: and, therefore, do me the justice to
believe, you have my wishes of prosperity here, and happiness
hereafter.
I did not receive the precious stone, you were so goad to send me,
till yesterday. I am most extremely obliged to you for it. It deserves to
be particularly distinguished on its own, as well as the giver’s
account. I shall keep it with a grateful remembrance of my
obligations to you.
Mr. Penn, as well as myself, were much obliged to you for

remarking to us, that the paper you wrote on, was the manufacture
of Ephrata: It had, on that account, great merit to us; and he has
desired our friend, Mr. Barton, to send him some specimens of the
occupation of some of your society. He bids me say, that he rejoices
to hear of your and their welfare.
It is I that should beg pardon for interrupting your quiet, and

profitable moments, by an intercourse so little beneficial as mine; but
trust your benevolence will indulge this satisfaction to one who
wishes to assure you, sir, that she is, with sincere regard, your
obliged and faithful well-wisher,
Juliana Penn.
Mr. Peter Miller, President of the Cloister at Ephrata.
To the Memory of the Honourable Thomas Penn, Esq. who died

March 21. 1775.
Peace, worthy shade! Peace to thy virtuous soul;

Life’s contest past, thou now hast gain’d the goal,
Destin’d for honest innate truth, like thine,
Where moral goodness rises to divine.
True to thy friendship, sacred to each trust,
In every duty most exactly just:
A princely wealth fill’d not thy heart with pride,
Thou nobly cast the glitt’ring bait aside;
Made it subservient to some useful aim,
Some gen’rous purpose, or some proper claim:
As bounteous streams in pleasing currents glide,
It roll’d, refreshing, like some charming tide;
Cheer’d the lone widow in her humble dome,
And scatter’d comfort o’er her lonely home.
Thy guardian angel snatch’d thee from below,
E’er Pennsylvania was consign’d to woe:
Thou now may’st view, without one kindred tear,
What we deem harsh, oppressive and severe;—
Life’s motley picture, at one view, may’st scan,—
Unwind its tangled, complicated plan,—
Where this great truth is clearly understood,
That “partial evil’s universal good.”
In broken parts, man the dark system spies,
While all lies open to celestial eyes;
The links, united, of our scatter’d chain,
Shew why Penn suffer’d tedious years of pain,—
Shew why one patient virtuous mind doth mourn,
And why sweet Peace is from a people torn.
For, individuals of earth’s humble vale
Mount, in gradation, on a heav’nly scale:
Yet Virtue, only, has a charm in death;
Wealth droops his plumes, as man resigns his breath;
Its social merits can’t ascend the skies,
Terrestrial substance can’t to heav’n arise;
Too gross to enter the abodes divine,
In earthly darkness it can only shine.
Letter from General Washington to the Writer of these Memoirs.
Mount Vernon, Sep. 7th. 1788.
Sir,
At the same time I announce to you the receipt of your obliging

letter of the 28th of last month, which covered an ingenious essay on
Heraldry, I have to acknowledge my obligations for the sentiments
your partiality has been indulgent enough to form of me, and my
thanks for the terms in which your urbanity has been pleased to
express them.
Imperfectly acquainted with the subject, as I profess myself to be;

and persuaded of your skill, as I am; it is far from my design to
intimate an opinion, that Heraldry, Coat-Armour, &c, might not be
rendered conducive to public and private uses, with us,—or, that
they can have any tendency unfriendly to the purest spirit of
Republicanism: on the contrary, a different conclusion is deducible
from the practice of Congress and the States; all of which have
established some kind of Armorial Devices, to authenticate their
official instruments. But, sir, you must be sensible, that political
sentiments are very various among the people in the several states;
and that a formidable opposition to what appears to be the prevailing
sense of the Union, is but just declining into peaceable
acquiescence. While, therefore, the minds of a certain portion of the
community (possibly from turbulent or sinister views) are, or affect to
be, haunted with the very spectre of innovation;—while they are
indefatigably striving to make the credulity of the less-informed part
of the citizens subservient to their schemes, in believing that the
proposed General Government is pregnant with the seeds of
Discrimination, Oligarchy and Despotism;—while they are
clamourously endeavouring to propagate an idea, that those whom
they wish, invidiously, to designate by the name of the “well-born,”
are meditating in the first instance to distinguish themselves from
their compatriots, and to wrest the dearest privileges from the bulk of
the people; and while the apprehensions of some, who have
demonstrated themselves the sincere, but too jealous, friends of
Liberty, are feelingly alive to the effects of the actual Revolution and
too much inclined to coincide with the prejudices above described,—
it might not perhaps be advisable to stir any question that would tend
to reanimate the dying embers of faction, or blow the dormant spark
of jealousy into an inextinguishable flame. I need not say, that the
deplorable consequences would be the same, allowing there should
be no real foundation for jealousy: (in the judgment of sober reason,)
as if there were demonstrable, even palpable, causes for it.
I make these observations with the greater freedom, because I
have once been a witness to what I conceived to have been a most
unreasonable prejudice, against an innocent institution: I mean, the
Society of the Cincinnati. I was conscious that my own proceedings
on that subject were immaculate. I was also convinced, that the
members,—actuated by motives of sensibility, charity and patriotism,
—were doing a laudable thing, in erecting that memorial of their
common services, sufferings and friendships;—and I had not the
most remote suspicion, that our conduct therein would have been
unprofitable, or unpleasing to our countrymen. Yet have we been
virulently traduced, as to our designs: and I have not even escaped
being represented as short-sighted, in not foreseeing the
consequences,—or wanting in patriotism, for not discouraging an
establishment, calculated to create distinctions in society and
subvert the principles of a republican government. Indeed, the
phantom seems now to be pretty well laid; except on certain
occasions,—when it is conjured up, by designing men, to work their
own purposes upon terrified immaginations:—You will recollect there
have not been wanting, in the late political discussions, those who
were hardy enough to assert, that the proposed General
Government was the wicked and traitorous fabrication of the
Cincinnati!
At this moment of general agitation and earnest solicitude, I should

not be surprised to hear a violent outcry raised, by those who are
hostile to the New Constitution, that the proposition contained in your
paper had verified their suspicions, and proved the design of
establishing unjustifiable discriminations. Did I believe that to be the
case, I should not hesitate to give it my hearty disapprobation. But I
proceed on other grounds:—Although I make not the clamour of
credulous, disappointed, or unreasonable men, the criterion of Truth;
yet, I think, their clamour might have an ungracious influence at the
present critical juncture: and, in my judgment, some respect should
not only be paid to prevalent opinions,—but even some sacrifices
might innocently be made to well meant prejudices, in a popular
government. Nor could we hope the evil impression would be
sufficiently removed, should your Account, and Illustrations, be found
adequate to produce conviction on candid and unprejudiced minds.
For myself, I can readily acquit you of having any design of

facilitating the setting up an “Order of Nobility:”—I do not doubt the
rectitude of your intentions. But, under the existing circumstances, I
would willingly decline the honour you have intended me, by your
polite Inscription; if there should be any danger of giving serious
pretext (however ill-founded in reality) for producing or confirming
jealousy and dissention, in a single instance; when harmony and
accommodation are most essentially requisite to our public
prosperity,—perhaps, to our national existence.
My remarks, you will please to observe, go only to the expediency,

not to the merits of the proposition: what may be necessary and
proper hereafter, I hold myself incompetent to decide; as I am but a
private citizen. You may, however, rest satisfied, that your
composition is calculated to give favourable impressions of the
science, candour and ingenuity, with which you have handled the
subject; and that, in all personal considerations, I remain with great
esteem, Sir, your most obedient and most humble servant,
Go. Washington.
Wm. Barton, Esq.
Dr. Benjamin Rush.
The foregoing Memoirs were entirely completed and prepared for

the press, before the decease of this Professor occurred; as is
mentioned in the preface.
Benjamin Rush was born in the county of Philadelphia, on the

twenty-fourth day of December, 1745, O.S. Having graduated in the
Arts at Princeton College, in the autumn of the year 1760, and
afterwards studied medicine under the direction of the late John
Redman, M. D. of Philadelphia, he completed his medical education
at the University of Edinburgh; where he received the degree of
Doctor in Medicine, in the spring of 1768. Returning to Philadelphia
in the summer of 1769, he was, on the 31st of July, in that year,
appointed Professor of Chemistry, in the College of Philadelphia; that
chair having been supplied for some time before, by the late John
Morgan, M. D. F. R. S. &c. About twenty years after this appointment
(viz. in 1789), he succeeded Dr. Morgan in the Professorship of the
Theory and Practice of Physic, in the same College: and in the year
1791, on the union of that College with the University of
Pennsylvania, he was chosen Professor of the Institutes and
Practice of Physick, &c. in the conjoint institution.
At divers times, and on various occasions, his talents were

employed in affairs of political concern. Besides having held, at
different periods, several other public stations, he was appointed a
member of Congress for Pennsylvania, on the 20th of July, 1776:
when he, together with some of his colleagues, appointed at the
same time, subscribed the Declaration of American Independence;
which great national act had received the sanction of congress, and
been generally signed by the members, sixteen days before.
He died of a typhus fever, in Philadelphia, on the 19th day of April,

1813; being then advanced a few months beyond the sixty-seventh
year of his age.
At the time of his decease, Dr. Rush was Professor of the

Institutes of Medicine, of the Theory and Practice of Physic, and of
Clinical Medicine, in the University of Pennsylvania: to which chair,
vacated by his death, Dr. Benjamin Smith Barton, Professor of
Materia Medica, Natural History and Botany, in the same institution,
was elected in the month of July, 1813.
FINIS.
A1. The reader will find a very learned and interesting dissertation
on the astronomy of these and other nations of antiquity, in Lalande’s
Astronomie, liv. ii. W. B.
A2. Our orator might well pass on, without noticing more
particularly the fabulous annals of the Chaldeans. They assigned to
the reigns of their ten dynasties, 432 thousand years: and Lalande
observes, that this number, 432, augmented by two or by four
noughts, frequently occurs in antiquity. This prodigious number of
years expresses, according to the notions of the inhabitants of India,
the duration of the life of a symbolical cow: in the first age, this cow,
serving as a vehicle for innocence and virtue, advances with a firm
step upon the earth, supported by her four feet; in the second, or
silver age, she becomes somewhat enfeebled, and walks on only
three feet; during the brazen, or third age, she is reduced to the
necessity of walking on two; finally, during the iron age, she drags
herself along; and, after having lost, successively, all her legs, she
recovers them in the succeeding period, all of them being
reproduced in the same order.
The Bramins thus make up their fabulous chronological account of

the age of the world; viz.
The duration of the first age, 1,728,000 years

The second 1,296,000 do.
The third 864,000 do.
The fourth will continue 432,000 do.
Making the total duration of the world 4,320,000 years.
Mr. Lalande remarks, that these four ages have a relation to the
numbers 4, 3, 2, 1, which seem to announce some other thing than
an historical division. Therefore, to give this fabulous duration of the
world some semblance of truth. Mr. Bailly[A2a] rejects, in the first
place, the fourth age, of which, at present, (that is, when Lalande
wrote,) only 4887 years have passed: the residue of this duration
could not be considered by Bailly as any thing more than a reverie:
and as for the three first ages, he takes the years for days; in order
to shew, that, in reality, they reckoned by days, before they
computed by solar years. By these means, Bailly has reduced the
pretensions of the people of India to 12,000 years; and he identifies
this calculation for the Indians with that of the Persians, who give,
likewise, 12,000 years for the duration of the world. The accordance
thus produced in the two chronologies, seemed to Bailly to
strengthen the authenticity of the recital; and makes it appear, that
these notions prevailed alike among the Egyptians and the Chinese.
Such are the data, such the calculations, and such the reasoning
of Mr. Bailly, on this subject.
But, although Mr. Lalande has noticed the retrograde series of the
progressive numbers (1,) 2, 3, 4, in the Asiatic account of the age of
the world, a kind of mysterious constitution of the amount of the
years, in the several ages which make up the entire sum of its
duration, seems to have escaped the observation of that acute
philosopher; and probably the same circumstance passed also
unnoticed by Mr. Bailly: it may be considered as a species of
chronological abracadabra, engendered in the prolific brain of some
eastern philosopher: the following is the circumstance here meant. It
will be perceived, in the first place, that the arrangement of the
numerical figures, in making up the years allotted to the fourth age of
the world, is apparently artificial, and therefore, probably, altogether
arbitrary. It will then be seen, that the number of years in the third
age is double the amount of those in the fourth; that those in the
second is made up by adding together the years in the fourth and
third ages; and, that those in the first age are constituted by an
addition of the number of years in the fourth and second ages. This
being the fact, it does not seem to bear out Mr. Bailly, in his
hypothesis, and the calculations founded on it. W. B.
A2a. Mr. Bailly was the author of a History of Ancient and modern Astronomy.
His Essay on the Theory of Jupiter’s Satellites, which is said to be a valuable
treatise, was published in the year 1766. Both works are in the French language,
and were printed in France.
A3. Lalande observes that Mr. Bailly has gone back, in his
astronomical researches, to the first traditions of an antedeluvian
people, among whom there remained scarcely any traces of such
knowledge; and that he has presented us, in his work, with ingenious
conjectures and probabilities; or, more properly, appearances of
truth, (“vraisemblables,”) written with many charms of extensive
information. But, according to Mr. Lalande himself, all the ancient
astronomy down to the time of Chiron, which was about fourteen
centuries before the Christian era, may with probability be reduced to
the examining of the rising of some stars at different times of the
year, and the phases of the moon; since, long after that period, as
this great astronomer remarks, the Chaldeans and Egyptians yet
knew nothing of either the duration or the inequalities of the
planetary movements. W. B.
A4. See the preceding note.
A5. Some of the constellations appear to have been named, even

before the time of Moses, who was born 1571 years before Christ:
but, probably, most of them received their names about the time of
the Argonautic expedition, which took place in the year 1263, B. C
Hesiod and Homer who were co-temporaries, or, at least,

flourished nearly at the same time, that is to say, about nine
centuries before the Christian era, mention several of the
constellations; and, among the rest, the Bear and the Hyades: and it
is noticed by Mr. Lalande, that La Condamine says the Indians on
the river Amazons gave to the seven stars in the Hyades, the name
of the Bull’s-head, as we do; and that Father Lasitau tells us, the
Iroquois called that assemblage of stars to which we give the name
of the Bear, by the same name; and named the polar star “the star
that does not move.”
These are interesting facts. There is not the least resemblance,

whatever, in the two constellations which have been mentioned, to
the animals whose names they bear. Is it not, then, a matter of great
curiosity, as well as one which may prove important in its result, to
enquire, why two great tribes of uncivilized men, (supposed, by
some, to be aborigines,) in the northern and southern sections of the
western hemisphere, should apply the same denominations to two
assemblages of stars, by which those constellations were known to
Hesiod and Homer, if not earlier, and at least twenty-five hundred
years before? W. B.
A6. Hipparchus (of Nicæa, in Bithynia,) was a very celebrated

mathematician and astronomer of antiquity. Mr. Lalande styles him
the most laborious and most intelligent astronomer of antiquity, of
whom we have any record; and asserts, that the true astronomy
which has come down to us, originated with him. He divided the
heavens into forty-eight (some say forty-nine) constellations, and
assigned names to the stars. He is also said to have determined
latitude and longitude and to have computed the latter from the
Canaries; and he is supposed to be the first who, after Thales,
calculated eclipses with some degree of accuracy: but he makes no
mention of comets. Hipparchus died one hundred and twenty five
years before the Christian era. W. B.
A7. Friar Bacon is said to have been almost the only astronomer
of his age; he informs us that there were then but four persons in
Europe who had made any considerable proficiency in the
mathematics.
A8. Regiomontanus was born in the year 1436, at Kœnigsberg, a

town of Franconia, subject to the house of Saxe-Weimar. His real
name was John Müller: but he assumed the name of Regiomontanus
from that of the place of his nativity, which signifies Regius Mons.
This astronomer, who was greatly celebrated in his time, was the
first, according to Lalande, who calculated good Almanacks; which
he had composed for thirty successive years; viz. from 1476 to 1506.
In these (which were all published at Nuremberg in 1474, two years
before his death,) he announced the daily longitudes of the planets,
their latitudes, their aspects, and foretold all the eclipses of the sun
and moon; and these ephemerides were received with uncommon
interest by all nations. After noticing these, Lalande mentions the
ephemerides which are published annually at Bologna, Vienna,
Berlin, and Milan; but he pronounces the Nautical Almanack, of
London, to be the most perfect ephemeris that was ever published.
Regiomontanus compiled several other works, which greatly
promoted his reputation, He died in 1476, at the age of forty years.
W. B.
A9. See some interesting particulars respecting this great man in

Lord Buchan’s account of the Tomb of Copernicus, and in the note
thereto, inserted in the Appendix. W. B.
A10. Tycho-Brahé, as Lalande remarks, was the first who, by the

accuracy and the number of his observations, prepared the way for
the renewal of astronomy. The theories, the tables, and the
discoveries of Kepler, are founded on his observations; and Lalande
thinks, that their names, after those of Hipparchus and Copernicus,
ought to be transmitted with immortal honour to posterity.
Tycho was born in the year 1546, at Knudsturp in Scania in

Denmark, of a noble family, which subsisted also in Sweden under
the name of Brahé, and to which the marshal count Lœwendahl was
allied. He died in 1601, at the age of fifty-five years.
Frederick II, king of Denmark, gave to Tycho the little island of

Huen, called in Latin Venusin, towards the Sound, and about ten
leagues, northward, from Copenhagen: where that prince erected for
him a castle, named Uraniberg, and an observatory attached to it,
completely furnished with the best instruments. Yet only fifty-one
years after the death of Tycho, Mr. Huet, whose curiosity led him to
visit a place so celebrated could find no vestige of the observatory.
One solitary old man, who yet retained some recollection of it, told
him that the tempestuous winds to which they were subject along the
Sound, had demolished it. Even the name of Tycho was then
unknown in that savage island, as Mr. Lalande indignantly styles it:
and Mr. Picard, who was sent by the French academy, in 1671, to
ascertain the exact situation of the observatory, was obliged to have
the earth dug away, in order to discover its foundation. W. B.
A11. “Certain it is,” says the learned and pious Dr. Samuel Clarke
(in his Discourse on the Evidences of Nat. and Rev. Religion,) “and
this is a great deal to say, that the generality, even of the meanest
and most vulgar and ignorant people,” (among Christians,) “have
truer and worthier notions of God, more just and right apprehensions
concerning his attributes and perfections, deeper sense of the
difference of good and evil, a greater regard to moral obligations and
to the plain and more necessary duties of life, and a more firm and
universal expectation of a future state of rewards and punishments,
than, in any heathen country, any considerable number of men were
found to have had.”
In like manner, Archdeacon Paley (in his View of the Evidences of

Christianity) observes:—“Christianity, in every country in which it is
professed, has obtained a sensible, although not a complete
influence, upon the public judgment of morals. And this is very
important. For without the occasional correction which public opinion
receives, by referring to some fixed standard of morality, no man can
foretell into what extravagances it might wander.” “From the first
general notification of Christianity to the present day,” says the same
ingenious writer, “there have been in every age many millions,
whose names were never heard of, made better by it, not only in
their conduct, but in their dispositions; and happier, not so much in
their external circumstances, as in that which is inter præcordia, in
that which alone deserves the name of happiness, the tranquillity
and consolation of their thoughts. It has been since its
commencement, the author of happiness and virtue to millions and
millions of the human race.” He then asks: “Who is there, that would
not wish his son to be a Christian?” W. B.
A12. Some of the commentators inform us, that Mahomet taught

that the earth is supported by the tip of the horn of a prodigious ox,
who stands on a huge white stone; and that it is the little and almost
unavoidable motions of this ox which produce earthquakes.
A13. Pythagoras, who was one of the most celebrated among the
Greek philosophers, in the knowledge and study of the heavens, was
born about 540 years before the Christian era. It is believed that he
was the first who made mention of the obliquity of the ecliptic, and of
the angle which this circle makes with the equator; although Pliny
attributes this discovery to Anaximander, whose birth was seventy
years earlier. Among the remarkable things which Pythagoras taught
his disciples, was the doctrine that fire, or heat, occupied the centre
of the world; it is supposed he meant to say, that the sun is placed in
the centre of the planetery system, and that the earth revolves
around him, like the other planets. He also maintained each star to
be a world; and that these worlds were distributed in an ethereal
space of infinite extent. W. B.
A14. Thales, who died about five centuries and an half before the
Christian era, in the ninety-sixth year of his age,[A14a] first taught the
Greeks the cause of eclipses, He knew the spherical form of the
earth; he distinguished the zones of the earth by the mean of the
tropicks and the polar circles; and he treated of an oblique circle or
zodiac, of a meridian which intersects all these circles in extending
north and south, and of the magnitude of the apparent diameter of
the sun.
Herodotus, Cicero, and Pliny, assert, as is noticed by Mr. Lalande,

that Thales had predicted, to the Ionians a total eclipse of the sun,
which took place during the war between the Lydians and the
Medes, But the manner in which Herodotus (who lived about one
century, only, after the time of Thales) speaks of this prediction, is so
vague, that one finds some difficulty in believing that it was fact, If it
were true, says Lalande, that Thales had actually foretold an eclipse
of the sun, it could be no otherwise, than by means of the general
period of eighteen years, of which he would have acquired a
knowledge from the Egyptians or the Chaldeans: for the period had
not yet arrived, when eclipses could be prognosticated by an exact
calculation of the motion of the moon. W. B.
A14a. But, according to Dufresnoy, he was born in the first year of the 35th
Olympiad, and died the first year of the 52d, those periods corresponding,
respectively, with the years 640 and 572, B. C.: and if so, he lived only sixty-eight
years.
A15. Alhazen was one of the greatest of the Arabian astronomers.

He went, about the year 1100, to Spain, where many of his nation
had established themselves in the eighth century, and carried thither
their knowledge of astronomy; yet, from the year 800 down to about
1300, science remained shrowded with the darkest ignorance,
throughout Europe.
Mr. Lalande observes, that the theory of Refractions is an

important one, in astronomy; although it was considered of little
consequence until the time of Alhazen. W. B.
A16. Aristotle, as though he had been of the race of the Ottomans,

thought he could not reign except he first killed all his brethren.
Insomuch as he never nameth or mentioneth an ancient author or
opinion, but to confute or reprove. Bacon. Advancement.
A17. Timocharis of Alexandria endeavoured, with Aristillus, a

philosopher of the same school, to determine the places of the
different stars in the heavens, and to trace the course of the planets.
Dr. Lempriere places him 294 years before Christ; and the Abbé
Barthelemy has inserted his name in the list of illustrious men, who
flourished in the fourth century before the Christian era: he probably
lived some time after the commencement of that century. W. B.
A18. By its peculiar situation it will continue to do so for a long

time.
A19. According to Lalande, Kepler was as celebrated in astronomy

by the consequences he drew from the observations of Tycho Brahé,
as the latter was for the immense mass of materials which he had
prepared for him: and the Abbé Delaporte (in his Voyageur François)
represents him as precursor of Descartes in opticks, of Newton in
physicks, and as a law-giver (“legislateur”) in astronomy.

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Medical Assisting-Administrative and

Clinical Procedures, 7e (Jan 6,

Kathryn A. Booth Leesa G. Whicker Terri D. Wyman

Leesa G. Whicker, BA, CMA (AAMA)

Terri D. Wyman, CPC, CMRS, CMCS, AS

CLINICAL PROCEDURES FOR MEDICAL ASSISTING

This book is printed on acid-free paper.

Cover Image: Pefkos/Shutterstock

ISTUDY boo66579_fm_ISE.indd ii 11/05/19 05:03 PM

Introduction to Medical Assisting 1 Legal and Ethical Issues 48

Professionalism and Success 13

4.3 Types of Communication 33 Introduction 82

C H A P T E R 7 Electronic Health Records 142

Safety and Patient Reception 98

9.1 The Exam Room 128 14.3 Telephone Etiquette 165

Patient Education 184

The Blood 300 Introduction 343

26.1 Components of Blood 301 29.2 Neuron Structure 344

Urinary Systems 542 PROCEDURE 41-1: Coaching and Communicating with

PROCEDURE 43-7: Performing Ear Irrigation 645 Introduction 677

Diagnostic Imaging 822

50.1 Brief History of the X-ray 823

50.7 Electronic Medicine 837 52.4 Dosage Calculations 872

ELECTRONIC HEALTH RECORDS: 50.01 Document

PRACTICE MEDICAL OFFICE: Clinical: Interactions 842 Introduction 881

Physical Therapy and Rehabilitation 912 U N I T N I N E

54.6 Traction 923 Introduction 965

PROCEDURE 54-2: Administering Thermotherapy 929 BODY ANIMAT3D: Concussions 971

*Indicates EHRClinic video

FIGURE FM-1 The new Practice Atlas.

A CLOSER LOOK xxiii

xxiv A CLOSER LOOK

proficiency. Procedure Goal: To create a new patient record using EHR

and CAAHEP medical assisting competencies covered in the

of medical assisting. The text features include the following: efficiently.

include pictures of each of the patients who comeConfirming

ing avatars in the new and ABAs). Students are ingorcertain

Mohammad Nassar has at once.)

d. Documentation d. The patient demographic form

tearable procedure sheets mirror the exact procedures in

­Outcomes. The summary is followed by an end-of-chapter

review with questions related to the case study, as well as 10

multiple-choice exam-style questions.

population and public health. Maintenance of the privacy and

ces present a list of common medical terminology, including

A GUIDED TOUR xxvii

FIGURE FM-3 A new Application-Based Activity (ABA)

You’re in the driver’s seat.

They’ll thank you for it.

Make it simple, Solutions for your

Efiective, efficient studying.

Study anytime, anywhere. “I really liked this

Calendar: owattaphotos/Getty Images

Learning for everyone.

7e Reviewers Kathy Gaeng, RMA, AHI Vatterott 6e Reviewers

is nervous about the exam

V.C.12 Define patient navigator 1. General Orientation

Introduction medical assistants include working and communicating with

INTRODUCTION TO MEDICAL ASSISTING 3

INTRODUCTION TO MEDICAL ASSISTING 5

TABLE 1-2 Medical Assisting Credentials

INTRODUCTION TO MEDICAL ASSISTING 7

INTRODUCTION TO MEDICAL ASSISTING 9

ISTUDY boo66579_fm_ISE.indd ii 11/05/19 05:03 PM

Outcomes. The summary is followed by an end-of-chapter