Michigan healthcare management professional Jill Vroegindewey started her three-decade healthcare career as a medical insurance coder in the billing department of a radiology group. She considered it 'just' a job while she was attending Western Michigan University with an eye on a bachelor's degree in business. Jill earned her Certified Medical Assistant certification along the way.
When the group's office manager unexpectedly left the practice for another job, Jill was promoted. One opportunity led to another within the practice. For a time, she scaled back her schedule to work two days a week to accommodate her growing family. The position grew with her availability, and a series of 'streamlining' moves between hospitals and practices led to a marketing/human resources role for the same radiology practice, then to her current role as the diagnostic marketing liaison for Bronson Methodist Hospital/Dept. of Radiology in Kalamazoo, Mich.
Jill's CMA certification requires 60 continuing medical education credits every five years for re-certification eligibility; she was first certified in 1987. Her business studies plus her CMA status served to pave the way in her healthcare management career in what she describes as a series of opportunities. "I've been very open to new experiences and career paths," she tells MedicalSchools.com.
Tell us about your career. How did you break into the medical field? How did your career unfold to allow you to advance to where you are today?
I went from a job in the billing office of a radiology group to deciding to attain my CMA certification. At that time, certification did not translate into additional benefits or pay, but it brought great personal satisfaction. My boss had been there 20 years, and unexpectedly left to go to another job. So I became the business office manager, which at that time also included the role of controller, and continued to attend Western Michigan University a few classes at a time. It was an interesting time, right at the beginning of computerization of files; before that we used the punch hole data cards.
When I started my family, I was able to cut back to part time; working two days a week calling on referring physicians in support of our radiology services, and basically catering to their needs. For nine years, eventually stretching the two day a week schedule to a four day a week schedule, I called on the physicians. This is where my medical assisting certification really paid off as I was able to speak intelligently with referring providers with regard to every aspect of our services.
When the controller retired, my educational background in business made me a natural. I guess you have to have a willingness to have opportunities presented to you for consideration, something that I have done throughout my career. Classes and certifications in human resources as well as the CMA opened all kinds of doors for me. I became HR/Benefits manager and served in that role for seven years.
In 2003 my radiology practice merged with another group – more than tripling the size of our practice. This merger eventually led to a joint venture between one of the hospitals we served and our radiology practice. When this change occurred, I wasn't sure if they would need me around. A new position was created for me, the first year, jointly paid by the practice and the hospital. It has resulted in more business for both the Joint Venture and the hospital radiology department. Once again, I am calling on referring providers to talk to them about the exciting things happening in diagnostics, including how to order our services and access testing results through the internet. Although my role is marketing radiology services, my knowledge base is broadening to include lab services. There is a learning curve, but less of a curve for a medical assistant than there would be for a straight marketing background person. The CMA has given me the opportunity to do cross-training.
How do you tap into your CMA training on the job?
Knowing both administrative and clinical aspects has become very important in healthcare management. For instance, malpractice companies are seeking credentialed personnel. When you are working with insurance billing, understanding diagnostic coding and terminology is critical. We can't market to people who can't come to our hospital, so I work with insurers all the time to understand what we have to do to work within their system to help their insured get our tests covered.
The psychology aspects of a CMA background are also important, as you are always striving to produce exceptional patient care. It helps you understand situations you find yourself in with the referrals. Sometimes a patient feels they've had a horrible experience, and it's important to remember that their perception is their reality. It's your job to find out how you can turn the experience into an opportunity to improve patient care for all patients.
What do you enjoy most about your career? Your current position?
I treasure the relationships I have been able to create with my referring providers, constantly searching to tools to give them to better care for our mutual patient. Being employed by the hospital, having the availability to tap into their resources, has been great for us.
Now we're film-less, with access to images over the internet or produced on a CD. Even the most 'Podunk' office is now getting internet. In radiology, we sell one product, it's a report. All our lab results and radiology reports are now available through the internet as soon as they are transcribed. The turnaround time on that report is the most critical thing we do so, because it allows referrers to diagnose their patients. Whatever we can do to cut that reporting time is great thing. It's been really satisfying.
Another aspect I enjoy is improving our access to providers. While we previously had limited the access to providers that were credentialed with our hospital, we've determined it is good patient care to open access to our reporting to other practices such as podiatrists, chiropractors, as well as interfacing with the other hospitals. It's all about patient care; it's the reason we're here.
What are the rewards and challenges in your current position?
One of the best things I've done over the 30 years is develop strong relationships with all different types of people in the medical offices, across state lines even. Networking is a great thing, in several cases I've been able to draw on my contacts to save valuable research time searching for new vendors or system upgrades.
One challenge is customer service. The thing to know is that if there is an issue, follow the 3-A rule: acknowledge, apologize and amend.
What ranks among the favorite projects that you've completed in your career and why?
The transition from punch card records to microfiche to computers for billing information. Today, film-less imaging is very exciting. If a patient needs their images to take to another provider we can produce them on a CD or in many cases are able to give the provider access to the images through our internet based reporting tools. I helped develop the radiology web site, as well as numerous brochures on diagnostic imaging.
What has been your personal key to success?
I love meeting new people in the field, and helping them to help their patients. If I can get them to mention what their biggest pet peeves are, and I can solve their problems, that makes me feel so good.
What are some of your personal and/or professional goals for the future?
I have no huge aspirations of getting to the next level. I feel it's been a wonderful ride. I'm happy being in a new position, developing that role. I only intend to work another five to eight years at the most. I don't intend to slack off, but I don't have my eye set on another career move. I'm very open. My faith plays a strong role in my professional life... I go where He leads.
Do you feel that is important for someone to be passionate about the healthcare field in order to be successful? Do you think that it's important to truly enjoy the field in order to be happy in life?
I don't know how you could do this job without having a heart for people. It would make no sense. It's what drives me to perform to the very best of my abilities.
Describe a typical week of work for you. What exactly do you do? What are your key responsibilities? On a basic level, what skills does your job demand?
I make between 15 and 20 calls a week on referring physicians. I'm always working on a publication, such as our quarterly newsletter, or developing a presentation. I get involved with service issues, marketing materials and communications. Identify new referral sources, payers and insurance groups.
I facilitate our Imaging Update luncheons, where we invite referring provider staff and exchange information regarding new radiology procedures and how we can better serve their practice. This event is co-sponsored by our local chapter of medical assistants so we are able to offer continuing education credits toward certification requirements. Usually we have a radiologist speak on a new topic, and then tell them how to schedule for that procedure. The luncheons are becoming quite evolved. The first one we hosted had 15 attendees, and these days, we're averaging 75 people at each event.
I also work closely with central scheduling at the hospital; I review the 'bad orders' with the referrers. Since the scheduling department will not schedule someone for an exam without a "good order," I call on the physicians offices, meeting with the office managers and physicians to make sure the order is turned into a 'good' order; it's part of the education process to help them help their patients. Whenever possible we want insured patients to receive all the benefits their coverage allows, and submitting clean orders with appropriate coding and documentation substantiating medical necessity of the procedure ordered is the first step in this process.
What are the tools of the trade that you use the most or favorite gadget?
My PDA. I would be lost without it; all of my contact info. And my radiologists' schedules are in there. Another tool I use is a quarterly report that tracks referring providers by procedure, by month. I use this as research to help make decisions on new equipment, and to call on physicians whose referral patterns have changed – for the better or worse – as well as those who are new referrals.
Has the popularity of the Internet affected your profession?
Web-based film viewing is the biggest impact. We're also moving to a direction where patients will be able to schedule their own exams, on-line.
What challenges will be addressed by your industry in the next five years?
HIPAA (Health Insurance Portability and Accountability Act) frustration. I think we're killing a lot of trees with the paperwork. It has actually changed the way some people practice. The patients sometimes feel the doctors are losing touch with them... HIPPA takes away one more level of personal attention to the patient.
Is it important to collaborate with your colleagues? How have your professional collaborations benefited your career?
Getting involved in the American Association of Medical Assistants has proved to be very rewarding. My activities there, including site surveys, opened my eyes to ways others practice medicine across the country. It gave me examples along the lines of 'who is doing what, and where.' I got to meet with them, talk to them about their successes; these relationships have become part of my network.
What are some common myths about your CMA licensing?
A myth is that CMAs are nursing assistants of some sort. People don't understand the credential, the scope of practice of a CMA. As a CMA, you're only as limited as the employer that employs you. You can do everything a nurse can do in the ambulatory setting. If you are seeking a job and are a new CMA, make sure the employers know what your credential is, and your scope of practice. The pay follows the understanding.
Can you share an interesting patient care or marketing anecdote?
Patients do take you very literally, sometimes. Once I was helping out with admissions in the radiology department, and I asked an elderly patient to put on her gown. The typical line to patients is "Take everything off; the gown goes over your head, when you're ready have a seat in the waiting room." When the technologist went to get her for her exam she the patient was sitting in the waiting room, stark naked, with the gown wrapped around her head. Luckily she was the only one there.
What contributions do you feel CMAs make to the healthcare field, and to society as a whole?
They're the right people to have in physicians' offices, as well as certain departments of the hospital. I think sometimes we think too narrow mindedly. More fields should specify medical training such as a CMA. We can add more than people understand, in all types of settings. It's our job to promote the credential, the scope of practice CMA's offer.
What are the best ways to land a CMA job?
Through other CMAs. Get involved in local, state and national organizations, use that network!
How available are externships?
Readily available. Before you graduate from an accredited program, you must serve 160 hours; unpaid and under the supervision of a licensed MD, DO or PA to receive your certification. It's a great opportunity for employers, particularly with the nursing shortage. If it works out, you've landed a job!
How is the job market now? How do you think it will emerge over the next five years?
It's very good right now. The nursing shortage is having a great effect for CMAs... However, it's still at lesser pay than nurses. Many CMAs later go on into nursing, as it is a very natural transition.
How can the reality of being a CMA differ from typical expectations?
Some of the things they teach in the medical assisting programs vs. real world expectations. I'm kind of disappointed that the CMA programs are slow to change the curriculum and planning; the curriculum doesn't seem to keep pace with the field and technology.
What career advice can you give to future CMAs?
They really need to understand the link between the clinical side and the administrative side. They come out wanting to do one or the other. But some fields tap into both, and I'm an example. The expertise in the medical jargon can open up all sorts of doors, from hospital administration to pharmaceutical sales to medical equipment vendors to occupational health.
What are your pet peeves as a CMA?
The lack of recognition for the credential, challenging of the CMA's right to practice, the low pay, and people who fail to see the link between administrate and clinical. People with the "that doesn't fall within my job category" attitude. I certainly would not have gone as far as I have with that attitude.
What are some of the trends that you see in the healthcare field which could help CMA students plan for the future?
You need to be more educated these days to be successful. Look for a program that at the very least, offers a certificate that allows you to easily move into an associate's degree program if later on you decide to do so. If you decide as you get into it that you'd like more training, and you are enrolled in a restricted program design that won't transfer, you're wasting time.
Keep pushing toward a program that can be built onto for further degrees and certification. Look at the ability to later transfer to bachelor's program. Don't limit your options.
In retrospect, what do you know now that you wish you knew before you pursued your education in the field?
My education pursued me! I wish I had the bachelor's right now, for personal satisfaction... I'm 11 credits away.
What factors should prospective students consider when choosing a school?
Make sure it's an accredited medical assisting program.
Based on what you hear in the industry, what do you think are the most respected and prestigious schools, departments or programs? Does school choice make a difference in landing a good job?
Having the credential from an accredited school is the big thing. But, having the degree with the credential makes a difference. Our community college switched to a certificate program that can go into an associate's program as a way to get students in allied health fields with a shorter education time commitment to get them employable.
What other advice can you give to prospective CMA students?
Do your research. You are not going to get rich in this job, but if you love caring for people, and get great satisfaction from helping people, being a CMA is something you should look into.
Editor's Note: If you would like to follow up with Jill Vroegindewey about the opportunities available to CMAs or about the field of radiology, click here and put the following in the subject line: CMA Interview.