Medical office assistants are the frontline workers who answer the calls that continuously come into the doctor's office but that's not all they do.
A medical office assistant is the listener, the rest-assurer, blood pressure taker, weight and height measurer, eye-examination conductor, procedural assistant, record keeper, office and medical supply orderer, lab requisition forwarder, specialist referral sender, appointment maker, billing clerk, examining room sterilizer, information relayer and yes, they are the person you hand your urine sample to once you're done peeing in the bottle.
Yet medical office assistants are not considered part of the healthcare team, however, according to the list of medical healthcare professionals on the B.C. government website. The consequences of this became glaringly obvious during the outbreak of COVID-19 when the shortcomings of not being recognized as healthcare workers included not having priority to get personal protective equipment or access to the wage subsidy offered by the federal government for frontline workers.
Two medical office assistants in Prince George spoke to The Citizen on the condition of anonymity about their working conditions and the problems MOAs face on the job.
"The system has been in place for years and we're not complaining about our employers, it's just something that has been going on for 15, 20, maybe even 30 years, and we want things just to slowly start to change," Marilyn, (not her real first name), said. "We are expected to find our own replacements if we are sick or want to go on holidays, we are all individually employed by the physicians we work for. I have never heard of another job where you can’t take holidays or call in sick because there is no one to call."
There is no union, no benefits and no call board to access to find a temporary replacement.
"So it's not so much an issue with our employers, just as a whole we need better support from the government to give us things like better resources to support us," Marilyn, who has worked as an MOA for five years, said.
Another local MOA, who has worked in the field for 10 years, gave an example.
"If any one of us MOAs was sick before COVID we would just go to work with a bad cold," Jane, not her real first name, said. "With COVID-19 and the new rules and regulations - for everybody feeling sick - because no one knows if it's bronchitis, pneumonia or COVID - they are saying for everybody 10 days minimum off unless you get a COVID test and it comes back negative, then when you start to feel better you can go back to work. But for us to be off 10 days, that leaves doctors without anybody to run their office."
In that case, if the doctor has an individual practice, with only one assistant, the doctor has to run the office on their own and see patients or they would be forced to close the office because they can't do their job properly unless someone is at the front desk, Jane added.
"That puts a lot of pressure on us because at this point we have no choice but to call in sick and leave that doctor pretty much stranded," Jane said.
"When it comes to the designation by the government, which became glaringly clear during the pandemic when the government offered wage top-ups for frontline workers, because family practitioners are paid in a fee-for-service format, we don't qualify," Marilyn said. "We're not recognized by the government. To them we don't exist."
The MOAs said they've contacted all branches of the government and there has never been a response or the response was a form letter that offered no follow up or solution.
"When we first looked into the wage top-up we were told that we don't qualify because doctors are paid in a fee-for-service format," Marilyn said. "Well, name one part of the medical industry that isn't paid in a fee-for-service format."
It's not the doctors' fault they are paid fee-for-service, Jane added.
"And I am sure the doctors would support us but it's going to take hundreds of thousands of people to take this on, not just two people," Jane said. "Everybody is so afraid to come forward because they think that they might possibly lose their job and I've told them - you're not going to lose your job - it has nothing to do with our employer. It has to do with the way things have been done for 20-some-odd years and the pandemic is forcing us to ask for these changes."
The pandemic wage top-up was the catalyst that inspired the two MOAs to approach the Citizen.
"It was the straw that broke the camel's back," Marilyn said.
It makes them feel like they're not equal to others doing similar work in the medical field, Jane added.
"It's just reinforced that we don't matter," Marilyn said.
There's never been a guideline put in place for wages or an opportunity to get benefits.
"Or all those other things that having a union or some sort of back up might help with," Jane said. "And again it's nothing against the employer. It's a system that's been here for so long but just because it's been here for 30 years doesn't mean it should stay here."
It seems the union umbrella could be the key.
"They tried to form a union a couple of years ago," Jane said. "It fell through because they didn't have the support. The employees are afraid that if they take a stand, the employer isn't going to put up with it."
The two MOAs hope getting their story out will spark a conversation that leads to change.
"It needs to happen," Jane said. "This situation isn't just in BC, it's all over Canada. The MOA community in Canada as a whole has to start talking so we're heard, we're recognized."
One expert observer agrees that change is needed to better protect MOAs.
"In providing good quality primary care I would say MOAs are essential," Andrew Longhurst, Canadian Centre for Policy Alternatives health policy researcher and research associate, said. "They are critical to the success of primary care and I think it's a very unfortunate blindspot. It's a long standing issue in B.C. and I would say we have not done a very good job from a policy perspective of ensuring and supporting medical office assistants as part of the healthcare team."
Longhurst also noted within the public healthcare system patients aim their frustration at an MOA.
"I think that's often unfair because they are really critical and not necessarily supported in their roles in the way that they ought to be and that's unfortunate," Longhurst said.
Medical office assistants are not regulated under the Health Professions Act, he added.
"But they certainly are a critical part of the team in terms of delivering care and being able to communicate patient needs to the regulated healthcare staff," he said.
After reaching out to the Ministry of Finance to inquire about the wage top up offered to frontline workers that excluded medical office assistants The Citizen received this response:
“We know that not every program can cover everyone, and it’s encouraging that many private sectors employers are stepping up to provide pay increases for their frontline workers. With the temporary pandemic pay program, we are recognizing the frontline workers delivering care to those most vulnerable, where physical distancing is the most difficult. We understand this will mean not all employees who have been working during this time will be eligible, however, given the limited funding parameters of this cost-shared federal program, we did our best to maximize the benefit to the most employees possible. More than 250,000 workers are expected to be eligible for temporary pandemic pay.”
After reaching out to the Ministry of Health for comment a representative directed The Citizen to the Ministry of Finance and then when The Citizen put in another request for comment about MOAs not being recognized as healthcare professionals, no other comment was offered.
The Medical Office Assistants Association of BC did not respond to requests for comment about this situation.
