Redesigning the Role of Medical Assistants in Primary Care: Challenges and Strategies During Implementation

Janette Dill, Jennifer Craft Morgan, Emmeline Chuang, Chivon Mingo

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Efforts to reform primary care increasingly focus on redesigning care in ways that utilize nonprovider staff such as medical assistants (MAs), but the implementation of MA role redesign efforts remains understudied in the U.S. health care literature. This article draws on rich, longitudinal case study data collected from four health care systems across the United States to examine critical challenges in the planning, implementation, and early sustainment of MA role redesign efforts in primary care. During the planning period, challenges included recruitment of highly trained MAs, compliance with organizational and state regulations regarding MA scope of practice, provision of consistent training across primary care clinics, and creation of career ladders that provided tiered compensation for MAs. During active implementation, challenges included provider training and preventing MA burnout. Strategies for addressing challenges in MA role redesign efforts are discussed, as well as early sustainment of program practices and organizational policies.

Original languageEnglish (US)
Pages (from-to)240-250
Number of pages11
JournalMedical Care Research and Review
Issue number3
Early online dateAug 14 2019
StatePublished - Aug 14 2019

Bibliographical note

Funding Information:
The authors would like to thank The Hitachi Foundation for underwriting the cost of Care Team Redesign projects and the Care Team Redesign National Evaluation, which funded the analysis presented in this article.

Publisher Copyright:
© The Author(s) 2019.


  • complex innovation
  • health care workforce
  • implementation
  • medical assistants
  • patient-centered medical home
  • primary care


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