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Medical Assistant Prep / Unit 27   MAS 674 review, 2 to 3 minutes

A Question About an Advance Directive

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The idea

This case is constructed for this course. It shows how a medical assistant supports a patient's advance care planning during the health history, while staying within her role and leaving the substance to the provider.

In practice

During the health history, the medical assistant asks an older patient whether he has an advance directive, as the practice's intake form requires. He says his daughter is his health care proxy, but he is not sure whether he ever completed a living will. He asks her what she thinks he should put in one. The medical assistant does not offer opinions about treatments. She explains that a living will states which treatments he would or would not want, and that a durable power of attorney for health care names someone to decide when he cannot. She tells him that the provider can talk with him about his wishes. She also mentions that forms vary by state and that the practice can give him information. She records that he has named a proxy, notes the proxy's name, and asks him to bring a copy of the document so it can be added to his record. She lets the provider know that he has questions about a living will. At his next visit he brings the proxy form, and she scans it into his record.

Where people slip

Advance care planning is a conversation about a patient's values, led by the patient and the provider. The medical assistant's part, asking, recording and making sure the documents reach the record, is what makes a patient's wishes findable when they matter most. A proxy form sitting in a drawer at home cannot guide anyone in an emergency.

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