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Tufts MC offers Medical Assistants a ladder to step up their careers


When the turnover rate for Medical Assistants jumped last year, Tufts Medical Center leaders knew they needed to be creative to retain these important patient care team members.

Medical Assistants (MAs) play a pivotal role in providing efficient, cost-effective, safe patient care in the clinics. Executive Director of Patient Care Heidi Waitkus, RN, MBA worked with Gina Giarusso, MSN, RN and Human Resources to develop a “Medical Assistant Clinical Ladder.” The program focuses on improving the quality of the employment experience for Medical Assistants through the retention, recruitment, advancement and education of nationally certified medical assistant candidates.

Exit interviews by Human Resources showed the turnover was only partially due to monetary reasons. More importantly, former MAs said they didn’t feel respected, valued or part of a team. They wanted more opportunities for development or growth. “We did some research and benchmarking, and created a four-step career ladder for medical assistants. It would give them an opportunity for professional growth and a market salary adjustment as they grow.” The ladder also gives Medical Assistants more opportunities to feel they are part of a team. .

As part of the ladder, MAs can earn national certification. “As an organization, we decided we would pay for that national certification. We would pay for the books for them to study for it,” said Heidi Waitkus. Gina Giarusso runs the program and educates the MAs, orders books and continues benchmarking other nationally certified Medical Assistant programs.

The program already has sparked an increase in motivation and a sense of belonging; Medical Assistants are pretty excited, and outside Tufts MC, others are excited about it as well. “When we met with The Joint Commission during our recent review, I talked to them about this program and the surveyor suggested I submit it to them because it’s one of the best practices she’s heard about,” Heidi added.

Medical Assistant clinical ladder steps

Step 1 on the ladder is Entry Level. Medical Assistants come to Tufts MC from a certified program that can run anywhere from six months to a year. According to Heidi Waitkus “We increased the grade for step 1, so everyone in the organization who was on step 1 increased a grade automatically.” 

Step 2 is Cross-trained which is primarily for MAs in smaller clinics. For example, they can learn to check-in patients within the scheduling system. 

Step 3 is Nationally Certified. “We have 98 Medical Assistants among our satellites and Tufts MC campus, with about 88 on this campus. Of those, four were nationally certified when we hired them and now they are our champions. Of the rest, 56 are studying for the exam, which is remarkable,” Heidi added. 

Step 4 on the ladder is a position as a Team Lead.

The success of this program may expand to other careers. Executive Director of Patient Care Justin Precourt, RN, MSN, and Heidi are looking at similar models for inpatient unit coordinators and licensed practical nurses.