Medical assistants help physicians examine and treat patients, as well as perform routine tasks needed to keep an office running efficiently. In small practices, medical assistants handle both clerical and clinical duties and report directly to the office manager or physician. Those employed in large practices tend to specialize in a particular area under the supervision of department administrators. Clerical duties may include patient scheduling, receptionist duties, medical record management, office correspondence, medical insurance procedures, and management of office accounts, fees, and collections. Clinical duties may include interviewing patients, patient education, taking vital signs, preparing patients for examination and assisting the physician during exams, performing routine laboratory testing and electrocardiography, sterilizing instruments, and administering medications.