medical assistant scope

Scope of Practice

Many occupations that involve taking care of people via a certain set of skills, duties, routines and conduct are regulated by the state, or a licensing board, committee,  or professional membership associations. When such workers practice their skill they are required to stay within their discipline’s scope of practice—meaning, they must adhere to established boundaries. This is especially true in health and medical professions and the same goes for beauticians, electricians, plumbers, firefighters, police officers and more.

We want to make it clear that a medical assistant is NOT a licensed doctor, health practitioner, or clinician.  Medical assisting is a vocation that falls into the so-called middle-skills job class. Professionals are held to a different level of responsibility than a skilled or assistive worker.  Every medical assistant, whether certified or non-certified, formally trained or trained on the job, must practice their skill only under the direct supervision of the doctor (M.D., PhD), licensed healthcare practitioner, or nurse practitioner who hired them. In turn, these professions are largely overseen and ruled by the State Medical Board and Medical Examiner and to some extend by the US Department of Health and State Board of Nursing.

Laws that Pertain To Medical Assisting

Too many doctors, medical office supervisors and even the medical assistants themselves are confused and unsure how to properly utilize and supervise medical assistants in their office. Only a few state’s laws are very specific when it comes to medical assistants.

The Tex Med Website has put it well when they state: “The term medical assistant has no real legal significance. Medical assistants (MAs) are not licensed, certified, or registered by any agency of the State of Texas, nor are they recognized under federal Medicare or Medicaid laws as a species of provider. There is no reference to medical assistants in the Medical Practice Act, or any other Texas Statute, thus, there is no specific legal regulation of medical assistants…”

South Dakota is a good example of a state that recognizes and regulates the activities of medical assistants.  Their application process for registration is stringent and requires renewals and fees. For your state see AMA List of State Medical Boards.

Medical assistants in California must have a diploma or certificate from a vocational training institution or health care instructor, when performing invasive procedures, such as drawing blood. This documentation must be retained as a record by the employer.

In New Jersey,  it is up to the physician to determine whether the medical assistant has attained a satisfactory level of comprehension and experience in the  performance of phlebotomy, or administration injections, which includes any substance related to allergenic testing or treatment, local anesthetics, controlled dangerous substances, experimental drugs including any drug not having approval of the Food and Drug Administration (FDA), or any substance used as an antineoplastic chemotherapeutic agent with the exception of corticosteroids. Other states my not permit such injections being administered by medical assistive staff.

Bottom line is: the physician is ultimately responsible for managing the health care of patients in all settings. Patients must be made aware that they are being cared for by a medical assistant and not a nurse, or physician assistant when direct care is provided. The medical assistant is generally prohibited from doing  invasive procedures, such as urinary catheter insertion, starting intravenous (IV) lines, arterial blood draws, cosmetic laser treatments, administering Botox injections and chemotherapeutic, or narcotic drugs.  Furthermore, they may need limited licences for highly technical tasks, such as operating radiological equipment and exposing patients to x-rays. Laws can change from state to state.

Researching Medical Assistant Regulations

If you are researching laws that pertain to a medical assistant in your state your first stop should be the State Medical Board, since this is the authority that regulates the practice of medicine. Some offices of Health and Human Services and the State Board of Nursing have also added text into their rules on how doctors and registered nursing staff can utilize medical assistants under their supervision.

Medical Assistants Are NOT Allowed to:

Medical assistants are prohibited from making independent health assessments, judgments about medical treatment, diagnoses and may not:

  • independently triage patients
  • interpret diagnostic test results
  • dispense medications without a prescription
  • administer medications without doctor’s orders
  • administer medications directly into the vein

A higher degree of caution is necessary whenever the medical assistant’s duties are predominantly clinical, rather than administrative, since more harm and damages can be done when direct patient care procedures go wrong, however, an administrative medical assistant entering incorrect patient demographics, or medical histories into the medical chart can be just as detrimental. While each medical assistant can and will be held directly responsible for their own actions in a court of law should something go wrong, their employer might also face serious consequences should laws be disregarded and harm occurred.

Leave a Reply

%d bloggers like this: