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On Licensure for MAs 

By Lexi, BSN, RN, CCMA, PBT-C
Member- American Association of Medical Assistants

So many hospitals across the US are closing units, hiring freezes on new hires, and even hospitals are closing down. Many people think the health care field is recession proof. Not true!!! One of the first things to go when times are tough are elective procedures, regular check-ups etc, and medical assistants who work in private practices have noticed the change also. They say:

"The patients just are not coming in for their checkups. They either cannot pay co-pays, or have lost their health insurance when they lost their job."

I know of one office that let go of their certified medical assistants and hired LPNs because they are LICENSED; not just certified. And at present there are many LPN who need a job and are willing to work for MA pay! This is why I so push for MAs to become licensed professionals to raise their status, and secure their own future.

Tough Measures for Tough Times

Times are very tough economically right now and it is not going to change anytime soon. To change how the health care world views medical assistants as professionals they must become proactive in their own interest. Change only happens when effort is put forth in numbers.

Why Settle for Good When You Can Have the Best?

Think of it this way-if you were remodeling your home and you had two great contractors to choose from-same price for the same work, both with great references-but only one is licensed, which one would YOU choose?

As a homeowner you would be crazy to choose the unlicensed professional! You would risk everything. Licensure means the state deemed the individual worthy to practice in their field through a series of exams, background checks, and in addition, they must carry professional liability, and workman's comp insurance, and such. Furthermore, and most importantly, the state that regulates them will allow any complaints against them to be filed, investigated, and documented, and hopefully resolved.

How Licensure Works in Health Care

Licensure in health care works the same way! If not, then how will the public know it the MA you work side by side with, or records your vital signs and changes your wound dressing has not been terminated from job after job because of harmful mistakes? As long as no one governs the medical assistant profession we just don't.

A governing state board of medical assistants would register the background and activities of a shoddy medical assistant while employed, and their record would follow them when changing jobs. All complaints, investigations, and performance issues would be kept within their record throughout the state they are licensed in. Furthermore, when seeking to obtain licensure in another state the same record, good and/or bad, would follow along.

Licensure to Regulate the Profession

I have had the pleasure of working with some excellent medical assistants, certified and non-certified alike. I also have had the displeasure of working with medical assistants who could not give a flip about mistakes made. And sadly, I hear on a daily basis from nurses how MAs do procedures they are not licensed to do. Let's change this!

Wouldn't we, as serious minded professionals, rather work as and with other MAs who meet criteria set forth by a board that regulates the profession? Just becoming certified as a MA does not ensure someone should be entitled to work with patients in a health care setting. Background checks are great, but if a MA is fired for negligent care there is no board to answer to! Patients are at risk and so are you if you work with this person by association.

*by Lexi

Lorraine, a Certified Medical Assistant (CMA) with years of experience in the field has shared the following views on the subject: 

Although medical assistants may be well aware of their duties, responsibilities, skill levels, and scope of practice, they are among the minority. Many working in the health care field, including doctors, medical office and health care facility manages, and nurses are not always one hundred percent sure what the pre-employment qualifications and medical assistant's duties are.

On Licensure:

More in our Medical Assistant Forum

Our patients may have an inkling that we're not all nurses but they don't quite know what our title or training is. Add to this confusion the commercials for MA schools that depict the medical assistant racing down the hospital corridor beside a gurney, as if she’s rushing someone into the ER, and it’s no wonder there’s so much confusion.

The Clout of Cluelessness

A glance at any nursing forum shows that aside from the nurses who work in outpatient or ambulatory care centers, most nurses don't have a clue. Comments like "MA's can give injections???" are commonplace due simply to lack of knowledge of the MA’s role and scope of practice on the part of the posters.

Since there are no "hard and fast" requirements for becoming a MA, there is naturally a huge disparity in regards to MA education and skill levels. Yes, one CAN have absolutely no medical education what-so-ever and be hired as a MA with "on the job training". While most of us would agree that this is not the ideal scenario, there are in most states no regulations to prevent this from happening.

I wouldn't take my computer to be repaired by someone who wasn't certified in that field but we expect the public and medical community to accept our capabilities without question? I believe this is a major stumbling block for MA's in their quest to being considered part of the professional medical field. How can we get the respect we deserve if there are no "standards" in our profession?

I work in a very busy family practice. Out of six medical assistants, I am the only one certified in any way. This is not to say that I am any more qualified than anyone else that I work with. In fact, the colleagus I work with have been in the field for many years and I seek their advice daily.

Most of them HAVE been certified by some organization and have simply let that certification lapse. In reality, what’s the point of keeping a certification up if it:

a.) is not required

b.) has no relevant bearing on your status or income 

In an updated version of an article by the AAMA originally published in 1996 and updated in 2003, it is noted that only seven states (Arizona, California, Florida, New Jersey, Maryland, South Dakota, and Washington) have specific regulations pertaining the scope of practice of MA's. In most instances, the MA is permitted to perform any technical procedure not prohibited elsewhere by law as long as the supervising physician deems the MA qualified and properly trained to perform.

There also seems to be no standard as far as medical assisting schools goes. Unless a school wants to be accredited by a certain agency (ABHES, CAAHEP, etc.) there are no guidelines required as to curriculum, classroom hours and so on.

This creates quite a conundrum for medical assistants. If we decide we want a specific scope of practice, it may actually narrow a pretty broad scope of practice that many of us now have. Also, if we decide we want specific standards by the way of licensure, we will open ourselves up to the liability issues that go along with that.

Instead of working under a physicians license as we do now, we'll be working under our own. As it stands, we have no one to be accountable to. You can't take away something (certification) that’s voluntary to start with. Well, you can, but what does it matter if you don't really need it to work in the field?

Mandatory Licensure For Medical Assistants

Despite the above reservations, I still feel that mandatory licensure, along with standardized educational requirements is the only way for the medical assistant to gain widespread acceptance and respect. Perhaps then, medical assistants would be welcomed by the rest of the medical community as the highly valued professionals we know we are.

*By Lorraine, CMA, CNA