Laws that Govern Medical Assistants
In order to protect the public, medical
assistants must properly introduce and identify themselves as such and practice ONLY those medical and
clinical methods and procedures that fall within their discipline's scope of practice and in accordance with
any and all federal and state laws (not to mention rules of morals and ethics). This applies to ALL medical
assistants, whether they are certified or not and regardless of years of experience in their
Scope of Practice Definition
Most US states have specific laws as to how doctors must supervise
their medical assistants and how they can be utilized in the medical practice. At the same time, their
employer, usually a doctor, also has very specific expectations of medical assistants under
their employ! These expectations typically vary from specialty to specialty and from office to
office, while statutes, laws and regulations may also vary from state to state. This can make it
very confusing. Let us try to shed some light by first defining what is meant by "scope of practice".
Scope of Practice is a terminology used by state licensing boards, or overseeing
authorities for various professions that defines procedures, actions, activities and processes that are
permitted on the job. However, since medical assistants, by definition, aren't licensed,
nor professionals, they must work under the umbrella of the doctor who hired them and holds a
valid license from the State Medical Board where they practice the art of medicine.
Medical Assistant's Scope of Practice
We often receive questions from people who want to know whether a specific medical procedure, or
clinical task, is within the medical assistant's scope of practice and permitted in their state. The questions
often revolve around the use of certain medical equipment, administration of medications, or types of invasive and
non-invasive healthcare procedures. While we are very ambitious and eager to provide answers, it is impossible to
provide a comprehensive and exhaustive list of laws that govern the medical assistant profession for each and every
state. Further more, we simply cannot respond to questions that require specificity as to a particular task medical
assistants can or cannot do, since that goes clearly beyond our own "scope of practice" and specific knowledge
The following advice should point you into the right direction for reliable information...
The governing body for doctors and their medical assistants is
State Medical Board/State Board of Medical Examiners, since they regulate the practice of
medicine for each state, and thus, what takes place in the medical office. Also, a state's Department of Health and
State Nursing Boards may have established rules and legislature as to which tasks and duties can be delegated under
their direct supervision.
Nationally recognized credentialing bodies for medical assistants, such as the American Association for Medical
Assistants (AAMA), American Medical Technologists (AMT), or National Healthcareer Association (NHA) may further
define the role of the medical assistant and lobby for their recognition and rights in the work place. All in all,
it can be said that medical assistants in the USA are required to work under the direct supervision
of a licensed healthcare provider such as a practicing medical doctor, licensed nurse practitioner, or physician's
assistant whenever they provide direct patient care.
1.) Proper IdentificationMedical assistants, who provide services that involve direct contact with
the public (e.g. patients and clients) must properly introduce and identify themselves as such, regardless
whether they are a medical assistant (MA) trained on the job, or certified, or registered. To avoid confusion
clearly state your name and job title when greeting a new patient. Just say: "Hello, I am your medical assistant,"
and wear your name badge with a lapel pin from your professional membership association to avoid being mistaken as
a nurse, doctor, or other licensed healthcare professional. Being addressed as a nurse could be taken as a
compliment, but whenever a medical assistant is mistaken for a RN or LPN they should always politely respond: "I am
not a nurse, I am a Medical Assistant.
"Medical assistants should ALWAYS be quick to correct someone who has mistaken them for a nurse. I never
want someone to think I am practicing as a RN in any way! I really love my work and continue to do so every
day. I appreciate opportunities to learn from fellow staff and healthcare members, which includes RN's, LPN's,
Dr's, and medical office support staff. We all work as a team, sharing valuable skills to help patients! Where
each one is willing to lend a helping hand much good can be done, even in the smallest offices and lowest
positions." (Contributed by MA15Years)
2.) Direct Supervision
Direct supervision requires the physical presence of the supervising doctor in the office before,
during and after the administration of medications or therapeutic modalities and also includes the diagnosis,
authorization and evaluation of a patient. Any disregard or transgressions of this law will be taken very
seriously and may have SERIOUS consequences. Some of the procedures a medical assistant may perform without
direct supervision include:
- Filing and sorting medical charts
- Billing and coding
- Verifying insurance
- Making patient appointments and scheduling
- Recording a doctor’s findings in patient charts
- Transcribing materials in patient charts and records
- Computer and file maintenance
It has been asked whether a medical assistant can be entrusted with the key to the controlled substances locker.
This decision is left up to the discretion of the supervising physician.
3.) Careful Documentation
Along with proper identification and direct supervision comes complete and careful record keeping. Complete and
careful record keeping is critical. In your role as a medical assistant each aspect of a patient encounter, whether
directly face-to-face, or over the phone, should be carefully documented to protect yourself, your employer and
also the patient: ask about personal and family histories, allergies to medications, or latex, medications
administered and prescribed, physical exam findings (such as vital signs), imaging and lab test results,
discussions with patients, including specific questions and responses and procedures performed during course of the
visit. If it is an emergency call, do not place the patient on hold, but keep him/her on the line. As a colleague
to call 911 from another line if necessary. All this should go in the patient's record, along with the date and
initialed by the doctor, nurse, or medical assistant who recorded the information into the chart.
REMEMBER the golden rule: if it isn't documented it didn't happen!!!!!
- Medical Assistant Regulations
It seems doctors and medical office managers still don't clearly understand what medical assistants can and cannot do under the Medical Practice Act and the Board
- Scope of Practice by State
Quick reference pertaining to the medical assistant's lawful scope of practice sorted by U.S. states to help locate resources.
- Laws for Medical Assistants
Performed under the supervision of the medical doctor or other licensed healthcare provider the medical assistant can... You can't afford to miss this!
- Respondeat Superior Doctrine
Respondeat Superior misconception: "Medical assistants work under the umbrella of the doctor, if something goes wrong then the doctor will be held responsible."
The above is not an exclusive
itemization of the technical supportive services a medical assistant can or cannot perform. Medical assistants must
ALWAYS adhere to state and local laws and regulations no matter where they are! As an integral part of the allied
healthcare team medical assistants must demonstrate practice consistent with legal standards and state regulations
that may apply. Since all fifty (50) states vary in their regulations as to the definition, training standards and
scope of practice of the medical assistant, specific state requirements for practice must be identified and met by
the concerned individual within the state they work.