Laws and  that Govern the Medical Assistant's Scope of Practice

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 field. 

Laws and 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, the doctor, also has very specific expectations of medical assistants they employ! Their employer's expectations may vary from specialty to specialty and from office to office, while statutes, laws and regulations may vary from state to state. This can become confusing. Let us try to shed some light by first defining the scope of practice.

Scope of Practice is a terminology used by state licensing boards for various professions that defines the procedures, actions and processes that are permitted for the licensed individual. However, since medical assistants aren't licensed professionals, they must work under the umbrella of the doctor who hired them and IS a licensed healthcare practicioner through the State Medical Board.

Medical Assistant Scope of Practice

We often receive questions 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, wherefore we cannot respond to questions that require specificity as to a particular task medical assistants can or cannot do. That goes beyond our own "scope of practice" and specific knowledge as webmasters.

HOWEVER...

The following advice should point you into the right direction for reliable information... The governing body for doctors and their medical assistants is the 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.

 Proper Identification

MA15Years Tells Us:

"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)

 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.

 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!!!!!

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Disclaimer:
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.