Medical Assistant vs. Physician Assistant

Q. What is the difference between a medical assistant and a physician assistant?

A. A physician assistant (PA) is licensed to practice medicine under the general oversight of a physician. A PA is permitted to diagnose and—in most states—prescribe certain medications.

A medical assistant is delegated certain clinical and administrative duties by a physician, and cannot make any independent diagnoses or assessments.

About Donald A. Balasa

Donald A. Balasa, JD, MBA, executive director and legal counsel for the American Association of Medical Assistants, keeps his eye on what is happening in the profession.
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16 Responses to Medical Assistant vs. Physician Assistant

  1. Jo Ann, LVN says:

    In our hospital outpatient department, it is not uncommon to receive orders for patients that are signed with the physician name/medical assistant initials with no credentials indicated. As far as I know, in the state of Texas, only licensed personnel are allowed to legally write orders on behalf of physicians, and only with their expressed consent, via telephone order or voice order. Is this an incorrect statement, or are there legal implications on behalf of the medical assistants, who also tend to refer to themselves as the office “nurses”? (When asked if they are a RN or LVN, they reply “No, medical assistant.”)

    Is it within the legal scope of practice for medical assistants (certified, registered, or otherwise) to write orders on behalf of the physician without the physician’s actual signature on the order, such as stated above?

    • Thank you for your questions.

      It is legal in all states for medical assistants to draft orders at the request of the overseeing/supervising/delegating physician(s), for the physician’s review, approval, and signature. It is not legal in any state for a medical assistant to write and transmit orders without the physician’s review, approval, and signature.

      It is illegal in all states for medical assistants to refer to themselves as “nurses,” even in a generic sense. I have written and spoken on this issue for over 20 years. I will e-mail some of my recent articles about this.

      I hope this is helpful. Please let me know how I can be of further assistance.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  2. frederick says:

    IS PHYSICIAN ASSISTANT THE SAME AS MEDICAL ASSISTANTS

    • Thank you for your question. Medical assistants and physician assistants are different professions. Physician assistants practice medicine under general physician supervision. Medical assistants are able to do both front-office administrative duties and back-office clinical duties. Clinical duties are done under direct physician supervision, which means the overseeing/delegating/supervising physician(s) is on the premises and reasonably available, although not necessarily in the same room.

      I will send you the articles about physician assistants and medical assistants in the most recent edition of the Department of Labor’s Occupational Outlook Handbook. A review of these two pieces should help you understand the differences between medical assistants and physician assistants.

      I hope you will find this helpful. Please let us know how we can be of further assistance.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  3. Monika Bell says:

    I think it is about time that medical assistants are offered some type of licensing – let them be LMAs. One requirement to qualify for the licensing exam could be a minimum amount of experience. Many excellent MAs who work in the field for years can’t help but learn and rise beyond their sometimes very limiting job descriptions.Many work next to physicians who come to regard their MAs as partners and not just “allied staff” who can’t think critically or make sound judgements. The only way to advance for an MA is to go into an administrative position or go back to school (which many can’t afford – or aren’t willing to do because they love their jobs but just want to do more). Licensing may also protect our right to practice and earn us respect from other health professions (most of which already require certificates or licenses). What is the holdup? Nurses guarding their turf?

    • Thank you for your question. I am happy to respond.

      State legislature are not willing to license a profession unless it can be demonstrated that the lack of licensure is harming the general public. It is difficult to prove that patients are being harmed because medical assistants are not required to have formal medical assisting education or to pass a medical assisting examination such as the CMA (AAMA) Certification Examination.

      I will also send you some of the articles I have written about this issue.

      Thank you again for posing this important question.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  4. Jessica says:

    Hello,

    I believe I already know the answer to this but I just want to get confirmation on the subject since I am not an expert…

    I work for a record retrieval company and would like to know if there is ever a situation in any state where a medical assistant is responsible for patient records, meaning if we are requesting records from a doctor and a MA for that doctor also worked on the patient, would we request records from both the doctor AND the MA? If it is a doctor and PA (Physician’s assistant), we request from both but I did not know if the same rule applied to MAs.

    Thank you in advance for your assistance!

    • Thank you for your question. I am happy to respond.

      I cannot foresee a situation in which a request for patient records would be issued to a medical assistant as well as the physician. This is due to the fact that–unlike physician assistants–medical assistants do not make diagnoses or independently treat patients. Therefore, there would be no legal basis for requesting medical records from a medical assistant as well as the physician.

      I hope this is helpful. Please let me know whether you have further questions, or would like further clarification.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

  5. Jorge says:

    I noticed the article specifies the difference of a Certified Medical Assistant and Physician Assistant. I am wondering though if you could be more specific about the differences between Certified Medical Assistant, Certified Clinical Medical Assistant and Physician Assistant.

    All I know is that a Certified Medical Assistant can be split into two professionals Administrative and Clinical. The Administrative doesn’t do any clinical work like taking blood, sterilizing etc…but the Clinical CMA does, and of course does everything the other administrative assistant does.

    But whats the difference between the Clinical Medical Assistant Vs Physician Assistant?

    • Thank you for your questions. I am happy to respond.

      The title of the profession is “medical assisting,” and the generic reference for an individual who works in medical assisting is a “medical assistant.” Those who have passed the CMA (AAMA) Certification Examination given by the Certifying Board of the AAMA are awarded the “CMA (AAMA)” designation, which is the gold standard of all medical assisting credentials. The “CCMA” (Certified Clinical Medical Assisting” credential is another certification given by a different certifying body.

      The medical assisting profession is not divided into a clinical medical assisting and an administrative medical assisting profession. According to the Occupational Outlook Handbook of the United States Bureau of Labor, medical assisting encompasses both front office administrative duties as well as back office clinical duties.

      So, the appropriate question is the difference between the professions of medical assisting and physician assisting. I believe I have answered that in the piece to which you refer.

      Thank you again for your questions. I hope my answers are helpful.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

      • Joseph says:

        I have been a certified and registered medical assistant for well over 12 years now, and have gained considerable clinical knowledge ands hands-on experience. The physician that I work alongside and receive my orders from has recently asked that I and another MA attend a CME/CED course on fascia release and soft tissue treatment therapies all under the hopes that he can evaluate the Pt’s needs then write an order for the appropriate soft tissue therapy for either of us to carry out.

        My question concerning this is, considering that we would have training and CEUs verifying our training, if the physician does the examination and orders a soft tissue treatment to be done in the office, can we as MAs execute the treatment?
        After all, he code of ethics and job description requires that an MA carry out the orders of their supervising physician

      • Thank you for your question. Please note the following excerpt from my Public Affairs article in the May-June 2013 issue of CMA Today:
        Does this mean that physicians are
        permitted to delegate any duties to a
        medical assistant as long as they are
        done under direct physician supervision?
        No. Medical assistants cannot be delegated
        any duties that: (1) constitute the practice
        of medicine or require the skill and
        knowledge of a licensed physician; (2) are
        restricted in state law to other health professionals;
        (3) require the medical assistant
        to exercise independent professional
        judgment or to make clinical assessments,
        evaluations, or interpretations.

        Thus, the question is whether this treatment requires a medical assistant to exercise independent professional judgment or to make clinical assessments, evaluations, or interpretations, and whether the execution of this treatment requires the skill and knowledge of a physician. If it does, then medical assistants cannot be delegated this treatment. If it does not, the treatment may be delegable if the medical assistant is sufficiently knowledgeable and competent, and if the delegating physician is exercising the appropriate degree of supervision.

        It may be good for someone to contact the malpractice insurance carrier for the practice to make sure it would extend coverage if there were to be an allegation of negligence against the medical assistant and the delegating physician.

        You are correct in stating that a medical assistant should carry out the orders of the overseeing physician. However, if a medical assistant is assigned a task for which she/he is of the opinion that she/he is not competent, or which she/he believes is beyond the legal scope of practice, she/he should respectfully point this out to the delegating physician.

        I hope this is helpful.

        Donald A. Balasa, JD, MBA
        Executive Director, Legal Counsel

        American Association of Medical Assistants
        Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

        Visit us on Facebook! http://www.aama-ntl.org/facebook

        The CMA (AAMA): Health Care’s Most Versatile Professional

  6. Sarah says:

    Can a Medical Assistant enter medication, laboratory, and/or radiology orders in a hospital setting that would qualify for Meaningful Use/EHR Incentive Program? I have been told that Medical Assistants are permitted to do so in physician practice settings but cannot find evidence for this. Do the rules on this vary by state?

    • Thank you for your question. It is my legal opinion that “credentialed medical assistants,” especially CMAs (AAMA), are permitted to enter medication, laboratory, and radiology orders into the EHR in a hospital setting as long as they are directed to do so by a provider, and they are following the provider’s orders verbatim, and are not required to exercise independent professional judgment, or to make clinical assessments/evaluations/interpretations. To my knowledge no state laws address this.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      Executive Director, Legal Counsel

      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

      Visit us on Facebook! http://www.aama-ntl.org/facebook

      The CMA (AAMA): Health Care’s Most Versatile Professional

      • Sarah says:

        Thank you, that is helpful. Why is it that Medical Assistants are not included in the MU rule definition of Eligible Professionals?

      • You are welcome. My recent CMS article in CMA Today contains the following:

        Are there different definitions of “eligible
        professionals” for the EHR incentive
        programs?
        Yes. Once again, an in-depth treatment will
        not be presented. Physicians, osteopaths,
        and dentists are deemed to be eligible professionals
        under both programs, however.

        Suffice it to say that “eligible professionals” under the Medicare and Medicaid Incentive Programs are MD, DOs, DMDs, physician assistants, nurse practitioners, although the list of EPs varies between the Medicare Program and the Medicaid Program.

        Donald A. Balasa, JD, MBA
        Executive Director, Legal Counsel

        American Association of Medical Assistants
        Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org

        Visit us on Facebook! http://www.aama-ntl.org/facebook

        The CMA (AAMA): Health Care’s Most Versatile Professional

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