Medical assistants are under a legal duty to not exceed the legal scope of practice in their state. Medical assistants are also under a legal duty to perform all tasks competently. It is important to understand the relationship between these two legal duties.
Even if a medical assistant performs a task competently, and meets or exceeds the standard of care that is required of a medical assistant, the medical assistant could face legal sanctions if the task is beyond the legal scope of practice for medical assistants in the state.
Similarly, if a medical assistant performs a task that is permitted under state law, the medical assistant (and, most likely, the medical assistant’s delegating provider) could be sued for negligence if the task is not performed competently.
Medical assistants must make sure they perform all tasks competently. They must also make sure that the tasks they perform do not exceed the legal scope of practice in the state (or other American jurisdiction) in which they are working. Of course, the best way to do so is by remaining informed about the laws in your own state. To help health care professionals navigate this issue, the AAMA website has a large collection of documents relating to different states’ scope of practice laws. Any medical assisting scope of practice questions that are not covered by these materials can be emailed to me at firstname.lastname@example.org.
Although I have written about the difference between medical assistants and medication aides/assistants/technicians in Public Affairs articles in CMA Today, I continue to receive questions about the topic. Here are the basics:
Medical assistants work in outpatient settings under direct provider supervision, and may be delegated clinical and administrative tasks. Medication aides/assistants/technicians work in inpatient settings, usually under registered nurse supervision. A primary task of medication aides is to pass medications as directed by the RN supervisor.
Medication aides do not exist under the laws of some states. The laws of other states refer to these health workers by a designation other than medication aide. In some states an individual must first meet the requirements and register with the state as a certified nursing assistant (CNA) in order to be eligible to receive additional training and become a medication aide.
Medical assistants do not work in a clinical capacity in inpatient settings as medical assistants per se. Medical assistants must meet the requirements and register with the state as a CNA and/or a medication aide in order to work in a clinical capacity in inpatient settings.
Some state laws refer to medication aides as “certified medication aides.” The initialism associated with this phrase can cause confusion between medical assistants and medication aides. To help minimize such confusion, the National Council of State Boards of Nursing refers to medication aides as “MA-Cs” and encourages states to use this initialism. This change was made at the request of the American Association of Medical Assistants.
I receive fewer questions than I did seven or 10 years ago about the legalities of medical assistants performing limited scope radiography. However, in some states medical assistants are called upon to expose patients to ionizing radiation, as specifically directed by the overseeing/delegating provider.
The legality of this task is governed by state law. In some states unlicensed professionals such as medical assistants are forbidden from doing any limited scope radiography. Only licensed radiologic technologists are permitted to perform radiography. In other states medical assistants are required to complete a short course and pass a test in order to be delegated limited scope radiography. In other states limited scope radiography under direct/on-site provider supervision is not regulated. Physicians are permitted to delegate limited scope radiography to knowledgeable and competent employees.
In the current ambulatory care environment, medical assistants are being delegated the preparation of injectable substances, as well as the administration of injections. I often receive questions about legal restrictions on medical assistants preparing injectable substances. In some states, there are specific laws that address this question. In general, it is my legal opinion that, if there is a likelihood of significant harm to a patient if an injectable substance is prepared improperly, the delegating provider must verify the identity and the dosage of the injectable substance before it is administered by the medical assistant.
A common source of confusion within medical assisting is the question of whether medical assisting credentials with “registered” in the name are superior to medical assisting credentials with “certified” in the name.
The answer to this question is no. National medical assisting credentials with the word “registered” as part of the credential name are not of a higher level status than medical assisting credentials with “certified” in their name.
This confusion may be engendered by the fact that “registered” indicates licensed status for credentials in fields other than medical assisting. For example, in professional nursing, a “registered nurse” is a nurse who has met state educational and testing requirements, and is licensed to practice professional nursing.
However, this is not the case in medical assisting. A medical assistant with a credential that has “registered” in its title is not in a different or higher legal category than a medical assistant with a credential that has “certified” in its title.
In fact, CMA (AAMA) certification has rigorous college-level education requirements, physician-quality exam standards, and is nationally and globally accredited, unlike other certifications and registrations.