On the Job, Scope of Practice

Performing Unfamiliar Tasks

If you have ever been asked to perform a task unfamiliar to you, consider the following situation brought to my attention:

My physician-employer asked me to perform a task that I have never done and did not learn in my medical assisting program. I explained to my employer that I did not feel it was right for me to perform the task because I didn’t have any experience with it and did not feel competent doing the task. My physician-employer said that I should perform the task to the best of my ability and not worry because she would be legally liable if something went wrong and I would not be. Is this correct? Should I perform the task?

It is my legal opinion that medical assistants should not perform a task for which they are not knowledgeable and competent. This is one of the most important legal and ethical duties of medical assistants.

It is true that the delegating provider is responsible for any negligence of a medical assistant in performing a task delegated by the provider to the medical assistant. However, it is not correct that the medical assistant is not responsible legally for performing a task in a negligent manner.

The correct legal principle is that the delegating provider and the medical assistant are responsible under civil law for any negligence by a medical assistant. A medical assistant is under the legal duty of performing all tasks to a level of quality that is equal to or greater than the level of quality that a reasonably knowledgeable and competent medical assistant would exhibit in performing the task.

9 thoughts on “Performing Unfamiliar Tasks”

  1. Thank you for this information.
    Having formal education and training is essential. But under no circumstances should you feel obligated to perform duties that are not within your scope, or that you have not been trained, instructed.
    Continuing education classes can be of value to keep you sharp and up to date.
    Physicians should be given the opportunity to allow for continuing education for employees, it’s a win win for the practice and the employees.

  2. Great points, Don. I get a lot of similar inquiries (as AMT’s legal counsel) from RMAs who are asked to do tasks for which they lack adequate training, but aren’t legally outside the scope of practice of medical assistants in their respective states. A lot of people are under the mistaken impression that the doctrine of “respondeat superior” shields an employee from liability while it shifts vicarious liability to the employer. In fact, respondeat superior is an offensive doctrine, not a defensive one. It makes an employer legally liable for the negligence of a subordinate employee, but it does not exonerate the employee for his/her own negligence.

    A difficult situation often arises, however, when the medical assistant is asked to perform a task that is clearly within the scope of practice for an MA, but she still doesn’t feel comfortable performing it. In those cases the MA faces a tough quandary because the employer is free to take adverse employment action (e.g., terminating the MA or placing her on probation) if the MA refuses to perform the task. The best solution is to obtain additional training as soon as possible for tasks that are typically delegated in the employee’s practice setting.

    1. You are welcome, Mike, and thank you for these excellent comments. I agree with all of them! Don

      Donald A. Balasa, JD, MBA
      Chief Executive Officer, Legal Counsel
      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org
      The CMA (AAMA): Health Care’s Most Versatile Professional®

  3. Good Afternoon,
    Your page here has quite a plethora of information and is amazing! I have a specific question as it pertains to MA’s/CMA’s in Illinois. We are reviewing currently what forms of autonomy our MA’s/CMA’s can have as it pertains to entering orders in the EHR (Lab, Radiology, Medications, Referrals, Return to clinic orders, etc.). This would be CPOE and more. The reason we have lumped it all together is due to the way the EHR settings are built. It is all or nothing, not one by one. We are also attempting to determine this for LPN’s and RN’s and have a team that is equally divided on what the Nurse Practice Act in IL allows and what the Medical Practice Act allows. Would you be able to shed some light on any of these topics? Please feel free to email me with any articles, references, or position stances you have.

    Warm Regards,
    Jessica N. CPHQ

  4. I have a question. I work in a Urology clinic. We administer Lupron injections to prostate cancer patients. Can a Medical Assistant perform this duty or is this something a RN or an LPN is supposed to do? Also, we insert urinary catheters. Is this within th scope of practice? Is something goes wrong, can the MA be held liable? I live in the state of South Carolina.

    1. Thank you for your question. Go to http://www.aama-ntl.org and click below “State Scope of Practice Laws” on the left side of the homepage. You will be able to find the medical assisting law of most states, including South Carolina.

      As you will see in the SC section of the State Scope of Practice Laws section on our website, it is my legal opinion that South Carolina law permits physicians to delegate to knowledgeable and competent unlicensed professionals such as medical assistants working under their direct/onsite supervision in outpatient settings the administration of IM, subq, and ID injections as long as all the conditions in the relevant SC law are met. However, it is also my legal opinion that, if there is a likelihood of significant harm to a patient if an injectable substance is prepared or selected improperly, the delegating provider must verify the identity and the dosage of the injectable substance before it is administered by the medical assistant. This would apply to a Lupron injection.

      In response to your question about liability exposure for medical assistants, note the following:
      • Medical assistants must not be delegated (and must not perform) any tasks for which they are not sufficiently knowledgeable and competent;
      • If a medical assistant performs a task in a negligent manner, both the delegating provider and the medical assistant may be held liable civilly for negligence;

      South Carolina law neither specifically forbids nor authorizes physicians to delegate to medical assistants the insertion of urethral catheters. I suggest that the first step should be contacting the malpractice insurance carrier for the practice to see whether it would cover any negligence by a medical assistant in performing this task.

      I hope this is helpful.

      Donald A. Balasa, JD, MBA
      Chief Executive Officer, Legal Counsel
      American Association of Medical Assistants
      Ph: 800/228-2262 | Fax: 312/899-1259 | http://www.aama-ntl.org
      The CMA (AAMA): Health Care’s Most Versatile Professional®

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