I recently received the following question from a medical assisting educator regarding scope of service for Iowa medical assistants:
Regarding urinary catheterization, we have been told that a Certified Medical Assistant® cannot insert a straight catheter, but they can remove the catheter. Our [medical assisting] course does not include performing this task, but I have had a few students who would be doing their externship in urology, and the question is always presented because the urinary [practices] allow medical assistants to insert catheters. But, we have been informed that it is out of our scope.
Are you able to provide some insight on this subject and possibly some documentation so we can correctly advise our externship sites as well as provide accurate information for our students?
Iowa law neither specifically authorizes nor forbids medical assistants being delegated and performing catheterization tasks.
The Commission on Accreditation of Allied Health Education Programs and the Medical Assisting Education Review Board recently issued new Standards and Guidelines for the Accreditation of Educational Programs in Medical Assisting, which includes a revised “Core Curriculum for Medical Assistants.” The Medical Assisting Education Review Board has also updated Educational Competencies for Medical Assistants. Note the following from this document:
Catheterization: Catheterization may not be a common day-to-day task of a medical assistant; however, some communities of interest may see a need for training in this area due to local physician office needs. Laws for catheterization performed by medical assistants will vary by state. It is important to know and follow the specific state regulations for medical assistants performing catheterization procedures.
Note the following from my handout on federal and state updates to medical assisting scope of practice:
30. … It may be prudent to ask the malpractice insurance carrier for the practice/clinic/health system whether it would cover any negligence by a medical assistant in performing [certain tasks.] The insurance carrier should be asked to put its opinion in writing.
31. To formulate a legal opinion on whether a particular task is delegable to medical assistants when state law does not address the legality or when state law is ambiguous, … I often begin my analysis by evaluating whether the task is usually and customarily delegated to medical assistants in the state and in other states. I also determine whether the task is contained in the “Core Curriculum” of the current CAAHEP [Standards]. [The “Core Curriculum” of the CAAHEP Standards takes into account the results of the most recent occupational analysis of the medical assisting profession.]
Thus, in such cases, I suggest that educators or practitioners contact the malpractice insurance carrier for their school and program or medical practice and ask whether it would cover any negligence by a medical assistant in performing these catheterization tasks.