delegation, On the Job, Professional Identity, Scope of Practice

Medical Assistants and Limited Scope Radiography

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.

medication administration, On the Job, Professional Identity, Scope of Practice

Preparation and Administration of Injections by Medical Assistants

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.

Certification and the CMA (AAMA) Credential, Professional Identity, Uncategorized

“Registered” vs. “Certified”: A Question of Terminology

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.

delegation, On the Job, Professional Identity, Scope of Practice

Can Medical Assistants Oversee and Perform Physical Therapy?

Recently I fielded a question from a chiropractor in New Jersey looking to expand his practice to include services such as physical therapy. In conducting research into this matter, he had been told that in New Jersey, state law allows MDs to delegate to medical assistants full oversight and performance of physical therapy activities, as prescribed by the MD. He asked whether this was true.

In my response, I cited a recent CMA Today article that addresses this very topic:

An example of [procedures that can be delegated only to certain health professionals other than medical assistants] is physical therapy. Although some states—explicitly or implicitly—permit physicians to delegate very minor physical therapy modalities to competent and knowledgeable medical assistants working under the physician’s direct supervision, no state allows a physician to delegate the full range of physical therapy to anyone other than a licensed physical therapist.

In addition, I recommended contacting the New Jersey Board of Chiropractic Medicine to inquire whether New Jersey statutes, regulations, and policies permit doctors of chiropractic medicine to assign to unlicensed professionals such as medical assistants the overseeing of patients performing exercises assigned by an MD, and whether there are any legal limitations on this. (Similarly, I would recommend such action to chiropractors in other states, as well.)

delegation, dental assistant, On the Job, Professional Identity, Scope of Practice

Medical Assistants in Dental Offices

This blog frequently discusses scope-of-practice issues, but health care always provides new questions to examine. This post will address the following: Are medical assistants permitted to work in a dental office under the authority/supervision of a dentist?

First of all, it is important to keep in mind the distinction between a dental hygienist and a dental assistant. Under the laws of all American jurisdictions, dental hygienists are required to be licensed. Licensure for dental hygienists requires graduation from a postsecondary dental hygiene academic program and the passing of a national (and in some cases, state) examination. Thus, medical assistants—including CMAs (AAMA)—are not permitted to work as dental hygienists.

Under the laws of some states, dental assistants are required to have formal education and pass a test in order to be delegated certain tasks by the overseeing/delegating dentist. Other states have no educational or testing requirements for dental assistants. A medical assistant should check with the state board of dental examiners (usually in the state capital) to find out whether the state has any educational or testing requirements for dental assistants, and whether any of the medical assisting education or credentialing can be used toward meeting any state requirements for dental assistants.