delegation, On the Job, Scope of Practice

New Alaska Standards for Delegation of Certain Duties

The Alaska State Medical Board has added a new section to its regulations that establishes standards and conditions under which a licensed physician (doctor of medicine or osteopathic medicine), podiatrist, or physician assistant may delegate certain medical duties to unlicensed professionals such as medical assistants.

These regulations remove any ambiguity from the assertion that knowledgeable and competent unlicensed allied health professionals such as medical assistants can legally perform intramuscular (IM), subcutaneous (subq), and intradermal (ID) injections delegated by a licensed provider under the provider’s direct/on-site supervision.

The regulations of the Alaska State Medical Board were finalized November 25, 2019, and went into effect December 25, 2019.

You can read the regulations by either accessing the December 2019 medical statues and regulations document (Page 37) via the Alaska State Medical Board webpage or the Alaska section of the AAMA State Scope of Practice Laws webpage on the AAMA website.

This is a significant scope of practice victory in Alaska, and I congratulate the Alaska Medical Assistant Society for its excellent and diligent work on strengthening and clarifying medical assistants’ right to practice!

delegation, On the Job, Scope of Practice

Medical Assistants and Fetal Nonstress Test Monitors

State laws are the best place to look for guidance on medical assisting scope of practice, but they are sometimes less thorough than desired. For cases such as those, consider the following:

We have some CMAs (AAMA) and RMAs(AMT) assisting physicians who are providing obstetrical services. The physicians delegate to the medical assistants the hooking up of patients to fetal nonstress test monitors. The medical assistants do not interpret the results of the fetal nonstress test. Is this delegation permitted by Minnesota law?

Based on my research, hooking up a patient to a fetal nonstress test monitor is a straightforward, repeatable process that does not require (1) the knowledge or skill or a licensed health care professional, (2) the exercise of independent clinical judgment, or (3) the making of clinical assessments. Therefore, my legal opinion is that this task is likely delegable to knowledgeable and competent unlicensed allied health professionals such as medical assistants working under direct/onsite physician supervision.

The delegating physicians should reverify periodically (perhaps every 12 months) the knowledge and skill of the medical assistants performing this task and should document in writing each medical assistant’s current competence in this task.

It may also be advisable to request a written opinion from the practice’s malpractice insurance carrier stating that it would cover any negligence by a medical assistant in hooking up a patient to a fetal nonstress test monitor.

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.

delegation, On the Job, Scope of Practice

Comments to the Montana Board of Medical Examiners

In the effort to protect patients in Montana from substandard medical assisting services, the Montana Society of Medical Assistants (MSMA) and the American Association of Medical Assistants (AAMA) wrote to the Montana Board of Medical Examiners on the proposed New Rule I “Medical Assistant—Delegation and Supervision.” Read the comments as well as an excerpt from the proposed new rules in the latest Public Affairs article. Access “Comments to the Montana Board of Medical Examiners” in the September/October 2018 issue of CMA Today on the AAMA website.

Certification and the CMA (AAMA) Credential, delegation, medication administration, On the Job, Professional Identity, Scope of Practice

Medical Assistants as Pharmacy Technicians

I have been receiving an increasing number of questions similar to the following:

Can a CMA (AAMA) work as a pharmacy technician in my state?  And, if so, can that CMA (AAMA) administer injections and take blood pressures under the supervision of a pharmacist?

Here is my response:

Thank you for this question.  A medical assistant—even a CMA (AAMA)—would have to meet the state law requirements and become a pharmacy technician in order to work in that capacity under the supervision of a pharmacist.  Once a CMA (AAMA) is registered by the state as a pharmacy technician, the scope of practice for this individual would be the same as all other pharmacy technicians as specified by the laws of that state.