whether you are successfully working within your legal scope of practice as a
medical assistant requires recognizing some situational nuances, especially on
the matter of delegation. The following demonstrates one such instance:
I work in an outpatient practice setting. At times, I work under the authority and supervision of a physician. At other times, I work under the authority of a nurse practitioner or a physician assistant. I have been informed that my legal scope of practice is the same regardless of which licensed provider is assigning tasks to me. Is this correct?
Not necessarily. Under the laws of
most states, the medical assistants’ scope of practice is determined by the
practice act and regulations of the delegating provider.
For example, the nurse practice act
and the regulations and policies of the state’s board of nursing determine which tasks nurses
(including advanced practice registered nurses [APRNs], such as nurse practitioners) are permitted to
delegate to medical assistants.
On the other hand, the medical
practice act and the regulations and policies of the state’s
board of medical examiners delineate which duties physicians are allowed to
assign to medical assistants. And physician assistant delegation authority is
established by other state statutes, regulations, and policies.
There are legal nuances that must
be taken into consideration. Some states permit nurse practitioners to work
autonomously and without a collaborative practice agreement with a physician.
In these states the delegation authority of autonomous nurse practitioners is
determined by the nurse practice act and the rules of the board of nursing.
However, nurse practitioners in an
independent-practice state may choose to work under physician authority and
supervision, and physicians may assign nurse practitioners to oversee medical
assistants who are performing tasks delegated to them by a physician. In such a
case, both the medical practice act and the nurse practice act may have a bearing
on the scope of practice of a medical assistant.