On the Job, Professional Identity

Misuse of “CMA (AAMA)” and “CMA” Can Have Legal Consequences

Some medical assistants who do not hold the CMA (AAMA) credential awarded by the Certifying Board (CB) of the American Association of Medical Assistants (AAMA) incorrectly use the initialisms “CMA (AAMA)®” or “CMA” after their names. The AAMA has also received reports that some employers are permitting their medical assisting employees to misuse the “CMA (AAMA)” or “CMA” designations.

The AAMA owns Registration Number 4,510,101 issued by the United States Patent and Trademark Office (USPTO) for the certification mark “CMA (AAMA).”

The predecessor credential to the CMA (AAMA) was the CMA. Because of the decades of use of the CMA initialism in interstate commerce, the AAMA has common law rights in the “CMA” designation.

Consequently, using the initialisms “CMA (AAMA)®” or “CMA” or the phrase “Certified Medical Assistant” to describe a medical assistant who has not been awarded or has not maintained currency of the CMA (AAMA) credential from the Certifying Board of the AAMA is both incorrect and a matter of intellectual property law. Anyone who does so may be in jeopardy of legal sanctions.

The AAMA urges all medical assistants who are misusing the CMA (AAMA) or CMA initialisms, and all employers who are permitting their medical assisting employees to do so, to cease and desist immediately. The AAMA also requests that any instances of such misuse be brought to our attention.

I further explain the legality behind the AAMA’s claim to “CMA (AAMA)” variations in “Letters and the Law.”

The CMA (AAMA) Logo and Branding Usage Guide describes who has permission by the Certifying Board of the AAMA to use the CMA (AAMA) designation, initialism, and/or logo and lists common misunderstandings.

On the Job, Professional Identity

Medical Assistants Must Not Refer to Themselves as “Nurses”

Medical assistants must scrupulously avoid conveying the message that they are nursing personnel or members of any profession other than medical assisting.

It is unethical, illegal, and a disservice to the medical assisting profession for medical assistants to refer to themselves as “nurses,” “office nurses,” “doctors’ nurses,” or any other generic term that even remotely implies that medical assistants are nurses.

Review the supporting evidence within excerpts from the National Council of State Boards of Nursing NCSBN Model Act (2012) and several states’ nurse practice acts in the May/June 2019 Public Affairs article, “Medical Assistants Must Not Refer to Themselves as ‘Nurses,’” on the AAMA website.

delegation, On the Job, Scope of Practice

Delegation Authority of Nurse Practitioners vs. Physician Assistants

If you have been told that different health care professionals share identical authority to delegate to medical assistants, consider the following situation:

A practice management consultant is telling us that medical assistants working under the authority of a nurse practitioner (NP) have the identical scope of practice as medical assistants working under a physician assistant (PA). Is that legally accurate? The consultant is saying that this is the case because the educational and licensing requirements for NPs and PAs are the same.

The medical assisting scope of practice under nurse practitioner authority is not necessarily the same as the scope of practice under physician assistant authority. Nurse practitioners are governed by the state nurse practice act and the regulations of the state board of nursing, whereas physician assistants are governed by the physician assistant practice act (which is sometimes part of the medical practice act) and the regulations of the state board of medical examiners. Consequently, the NP legal delegation authority in a state often differs significantly from the PA legal delegation authority in the same state.

And although the educational and testing requirements for NPs and PAs are similar, they are not identical. I have read articles asserting that the “nursing model” under which NPs are trained is very different from the “medical model” under which PAs are trained. This is a debatable point. However, it is indisputable that the tasks delegable to unlicensed allied health professionals such as medical assistants by NPs and PAs practicing in the same state are sometimes very different.

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.

On the Job, Scope of Practice

Scope of Practice near State Borders

I received the following interesting question:

I’m struggling with a difficult question! I am the clinical operations director for a medical group located in Oregon near the Oregon-Washington border. We provide care to Oregon and Washington residents and employ several medical assistants. As you know, Washington law requires certain medical assistants to meet educational and credentialing requirements and to register with the Washington State Department of Health. There are no such requirements for medical assistants under Oregon law.

Do my medical assistants who assist providers treating Washington residents need to meet the medical assisting requirements of the Washington law? All our providers (e.g., physicians, nurse practitioners, physician assistants) are licensed in Oregon.

The following is my response:

Because you are located in Oregon and the providers are licensed under Oregon law, the governing law is that of Oregon. Therefore, your medical assistants are not required to meet the requirements and register with the Washington State Department of Health. It does not matter that some patients are residents of Washington.

However, if your medical group had another location in Washington, the medical assistants would have to meet the requirements of Washington law to work as medical assistants.