On the Job

The Role of Medical Assistants in Increasing Colorectal Cancer Screening Rates

On April 16, 2019, I presented a webinar for the Illinois Primary Health Care Association to illustrate that the utilization of knowledgeable and competent medical assistants, especially CMAs (AAMA), across health care settings significantly increases colorectal cancer (CRC) screening rates.

Review the supporting evidence in the July/August 2019 Public Affairs article, “The Role of Medical Assistants in Increasing Colorectal Cancer Screening Rates,” on the AAMA website.

delegation, On the Job, Scope of Practice

Relaying Providers’ Orders by Telephone

Part of the AAMA’s mission is to protect medical assistants’ scope of practice. Sometimes that means gathering evidence to prove that what other health professionals think is a limitation of medical assistants’ scope of practice is unsubstantiated by state law. Consider the following from a medical assistant in Wisconsin:

I work in a small physician-owned clinic. Our primary care providers visit two local skilled nursing facilities each month. … [Does] our state permit nurses to take a provider’s order by telephone that is conveyed by a medical assistant? These telephone orders are always followed up by a written electronic order from the provider. [But] we are being told that nursing home staff will only take telephone orders directly from licensed health professionals.

Why would this be any different from a provider directing one of our medical assistants to convey a normal lab value? Our providers would spend all day calling the nursing homes if medical assistants cannot relay information at the request of the provider. If the nursing home staff members do not understand the order, they can always ask for clarification from one of our providers.

I reviewed the nurse practice act and the regulations and policies of Wisconsin’s state board of nursing. I found nothing stating that registered nurses (RNs) and licensed practical nurses (LPNs) are prohibited from receiving and executing orders from a licensed provider (e.g., physicians, nurse practitioners, physician assistants) that are transmitted verbatim by telephone by an unlicensed allied health professional, such as a medical assistant.

Unless state law specifically indicates otherwise, my legal opinion is that knowledgeable and competent medical assistants are permitted to convey verbatim information (including orders) on behalf of the delegating provider and receive verbatim information for the overseeing provider. Information conveyed by telephone should be followed up by a written order (electronic or hard copy).

delegation, On the Job, Scope of Practice

Standing Orders and Supervision Requirements

I welcome further questions about my blog posts because addressing those questions allows me to dive deeper into a pertinent topic for medical assistants who wish to better understand their scope of practice.

For instance, in response to my blog post “Standing Orders from an Overseeing Provider,” I received the following question:

Does a standing order change the supervision requirements for medical assistants? For example, if our state law requires the delegating licensed provider to be on the premises when a medical assistant is performing venipuncture, is this supervision requirement changed by a standing order from the provider?

A standing order does not change the supervision requirement established by state law. The supervision requirements apply regardless of whether the licensed provider issues a standing order, verbal order, or written order. If this were not the case, a provider could circumvent supervision requirements by issuing standing orders instead of verbal orders.

The purpose of supervision requirements is patient protection.

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

Standing Orders from an Overseeing Provider

I receive the following question about standing orders fairly often, and it is a bit difficult to answer because state law seldom addresses it:

Our new office manager claims that it is illegal for medical assistants to perform tasks based on standing orders of our licensed providers. She states that only licensed professionals, such as registered nurses (RNs), are permitted to work under standing orders. Is this legally accurate?

Most state laws do not prohibit physicians, nurse practitioners, and physician assistants from assigning tasks to unlicensed allied health professionals such as medical assistants by means of standing orders.

However, the crucial issue is what tasks medical assistants may or may not be delegated by standing order.

It is my legal opinion that medical assistants are permitted to receive and execute standing orders from an overseeing/delegating provider as long as the following conditions are met:

  1. The standing order is understood by the medical assistant.
  2. The standing order is for a task that is delegable to medical assistants under the laws of the state, and the delegating provider is exercising the degree of supervision required by the laws of the state.
  3. The standing order is either patient-specific or applicable to all patients without exception.
  4. The standing order does not require the medical assistant to exercise independent clinical judgment or make clinical assessments, evaluations, or interpretations.

If you’d like to know more about your specific state laws, visit the State Scope of Practice Laws webpage on the AAMA website.