delegation, Scope of Practice

The Relationship between Scope and Competence

Medical assistants are under a legal duty to not exceed the legal scope of practice in their state.  Medical assistants are also under a legal duty to perform all tasks competently.  It is important to understand the relationship between these two legal duties.

Even if a medical assistant performs a task competently, and meets or exceeds the standard of care that is required of a medical assistant, the medical assistant could face legal sanctions if the task is beyond the legal scope of practice for medical assistants in the state.

Similarly, if a medical assistant performs a task that is permitted under state law, the medical assistant (and, most likely, the medical assistant’s delegating provider) could be sued for negligence if the task is not performed competently.

Medical assistants must make sure they perform all tasks competently.  They must also make sure that the tasks they perform do not exceed the legal scope of practice in the state (or other American jurisdiction) in which they are working. Of course, the best way to do so is by remaining informed about the laws in your own state. To help health care professionals navigate this issue, the AAMA website has a large collection of documents relating to different states’ scope of practice laws. Any medical assisting scope of practice questions that are not covered by these materials can be emailed to me at dbalasa@aama-ntl.org.

medication aide, medication assistant, medication technician, Uncategorized

Medical Assistants and Medication Aides/Assistants/Technicians: Differences and Clarifications

Although I have written about the difference between medical assistants and medication aides/assistants/technicians in Public Affairs articles in CMA Today, I continue to receive questions about the topic. Here are the basics:

Medical assistants work in outpatient settings under direct provider supervision, and may be delegated clinical and administrative tasks. Medication aides/assistants/technicians work in inpatient settings, usually under registered nurse supervision. A primary task of medication aides is to pass medications as directed by the RN supervisor.

Medication aides do not exist under the laws of some states. The laws of other states refer to these health workers by a designation other than medication aide. In some states an individual must first meet the requirements and register with the state as a certified nursing assistant (CNA) in order to be eligible to receive additional training and become a medication aide.

Medical assistants do not work in a clinical capacity in inpatient settings as medical assistants per se. Medical assistants must meet the requirements and register with the state as a CNA and/or a medication aide in order to work in a clinical capacity in inpatient settings.

Some state laws refer to medication aides as “certified medication aides.” The initialism associated with this phrase can cause confusion between medical assistants and medication aides. To help minimize such confusion, the National Council of State Boards of Nursing refers to medication aides as “MA-Cs” and encourages states to use this initialism. This change was made at the request of the American Association of Medical Assistants.

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.

delegation, On the Job, Scope of Practice, Uncategorized

Physician Delegation: Standing Orders

Under the laws of most states, physicians are permitted to delegate by means of standing orders to knowledgeable and competent medical assistants 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 physician is exercising the degree of supervision required by the laws of the state
  3. The standing order is applicable to all patients without exception
  4. The standing order does not require the medical assistant to exercise independent professional judgment, or to make clinical assessments, evaluations, or interpretations
Certification and the CMA (AAMA) Credential, On the Job, Professional Identity, Scope of Practice

Medical Assistants as Home Health Aides

Because of the great versatility of medical assistants, questions have arisen about whether medical assistants—especially CMAs (AAMA)—are permitted to work as home health aides (HHAs).

Most states have laws defining what qualifications an individual must have in order to work as a home health aide.  These laws also assign responsibility for the HHA program to an existing state agency, such as the department of health.  CMAs (AAMA) would have the opportunity to ask this agency whether their education in a CAAHEP or ABHES accredited medical assisting program, and their demonstration of didactic knowledge by passing the CMA (AAMA) Certification Examination, would meet or exceed the requirements of the home health aide law.  If the agency accepts the CMA (AAMA) credential in lieu of home health aide training, the CMA (AAMA) would then be able to work as an HHA.