Your Scope of Practice as a Medical Assistant - A Guide

What you can and can't do as a medical assistant - your scope of practice - is hugely important. Get up-to-scratch with this guide.

Medical assistants have a narrow list of things they can and cannot do for patients or a doctor in a doctor's office. It's often difficult to know what's allowed because there are not strong laws regarding medical assistants in place.

In fact, most MAs learn their skills on the job. They're only recently started earning medical assisting degrees and getting certified with national agencies.

If you're a medical assistant or interested in becoming one, you're probably interested in what exactly your duties are - and what you absolutely cannot do.

Make sure you read up on your individual state's statues before you undertake any task that you're unsure of. Each state has different rules.

Also, don't fall into the habit of doing whatever you are instructed to by your employer. Just because they're telling you to do it, it doesn't make it legal! You could still end up getting sued. That's why it's important to know your medical assisting scope of practice.

Regulation of medical assistants

Your scope of practice as a medical assistant

The problem with medical assistants is that no one really regulates them. Some states are now enacting laws to require these professionals to register, but the profession is frighteningly undermonitored by any sort of government agency.

This is bound to change as medical assistants become more in demand in doctor's offices, hospitals, and clinics.

So many medical assistants are wondering what they can and cannot do, and this is often a point of confusion for many working professionals.

The state medical board does have some oversight into the scope of practice of medical assistants, but each state has its own ideas of what is ideal for a medical assistant to do.

This makes it difficult for any professional who wants to cross state lines or for the regulation of education. Since it varies, schools have to teach a broad amount of knowledge and tailor certain classes towards the particular state the student is in.

Certification is now possible, but the profession as a whole is lacking a unified scope of practice.

Medical assistants and delegation

Whenever a medical assistant performs a skill, she is doing so under a doctor's supervision. The doctor assumes responsibility for whatever the medical assistant does.

But there's a gray area that can leave medical assistants open to litigation.

Doctors can tell a medical assistant to do anything, but if the doctor is out of line and telling her to do something outside her medical assisting scope of practice, then she is liable for doing something that she is not qualified to do.

This is where it's important to know your scope of practice and the laws in your state regarding what you are allowed to do as a medical assistant.

Most states have in their laws that a medical assistant can perform duties that they are adequately trained to perform, and are not prohibited from performing under state medical or nursing laws.

As a medical assistant, you need to make sure that you understand what state nursing law reserves for nurses. Nurses can delegate certain duties to medical assistants, but some duties must stay strictly with the nurse.

What medical assistants can do

Your scope of practice as a medical assistant

Medical assistants can perform certain basics tasks without any supervision from a doctor or nurse:

  • prepare medical records
  • maintain patient charts
  • order supplies
  • maintain medical office equipment
  • manage money accounts from patients
  • and schedule appointments.

They can also prepare instruments for examination, prepare exam rooms, and record vital signs. Assisting the doctor during procedures and minor surgical interventions is also within the medical assisting scope of practice.

Actually, medical assistants can administer medications as ordered and under the supervision of the doctor.

Medical assistants can collect specimens, such as urine, blood, or sputum, for lab tests, and perform STAT screenings. They can relay questions from a patient to a doctor by phone, and can transcribe dictated medical documents for the doctor.

Medical assistants can also relay lab test results, but can't provide an interpretation of them. In some states, they can even start an intravenous line.

What medical assistants can't do

Your scope of practice as a medical assistant

There are a few things that medical assistants can definitely not do.

They cannot treat or diagnose patients. They can educate patients about a diagnosis a doctor has given or perform a prescribed treatment, but cannot treat or diagnose on their own.

Medical assistant cannot assess, plan, or evaluate a patient or their care. A doctor or nurse has to examine a patient to determine the plan of care for them.

Medical assistants cannot interpret test results or advise a patient about their medical condition in any way.

Medical assistants cannot give IV medications or administer anesthetic medications for the purpose of making a patient unconscious.

Prescribing and refilling medications independently is not within the scope of practice, and they cannot perform physical therapy, except in an assisting role.

Medical assistants cannot perform any procedure, technique, or treatment that would constitute the practice of medicine.

State-specific scope of practice statutes

Every state is different, so check with your state's board of medicine to determine what your medical assisting scope of practice is.

For instance, in Connecticut, medical assistants are not allowed to perform x-rays or give medication by any route, including oxygen and injections.

In Maine, a doctor must be a reasonable distance away from the practicing medical assistant to help in case anything should go wrong. Of course, if anything should go wrong, the responsibility falls on the physician.

In Nevada, a medical assistant was sued for illegally administering medications. That state is currently revising its scope of practice laws for medical assistants and their ability to pass medications.

In New Mexico, medical assistants have to be trained to use equipment before they can be reasonably delegated the responsibility of using it. Even then, it cannot be invasive equipment that they use on a patient.

As you can see, each state has its own ideas about what a medical assistant can reasonably do in her scope of practice. You are open to liability if you do not know your limitations, so do your homework and learn what your scope of practice is in your particular state.

For more info, see this article, or examples of scope of practice rules by state.

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