So, if you’ve read our other articles on What Does A Medical Assistant Do, you’re probably what the law allows a Medical Assistant to do. The Medical Assistant scope of practice includes both clinical and administrative tasks that a medical assistant may perform. It is governed by state laws and regulations, and therefore varies accordingly. The following are scope of practice laws for selected states, and medical assistants mentioned must be certified medical assistance as defined by the American Association of Medical Assistants, the National Center for Competency Testing, or American Medical Technologists.
In Arizona, a medical assistant may perform the following procedures only under the direct supervision of the physician: whirlpool treatments, diathermy treatments, electronic galvation stimulation treatments, ultrasound therapy, massage therapy, traction treatments, transcutaneous nerve stimulation unit treatments, hot and cold pack treatments, and small volume nebulizer treatments.
In the state of California, medical assistants are unlicensed, and thus may only perform basic administrative, clerical and technical supportive services as permitted by law. They may administer medications intradermally, subcutaneously, or intramuscularly, perform skin tests, and other technical supportive services after specific authorization and under supervision of a licensed physician or podiatrist. They may apply and remove bandages and dressings, remove sutures, perform ear lavage, prepare patients for examinations, and shave and disinfect treatment sites. They are also permitted to draw blood if they have completed the minimum training prescribed by regulation. On the other hand, they are not permitted to diagnose or treat or perform any task that is invasive or requires assessment. Invasive tasks include placing the needle or starting and disconnecting the infusion tube of an IV, administering IV medications, administering IV injections, charting the pupillary responses, inserting a urine catheter, injecting collagen, administering chemotherapy, interpreting the results of skin tests, using lasers for hair removal, wrinkles, scars and other skin blemishes, and performing telephone triage without direct physician supervision.
In Florida, medical assistants may perform the following clinical procedures under the direct supervision and legal responsibility of licensed physicians: aseptic procedures, obtain vital signs, prepare patients for the physician’s care, perform venipunctures and non-intravenous injections, monitor and report the patient’s signs or symptoms, administer basic first aid, assist during patient examinations or treatments, operate office medical equipment, collecting routine laboratory specimens as directed by the physician, administer medication as directed by the physician, perform basic laboratory procedures, perform dialysis procedures, and other general administrative duties required by the physician.
In Illinois, medical assistants may perform all tasks that are delegated by a physician licensed to practice medicine, under their supervision.
In Maryland, a medical assistant may perform the following tasks if they have been explicitly delegated by a licensed physician: surgical technical procedures while the physician is in the same room, and nonsurgical technical acts under the physician’s direct or on-site supervision. Tasks which a medical assistant may perform without on-site supervision include preparing patient for physician examination, patient history interview, collecting and processing specimens, such as performing phlebotomy and inoculating culture media, preparing specimens for pregnancy tests, dipstick and microscopic urinalysis, and microbiology, laboratory tests that the physician believes the assistant is qualified to perform under state and CLIA regulations, tuberculin skin tests, electrocardiography, administering basic pulmonary function tests, visual field tests, transmitting prescriptions to a pharmacy, providing medication samples, selected by a physician, and preparing and administering oral drugs. On-site supervision by licensed physicians is required for preparing and administering injections intradermally, subcutaneously, and intramuscularly, establishing a peripheral intravenous line and injecting fluorescein-like dyes for retinal angiography. Direct supervision by the licensed physician is mandatory when performing intravenous injections. Finally, medical assistants are not permitted perform physical examinations, administer intravenous or inhalational anesthetic agent or sedatives, independently initiate treatment aside from CPR, dispense medications, provide physical therapy, and give medical advice without consulting of a licensed physician.
New Jersey allows the medical assistant to perform injections under on-site supervision provided the licensed physician has thoroughly assessed the patient and the need for the injection, as well as determined all the aspects of the treatment such as drug, dose, route of administration, side effect, etc. Medical assistants are not permitted to inject the following substances: any substance related to allergenic testing or treatment, local anesthetics, controlled dangerous substances, experimental drugs, and chemotherapeutic agents aside from corticosteroids.
In South Dakota, medical assistants are permitted to perform the following under the direct supervision of a licensed physician, physician’s assistant, nurse practitioner, or nurse midwife: performing clinical procedures to include: aseptic procedures, taking vital signs, preparing patients for examination, phlebotomous blood withdrawal and non-intravenous injections, monitoring and reporting patients’ signs or symptoms, administering basic first aid, assisting with patient examinations or treatment, operating office medical equipment, collecting routine laboratory specimens, administering oral and inhalation medications by unit dosage, performing basic laboratory procedures, performing skin tests, telephone prescriptions to the pharmacy, and performing general administrative duties. They are not permitted to inject insulin, collect blood via arterial puncture, perform irrigations for stoma or ostomy care, administer medications that require calculation of the dose, and perform health teaching or counseling.
Virginia permits licensed physicians to delegate the administration of controlled substances to medical assistants under his or her direct and immediate supervision, provided the route of administration is not intravenous, intrathecal, or epidural.
In summary, since medical assistants are not licensed healthcare providers, the delegation of certain clinical tasks usually depends on the discretion of licensed physicians, unless state laws and regulations explicitly state otherwise. Prior to delegation, the licensed healthcare practitioner must ensure that the medical assistant is competent and properly trained to perform these tasks, as liability will fall completely on his or her shoulders.