Medical Assistant Scope of Practice
There is no single definition of a medical assistant and their scope of practice that universally applies in all US
states, however one general rule that applies to ALL medical assistants is that they must work under the
direction of a doctor or licensed health care professional and the employer is ultimately accountable for the
actions of the employee (respondeat superior doctrine) regardless of the amount of prior training provided,
documented, or repeated many times before. Medical assistants are not allowed to independently assess or
triage patients, make medical evaluations, independently refill prescriptions, or give out drug samples without
the approval of the physician. Doctors who allow medical assistants to perform any such activities could
become subject to disciplinary action for professional misconduct.
Medical Office Rules
Rules and regulations that govern the practice of medicine are instituted by the State Medical Board, or Board
of Medical Examiners and other state authorities such as the Department of Public Health. These peer
reviewed boards have now also begun to include provisions on how doctors may utilize medical assistants and
how they must be supervised. It is advisable that doctors and supervisors are diligent in determining each
medical assistant's qualifications and periodically reassess their knowledge and skill levels before delegating
any tasks to them.
The medical assistant is not permitted to diagnose, treat or perform patient care or medical procedures that
are invasive or require assessment (e.g. charting pupillary responses, interpreting the results of allergy skin
tests). Invasive tasks may include, but are not limited to placing an injection needle into a vein or artery, starting
and disconnecting the infusion cannula of an intra venous (IV) infusion, administering IV medications, inserting
a urine catheter, injecting collagen, administering chemotherapy, using lasers for hair removal, wrinkles, scars
and other skin blemishes and performing telephone triage without direct physician supervision.
In an article originally published by Michael N. McCarty, American Medical Technologists (AMT) Legal Council
from 1996 and updated in 2003 it was noted that as far as they could tell, only seven states, namely Arizona,
California, Florida, New Jersey, Maryland, South Dakota and Washington had specific regulations that govern
the medical assistant's scope of practice. The article further mentioned that only Colorado, Georgia, Illinois,
Indiana, Kansas, Massachusetts, Main, Michigan, Montana, North Carolina, North Dakota, Nebraska, New
Mexico, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas Utah, Virginia and Wisconsin had
specific laws and regulations that address the medical assistant's actions. Unfortunately we are no longer able
to locate this article for reference on the Web.
Scope of Practice By State
State laws affecting the scope of medical assisting practice generally fall into one of three categories:
1. Laws that expressly recognize the practice of medical assisting and list some of the specific clinical
functions that properly qualified medical assistants may perform
2. Provisions in state practice acts that preserve the right of licensed practitioners to delegate basic clinical
tasks to unlicensed assistants or exempt such assistants performance of delegated tasks from legal
definitions of unauthorized practice
3. Laws are completely non-existent with regards to the delegation of clinical tasks to unlicensed personnel.
Below is a small selection of medical assistant scope of practice links we have found. Remember that each
state's rules are different. The handful of links posted will give you an idea where you can look for answers in
your own state. Please check directly with your own State Board of Medical Examiners and State Nursing
Board for their latest statutes, rules and regulations.