Are you putting your medical practice at risk by using a medical assistant (MA) improperly?

Beginning in 1992, the functions that MAs may perform have been defined by California’s Business and Professions Code and by the California Code of Regulations. The Medical Board of California (MBC) and the California Medical Association provide additional interpretive guidelines based on the governing laws.

In the intervening years since 1992, economic considerations have caused many medical practices to reduce their use of licensed RNs and LVNs in favor of lower-paid MAs. The practice of medicine, however, must always be carried out by licensed healthcare professionals. Medical assistants are not licensed.

On the other hand, a physician may legitimately train and authorize a medical assistant to perform basic administrative and clerical functions, administer medication by injection, administer skin tests and withdraw blood by means of venipuncture.

In addition, the law provides a category of specifically delineated tasks called “technical supportive services,” which include the following:

• Administer medication by methods other than injection.
• Apply and remove bandages and dressings; apply orthopedic appliances; remove casts, splints and other external devices.
• Remove sutures or staples from superficial incisions or lacerations.
• Perform tests not involving the penetration of human tissues (EEG and ECG, for example) and collect by noninvasive techniques specimens for testing.
• Provide patient information and instructions as authorized by the physician.
• Perform simple laboratory tests and screening tests customarily performed in a medical office.

Medical assistants must carry out all job duties under the supervision of a physician or podiatrist. Also, the MBC has clearly stated that a medical assistant may not diagnose or treat a patient, or perform any task that is invasive or requires assessment. While they are at work, medical assistants are required to wear a nametag that displays, in at least 18-point type, their name and status as a medical assistant.

Violating any of the relevant codes—either deliberately or because of misunderstanding—not only puts the physician and medical assistant at risk for serious sanctions by the MBC, but also makes the medical practice more vulnerable to medmal lawsuits.