Understanding Medical Assistant Practice Liability Issues

Carolyn Buppert


Dermatology Nursing. 2008;20(4):327-329. 

In This Article

A Look at California Law

Of course, a list on a Web site is not law, but, in general, this list accurately describes the law in several states. Let's look at California law, which specifically addresses the scope of practice of a medical assistant. California law defines a medical assistant as "a person who may be unlicensed, who performs basic administrative, clerical and technical supportive services in compliance with this section...for a licensed physician and surgeon or a licensed podiatrist, or group thereof, for a medical or podiatry corporation, for a physician assistant, a nurse practitioner, or a nurse-midwife...or for a health care services plan, who is at least 18 years of age, and who has had at least the minimum amount of hours of appropriate training pursuant to standards established by the Division of Licensing." (Source: California Business and Professions Code, Section 2069 b[1]).

In California, a medical assistant may perform the following services:

  1. Administer medication orally, sublingually, topically, vaginally, or rectally, or by providing a single dose to a patient for immediate self-administration. Administer medication by inhalation if the medications are patient-specific and have been or will be routinely and repetitively administered to that patient. In every instance, prior to administration of medication by the medical assistant, a licensed physician or podiatrist, or another person authorized by law to do so shall verify the correct medication and dosage. Nothing in the section shall be construed as authorizing the administration of any anesthetic agent by a medical assistant.

  2. Perform electrocardiogram, electroencephalogram, or plethysmography tests, except full-body plethysmography. Nothing in this section shall permit a medical assistant to perform tests involving the penetration of human tissues except for skin tests...or to interpret test findings or results.

  3. Apply and remove bandages and dressings; apply orthopedic appliances such as knee immobilizers, envelope slings, orthotics, and similar devices; remove casts, splints, and other external devices; obtain impressions for orthotics, padding, and custom molded shoes; select and adjust crutches to patient; and instruct patient in proper use of crutches.

  4. Remove sutures or staples from superficial incisions or lacerations.

  5. Perform ear lavage to remove impacted cerumen.

  6. Collect by noninvasive techniques, and reserve specimens for testing, including urine, sputum, semen, and stool.

  7. Assist patients in ambulation and transfers.

  8. Prepare patients for and assist the physician, podiatrist, physician assistant, or registered nurse in examinations or procedures including positioning, draping, shaving, and disinfecting treatment sites; prepare a patient for gait analysis testing.

  9. As authorized by a physician or podiatrist, provide patient information, and instructions.

  10. Collect and record patient data including height, weight, temperature, pulse, respiration rate and blood pressure, and basic information about the presenting and previous conditions.

  11. Perform simple laboratory and screening tests customarily performed in a medical office.

  12. Cut the nails of otherwise healthy patients.

(Source: California Code of Regulations, CCR Title 16, Section 1366).

After a 2002 act of the California Legislature, medical assistants in California may also:

  1. Administer medication by intradermal, subcutaneous, or intramuscular injection if they are so authorized and supervised by a physician. In certain clinics, a nurse practitioner may authorize a medical assistant to administer intradermal, subcutaneous, or intramuscular injections. (Source: California Business and Professions Code, Section 2069).

  2. Administer injections of scheduled drugs if the dosage is verified and the injection is intramuscular, intradermal, or subcutaneous and if the supervising physician or podiatrist is on the premises. (Source: California Business and Professions Code, Section 2069).

  3. Perform venipuncture or skin puncture for the purpose of withdrawing blood, upon specific authorization of a physician, physician assistant, nurse practitioner, or nurse midwife. (Source: California Business and Professions Code, Section 2070).

Medical assistants in California are specifically prohibited from independently performing telephone triage.

Most states' law on medical assistant practice is not as detailed as California's. If working with a medical assistant, or if you are a medical assistant, check your state's statutes and regulations to determine the scope of practice for a medical assistant. In some states, medical assistants are overseen by the board of nursing and the law can be accessed through the board's Web site. In others, it is board of medicine which oversees medical assistants. In some states, there is no agency overseeing medical assistants. In that case, practices should write a policy stating what the medical assistant may do (and may not do), and stating that the physician in charge delegates the stated duties to the medical assistant.


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