Understanding Medical Assistant Practice Liability Issues

Carolyn Buppert


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

In This Article

Supervision Considerations

There is another legal issue that practices should address when employing medical assistants: who can supervise a medical assistant? In some states, registered nurses can supervise and give orders to medical assistants. In other states, only a physician (and not even nurse practitioners) can supervise a medical assistant. In some states, the rules are so vague that no one is really sure. Again, let's look at California law, as an example. Nurses in California may train, supervise, and assign tasks to medical assistants, so long as the tasks are within the scope of practice of the medical assistant, but the medical assistant may only perform services when a physician is physically present in the office or clinic, with one exception. The exception is that a supervising physician at a "community clinic" or "free clinic" may, at his or her discretion, in consultation with a nurse practitioner, provide written instruction to be followed by a medical assistant in the performance of tasks or supportive services. The written instructions may provide that the supervisory function for the medical assistant may be delegated to the nurse practitioner and the tasks may be performed by the medical assistant when the supervising physician is not on-site.

Check your state's law to see whether there are restrictions on who may supervise and give orders to medical assistants. In states where there is no law regarding medical assistants, practices should use medical assistants conservatively and with careful supervision.

If you have been assigned to supervise a medical assistant, be clear about what the assistant can and cannot do. Ascertain that the assistant has adequate training for any skills the assistant is performing. Spend an hour or 2 a month monitoring the medical assistant's encounters with patients. If the assistant is exceeding his or her scope of practice, inform the assistant and your supervisor about what is happening, so that the medical assistant can bring his or her practice in compliance with the law.


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