What Medical Assistants Can and Cannot Do

Please Note: The information contained on this page is provided for information purposes only and should not be considered legal advice, nor is it a substitute or interpretation of regulations established by authorities having jurisdiction over practicing doctors, nurses and their medical assistants in your state. Please contact your State Board of Medical Examiners directly for specific advice, official business, or consult with your attorney. We cannot provide this information to you.

Medical Assistant Responsibilities and Limitations

Each medical office should have an organized plan that outlines the duties of every staff member in the medical office. It should state who handles patients and who is responsible for what, address how to handle patient assessment, triage, administration of medication, treatment procedures, responses to upset patients and emergency situations, and instruct how to  report incidences and follow the so-called chain of command.

A good medical practice and healthcare facility has established policies and provides a written job description to each staff member outlining the responsibilities for each specialty and discipline under their employ, including medical assistants. It is good policy to also instruct each staff member verbally about their specific responsibilities, while also addressing certain limitations they have when performing work related duties. These responsibilities and limitations are based on the quality and type of education, training and experience of each employee, as well as taking into consideration established local and state regulations. The responsible medical assistant will accept and demand that these limitations are respected and strictly adhered to wherever they work. Medical assistants can only practice skills that lie within their scope of practice and training. Below is a general list of what a medical assistant can and cannot do.

Examples of What Medical Assistants Can Do

Generally speaking, when performed under the supervision of a medical doctor (MD), ophthalmologist, podiatrist, surgeon, or other licensed healthcare practitioner a medical assistants is allowed to do the following tasks:

1.  Prepare and file medical records and patient charts
2.  Maintain medical records using standard filing systems 
3.  Perform inventory control and ordering supplies 
4.  Maintain and adjust medical office equipment 
5.  Manage a petty cash drawer 
6.  Post service charges and payments 
7.  Gather community resources 
8.  Prepare and maintain appointment books 
9.  Sterilize, wrap and label instruments 
10.  Set up the examination room for the next patient 
11.  Record body measurements and vital signs 
12.  Prepare patients for their physical examinations 
13.  Assist with therapeutic procedures 
14.  Assist during simple surgical procedures 
15.  Prepare and administer medications as ordered 
16.  Draw up liquid medications and administer (most of) them as ordered 
17.  Collect and preserve bodily fluids, blood, and other specimens 
18.  Perform simple STAT screening tests on collected specimens 
19.  Answer phones and relay patient's requests and questions 
20.  Type business correspondence 
21.  Transcribe dictated documents 
22.  Repeat and explain doctor's instructions (i.e. patient education) 
23.  Write the "S" and the "O" part of the SOAP note 
24.  Read laboratory or other results over the phone, but not interpret them
25.  Respond to medical office emergencies, administer CPR and basic first aid 
26.  apply a topical numbing agent to the skin, such as an EMLA® patch
27. Fill out a laboratory requisition slip - and obtain physician's signature
28.  Lay out and set up intravenous infusion therapy (IV) equipment
29.  Place and initiate an IV line except* in states where the Medical Board prohibits it

Examples of What Medical Assistants Are NOT Allowed To Do

1.  Independently diagnose or treat patients
2.  Assess, plan and evaluate patients, or their care (nor can this ever be delegated)
3.  Perform arterial punctures (NEVER EVER!)
4.  Perform tests that involve the penetration of human tissues except for skin allergy tests and venous and capillary blood collection to obtain a sample for diagnostic laboratory tests
5.  Administer intravenous (IV) medications (see new rules on IV therapy here)
6.  Independently provide medical treatment, analyze test results, advise patients about their condition, or treatment regimen, or perform medical care decision making
7.  Administer any anesthetic agents that render a patient unconscious, or semiconscious
8.  Independently prescribe or refill medications
9.  Practice physical therapy, except technical supportive services, which utilize concepts of physical therapy under the supervision of a licensed healthcare professional
10.  Do clinical skills which require healthcare professional licensure and constitute the practice of medicine 

Medical Assistants Who Give Injections

Attention: there has been a lot of controversy and headlines about medical assistants giving Botox shots, and the law remains fuzzy on this particular issue. Medical assistants in a typical medical office setting are often asked to administer different types of injections, such as vaccines, medications, hormones, B12, and intradermal injections like TB skin and allergy testing when ordered and supervised by the physician. In order to do this they must be fully trained and supervised. Medical assistants can give any of these "shots" only if the doctor is present. He/she doesn't have to literally be standing over the medical assistant observing the procedure, but must be present in the office or the building and be reachable at the spur of a moment. Any medical assistant who administers injections without a doctor's orders, or without a doctor present, even if it is to an established patient who had them before, or is on a regular schedule, is in violation of the law.

Medical Assistants and Intravenous Infusion (IV) Therapy

A medical assistant may be asked to lay out equipment, monitor, or inform a patient about IV therapy procedure, which is allowed, however, if asked to *initiate or discontinue IV therapy then it is extremely important to check specific laws and regulations to find out whether this is permitted and deemed within the medical assistant's scope of practice before proceeding. Most State Medical Boards/Boards of Medical Examiners rule that only certified, or licensed professionals and clinicians are allowed to start and discontinue IV therapy lines on patients, which typically is a physician, specially licensed technologist, such as an Emergency Medical Technologist (EMT), LVN/LPN, Registered Nurse (RN), Nurse Practitioner, or Physician Assistant (PA), since it is considered a highly skilled invasive procedure.

Medical Assistants and X-Rays

Medical assistants may work in a medical office, or facility where x-rays are part of the daily routine. The doctor might wish for the medical assistant to take radiographic images, however, a special limited x-ray license might be required.

Medical Assistants Relaying Diagnostic  Results

When it comes to medical assistants giving out medical screening, lab, or x-ray results to patients over the phone, that is permissible. Medical assistants are allowed to read results verbatim to the patient from the medical chart - but only after the supervising physician has seen, acknowledged and signed them off to the medical assistant, and without making any health or medical assessments, or giving medical advice, even if the patient asks. The medical assistant must ONLY repeat what the record states, or specific instructions that were added to the record by the physician. 

After the test results have been transmitted directly to the patient over the phone and the patient has specific questions about the values then the medical assistant must refer them back to the doctor for interpretation and further clarification. Once the results were read, the medical assistant annotates the lab slip with the date, who he/she spoke to and any other brief notes, initials it, files it back into the patient's chart and brings the chart back to the doctor if there were any further questions. A short annotation is enough (but very important!): "05/15/2011; results read to PT over phone, referred to doctor Such-And-Such for further interpretation; YOUR INITIALS, CCMA."

If you was instructed to call a patient and no one is home, do NOT read the results on the answering machine. Instead, just leave a brief message to call the doctor's office back, and annotate the records with: "05/15/2011, left message (abbreviated LM) to call us back; YOUR INITIALS, CCMA."

It is good practice to also mail a copy of the lab results, special instructions, diet plans, or any other supporting literature to the patient.

• Medical Assistants Following Standards of Care
  
  Every doctor should have a trusted medical assistant present to assist with patient care procedures, however, they must ALWAYS follow proper standards of care.
• Medical Assistants and Medical Advice
  
  Medical assistants can not give medical advice. An area that can quickly lead to potential legal implications is when a medical assistant steps outside their limits.
• Medical Assistant and IV Therapy
  
  An area that can quickly lead to potential legal implications is when a medical assistant steps outside their limits and starts IV lines where not permitted.
• Medical Assistants and X-Rays
  
  Medical assistants can not take x-rays without a limited x-ray license. An area that can quickly lead to potential legal implications where not permitted by state.