Medical Assistant Supervision

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Practicing Medicine Without a License

U.S. laws restrict who can give medical and health advice, or apply certain medical treatments, or modalities to patients, making the unauthorized practice of medicine a serious crime. Physicians and non-physician practitioners (physician assistants, or nurse practitioners) are in charge of the care of their patients, and must keep a watchful eye over those to whom they delegate tasks.

Training, Supervision, and Documentation

Procedures that may lead to medical acts of negligence, and scope of practice violations must be recognized so that they can be prevented to avoid harm to all involved.

Unless prohibited by state law, supervising physicians, and licensed nursing staff are authorized to delegate clinical and healthcare duties to their medical assistants, except those that constitute the practice of medicine.

When it comes to assigning procedures that carry a higher risk of injury, such as injections, venipunctures, and other intravenous procedures the medical assistant must have been properly taught and have logged the appropriate amount of hours of training and documented evaluation of the particular skill. It is a good idea to check malpractice and professional liabilty insurance policies for specific riders to see if the employee is covered during all stages of the training phase.

Delegation of Tasks

Between 2000 and 2007 the state Board of Medicine and State Board of Osteopathic Medicine in Pennsylvania has fined 57 people for unlicensed practice of medicine, among them medical assistants.

One of the more infamous cases involves a Pennsylvania certified medical assistant, who, acting on a doctor's orders, administered an experimental intravenous drug treatment that killed a 5-year-old boy in 2005. The doctor who authorized the unapproved treatment for autism spectrum disorder faces civil and criminal charges including manslaughter. The medical assistant, who reportedly never administered an IV-push before, has not been charged. 

The rule of thumb is that a medical assistant may only do tasks that a medical doctor, or other licensed healthcare practitioner, such as a nurse practitioner, or PA has ordered and delegated. Certain tasks can also be delegated to the medical assistant by a registered nurse (RN).

However, one exception is Alaska, where patient care tasks CANNOT be delegated by a RN nurse. As a matter of fact, medical assistants can not do anything supervised by a nurse in Alaska. A medical doctor MUST be present in the building at all times.

Liability

The very critical issues of medical errors and patient safety have received a great deal of attention. In November 1999, the Institute of Medicine (IOM) released a report estimating that as many as 98,000 patients die as the result of medical errors in hospitals each year.

As more patients, their friends and malpractice lawyers become aware of the role of the medical assistant in direct patient care, they also see a potential malpractice target if they believe they have received a poor standard of care. Injured patients, either on their own, or encouraged by family members, friends, or their attorneys, wind up taking their cases to the courts.

Situations involving injuries or damages that generations ago would have been ignored by the injured person are now regularly the basis for lawsuits. Liability has become a major risk not only for the physician but also for allied healthcare professionals working under their direct supervision, such as the medical assistant. As in any legal proceedings, when a medical malpractice law suit is filed as many people as possible will be named.  

• Ultimate Authority in Charge
• Respondeat Superior
  
  When a master acts through the servant to accomplish the master's task, such as the medical assistant carrying out direct patient care under the control of the physician.