A Medical Assistant (MA) is an unlicensed individual who performs technical supportive, administrative, clerical, and non-invasive routine services in an outpatient medical setting under a supervising clinician such as a licensed physician, podiatrist, physician assistant, nurse practitioner or nurse midwife.

Supervision is considered to be where the supervising licensed clinician is readily available to the unlicensed staff in the event of an untoward occurrence. As the MA is unlicensed, the technical term of supervision relates to clinicians with advanced degrees and clinical competency as a ‘supervising clinician'. The term "supervision" as described above is not in the same context as oversight or delegation of tasks.

Each state's Medical Board is responsible for classifying and governing the role of the medical assistant. The Medical Practice Act, a provision of the Medical Board, defines MA training and role expectation. For example, the California Medical Board lists two ways in which a Medical Assistant can gain training: 1. Directly from a physician/podiatrist or through other qualified medical personnel under the direction of the physician/podiatrist or 2. Through a formal education program that meets the defined criteria.

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Some states do not recognize a formal Scope of Practice for unlicensed medical personnel. The supervising physician or podiatrist is responsible to have written job duties and expectations available for the MA as more of a "scope of employment" rather than practice. The American Association of Medical Assistants offers state-by-state descriptions of practice issues and questions. For example, an MA in Idaho may be delegated the task of intramuscular injections once the MA has been trained and is proven competent to perform the task as long as the supervising clinician has verified the patient-specific order, dose, and route prior to the MA administering the medication.

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Each state's Board of Nursing, through the Nurse Practice Act, allows for nurses to delegate tasks and to oversee unlicensed assistive staff such as a medical assistant. Nurses are also authorized to assess the competency of staff to ensure the tasks that are delegated and performed in a safe manner for the patient. Written permission by the supervising physician or podiatrist, often times in the form of a policy, can grant a registered nurse the ability to delegate technical supportive services which are routine and simple medical tasks/procedures.

Nurses, while authorized to delegate tasks and oversee the competency of those tasks to unlicensed medical personnel such as an MA, should verify such allowance with the Board of Nursing and Medical Board for the specific state requirements or nuances.

Amanda Bucceri Androus, RN, BSN
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