Scope Of Practice

The Basics

What is a “Scope of Practice”?

• The range of activities that a qualified practitioner of an occupation may perform.

• Establishes the boundaries of an occupation.

What Professions have a Scope of Practice?

• Medical Professions – Dieticians, Respiratory Therapists, Nurses, Midwives, EMT’s, Physicians, Surgeons, Physician Assistants, Dentists, Dental Hygeinists, Chiropractors, Audiologists, Radiographers, Nuclear Medicine Specialists

• Social Workers, Occupational Therapists, Physical Therapists, Speech & Language Pathologists

• Non-Medical Professions as well

Where to Find Scope of Practice for Medical Assistant

• Federal and State Laws• Professional Codes of Ethics• Employer Policies • Job Description from your Employer• Professional Publications• Standards of Care and Practice in your

community• Continuing Education (as noted in Ethics Codes)

Which Laws & Standards Apply to the Medical Assistant Scope of Practice?

• Federal Standard: U.S. Board of Medical Examiners– Doctors may delegate tasks to Medical Assistants

under their employ• So long as the doctor is “in reasonable proximity” when

the M.A. is performing direct patient care and hands on procedure– REGARDLESS of the amount of training and experience.– “Supervision” means initial AND ongoing direction, procedural

guidance, observation, and evaluation.

Scope of Practice for Medical Assistants are subject to State Laws

• Standards and laws vary from state to state– Example: In California, C.M.A.’s must have

additional licenses for phlebotomy and EKG procedures.

– Example: In New Hampshire and New York, the C.M.A. scope of practice is partly defined in the context of nursing delegation in the state Nurse Practice Acts.

What about Pennsylvania?

In Pennsylvania, there are no specific laws dictating the scope of practice for Medical Assistants. But we do have some guidelines:

-PA Code, Title 49 ᶳ18.402 (handout)- Physician Delegation of Duties

-AAMA Occupational Analysis of the C.M.A. (handout)

Scope of Practice Scenario

Jane has been working for Dr. Good for 5 years. Dr. Good has performed a routine, uncomplicated procedure in the office on Mr. Lowe. The procedure is invasive and patients generally require about 1-2 hours of rest in the office afterwards. Also, Mr. Lowe has hypertension and his blood pressure is 220/104. Dr. Good has an out-of-office appointment and leaves Jane to look after Mr. Lowe. Dr. Good has a cell phone and pager. No other employees are in the office with Jane today.Do you feel that Jane is working within her scope of practice? What should she do?

Why is the Scope of Practice Important?

• Practical Reasons – People need to know what is expected of them within their profession.

• People need to know when to refer things to other professionals.

• Liability – The scope of practice provides a “safety net” of sorts at work—so long as you are working within your scope, consistent with your training and ethical standards, your employer will usually be liable for untoward events under the doctrine of respondiat superior.

What if a person does something outside of the scope of practice for his/her profession?

• Risk of liability for the individual who is doing this. . . PERSONAL liability—you could be sued.

• Patient injury or death• Employer reputation damaged• Supervisors could be sued• Individual could be fired from job.

Job Descriptions are your Best Friend!

Your responsibilities as a Medical Assistant should clearly be outlined in your job description

- Should spell out specific tasks-Example: administering IM vaccine

-Should mention all special licenses, training, and certification that are required for your job.

What are some things that Medical Assistants should NEVER do?

• Make independent assessments• Triage Patients• Give independent medical advice• Dispensing Medication• Giving out Medications without explicit orders

and permission from a doctor

Resources for More Information

American Association of Medical Assistants – www.aama-ntl.org– 800-228-2262

Medical Assistant Web Forum (Bravenet)Discussion site on all topics for Medical Assistants and Student Medical Assistants.

THANK YOU

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