Medical Assistant Scope of Practice: What Can – and Can’t – They Do?
Medical assistants (MAs) play a crucial role in healthcare. While they aren’t nurses or doctors, MAs are trained to work under a supervising physician to perform important clinical and administrative tasks. But how much can they legally do on the job?
Understanding the MA scope of practice is key to patient safety and staying compliant with state laws. Whether you’re considering a medical assistant program or are already working in the field, this guide will help you understand the clinical and administrative responsibilities MAs are trained for and where legal lines are drawn.
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Core Duties and Responsibilities of All Medical Assistants
MAs do everything from checking vitals and assisting with procedures to scheduling appointments and managing patient records. All of this happens under the supervision of a licensed physician.
However, since MAs work in a wide range of medical settings, the specific tasks they perform depend on the type of healthcare facility they work in. State laws and employer guidelines also dictate what an MA can and cannot do.
While some MAs specialize in administrative work or patient care, most handle both. This makes MAs a valuable and efficient member of the healthcare team.
Patient Intake & Vital-Signs Measurement
Before a doctor enters the room, a medical assistant is often the first person a patient sees. MAs frequently take the lead on patient intake, review medical histories, confirm medications, and collect basic information.
MAs also measure vital signs and document everything in the electronic health record (EHR). This initial work improves the patient’s experience and lays the foundation for accurate, efficient care during the rest of the appointment.
Help with Minor Clinical Procedures
Medical assistants are often present during minor procedures to assist providers and ensure that everything runs smoothly and safely. They may prepare sterile instruments, set up exam trays, hand tools to the provider, and offer strong bedside etiquette to nervous patients.
Whether it’s removing stitches, applying a dressing, or freezing a wart, MAs handle extra tasks so providers can focus on clinical outcomes.
Specimen Collection & Patient Prep
MAs handle a range of specimen collection duties, such as urine samples and various swabs to test for illness. Their duties also include tasks like ensuring samples are labeled properly, storing them according to facility guidelines, and transporting and reporting results to the lab.
Medical assistants also help prepare patients for exams or imaging procedures. This can mean anything from assisting the patient into a gown, explaining what to expect, or creating a calm, respectful environment.
Medication Administration
Depending on state law and employer policy, medical assistants may be authorized to administer certain medications. This typically includes oral medications, topical ointments, or certain vaccines.
Medication administration is one of the least common tasks MAs perform, as nurses on staff will typically handle this. That said, with proper training and authorization, MAs can sometimes perform these tasks to help with the patient care load.
Electronic Health Record (EHR) & Front-Office Tasks
Beyond the exam room, MAs keep the clinic running by managing various front desk duties. They answer phones, schedule appointments, verify insurance details, and assist with billing. This clerical work enables other providers to spend more time with patients and perform hands-on care.
On the digital side, MAs are often responsible for entering data into the EHR system. Through the EHR, they document patient visits, test results, and provider notes.
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Medical Assistants’ Scope of Practice by State
Medical assistants may share a common job title, but what they’re legally allowed to do depends largely on where they work. This is because laws regulating the scope of practice for MAs are governed at the state level, not nationally. For example, a task that’s routine for an MA in Texas might be completely off-limits just across the border.
The following three areas of care tend to vary most from state to state:
- Medication administration and injections
- Blood draws and lab-related work
- The level of required supervision
Across the country, states fall into one of three broad categories in defining the scope of practice for medical assistants: restrictive, permissive, or somewhere in the middle. In more permissive states, such as Arizona, MAs are granted considerable freedom to carry out clinical tasks with minimal supervision.
More moderate states, like Texas, are those that land somewhere in the middle. MAs in this state can perform many clinical tasks, but only if specific supervisory conditions are met.
Meanwhile, MAs in restrictive states like New York are more tightly limited. In these states, MAs may be limited to administrative tasks or non-invasive clinical duties. These restrictions apply even when the MA is under direct supervision.
California
In California, medical assistants operate under one of the nation’s more clearly defined regulatory structures. The state’s scope of practice is governed by the Medical Board of California.
MAs in the Golden State can perform a broad range of clinical tasks, including taking vitals, giving injections, conducting CLIA-waived tests, and updating the EHR. However, a physician must be physically present to supervise their work.
There are firm boundaries to consider if you would like to become an MA in California. MAs in this state are not allowed to diagnose, interpret test results, perform invasive procedures, or start intravenous (IV) lines. Employers must also ensure that MAs receive the required training and documentation before assigning them any clinical responsibilities.
Texas
For those looking to become an MA in Texas, the Lone Star State offers these professionals a moderately flexible practice environment. However, there is one important caveat to keep in my: MAs in Texas are not licensed by the state. Instead, the scope of practice for MAs here is defined by how much a physician is willing and legally allowed to delegate.
The Texas Medical Board gives providers the discretion to assign clinical tasks if the MA is properly trained. That said, some tasks remain strictly off-limits. These include diagnosing conditions, performing triage, and prescribing medications. The law emphasizes that providers cannot delegate tasks considered the “practice of medicine.”
How to Verify Your State’s Rules
Since every state draws its own legal boundaries for medical assistants, it’s crucial to take an active role in understanding what’s allowed in your home state. A good first step is to check your state’s medical or nursing board website. Most of these agencies provide clear summaries or FAQs that explain what MAs can and cannot do.
You can also use national resources like the American Association of Medical Assistants (AAMA), which maintains a helpful state-by-state scope of practice guide. Don’t overlook your workplace, either. Providers, clinic managers, and the human resources (HR) department can walk you through site-specific policies that align with state law.
Resources
Comparing the Scope of Medical Assistants and Nurses
Medical assistants and nurses are both essential members of the healthcare teams that operate in today’s hospitals. Both interact with patients, assist with treatment, and support clinical operations.
However, there are important differences in their training, licensing, and legal responsibilities. Here’s how the two professions compare across several job duties.
Direct Patient Care
Both MAs and nurses regularly interact with patients, but the depth of care they’re allowed to provide differs. Medical assistants often handle the basics, such as greeting patients, taking vital signs, and reviewing medical histories.
Nurses, particularly licensed practical nurses (LPNs) and registered nurses (RNs), take on more advanced care duties. They may manage wound care, monitor serious conditions, start and manage IV lines, and provide patient education. Nurses are also trained to identify clinical concerns and escalate care independently when needed.
Medication Administration
Medical assistants can administer medications in many states, but only under direct supervision and with explicit provider orders. In these states, an MA’s role may include giving oral medications, topical treatments, or injections like flu shots.
Nurses have much more autonomy when giving medications. LPNs and RNs are licensed to administer a broader range of medications, including IV drugs and controlled substances, without physician oversight. Nurses also monitor patients for side effects or adverse reactions.
Invasive Procedures & Equipment Use
Nurses are far more involved in care when it comes to any invasive procedures. MAs typically aren’t permitted to insert catheters, start IVs, or handle tasks that involve breaking the skin or entering body cavities. In states where they are permitted to do so, it is only with proper instruction and supervision.
In contrast, nurses are licensed and trained to perform these procedures. Their scope of practice includes tasks that involve critical thinking, sterile technique, and a deeper understanding of anatomy.
Autonomy & Supervision
Supervision is one of the most defining differences between the two roles. Medical assistants always work under the supervision of a licensed provider who delegates their duties. They do not have the independent authority to make clinical decisions.
Nurses operate under their own license, giving them much more autonomy. While they still work as part of a care team, RNs and even LPNs have a legal responsibility to assess, plan, and implement care independently, especially in long-term care or hospital settings.
Documentation & Orders
Both MAs and nurses handle documentation, but the expectations for their contributions differ. Medical assistants typically input information into the EHR after it is collected from an initial assessment or relayed from a provider.
Nurses not only document their own assessments and interventions, but they also receive and execute provider orders. In some states, nurses can even take verbal or telephone orders directly from a physician, a responsibility that is strictly outside the scope of practice for MAs.
Legal Accountability & Boundaries
Because medical assistants are not licensed to practice in the way that nurses are, they are held to different legal standards than nurses. If an MA steps outside their permitted duties, the supervising physician often shares liability.
Nurses, however, are personally accountable for their actions under their nursing license, as the broader scope of practice that nurses carry comes with greater responsibility and liability. They can be disciplined by their state board for professional misconduct or negligence.
Answers to Common Questions
Still unsure about what a medical assistant can or cannot do? These are some of the most frequently asked questions by aspiring and current MAs.
These answers may help clear up confusion and keep you within your legal boundaries for safe practice. Also, if you are curious about entering the MA profession for yourself, you might be surprised at what there is still left to learn about being a medical assistant.
Can a medical assistant give injections or draw blood?
In some states, MAs can give injections and even perform blood draw procedures. However, this is only if they’ve been administered the proper training and are working under the supervision of a licensed provider.
State laws on this matter differ. While it may be common practice in one state, this isn’t universal, so be sure to understand the local laws that govern the MA scope of care.
Are medical assistants allowed to start IVs or administer medications?
Medical assistants are generally not allowed to start IVs, since this is considered too invasive for their scope of practice. As for medication administration, in some states, MAs can administer oral or topical medications if delegated by a physician.
Where do medical assistants work?
You’ll find that medical assistants work in a wide variety of settings, with physician offices and hospitals being the most common. They’re also found in urgent care clinics, outpatient surgery centers, and specialty practices like dermatology or cardiology offices.
Some MAs focus more on administrative duties and work in billing offices and telehealth environments. What setting an MA works in often determines their day-to-day tasks and how much clinical versus administrative work they perform. This gives prospective MAs diverse choices for roles and work environments to pursue after their training.
Who decides a medical assistant’s duties?
A medical assistant’s duties are almost always determined by state regulations. Within that legal framework, supervising physicians and employers determine what tasks an MA can perform.
When you enter your role as a medical assistant, make sure to gain a firm understanding of who can dictate your duties and who will be supervising your tasks. This will help to ensure patient safety and quality care.
What tasks are medical assistants specifically prohibited from performing?
Medical assistants are not allowed to diagnose medical conditions, interpret test results, develop treatment plans, or prescribe medications. They also can’t perform invasive procedures, including starting IVs, inserting catheters, or suturing wounds.
MAs are additionally prohibited from making independent clinical decisions. In most states, tasks that involve critical thinking or direct patient assessment are also off-limits.
