Physicians and Surgeons

Medical Assistants

Medical assistants are unlicensed individuals who perform non-invasive routine technical support services under the supervision of a licensed physician and surgeon, podiatrist, physician assistant, nurse practitioner, or nurse midwife in a medical office or clinic setting without the need of receiving a certification. The supervisor must be on the premises in order for the medical assistant to perform non-invasive technical support services.

A medical assistant gains experience by training in one of two ways:

1. Per Title 16 of the California Code of Regulations section 1366.3(a)(1), training under a licensed physician or podiatrist, who shall ascertain the proficiency of the medical assistant; or under a registered nurse, licensed vocational nurse, physician assistant, or a qualified medical assistant acting under the direction of a licensed physician or podiatrist who shall be responsible for determining the content of the training and proficiency of the medical assistant except that training to administer medication by inhalation shall be provided by a licensed physician or respiratory care practitioner; or
2. Per Title 16 of the California Code of Regulations section 1366.3 (a)(2), in a secondary, postsecondary, or adult education program in a public school authorized by the Department of Education, in a community college program provided for in Part 48 of Division 7 of the Education Code, or a postsecondary institution accredited by an accreditation agency recognized by the United States Department of Education or approved by the Bureau for Private Postsecondary Education under Sections 94130 or 94311 of the Education Code. A licensed physician or podiatrist shall serve as advisor to the medical assistant training program. The instructor in a public school setting shall possess a valid teaching credential issued by the Commission on Teacher Credentialing. The instructor in a private postsecondary institution shall meet the requirements of Sections 94310 and 94311 of the Education Code and any regulations adopted pursuant to those sections.

"Qualified" Medical Assistants

Qualified medical assistants, who are sometimes used for the purpose of initial training or teaching, must meet specific qualifications and pass an examination given by a certifying organization in order to obtain certification as a qualified medical assistant.

Per Title 16 of the California Code of Regulations section 1366.3 (c)(1)(2)(3), a "qualified medical assistant" is a medical assistant who:

1. Is certified by a medical assistant certifying organization approved by the Board (see below for list of Board approved medical assistant certifying organizations);
2. Holds a credential to teach in a medical assistant training program at a community college; or
3. Is authorized to teach medical assistants in a private postsecondary institution accredited by an accreditation agency recognized by the United States Department of Health or approved by the Bureau for Private Postsecondary Education.

A list of "Frequently Asked Questions" addressing the appropriate training, supervision, and scope of practice issues, is available to assist members of the public and profession to understand the role of the medical assistant within the health care system.

A copy of the Business and Professions Code, the Health and Safety Code, and the California Code of Regulations, relating to the scope of practice of medical assistants in the State of California, may be obtained below.

Board Approved Medical Assistant Certifying Organizations

American Association of Medical Assistants 20 N. Wacker Drive, #1575 Chicago, IL 60606-2963 http://www.aama-ntl.org	(312) 424-3100
American Medical Certification Association 310 Passaic Avenue, Suite 204B Fairfield, NJ 07004 https://www.amcaexams.com/	(888) 960-2622
American Medical Technologists 10700 W. Higgins Road, Suite 150 Rosemont, IL 60018 www.americanmedtech.org	(847) 823-5169
California Certifying Board of Medical Assistants P.O. Box 462 Placerville, CA 95667 http://www.ccbma.org	(866) 622-2262 or (530) 622-1850
Multiskilled Medical Certification Institute, Inc. P.O. Box 17 7007 College Boulevard Overland Park, KS 66211 http://www.mmciinc.com/	(888) 625-8408 or (913) 754-3287

• Frequently Asked Questions - Medical Assistants
• Frequently Asked Questions - Cosmetic Treatments
• Laws and Regulations
  • Business and Professions Code Section 2069 - 2071
  • Health and Safety Code Section 1204
  • California Code of Regulations Title 16, Article 2, Section 1366 - 1366.4
  • Medical Assistant Certifying Agency Application (Per 16 CCR Section 1366.31 )

Is Your Medical Assistant Practicing Beyond their Scope of Training?

The Medical Board receives numerous inquiries concerning the use of medical assistants in a physician's office. (By law, a medical assistant may not be employed for inpatient care in a licensed general acute care hospital.)

Medical assistants are unlicensed, and may only perform basic administrative, clerical and technical supportive services as permitted by law. An unlicensed person may not diagnose or treat or perform any task that is invasive or requires assessment. The responsibility for the appropriate use of unlicensed persons in health care delivery rests with the physician.

The classification of medical assistant is defined under the provisions of the Medical Practice Act (Business and Professions Code sections 2069-2071) as a person who may be unlicensed who performs basic administrative, clerical, and technical supportive services under the supervision of a licensed physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife.

Under the law, "technical supportive services" are simple, routine medical tasks and procedures that may be safely performed by a medical assistant who has limited training and who functions under the supervision of a licensed physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife. "Supervision" is defined to require the licensed physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife to be physically present in the treatment facility during the performance of those procedures.

Prior to performing technical supportive services, a medical assistant shall receive training by either (1) a licensed physician and surgeon, podiatrist, physician assistant, nurse practitioner, or nurse midwife or (2) an instructor in an approved school program to assure the medical assistant's competence in performing a service at the appropriate standard of care.

A medical assistant who has completed the minimum training prescribed by regulation may administer medication by intradermal, subcutaneous, or intramuscular injections, perform skin tests, and other technical supportive services upon the specific authorization and supervision of a licensed physician and surgeon, podiatrist, physician assistant, nurse practitioner, or nurse midwife.

"Specific authorization" means a specific written order prepared by the supervising physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife authorizing the procedures to be performed on a patient, which shall be placed in the patient's medical record; or a standing order prepared by the supervising physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife authorizing the procedures to be performed, the duration of which shall be consistent with accepted medical practice. A notation of the standing order shall be placed in the patient's medical record.

Other technical supportive services which a medical assistant may perform have been established by regulation and include: applying and removing bandages and dressings, removing sutures, performing ear lavage, preparing patients for examinations, and shaving and disinfecting treatment sites. A medical assistant may also hand patients properly-labeled and pre-packaged prescriptions drugs (excluding controlled substances) that have been ordered by a licensed physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife. The properly-labeled and pre-packaged prescription drug must have the patient's name affixed to the package, and the physician, podiatrist, physician assistant, nurse practitioner, or nurse midwife must verify it is the correct medication and dosage for that specific patient and provide the appropriate patient consultation regarding use of the drug prior to the medical assistant handing medication to a patient. The regulations governing medical assistants can be found in Title 16, California Code of Regulations, sections 1366-1366.4. Medical assistants who have completed the minimum training prescribed by regulation may draw blood.

Medical assistants are not allowed to perform such invasive procedures as:

• placing the needle or starting and disconnecting the infusion tube of an IV.
• administering medications or injections into the IV line.
• charting the pupillary responses.
• inserting a urine catheter.
• independently performing telephone triage.
• injecting collagen.
• using lasers to remove hair, wrinkles, scars, moles or other blemishes.
• administering chemotherapy.

Medical assistants may not interpret the results of skin tests, although they may measure and describe the test reaction and make a record in the patient's chart.

In summary, medical assistants are not licensed, and it is not legal to use them to replace highly trained, licensed professionals. The medical assistant is present to assist and perform basic supportive services in the physician's office.

Those duties must be appropriate with the medical assistant's required training.