Frequently Asked Questions - Medical Assistants

Define acceptable and appropriate training to practice as a medical assistant.

Prior to performing technical supportive services, a medical assistant shall receive training, as necessary, in the judgment of the supervising physician, podiatrist or instructor to assure the medical assistant's competence in performing that service at the appropriate standard of care.

Such training shall be administered in either of the following settings: 1) Under a licensed physician or podiatrist, or under a registered nurse, licensed vocational nurse, a physician assistant or a qualified medical assistant, or 2) in a secondary, post secondary, or adult education program in a public school authorized by the Department of Education, in a community college program provided for in the Education Code, or a post secondary institution accredited or approved by the Bureau for Private Postsecondary and Vocational Education in the Department of Consumer Affairs.

To administer medications by intramuscular, subcutaneous and intradermal injections, to perform skin tests, or to perform venipuncture or skin puncture for the purposes of withdrawing blood, a medical assistant shall complete the minimum training prescribed in the regulations. Training shall be for the duration required by the medical assistant to demonstrate to the supervising physician, podiatrist, or instructor, as referenced in 16 CCR Section 1366.3 (a)(2), proficiency in the procedures to be performed as authorized by section 2069 or 2070 of the code, where applicable, but shall include no less than:

  • 10 clock hours of training in administering injections and performing skin tests, and/or
  • 10 clock hours of training in venipuncture and skin puncture for the purpose of withdrawing blood, and
  • Satisfactory performance by the trainee of at least 10 each of intramuscular, subcutaneous, and intradermal injections and 10 skin tests, and/or at least 10 venipuncture and 10 skin punctures.
  • For those only administering medicine by inhalation, 10 clock hours of training in administering medical by inhalation.
  • Training in (a) through (d) above, shall include instruction and demonstration in:
  • pertinent anatomy and physiology appropriate to the procedures;
  • choice of equipment;
  • proper technique including sterile technique;
  • hazards and complications;
  • patient care following treatment or tests;
  • emergency procedures; and
  • California law and regulations for medical assistants

In every instance, prior to administration of medicine by a medical assistant, a licensed physician or podiatrist, or another appropriate licensed person shall verify the correct medication and dosage. The supervising physician or podiatrist must authorize any technical supportive services performed by the medical assistant and that supervising physician or podiatrist must be physically present in the treatment facility when procedures are performed, except as provided in section 2069(a) of the code.

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Are medical assistants required to be licensed or certified by the State of California to perform procedures within their "scope of practice"?

No. Medical assistants are not licensed, certified, or registered by the State of California. However, the medical assistant's employer and/or supervising physician's or podiatrist's malpractice insurance carrier may require that the medical assistant be certified by a national or private association. A medical assistant must be certified by one of the approved certifying organizations in order to train other medical assistants. (Title 16 CCR 1366.3)

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How may medical assistants legally "administer medications"?

The phrase intends to mean the direct application of medication in several ways including simple injections, ingestion and inhalation or pre-measured medications. For our purposes, the phrase "administer medications" when used regarding medical assistants, means to inject, handle, or provide medications to a patient after verification by a physician, podiatrist or another appropriate licensed person.

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Are medical assistants allowed to administer injections of scheduled drugs?

If after receiving the appropriate training as indicated in Item 1, medical assistants are allowed to administer injections of scheduled drugs only if the dosage is verified and the injection is intramuscular, intradermal or subcutaneous. The supervising physician or podiatrist must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section. However, this does not include the administration of any anesthetic agent.

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Are medical assistants allowed to start or disconnect IV's or administer injections or medication into IV's?

No. Medical assistants may not place the needle or start and disconnect the infusion tube of an IV. These procedures are considered invasive, and therefore, not within the medical assistant's scope of practice. Medical assistants are not allowed to administer medications or injections into the IV line. (Title 16 CCR 1366(b)(1))

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Are medical assistants allowed to perform nasal smears?

Yes. Only if the procedure is limited to the opening of the nasal cavity.

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Are medical assistants permitted to perform "finger sticks"?

Yes. Medical assistants are trained and allowed to draw blood as long as they have received the proper training. The procedure of finger stick is the pricking of the finger in order to collect a sample of blood. This procedure is within the "scope of practice" of a medical assistant.

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Are medical assistants allowed to swab the throat in order to preserve the specimen in a throat culture?

Yes. Medical assistants are allowed to swab throats as long as the medical assistant has received the proper training and a physician or podiatrist is on the premises.

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Are medical assistants allowed to take a patient's blood pressure?

Yes. Medical assistants are allowed to take the necessary information to prepare a patient for the physician's or podiatrist's visit. This information may include taking the patient's height, weight, temperature, blood pressure and noting the information on the patient's chart.

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Are medical assistants allowed to give narcotic injections?

Yes. At this time there are no restrictions as to what type of medications a medical assistant may inject, EXCEPT anesthetic agents, as long as the medication has been pre-verified and the injection is either intradermal, intramuscular, or subcutaneous. (16 CCR 1366 (b)(1)). Both 1366 and Business and Professions Code section 2069 provide that they shall not be construed as authorizing the administration of any anesthetic agent by a medical assistant."

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Are medical assistants allowed to have access to the keys of the narcotic medication cabinet?

This question should be directed to the supervising physician or podiatrist as it is an "in-house" procedure and the decision must be made by the supervising physician or podiatrist.

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Are medical assistants allowed to chart pupillary responses?

No. The charting of pupillary responses is considered an assessment, which is a form of interpretation. Medical assistants are not allowed to read, interpret or diagnose symptoms or test results.

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Are medical assistants allowed to insert urine catheters?

No. Insertion of a urine catheter is considered an invasive procedure and therefore, not within the medical assistant's scope of practice.

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Are medical assistants allowed to perform telephone triage?

No. Medical assistants are not allowed to independently perform telephone triage as they are not legally authorized to interpret data or diagnose symptoms.

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Are medical assistants allowed to inject collagen?

No. The injection of collagen does not fall within the medical assistant's scope of practice. 16 CCR section 1366.4 states that medical assistants may inject "medications".

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Are medical assistants allowed to use lasers to remove hair, wrinkles, scars, moles or other blemishes?

No. Medical assistants are not legally authorized to use lasers to remove hair, wrinkles, scars, moles, or other blemishes.

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Are medical assistants allowed to administer chemotherapy and/or monitor patients?

No. Medical assistants are not legally authorized to administer chemotherapy or make an assessment of the patient as the procedure does not fall within the medical assistant's scope of practice.

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Are medical assistants allowed to apply orthopedic splints in emergency situations, such as splints in a physician's office?

No. Medical assistants are legally authorized only to remove casts, splints and other external devices. Placement of these devices does not fall within the medical assistant's scope of practice. Please reference CCR Section 1366(b)(3).

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Are medical assistants allowed to interpret the results of skin tests?

No. Medical assistants may measure and describe the test reaction and make a record in the patient's chart. For every questionable test result, the result should be immediately brought to the physician's attention. In addition, all results need to be reported to the appropriate provider. Please reference 16 CCR 1366(b)(2).

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Can medical assistants be supervised by a nurse practitioner, nurse midwife, or physician assistant in the absence of a physician and surgeon?

Per Business and Professions Code section 2069 (a)(1), a supervising physician and surgeon may, at his or her discretion, in consultation with the nurse practitioner, certified nurse midwife, or physician assistant, provide written instructions to be followed by a medical assistant in the performance of tasks or supportive services. The written instructions may provide that the supervisory function for the medical assistant in performing these tasks or supportive services may be delegated to the nurse practitioner, nurse midwife, or physician assistant when the supervising physician and surgeon is not on site.

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Can medical assistants call in refills to a pharmacy?

Yes. Under the direct supervision of the physician or podiatrist, a medical assistant may call in routine refills that are exact and have no changes in the dosage levels. The refill must be documented in the patient's chart as a standing order, patient specific. Medical assistants may not call in new prescriptions or any prescriptions that have changes. The physician should view carefully his or her decision to allow medical assistants to perform this task, as the authority to prescribe or refill prescriptions is only granted to licensed physicians and surgeons, podiatrists, or those individuals authorized by law to do so.

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Can medical assistants perform hearing tests?

Yes. Medical assistants may perform hearing tests under the direct supervision of a licensed physician and surgeon or podiatrist. This procedure is within the scope of practice of a medical assistant. Per Business and Professions Code section 2530.5(a), "Nothing in this chapter shall be construed as restricting hearing testing conducted by licensed physicians and surgeons or by persons conducting hearing tests under the direct supervision of a physician and surgeon."

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Are medical assistants allowed to administer flu shots and other vaccines?

Yes. After receiving the appropriate training as indicated in the first question, medical assistants are allowed to administer vaccinations in a clinic or physician's office settings. The dosage must be verified and the supervising practitioner must be on the premises as required in section 2069 of the Business and Professions Code, except as provided in subdivision (a) of that section.

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Are medical assistants allowed to hand patients prescription drugs?

Yes, in certain locations identified in Business and Professions Code sections 4180 and 4190, other than facilities operated by the state, medical assistants may 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.

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Can a medical assistant lawfully perform spirometry pulmonary function testing?

A medical assistant may lawfully perform spirometric pulmonary function testing if the test is a usual and customary part of the medical practice where the medical assistant is employed, and the requirements for training, competency, authorization and supervision are satisfied.

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