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CERTIFIED MEDICAL ASSISTANT®
SCOPE OF PRACTICE IN IOWA
Updated May 2006
The following information is provided by the American Association
of Medical Assistants Executive Director and Legal Counsel, Donald
A. Balasa, JD, MBA:
“My research has not revealed any language in Iowa statutes
or regulations that addresses what physicians can delegate to Certified
Medical Assistants® (CMA). Nevertheless, it is my legal
opinion that common law principles inherent in state licensure
authorize physicians to delegate clinical procedures (including
venipuncture, injections, and calling in prescriptions upon the
physician's order) to unlicensed allied health personnel such as
a CMA if the supervising physician(s) determines that the unlicensed
employee is able to perform such procedures safely and efficiently. There
is also no Iowa law forbidding a physician from delegating certain
intravenous procedures to a competent and knowledgeable CMA if
the physician exercises a greater degree of supervision than for
other delegated procedures, the physician indicates in writing
that the CMA is qualified to undertake such procedure, the CMA
has documented training in the specific intravenous procedures,
and the malpractice insurance carrier does not object.
Although the nurse practice act and the attendant regulations
of the board of nursing govern what nursing duties can be delegated
by nurses to unlicensed personnel, the medical practice act and
the attendant regulations of the board of medical examiners govern
what procedures can be delegated by a licensed physician to unlicensed
employees such as a CMA.” There is an Iowa Department
of Public Health ruling that states only an AAMA current CMA can
sign a certificate of immunization form.
“I define telephone triage as exercising independent professional
judgment when dealing with patients or their representatives. I
defined telephone screening as following physician-approved protocols,
decision trees, algorithms that do not require the exercise of
independent professional judgment. It is my legal opinion
that Iowa law permits physicians to delegate telephone screening
but not telephone triage to a competent and knowledgeable CMA working
under the physician’s direct supervision.
Procedures which constitute the practice of medicine, or which
state law specifically and unambiguously permits only certain
licensed allied health care professionals to perform, however,
may not be delegated to unlicensed personnel such as medical assistants.”
With that said, as a CMA, you are trained to do what you learned
during your CAAHEP or ABHES accredited medical assistant curriculum. Further,
you are capable of learning additional skills on the job as your
provider may request. Additional training and competencies
should be in place for such tasks (those learned outside of your
formal training).
Additional information pertaining to the Certified Medical Assistant® scope
includes:
- Advance Practice of Medical Assisting document
- AAMA Content Outline
- Role Delineation document
These documents may be obtained from the AAMA via their web site www.aama-ntl.org
or phone 800-ACT-AAMA.
Specific questions about medical assisting scope of practice in
Iowa can be directed to Mr. Balasa at
dbalasa@aama-ntl.org
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