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Use of Unlicensed Healthcare Personnel

With ever-increasing demands on the time and resources of physicians, the role of unregulated healthcare personnel is expanding.  As a result, high quality patient care depends on the contributions of a wide variety of personnel, including medical assistants.  When establishing expectations and limitations for medical assistants in a medical office, the OMB advises that patient safety should be the primary factor.

The physician is responsible for ensuring that the medical assistant is qualified and competent to perform any delegated services.  It is within the physician’s judgment to determine that the medical assistant’s education, training and experience is sufficient to ensure competence in performing the service at the appropriate standard of care.  Performance of delegated services is held to the same standard of care applied to the supervising physician, and the physician is ultimately accountable for the actions of his or her supervised personnel.  

Unlicensed healthcare personnel must be adequately supervised by a licensed physician.  Examples of supervision include verifying the correct medication and dosage prior to administration of medicine by a medical assistant and being physically present in the facility when services are performed by a medical assistant.

The physician may not allow any unlicensed healthcare personnel to practice medicine as defined by the Oregon Medical Practice Act.  Unlicensed healthcare personnel may not provide independent medical judgment.  Therefore, medical assistants should not provide assessments, interpretations, or diagnoses and should not perform invasive procedures.

Physicians should exercise caution when employing a person who has education and training as a healthcare professional but is working as an unlicensed medical assistant.  In this situation, it may be tempting for the physician to delegate (or the medical assistant to perform) duties beyond the scope of unlicensed healthcare personnel.

Medical assistants and other unlicensed healthcare personnel must maintain patient confidentiality to the same standards required of physicians.  Medical assistants must be clearly identified by title when performing duties.  This can be accomplished through wearing a name tag with the designation of “medical assistant” and clearly introducing oneself as a “medical assistant” in oral communications with patients and other professionals.

In order to fulfill its mission to protect the health, safety and wellbeing of Oregonians, the OMB asks physicians to follow these guidelines and to be mindful of patient safety when delegating services to other healthcare personnel.

-Adopted October 2012