Experted from Chapter 2 of the California Physician Assistant’s and Supervising Physician’s Legal Handbook – Fourth Edition
h. Supervision of Medical Assistants. A medical assistant (“MA”) is an unlicensed but sometimes certified individual who provides services in a medical practice or outpatient clinic, including a physician’s office. Pursuant to Section 2069 of the Medical Practice Act, MAs may administer medication by intradermal, subcutaneous or intramuscular injections and perform skin tests and “additional technical supportive services,” as specified in a regulation of the Medical Board, with the specific authorization and supervision of a physician or podiatrist.
MAs must work under the supervision of a physician, physician assistant, nurse practitioner or nurse midwife (“supervising practitioner”). They may only provide services in an outpatient setting, which includes but is not limited to doctor’s offices or licensed primary care clinics. The supervising practitioner must be personally present in the clinic or office.
When a PA, NP or nurse midwife supervises a MA, the SP, in consultation with the PA or other supervising practitioner, must provide written instructions to be followed by the MA in the performance of these tasks. These written instructions may provide that the supervisory function may be delegated to the PA or other mid-level practitioner, and that such tasks may be performed when the SP is not on site, so long as the PA or other mid-level practitioner is on-site and functioning pursuant to protocols or standardized procedures, as the case may be.
MAs must operate under “specific authorization.” The “specific authorization” required for MAs to provide services is defined as a specific written order prepared by the supervising practitioner authorizing the procedures to be performed, or a standing order prepared by the supervising practitioner. The written order, or notation of the standing order, must be placed in the patient’s record. The “supervision” required for MAs to perform services is defined as the personal presence by the supervising practitioner in the treatment facility during the performance of the procedures.