Quote from Chaya
Tread cautiously, Sherry. Try to find from your state's scope of practice regulations if there is anything specific that a nurse can do but a medical assistant with other certification is not allowed to do. Can you clarify whether she is truly working inder the Doctor's license? Just make sure she isn't doing anything under YOUR license that is questionable.
Working under the .......'s license.
This phrase is oft used which is odd because quite simply nobody works under another's license.
On this board many RN's will state that they are worried because an LPN or CNA works under their license and not doing a good job. LPNs have their own license and must practice within the scope of that license. RNs may delegate duties to the LPN, but those duties must be within the scope of that LPNs practice and level of competency; conversely they may not delegate duties outside of the LPNs scope of practice with the understanding that they are being performed under the RN's license. Should they do so the RN could be disciplined for improper delegation and the LPN for practicing out of their scope of practice. The key here is since both have a license (and years of education invested) there is a viable means of control.
In the case of unlicensed providers, the situation is much the same whether it is a physician or a nurse performing the delegation. A doctor can not legally tell a CNA to go perform brain surgery as an extreme example. In the hospital environment the issue does not arise because the hospital requires privilages/credentialing of their non-employee providers, and since they won't grant the right to perform brain surgery to CNAs it doesn't happen. In the physician's office the responsibilities appear less clear cut when in fact they are not. Only the level of oversight has changed. The physician can delegate however he/she sees fit without a problem-----until someone complains or something goes wrong. But even then the unlicensed person is not working under the physician's license although they have none of their own. They (CNAs) may be sued or even arrested if applicable; most often they are not sued because their assets are so few it's not worth it.
So yes, I am aware that physicians ask others to do all sorts of things----but their license or even presence does not give them carte blanche rights to delegate tasks to individuals under that license.