Is it legal for Nev. physicians to let medical assistants handle drugs?

An advisory opinion considers whether physician oversight is enough for jobs such as administering shots. Doctors say barring assistants from these tasks could disrupt care.

By Amy Lynn Sorrel — Posted Dec. 16, 2009

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A regulation proposed by one of Nevada's medical boards that allows medical assistants to administer prescription drugs with physician supervision could conflict with state law, according to a legal opinion by the state's legislative counsel.

State law permits physicians to delegate certain medical tasks to medical assistants. But some confusion arose over whether doctors could use medical assistants to administer flu shots and other prescription drugs after the Nevada State Board of Medical Examiners began cracking down on medical spas where such assistants administered botulinum toxin type A shots without physician oversight.

In an attempt to clarify the situation, the board issued an emergency regulation in September allowing physician offices to delegate prescription drug administration to medical assistants as long as the assistants were supervised. Gov. Jim Gibbons endorsed the measure, which noted that many physician offices were curtailing certain procedures or firing assistants for fear of potential legal violations.

The medical board later submitted a formal proposed regulation to the Nevada Legislative Counsel Bureau. In a Nov. 6 opinion, the legislative counsel said such a measure would conflict with state law permitting only certain licensed professionals, such as nurses, to administer prescription drugs.

Although doctors can delegate certain medical tasks to medical assistants, assistants are not licensed and therefore not among health professionals permitted to handle medications, wrote Nevada Legislative Counsel Brenda J. Erdoes.

The medical board is drafting a revised proposal to address the legal concerns, said Interim Executive Director Douglas C. Cooper. But he noted that it has been longstanding, legitimate practice for physician offices to supervise medical assistants in handling some medications.

Nevada State Medical Assn. Executive Director Lawrence P. Matheis said the issue could lead to formal regulation of medical assistants. While the medical society is not necessarily opposed to such action, physicians want to make sure those efforts do not cause further disruptions in care, he said.

"We don't want a radical loss of access, and with the flu pandemic going on, this is no time to take out what has been a big part of our work force."

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