Proposed rules clarify what medical assistants can, can't do

Medical assistants will be able to administer vaccinations and other critical prescription shots legally but will be prevented from injecting patients with Botox and other cosmetic drugs, according to a copy of emergency regulations obtained Thursday by the Las Vegas Review-Journal.

The document says medical assistants can "perform or provide a service upon the body of a patient" only when a physician or physician assistant has trained and directed them to do so and when the physician or physician assistant is "in close proximity to the patient."

That aspect of the regulation, according to Tracy Hurst, owner of the Medical Spa in Summerlin, could end up shutting down many medical spas in town.

Hurst said it's not necessary for a doctor to be physically present for all the types of services such spas provide, including skin care and anti-aging procedures.

"You're going to put a lot of medical assistants out of work and put a lot of people out of business in a terrible economy," she said.

If the new rules are passed today during an emergency session of the Nevada State Board of Medical Examiners, they will go into effect immediately. The board then has 120 days to come up with permanent regulations.

The emergency session was called after medical officials recently learned that medical assistants had been illegally administering shots.

A 30-year-old law that Louis Ling, the board's executive director, cited as prohibiting medical assistants from giving Botox injections also turned out to apply to administration of any shots.

That prohibition made Gov. Jim Gibbons uneasy, according to his spokesman, Dan Burns.

"We're preparing for a pandemic of swine flu, and we had to make sure people could get their flu shots," Burns said.

The document obtained Thursday also noted that medical assistants were "being laid off from their employment because of the confusion and uncertainty."

Ling noted Thursday that the new regulations, while giving a fuller picture of what a medical assistant can and cannot do, will probably become even broader in the next two months. He said public sessions will be held where ideas can be shared.

"We've got much more to do," he said. "Right now, we're just ensuring that the public is safe."

Jacob Hafter, a health care attorney, said it is important that an education component for the profession be added.

"You need to have a list of technical skills that they are capable of performing," he said. "And perhaps there should be a national exam taken to show that someone is competent to perform a skill set."

Hafter said requiring physicians to be in close proximity to medical assistants while they work is sure to be controversial.

"That means within eyesight to most people, and physicians won't be able to do that."

The new regulations for medical assistants also prevent them from administering chemotherapy or anesthetics that would render the patient unconscious or semi conscious. Certain types of steroid injections would also be off limits for medical assistants.

Contact reporter Paul Harasim at or 702-387-2908.