AmericAn AssociAtion
of medicAl AssistAnts
0 N. WACKER DR., STE. 1575
CHICAGO, ILLINOIS 60606
website: www.aama-ntl.org 800/ 8- 6
Certification and Licensure
Facts you should know
BY DONALD A. BALASA, JD, MBA
AAMA EXECUTIVE DIRECTOR AND
LEGAL COUNSEL
J
ust as understanding terminology is
important in medicine, having a work-
ing knowledge of the language of
professional credentialing is most helpful for
medical assistants. To simplify matters, this
article will focus on the differences between
licensure and certication.
I
Licensure may be dened as a mandatory
credentialing process established by a gov-
ernment entity, usually at the state level. If
a profession is licensed, it is illegal for an
individual to practice the profession without
a license. The requirements and procedures
for obtaining a license may vary from state
to state. Therefore, unless some sort of reci-
procity agreement has been forged between
states, it may not be easy for a professional
licensed in one state to obtain a license in
another state.
On the other hand, certication may
be dened as a voluntary credentialing
process—usually national in its scope and
most often sponsored by a nongovernmental,
private-sector entity. Because of its voluntary
nature, an individual need not be certied in
order to practice a profession.
It should be apparent from these deni-
tions that it is inappropriate to use the expres-
sions “voluntary licensure” or “mandatory
certication.” If the license is voluntary, it
is not, strictly speaking, a license. Similarly,
if the certication is mandatory, it is really
licensure.
Some states have incorporated a national
certication into their licensure programs.
Such an arrangement, however, does not
render the certication itself mandatory, but
merely makes it a prerequisite for obtaining
licensure in that state.
Other states have started their own cer-
tication programs. Unlike licensure, state
certication is not required to practice, but
provides information to consumers about
the educational and competency-verifying
attainments of the certicate.
With these simple denitions in place,
it is now possible to see how the terms cer-
tication and licensure are used in regard to
medical assisting.
II
The CMA (AAMA) credential represents a
medical assistant who has been certied by the
Certifying Board of the American Association
of Medical Assistants (AAMA). The CMA
(AAMA) fullls the denition of certication
given above in that it is:
u voluntary
u national
u sponsored by a nongovernmental,
private-sector body
A signicant strength of the CMA (AAMA)
Certication/Recertication Examination is
that its content is based on a scientically-
grounded occupational analysis.
At present, no state has instituted gen-
eral licensure for medical assistants. Some
states, though, do have mandatory educational
and/or experiential requirements for a very
limited number of duties (e.g., radiography,
venipuncture, and injections). A mandatory
credential addressing a narrow area of a
profession’s activity is sometimes called a
“permit” to distinguish it from traditional
licensure, which encompasses all or most
of the profession’s scope of practice.
Should medical assisting seek licensure
for itself, as so many other allied health
professions have done? This question was
addressed in the “Position Statement on
Certication, Licensure and Registration”
discussed and adopted by the 1985 House
of Delegates of the AAMA. The Position
Statement argued against pursuing licen-
sure and advocated an intensied effort to
encourage and convince physicians to hire
the CMA (AAMA). The Position Statement
concluded that:
AAMA should remain a professional
association promoting voluntary certica-
tion [for medical assistants]. Certication
offers status and denition to the practi-
tioner; provides a means of establishing
a national standard of care with regard to
the legal duty of the medical assistant to
the patient; offers the employer guidelines
for hiring qualied staff, as well as a pool
of applicants; provides an environment
for continuing education to take place for
medical assistants; and is cost-effective.
III
Credentialing will continue to be a vital issue
in allied health circles. Keeping in mind the
basic denitions of licensure and certica-
tion—despite a confusing array of similar
terms—will foster a better understanding of
the impact of credentialing on the medical
assisting profession.