Medical assistants are hired to provide specific technical supportive and patient care services in an ambulatory medical office setting. The supervising physician, licensed, practicing healthcare provider, or clinician who hired them authorizes these services to patients who are under his, or her care. These services, whenever provided must be a usual and customary part of the medical office, or practice where the medical assistant is employed. A record of any medical care and services rendered must be made in the patient’s medical record or chart by the medical assistant who provided it, indicating the name, initials or other identifier, the date and time, and a brief description of what was done signed, or initialed by the physician who gave the order. The supervising physician may, at his or her discretion, provide written instructions to be followed in the performance of such tasks. It is the physician’s responsibility to assure the medical assistant is competent and proficient in performing any such delegated technical and patient care services at the appropriate standard of care. According to Donald A. Balasa, JD, MBA, and executive director and legal counsel for the American Association of Medical Assistants, the standard of care of a reasonably competent medical assistant is not necessarily the same in all parts of the United States.