It has been brought to the California Nurses Association's attention that surgical techs are assuming the role of first assistant. Because surgical techs are unlicensed, functioning as a first assistant is outside their legal scope of practice and constitutes the practice of medicine. It is unlawful for any person to practice medicine without an appropriate license or statutory authority. The practice of medicine includes diagnosing, prescribing, treating, or doing surgery for any human illness, ailment or disorder.
Suturing tissue constitutes the practice of medicine.
It is unprofessional conduct for a physician and surgeon to employ directly or indirectly, aid or abet, any unlicensed person to engage in the practice of medicine. The California Nurses Association does not know of any statute or regulation under California law that authorizes an unlicensed technician to perform the procedures described above. California is a non-delegation state. Thus, a supervising physician cannot delegate first assistant duties to an unlicensed surgical tech. Delegating first assistant duties to an unlicensed surgical tech could expose the physician to a charge of unprofessional conduct for aiding and abetting the unlawful practice of medicine under section 2234, Business and Professions Code.