Doctor or Assistant Doctor?
Who will meet your community’s need for primary care in the future: a doctor, nurse practitioner, physician assistant … or someone else?
The growing shortage of primary care physicians has been well documented, with estimates from the Association of American Medical Colleges putting the predicted shortfall at 45,000 by the year 2020. Many experts call for using PAs and NPs to fill some of the gaps in primary care. Now, the state of Missouri is looking to another solution: assistant physicians.
Missouri has great need for primary care providers, especially in rural areas. According to the Missouri Foundation for Health, 98 of Missouri’s 101 rural counties are designated Primary Medical Health Professional Shortage Areas. So the state passed a law allowing medical school graduates to practice in those rural areas as “assistant physicians,” even though they haven’t landed a residency, as long as they have passed the first two parts of their licensing exam.
Under the law, assistant physicians must enter into a collaborative agreement with a nearby physician, similar to the agreements in many states that govern nurse practitioners’ practices. Collaborating physicians would supervise assistant physicians on site for 30 days. But after that, assistant physicians could practice without direct supervision up to 50 miles away and will be able to prescribe Schedule III, IV and V drugs.
Supporters say the scope of practice will be sufficiently narrow. But opponents are concerned that medical schools don’t produce physicians ready to practice independently without additional training. The American Medical Association has expressed opposition.