A recently passed bill in Missouri aims to solve two problems by attracting unemployed medical professionals from around the country to fill its severe statewide doctor shortage.
Republican Rep. Lynn Morris introduced legislation to ease qualification standards for medical school graduates who would be unable to practice unless they complete their residency. Under the bill, all legal U.S. residents who have graduated from medical school within the last three years and have passed their medical licensing exams within the past two years could apply for an "assistant physician" license.
The "assistant physician" term is separate from a physician assistant license.
Since 2002, medical school enrollment has increased 25 percent to nearly 87,000 students nationally, according to data from the Association of American Medical Colleges.
While physician hopefuls are flooding the education marketplace, they are struggling to find required residencies following their three years of schooling. The National Resident Matching Program found that 41,334 applicants applied for 30,212 residency slots in 2015.
Residencies pay little to nothing, complicating medical school graduates' efforts to become accredited and be on their way to their medical career. The medical college association has blamed the residency shortage on a cut in Medicare spending for graduate-level medical education and medical licensing, which Congress froze in 1997 as part of the Balanced Budget Act.
Three years ago, state Rep. Keith Frederick sponsored a bill that effectively created the new medical classification. The Board of Registration for the Healing Arts was tasked with overseeing the process, but it did not begin accepting applications until Jan. 31, clashing with the two- and three-year deadlines in the 2014 law.
Morris' bill would turn back the clock and allow those applicants to be eligible again. The registration board has received 133 assistant physician applicants and issued 34 licenses as of May 30.
The assistant physicians would have to practice alongside a licensed physician in one of the state's "healthcare shortage areas," where 98 of its 101 rural counties don't have enough primary care providers, according to U.S. Department of Health and Human Services data.
Some are concerned about pairing desperate patients with lesser-trained physicians. The medical college association, which does not typically take a position on state or local legislation, warned that the bill could result in subpar care.
"The Association of American Medical Colleges is concerned by efforts that would bypass the experiences necessary for physicians to provide safe and effective patient care independently," said Matthew Shick, the AAMC's director of government relations and regulatory affairs.
The association is one of eight national medical groups that make up the Coalition for Patients First. They issued a formal statement in August criticizing the proposal.
However, one physician assistants organization said assistant physicians will not be taking physician assistants' jobs, just helping to fill a growing marketplace.
Republican Gov. Eric Greitens soon will determine the fate of Morris' efforts, but other states, including Utah, Arkansas and Kansas, have passed similar measures since Missouri's 2014 law was passed.