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Missouri Assistant Physicians

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The application process has rolled for this as of January, I believe. It appears to be taking flight. 

 

I am seeing more and more conversation about this and it always winds up in trash talking PAs/NPs while trying to legitimize an unmatched MD/DO working in the "AP" role. I am not sure what to make of it. I see people saying that PAs/NPs are the same as non-residency trained MD/DOs (+ IMGs). I cringe at this a bit because a lot of PAs have prior HCE, but I have to admit, I am not certain how useful that is a lot of the time now (i.e. the pool is diluted with direct HCE that is functionally useless and "counts"). I also feel like, in some ways, the training is not equal. Medical schools know the applicant will go on to residency. On the flip side, they are trained and it is pretty similar. We learn a lot on the job, as they could. At the risk of sounding arrogant, I worry that we will have the lower ranks of MD/DOs masquerading as us. If they are allowed to perform the same roles as us with the same responsibilities, does that mean we are sufficient to apply to residency programs if we pass the STEP exams? 

 

Lots of interesting thoughts coming out of this. Could be great for us in the some ways and terrible for us in others. What is your input? 

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The biggest issue I have with this is the idea that the (generally) bottom of the barrel MDs are equal to us.  I use the term "generally" because those who don't match, for the most part, are those who are not good students.  They are the ones who have had bad evaluations or failed to pass certain rotations, in general.  There are some who don't match because they only want a specific specialty and won't take anything else. 

 

Do we really want these providers representing us?  Wouldn't these MDs be better served by taking other primary care residencies (or residencies they didn't necessarily want), finishing those and then being board eligible MDs instead of APs?  Wouldn't their patients be better served by that as well? 

 

PAs are expected to practice with collaboration after school.  MDs are expected to practice with multiple layers of collaboration and senior MDs scrutinizing everything.  I'm not sure how well this model will work. 

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"So Mr. John Q. Public, you have your choice of two healthcare providers today. You can be seen by a certified graduate PA, or by some med school graduate who could not get accepted into a residency program."

 

I know who I would pick.

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Honestly, I would be surprised if there was support from the AMA on this.

 

I was never very interested in the whole PA name debate until now. I don't want to be confused as an AP. 

 

EDIT: Seems like I may have found my own answer:

 

"Assistant physicians: In Missouri, AOA urges limiting license renewals

In the interest of patient safety, quality care and assistant physicians’ own career prospects, AOA says license renewals should stop after two."

http://thedo.osteopathic.org/2016/09/assistant-physicians-in-missouri-aoa-urges-limited-license-renewals/

 

Key points from the article:

 

  • Patient safety could be jeopardized if medical school graduates who don’t have complete medical training are allowed to provide care under limited supervision.
  • Medical students who don’t match into their desired specialty won’t necessarily make good primary care physicians.
  • States who adopt such legislation risk creating a two-tiered physician system. “Patients in rural and underserved areas, who are already at a geographic and often economic disadvantage, deserve the same quality of care as those who live in a more prosperous part of the state,” the statement notes.

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Interestingly enough, I think the obstructionist insurance industry may be part of the solution to this one.  Have you seen the other thread about the MD who decided to let her board certification lapse?  These guys are "physicians" but neither board certified nor board eligible...

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 These guys are "physicians" but neither board certified nor board eligible...

 

I'm not sure they really are, Rev. "Doctor of Medicine/Osteopathy" is a degree awarded by an academic institution. "Physician" is a title or license given by a government authority. These guys are neither licensed nor (ever) board certified. They have essentially no quality control.

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I'm not sure they really are, Rev. "Doctor of Medicine/Osteopathy" is a degree awarded by an academic institution. "Physician" is a title or license given by a government authority. These guys are neither licensed nor (ever) board certified. They have essentially no quality control.

True. Proto-physicians, then...

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