Making Government Work

Would You See a Doctor Who Never Completed His Residency?

August 1, 2014
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Would You See a Doctor Who Never Completed His Residency?
A new Missouri law allow med school graduates to skip residency and start practicing in underserved areas. Joe Raedle/Getty Images
A new Missouri law allow med school graduates to skip residency and start practicing in underserved areas.

For most of us, going to the doctor can be as simple as making an appointment. But for some, especially those in living in rural areas, getting medical care can be much more difficult.

This is the case for those living in desolate locals of Missouri where 40 percent of the population reside, but only 25 percent of the doctors statewide practice.

However, that’s scheduled to change, due to a new law signed by Gov. Jay Nixon earlier this month. Under it, medical school graduates will be allowed to practice in underserved areas without completing their residency.

In every state, medical school graduates can’t apply for their license until they have completed a residency that lasts at least a year. That is, in every state except for Missouri. For those graduating in the Show Me state, they can begin to practice immediately upon completion of their licensing exams — even if the residency still isn’t finished.

Instead, the grad will work as an “assistant physician” alongside a “collaborating physician” who agrees to be responsible for the assistant. After a month, the assistant physician will be allowed to work independently, but still under the watchful eye of the collaborating physician.

The new law is dividing medical professionals. Proponents express its need considering how few doctors there are to serve underserved areas, which are defined as a place where there is a low ratio of primary-care doctors per 1,000 residents, a high rate of infant mortality or where many senior citizens and others live below the poverty line.

Opponents, however, are not so sure that this is the best solution for Missouri residents. Since many those living in underserved areas may need more medical attention, a recent grad with little experience might not be the best option.

Rosemary Gibson of the Accreditation Council for Graduate Medical Education is one such person wary of the law. “Primary care is not simple,” Gibson told Governing. “If you have a lot of older people living in rural areas, they have a lot of co-morbidities [such as diabetes combined with heart disease].”

Jeff Howell, a lobbyist for the Missouri State Medical Association, sees the law as a viable and helpful solution and believes that the critics’ concerns about the qualifications of the grads aren’t warranted. “They’ll still be in collaboration with a licensed physician,” Howell told Governing. “That collaborative practice never disappears.”

While those in the medical field continues to squabble over whether or not this is a good idea, for those in rural Missouri, this law could make a doctor a stone’s throw away.

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