For many years, the Pennsylvania Medical Society (PAMED) has been engaged in alerting the state to impending workforce issues, which now have been accelerated by the Affordable Care Act and other recent changes in the health care marketplace. PAMED members and staff are serving on a recently-created state advisory committee tasked with looking into physician workforce issues in the commonwealth.
House Resolution 735, adopted by the Pennsylvania House in April, directs the Joint State Government Commission to study physician workforce issues, including recent reports and other states’ proposals. The commission established an advisory committee comprised of 25 public health officials and experts to conduct the work and send their findings and recommendations to the House this time next year.
In July 2014, the state of Missouri decided to allow medical school graduates to work as “assistant physicians” to treat patients in underserved rural areas to help fill the gaps in access to care in those areas.
Under the new law, signed by Missouri Gov. Jay Nixon, med-school graduates who have passed the first two sections of the national licensing exam and been approved by their state board can treat patients on their own as far as 50 miles away, after spending 30 days supervised in person by a collaborating physician. They also can prescribe most medications.
The Missouri State Medical Association, which represents 6,500 physicians, helped draft the legislation, saying it was needed to address a severe shortage of health care professionals. About one-fifth of Missouri residents lack adequate access to doctors, according to federal surveys. “We felt it was time for someone to think outside the box and come up with a solution for rural health care access, so that is what we did,” said Jeffrey Howell, the group’s director of government affairs.
In June 2014, the American Medical Association’s House of Delegates resolved to oppose special licensing pathways for doctors who hadn’t completed at least one year of residency and the American Academy of Physician Assistants also opposes the law, saying the “assistant physician” title could cause confusion.