'This Is Nuts'
"The magnitude of the potential for harm is so striking, it's hard to put into terms," says Thomas Nasca, MD, CEO of the Accreditation Council for Graduate Medical Education. In the third and fourth year of medical school, students have only four months of experience evaluating patients, yet "the scope and diversity of diagnoses is measured in the thousands.
"These are physicians with rudimentary experience. But you'll then turn them loose to manage patients with complex diabetes, congestive heart failure, arrhythmias? Malignancies? This is nuts."
But the bill's proponents, including the Missouri State Medical Association (MSMA), which represents some 10,000 practicing Missouri physicians and helped draft the legislation, say Bravo! Allowing these new physicians to treat patients who otherwise have miserable access to care is a brilliant solution to a dire physician shortage.
After all, Missouri last year received a federal designation as one of the 10 most medically underserved states in the nation. Acknowledging that many more doctors are needed to treat thousands of newly insured, Jeffrey Howell, the MSMA's government relations director and general counsel, insists the pending bill does not set up a different standard of care.
Only Worried About Competition
"The people who are objecting to this are only worried about competition. They can talk about standards of care, or what happens if someone gets hurt all they want, but all this really just boils down to competition," Howell contends.
"You can help people in rural areas by thinking outside the box, and come up with solutions, or you can continue to allow those people to not get care. We prefer Option A."