In 2014, Missouri, Indiana, and Kansas have signed a bill that would allow medical graduates that were unmatched to a residency program to prescribe medications and work as an assisting physician in rural and underserved areas. Due to the physician shortage, states are pushed with a difficult decision in increasing the physician workforce. Missouri decided to alleviate this need by allowing a selected pool of unmatched medical graduates to practice medicine as “assisting physicians.” These assisting physicians would work under a physician collaborator and be able to prescribe medications including Schedule III drugs (hydroxycodone or codeine when compounded with a NSAID as well as synthetic tetrahydrocannabinol], IV, and V drugs.)

With minimal clinical care practice and exposure to patients, these assisting physicians would have a license to practice as normal physicians, as long as they treat patients in the neediest areas of the state.  Although the bill was signed in 2014, there have not been many updates regarding this bill and implementation has dragged with growing dissatisfaction and more risks. The Missouri Board of Registration for the Healing Arts’ board held a hearing in September 2016, and the joint committee on Administrative rules had until October 2016 to hold a hearing. Depending on the outcome, if no hearing was scheduled before October 23, 2016, the Final Order of Rulemakings will be filed with the Secretary of State’s Office.

View Missouri’s  Final Order of Rulemakings

Kansas and Arkansas have passed similar laws — over the objection of many medical association groups such as the Association of American Medical Colleges, American Medical Association, and AACOMAS, in which they believe that it’s not safe to let doctors bypass the traditional residency, which lasts at least three years. Kansas, whose licenses will only be restricted to graduates of the University of Kansas, has not had any licenses issued yet. Arkansas is only considering graduates from only with those who have ties to the state.

Other states may follow pursuit as they are grappling with a failing healthcare system and are facing a physician shortage. However, despite a new licensure for assisting physicians, this act puts a strain on regulatory authorities, graduate medical programs, and accreditation agencies in medical education.

You can follow the development of assistant physicians by reading updates on the state’s Board of Healing Arts.

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