ACGME Chief Sees 'Huge' Risk of Error in Proposed Assistant Physician Licensure

Cheryl Clark, for HealthLeaders Media , July 11, 2014

The CEO of the Accreditation Council for Graduate Medical Education calls Missouri's move to license assistant physicians "precedent-setting and very concerning on a number of fronts."


Thomas Nasca, MD

Missouri doctors are pushing for a new physician workforce to help solve the state's dire physician shortage.

And to put it mildly, Thomas Nasca, MD, CEO of the Accreditation Council for Graduate Medical Education doesn't like the idea one bit. Nasca runs the organization that oversees accreditation of 9,300 U.S. residency programs in the U.S. and another 1,000 international programs that assure a steady supply of doctors.

Endorsed by the Missouri State Medical Association, the bill was signed into law Thursday by Gov. Jay Nixon. It sets up rules by which medical school graduates who haven't yet passed their final credentialing exam can treat patients in primary care settings.

Doctor Shortage 'Fix' Is a Disaster Waiting to Happen

The new law requires these doctors to be supervised on site by a "collaborative" physician for 30 days, after which the assistant physician could treat patients without that collaborator's presence in settings 50 mile away. These young assistant physicians will  be able to prescribe Schedule III, IV, and IV drugs.

Beyond that 30-day period, the collaborative physician is required to perform chart reviews on 10% of the assistant physician's cases every two weeks, but little else.

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16 comments on "ACGME Chief Sees 'Huge' Risk of Error in Proposed Assistant Physician Licensure"

Tim Fontaine (12/3/2015 at 5:17 PM)
It is so obvious that the CEO is fear-mongering by stating that one of his concerns would be that Assistant Physicians/MD may make drug interaction mistakes...REALLY? What the general public does not know is that all doctors either use medication interaction apps on their laptop or phones, or consult a hard text reference source in order to not make these mistakes. Trained pharmacists are the only professionals I have ever spoken with that know most of the drug interactions per rote memory. Moreover, most hospitals/clinics are on or will be going to EMR/EHR [INVALID]ems - they have built-in drug interaction settings which automatically alert you if a dangerous interaction could occur. The CEO is creating a paper tiger. If you look at what the CEO and the ACGME has to lose when MO starts licensing APs and other states start following suite, then you will see why he states what he does. Thanks, Tim F.,MD,MPH,CT(ASCP)

dana (12/9/2014 at 7:09 PM)
I live in USA from 10 years,I'm an US citizen,,,I have passed all USMLE steps but couldn't get a residency spot. I don't have a job ,I'm a saty at home mom.I was a reputable physician in Europe but I cannot use my knowledge to help American people,Very sad!!!!!

Andrews C Ninan, MD, MS, FRCS (12/7/2014 at 2:12 PM)
There is yet another side of this equation. There are legal citizens in this country, people who have been qualified and worked abroad (U.K. and India) after doing their residency abroad in specialities (for over 20 years in both countries) but not had the chance to be included into any residency programs in this country due to being "overqualified". These people, like myself, are wasting their time when their knowledge could be utilised without any fear of not having had any supervised training in this country.




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