HLM: Has any other state tried to do anything like this?
Nasca: No, and here's the irony: We've been asked by other countries to introduce our system of education and oversight because they aspire to have the quality and high levels of care that we have. We have other parts of the world saying, "We don't want this anymore." And here we have Missouri introducing this in United States.
That's irony in the extreme.
HLM: NYU Langone medical ethicist Art Caplan thinks the idea is OK for rural areas with few physicians.
Nasca: I have to quibble with Dr. Caplan. He's talking about this as a stopgap measure. But these people are going to be practicing for 40 years. The reality is, they're not going to get into a residency program. Because the next year, and the year after that, there are another 7,000 medical school graduates trying to get into residency programs.
The odds of getting into a residency slot after failing the first time goes down dramatically, and after two or three years, it's almost a given that you will not get in.
And the insinuation that primary care can be done by anybody is flawed.
HLM: Have you told the MSMA your view?
Nasca: No one has asked for my opinion. But I think the AMA has done that in spades.