Missouri targets doctor dearth, expands first-in-nation law

— Numerous additional doctors from around the U.S. could become eligible to treat patients in Missouri’s underserved areas as a result of a planned expansion of a first-in-the-nation law aimed at addressing a pervasive doctor shortage.

The newly passed Missouri legislation would broaden the reach of a 2014 law that sought to bridge the gap between communities in need of doctors and physicians in need of jobs. That law created a new category of licensed professionals — “assistant physicians” — for people who graduate from medical school and pass key medical exams but aren’t placed in residency programs needed for certification.

But it took nearly two and a half years before Missouri finally began accepting applications on Jan. 31. By then, some applicants no longer qualified because too much time had lapsed since their medical exams. Missouri’s new legislation seeks to turn back the clock, so those who became ineligible during the slow rollout can still get licensed as assistant physicians.

Supporters hope the legislation, if signed by the governor, will help jumpstart a program that has been promoted as a model for other states.

“We’ve been trying for years to address our maldistribution of physicians in the country. We have all sorts of incentive programs and all sorts of ways to try to get them to go out to Podunk, but a lot of them just don’t want to go to Podunk,” said Missouri Rep. Keith Frederick, an orthopedic surgeon who sponsored the assistant physician law.

“This bill takes folks that very much want to ply their trade — they just want the opportunity to provide patient care — and the bill requires that they serve in an underserved area,” Frederick added.

Nearly 6,800 places in the U.S. are short on primary care physicians, from particular medical clinics to certain urban communities and entire rural counties, according to the U.S. Department of Health and Human Services. Of those, 225 are in Missouri — a disproportionately high amount compared with the state’s population.

Since Missouri’s original law passed, Arkansas and Kansas approved slimmed-down versions, and Utah enacted a similar measure this year. Lawmakers also have considered similar programs in Oklahoma, Virginia and Washington.

Missouri’s assistant physician license is available to all legal U.S. residents who graduated from medical school within the last three years and passed the first two rounds of medical licensing exams within the last two years. It lets them provide primary care in “medically underserved” areas with the supervision of another physician.

People can work as assistant physicians indefinitely, essentially sidestepping traditional residency requirements.

So far, 127 people have applied for Missouri’s program. Just 23 have been issued licenses while 55 have been deemed ineligible and 44 remain under review.

Dr. Tricia Derges is among those who have been excluded because the state took so long to implement the program.

Derges sold her candle manufacturing company about a decade ago to enroll in medical school. She said she completed the second step of the medical exam in January 2014 and graduated from Caribbean Medical University in Curacao three months later. She didn’t get matched with a residency program.

Derges nonetheless opened a clinic for the homeless and poor in Springfield, believing she could get licensed as an assistant physician. While waiting for that license, she has relied on other physicians to volunteer their services.

Derges said her assistant physician application was denied because more than two years had passed since her medical exam. The new legislation could allow her to reapply, and to potentially expand her clinic.

It “will save a lot of people’s lives,” Derges told The Associated Press.

The bill also was championed by state Rep. Lynn Morris, a pharmacy owner who said the expanded program could save people long drives to see doctors.

It’s “a commonsense approach to help take care of a crisis we’ve had,” Morris said.


Michael Kort 1 year, 2 months ago

Notice that Dr. Derges was talking about starting a low or no cost clinic in Springfield Missouri........Not a town of 200 in the middle of nowhere or Kansas .

You go to college for 4yrs and then to Medical or Dental School for another 4 yrs and some legislative clown wants to offer you tax breaks to become a rural Doctor ( who would be an LLC anyway ) who has graduated from school with one large ton of debt ! RIGHT ? !

I once many years ago asked my dentist how much her office equipment costs.......about 1/4 of a million was her answer......and then you have an office that you buy or rent, a receptionist, computers, records and reception space, materials, people who don't pay or go bankrupt......and truthfully this countries poorest people are in the rural areas where there is little in the way of social saftey net services such as are here in Lawrence, so if they are that poor how does a dentist or Doctor make ends meet working there .

Now the State could put in one multiuse medical dental prefab office with a place to land a helicopter for urgently I'll people, every so many counties with doctors and dentists who would work a circuit of a couple of days a week here or there, within so many miles of their home.......but that would be a sin against the Legislative Gods of "how the world is supposed to work" and Kansas is too broke anyway thanks to rural interests and their votes .

Kansas should open a basic dental school at Whicita State where they already have an Advanced Education In General Dentistry ( AEGD ) School ( which is what comes after regular 4yr dental school ) which is a one or two year ? program that attempts to lure in other dental school grads from other states schools who don't get into another states AEGD program elsewhere .

When a plain MD or DDS can get out of school and join an existing practice as a Jr person and make some money to pay the cost living and of getting to that point why should they take on a moral crusade where it is obvious that the state will simply wish them well with little meaningful support to help them get established in the back woods or to assure an adequate income to their debt that they carry ( where's the MEDICAID ) ( or help them to set up the shop......basic equipped turn gold faucets but working and maintained ) .

So, you take your life in your hands to live in the most rural areas of Kansas because healthcare is non existent.....and who ever imagines getting ill ( or old and ill ) until it is in your face personally ( not the clowns in Topeka......or some person driving thru western Kansas who suddenly is in need of a doctor or dentist ).

Michael Kort 1 year, 2 months ago

Has anybody noticed how suddenly popular in Topeka that KU Medical has instantly become now that they are Brownbacks savior of choice, along with a private healthcare partner, for the failing St Francis hospital ?

Yep, they went from being costly government funded pariahs and having their budget cut to being Heroes in Topeka .

Wonder how long that will last ?......not very long..... is my guess !

Something for nothing is always popular allong with tax cuts that this state could not afford to begin with......but the road goes on forever...... and the party never ends ?

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