House backs attempt to fill physician shortage

Measure would allow non-residency ‘graduate physicians’ to practice in NH

You may get a new kind of primary care provider if a law passed by the NH House on Wednesday becomes law, and chances are he or she will have a foreign medical education.

House Bill 1506 would create a “graduate physician” category for a physician who has graduated from medical school but has been unable to find a residency in the United States, and therefore can’t practice.

Most U.S. medical school graduates can find a residency, but there is a growing shortage of residency spots for graduates of foreign schools. According to the sponsors of the bill, nationwide, there were 42,370 applicants for 30,750 spaces – limited due to the lack of federal funding – leaving a gap of 12,000 graduates who could not practice here, at a time where there is an acute shortage of primary care providers in the United States, and particularly in rural states like New Hampshire.

The bill would put a graduate physician under the supervision of a doctor and the doctor’s medical malpractice insurance.

Supporters noted that such practitioners have all the same training as a regular doctor minus the residency, which is considerably more than a physician’s assistant or nurse practitioner.

“These are highly qualified graduates who have eight years of medical education and are stuck, who can’t move forward and we need primary care physicians,” said Rep. John Fothergill, R-Colebrook.

But the program has its detractors.

Rep. Skip Bearing, D-Exeter, a former professor of clinical pediatrics at the University of Connecticut, said that the supervision under this bill is looser than a residency, so graduate physician won’t get proper training. Secondly, while they agree to practice here, there is not a reimbursement mechanism should the doctors leave the state, the practice of primary care, or even the country.

Finally, he said, it is too easily to confuse graduate physician with general practitioner, both of which have the same initials.

Others worried that the students weren’t getting a residency because they weren’t qualified, and pointed to problems in Missouri, the only other to institute the program, where malpractice insurance refused to cover them.

But Rep Jess Edwards, R-Auburn, said that the whole discussion was more like a “turf war” similar to the debate over whether to create physician assistants nearly 50 years ago.

The House passed the bill on a vote of 215-108.

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