In a move that creates some confusing liability issues for physicians, to say nothing of quality of care issues for patients, the State of Missouri has now allowed for a license called an “assistant physician” to be issued to someone who has been graduated from any medical school and has completed steps 1 and 2 of the USMLE but has not completed any residency training. These folks will be allowed to call themselves “doctor” and be allowed to practice as regular doctors. Interestingly, the state of Missouri has traditionally placed more restrictions on nurses than most states and does not allow for independent practice by advanced practice nurses as many states have done to help ease the primary care physician deficit.
Presumably, these assistant physicians will be seeking hospital privileges. As presumably few hospitals will grant admitting privileges to an assistant physician, they will then most likely seek arrangements with physicians to agree to admit and care for their patients who require admission. Therefore, one open question is the degree of liability those physicians who agree to such arrangements will be taking on. It is unclear if the courts will be able to see the difference between assistant physicians and physician assistants; for the latter, the supervising physician has full liability exposure for the actions of the PA.