By Mark D. DuBay
---- — Michigan has a physician shortage. Those living in Michigan's rural areas already know this. So you would think if a doctor graduates from medical school and passes the United States Medical Licensing Examination (USMLE), a license of some kind would be quickly issued. After all, when accountants, dentists, engineers, lawyers or pharmacists pass their licensing exam, a license is issued without question. This is not true for doctors and it explains why Michigan has a physician shortage.
To become a fully licensed doctor in Michigan, it is not enough to have earned a medical degree and to have passed a national licensing exam. Additional study is required in what is known as a residency program. These programs, funded by U.S. tax dollars, are in short supply. In some cases, applicants from foreign countries are given positions while U.S. citizens are made to wait. While waiting, doctors are prevented from having patient contact. Michigan law prevents a doctor waiting for a residency from practicing medicine even under a limited license and even the supervision of a fully licensed doctor.
A bill recently introduced in the Michigan Senate would allow a doctor denied a residency to work with a limited license. Senate Bill 1201 (2012) respects the current residency system and is intended to work in harmony with it. However, when there are more eligible doctors than open residency positions, doctors should be allowed to work under a limited license — at least until a residency becomes available.
Because this may never happen, the bill provides another pathway to licensure. It is illogical to complain, on the one hand, that Michigan has a physician shortage, but on the other, prevent doctors who have passed national licensing exams from practicing their profession.
According to MCL 333.17031, education beyond medical school is intended to make a doctor "proficient in the practice of the profession." The statute does not specify this training must be provided in a residency program. It does not require a doctor to specialize or become Board Certified. Yet by administrative rule, a Michigan doctor must enter a residency program and by program rules must apply to become a specialist before a license will be granted.
It is no longer deemed sufficient to become a "fully licensed" doctor. The specialization of American medicine has driven up costs and made doctors less accessible to their patients. Michigan is increasingly being served by mid-level providers — Physician's Assistants and Nurse Practitioners. This is because doctors who could and should be licensed are being denied a residency and, in the process, being denied a license to practice medicine.
If mid-level providers who have less education and training than a doctor are allowed to have direct patient contact and have substantial authority to render care, why are doctors being denied this privilege simply because residency programs are insufficiently funded? Regulations are restricting the supply of doctors. Michigan law regarding the licensing of physicians must be reconsidered.
Ask your local state senator and representative to support Senate Bill 1201.
About the author: Mark D. DuBay is an attorney in the private practice of law.
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