IMPACT

Drawing over 40 family physicians, residents, and students, this year’s Advocacy Day successfully addressed legislation that impacts your practice and patients. Attendees spent Valentine’s Day visiting with legislators and their staff sharing their love for family medicine and stressing the importance of primary care. The issues and legislation discussed can be found on pages 24-25. Members unable to attend Advocacy Day participated by submitting a Speak Out message to their legislators. This year’s messages focused on GME expansion, DEI/Do No Harm Act, and Scope of Practice.

Scope of practice continues to recur each session, and this year was no exception. The Missouri Board of Nursing’s Annual Workforce report confirms what we already knew, that nurse practitioners do not go to rural areas.

The 2022 report shows that 5.3% of nurse practitioners work in rural areas. And, when analyzing the data from 2018 through 2022, it shows that modifying the collaborative practice requirements for mileage from a 50-mile radius to 75 miles, and changing the number of nurse practitioners a physician can collaborate with, did not increase the number of nurse practitioners in rural areas.

Another issue addressed is legislation that would increase graduate medical education residency spots in primary care with state funding. Based on a 2021 MAFP survey of family medicine residencies, we estimate existing programs can increase their residency spots pending ACGME approval and funding. Sarah Cole, DO, FAAFP, Mercy Family Medicine Residency, met with Senate and House appropriation committee chairs on funding for primary care residency spot expansion.

Then, she, along with Misty Todd, MD, Bothwell Family Medicine Residency, presented testimony in support of a state program and funding for GME expansion. Negotiations are ongoing, and we will keep you updated in the weekly legislative report.

Another issue important to medical schools and residency programs is legislation, HB 489/ SB 410, the “Do No Harm Act,” that would prohibit the incorporation of diversity, equity, and inclusion (DEI) in admissions requirements and curriculum. Banning the discussion on DEI, which includes social determinants of health and their impact on diseases and treatments, will negatively impact the Missouri healthcare community. We do not support legislative limitations on specific educational content due to the various settings in which family physicians practice. In addition, the ACGME requires that DEI be incorporated into the curriculum. This legislation would force residency programs to choose between funding and accreditation.

Family physicians do not get to select their patients and need to be educated to care for the population in their communities. Family physicians are uniquely positioned to address social determinants of health as a factor that affects the health and safety of our patients.