Dean Andrea Amalfitano PhD DO
Michigan State University College of Osteopathic Medicine
East Fee Hall
965 Wilson Rd Room A309
East Lansing, MI 48824

April 5, 2022

Dear Dean Amalfitano,

On behalf of the nearly 13,000 physician members of Physicians for Patient Protection, we are writing to express concern about the MSU College of Osteopathic Medicine’s plan to train Physician Assistant (PA) students ‘synergistically’ with Doctor of Osteopathic Medicine students. We are aware that MSUCOM is not the only medical school with a non-physician training program, but it is the most recent to announce a new program, and the only to do so with a ‘synergistic’ approach.

Given the current state of medicine, exacerbated by an ongoing pandemic, the timing of this announcement couldn’t be worse from a physician point of view.  Our healthcare system is in crisis, and the increase of nonphysician practitioners—nurse practitioners and physician assistants—entering the workforce is a particular concern for medical students and physicians. Across the country, we are hearing reports that medical students and resident physicians are being displaced from training opportunities due to an increase in nonphysician trainees. Corporations and private equity groups are hiring nonphysician practitioners preferentially over physicians to cut costs and increase shareholder profits.

By training PA students alongside DO students, MSUCOM is bolstering the main argument of the American Association of Physician Assistants (AAPA) that PAs “take the same courses as medical students,” and should therefore be granted freedom from a physician supervision requirement.  In fact, the Dean’s letter introducing the program implies that the goal of the program is to compensate for a physician shortage by training PAs to work in underserved areas, potentially without physician supervision.

We believe there are other, better options to increasing patient access, such as developing a program for unmatched medical school graduates, or “Assistant Physicians” to fulfill rural and underserved urban healthcare needs.  This option would preserve the integrity of a medical school education, challenge the argument that there is a physician shortage (which is actually a residency position shortage, rather than a physician shortage), and provide physician healthcare to more patients.

While this program is being lauded as a way of integrating interprofessional skills into medical education, there are other ways to promote teambuilding and mutual respect, including preparing DOs to lead the healthcare team and PAs to work under physician supervision. We are also concerned that this program will further increase patient confusion about the role of healthcare practitioners.  Words matter.  The language you use to introduce the PA students and the synergistic PA-DO program will dictate how patients, the public, and legislators view the role of each healthcare team member.

In summary, we fail to see any true advantage that this model brings to students or graduates and believe that the program will negatively impact medical student education and DOs as a whole.  Maintaining osteopathic medical student education as your highest priority, we ask that the College of Osteopathic Medicine reevaluate your relationship with this program.

At a minimum, we request that you consider the potential effects this program will have on graduating DO students, including worsening prejudice against DOs, perceived inadequacy in training of MSUCOM graduates, decreased job opportunities for your graduating DOs, and the implied perception of DOs as being more like PAs than MDs by referring to them collectively as “minority professions.” We request that you clarify the synergy you expect from these two programs, specifically addressing how that combined outcome benefits DOs and we specifically request that you remove the term “medicine” from “SpartanPA medicine student,” as it infers a medical school education.

Sincerely,

Roy Stoller DO
Board Member

Chantel O’Shea DO
Officer