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Does the Practice of Medicine Require a Medical Degree?

Harold C. Sox Jr, MD
Arch Intern Med. 1978;138(2):199-200. doi:10.1001/archinte.1978.03630260013008.
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During the past decade, many primary care physicians have discovered that much of their work can be done quite well by nonphysicians. Consequently, there has been a steady growth of training and employment opportunities for nonphysician clinicians (a generic term for physicians' extenders, physicians' assistants, and nurse practitioners). Although the nonphysician clinician usually works under the supervision of a physician, two thirds of the patient contacts in the primary care setting may be managed without directly involving a physician.1,2 In some states, a patient contact managed by a nonphysician clinician is reimbursed by third parties for the full fee customarily charged by a physician, implying that society places the same value on certain diagnostic and therapeutic services, regardless of the training of the direct provider of the service. Since this implicit societal judgment may have considerable effect on health care costs, the quality of these services as provided by


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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