With many areas of the country confronting physician shortages, particularly in rural America, a growing number of states are dropping the requirement that doctors who received their medical training overseas complete a U.S. residency before they can obtain a full medical license. Virginia is among nine states since 2023 that no longer require a second residency. A dozen more states are considering following suit.
That’s one idea to help increase access to health care among rural populations. Here’s another: Dr. Art Kellermann, former dean of the School of Medicine at the leadership academy for military health, the Uniform Services University in Bethesda, MD, believes that there is an untapped resource whose training and experience make them ideally suited to play a critical role in primary health care.
It’s a position he calls Primary Care Medical Technicians or “PMTs”, and much like the similarly named Emergency Medical Technicians (EMTs), these trained professionals would serve in a front-line capacity to extend the impact and reach of primary care physicians (PCPs), nurse practitioners (NPs) and physicians assistants (PAs).
Transitioning from military medical roles to community and primary care
In the U.S. military, enlisted service members – Army Medics, Navy Corpsmen, and Air Force Medical Technicians – often handle “sick call” under the supervision of military doctors. The most talented enlisted providers take on additional responsibilities during their years of military service.
“Medics and corpsmen have long been the backbone of military health care,” Dr. Kellerman notes. “Military doctors and military surgeons are phenomenal, but there are only but so many of them, and so in addition to providing casualty care on the battlefield and in combat aid stations, medics and corpsmen could treat minor illness and injury and provide preventive care to units overseas. Unfortunately, when they retire, there’s no analogous role for them in civilian health care.”
Virginia was the first state in the nation to allow former military medics and corpsmen to obtain civilian health care roles after completing their military service, but most are employed as care assistants in Virginia hospitals. Kellerman believes they can and should do more.
Community PMTs could expand the impact and reach of PCPs, PAs, and NPs, making primary care more accessible in rural communities by increasing the number of providers available and removing barriers like geography when sessions are conducted virtually.
“Telehealth is an integral component”
Working in clinics or remotely but connected by mobile telehealth, PMTs could see patients for checkups, take a focused history, perform a basic physical exam, and follow problem-specific guidelines to deliver highly effective care. If uncertain what to do, they’d be able to immediately contact their clinical supervisor by telehealth.
“Telehealth is an integral component, and it keeps people from having to drive 50-60 miles, then sit in a waiting room to receive primary care,” said Dr. Kellerman. “If we ever hope to reduce costs and achieve better health outcomes, we have to think differently. In Virginia we can save the Department of Medical Assistance Services, Medicare, and private health insurance a lot of money – and get better health in return, if we reengineer primary care by combining mobile telehealth with a human touch. PMTs could do that.”