March 2002 • Volume 8 • Number 3 |
To the editor:
I read with interest the letter of Maury Greenberg, M.D., in the December FP Report.
I am in total agreement with his concern that in time nurse practitioners and physician assistants will be licensed in various states to provide primary care. We in family practice shouldn't be too upset about it, for we have, for a variety of reasons, done it to ourselves. Many family physicians have been actively involved in the training of nurse practitioners, and they are widely used in many offices. In some remote areas of Texas, nurse practitioners practice medicine under the guise of physician supervision that in some cases is so superfluous, it is close to being a sham.
Four years of medical school and a three-year family practice residency develops in the physician the diagnostic acumen, the procedure ability and the therapeutic expertise that cannot be matched by nurse practitioners or physician assistants. We must educate the public -- our patients -- about the difference. Otherwise, in the future, government and private insurers will direct those covered to the lesser-trained in the guise of cost saving. It's up to us; let's do it.
Bruce Jacobson, M.D.
Fort Worth,
Texas
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To the editor:
I'm writing regarding Dr. Maury Greenberg's comments in the December FP Report in which he stated we need to stop worrying about collaborating with other groups that may be usurping us and start worrying about our own members.
He happened to mention colonoscopy and OB-Gyn privileges. I recently returned from job interviews in Florida, where I was informed I would not be doing any colonoscopies or obstetrics, even though I am credentialed in these areas in Indiana.
We need to start ensuring that our members are able to become proficient and gain credentials in various skills or we will continue the downward spiral of the scope of practice that many family physicians are experiencing, while nurse practitioners' and physician assistants' scope of practice continues to grow.
John Chomer, M.D.
Noblesville, Ind.
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