To the editor:
I am grateful for the articles in the February FP Report on the Florida State University College of Medicine. Maybe they will help keep the dream alive here.
Joseph Scherger, M.D., M.P.H.
Tallahassee, Fla.
Editor's note: Scherger, a family physician and founding dean of the college, was removed from that position right after the February FP Report went to press. Visit http://www.aafp.org/fpr/20030200/3.html to read the February coverage; click on "Update" to learn more about what happened after the issue was printed.
To the editor:
I never respond to articles, but I always get worked up when I read about trial lawyers in places where they have so much power, as pointed out by David Avery, M.D., of Vienna, W.Va. (quoted in the February FP Report story, "FPs in West Virginia Dare to Hope for Tort Reform").
The governor and all Supreme Court judges in that state are trial lawyers. That's enough to send shivers up my spine! The keynote speaker at the San Diego AAFP annual meeting last year pointed out that each trial lawyer can easily contribute $10 million to fight any court reform. At least one presidential candidate (a senator from North Carolina) is a trial lawyer, and I think there may be others. We as physicians are doomed if more trial lawyers are elected or appointed to positions of power. Dr. Avery phrased it well when he identified some of them as "very anti-physician."
Bill Ogg, M.D.
Satellite Beach, Fla.
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To the editor:
I enjoyed the article on patient assistance programs in the February FP Report.
Since a significant percentage of my patient population lacks insurance coverage, we frequently access these programs for our patients. Unfortunately, the paperwork involved can be onerous. One of my nurses has thanklessly accepted the task of sorting out the various programs and trying to keep track of different patients.
Also, we have noticed that subspecialists refer patients back to us for the express purpose of enrolling them in patient assistance programs for medications that the subspecialists have prescribed. Accepting a solely clerical role, especially as it is not reimbursed, is difficult to swallow.
Although it would be somewhat satisfying to charge patients for these services, it would be ridiculous to do so in my practice. If the patients had the money to pay for these medications or the insurance to cover their cost, we wouldn't need the patient assistance programs in the first place!
Kristin Elliott, M.D.
Marquette, Mich.
To the editor:
In response to Dr. Fearon's letter in the March FP Report, I couldn't disagree more! His plea to further train nurse practitioners in our profession, if heeded, would only lead to a more rapid demise of the family physician, not help to preserve our profession. His fear that we may end up in direct competition with midlevel health providers if we don't train them is already a reality. Read any nurse practitioner journal, and it is clear they view FPs as competition and have no qualms about representing themselves as "physician equivalents." We are partly to blame for this situation, as we have elevated midlevel professionals to the stature of medical doctors in the eyes of our patients, insurance payers and colleagues. It's no wonder medical students shun our discipline when we teach them that you don't really have to be a medical doctor to practice family medicine! Midlevel providers do not have the education, training or experience of medical doctors and should not be supported in their attempt to replace family physicians.
Allen Roberts, M.D.
Denver, Colo.
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