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EXTRA!
To the editor:
I read your June FP Report article ("A Trend? -- Other Specialists Crowd Primary Care Picture, Study Says") about the Robert Graham Center research published in the March/April Journal of the American Board of Family Practice. The FP Report article discussed nonprimary care physicians providing primary care services. We must also recognize that nonphysicians are providing much of the primary care services in Colorado.
If research shows nonprimary care-trained physicians provide lesser quality primary care, it stands to reason that the nonphysicians who are practicing medicine -- often in primary care physicians' offices without appropriate supervision -- are also providing substandard care. Together, these two groups -- the nonphysicians and the untrained physicians providing primary care -- mean unqualified providers are delivering a great deal of services.
Perhaps this is why so many studies show that patients often do not receive a high-quality standard of medical care for everything from diabetes management to blood pressure control. Unfortunately, the Future of Family Medicine architects have chosen to ignore these issues about scope of practice and nonphysician providers. As this trend continues, we will see the end of family medicine as practiced by appropriately trained physicians, and a further degradation of care.
Robert Brockmann, M.D., M.S.
Englewood, Colo.
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Copyright © 2004 by American Academy of Family Physicians.