[NPInfo] 2 Editorials in San Diego tribune

[David Mittman]

http://www.signonsandiego.com/uniontrib/20071112/news_mz1e12letter.html

Letters to the editor

November 12, 2007
Comments on health professionals assailed
As a graduate of the Yale School of Medicine Physician Assistant Program and
a practicing physician assistant in San Diego, I would like to respond to
Tom Gehring's comments in ³Retail health clinics aim for convenience² (A1,
Nov. 7).
Keith Darcé quoted Gehring as saying, ³Physician oversight of allied health
professionals must be maintained. If you want to be a doctor, go to med
school.² Gehring, as an administrator representing the San Diego County
Medical Society, fails to recognize that physician assistants practice
medicine in California, diagnosing, treating and prescribing medications to
patients with physician supervision as outlined in California regulations.
It is the stated policy of the California Academy of Physician Assistants
that PAs are not independent practitioners. Furthermore, we embrace
physician supervision as a cornerstone of our practice. I went to PA school
because I wanted to become a physician assistant.
JUDD M. LARAWAY 
San Diego
As secretary of the American College of Clinicians, I take umbrage with the
comments ascribed to Tom Gehring, as they are unfair and unsubstantiated by
any medical evidence. A representative of a medical organization should know
better. He states that ³What's important is the expectation about the level
of care able to be provided and that the person providing the care knows
their limitations.² One would think that would be something that all
clinicians should do. Why limit it to nurse practitioners and physician
assistants?
While I agree that any competent practitioner can miss something, why would
he choose these two professional groups to point this out about, and not
also his own? There are nearly 180,000 nurse practitioners and physician
assistants practicing nationwide. Many of us are in satellite clinics, and
many of us are in rural and poor neighborhoods, and we are not missing
problems that are much more complex than seen at these retail clinics.
There are PAs and NPs in Iraq and Afghanistan doing complex trauma care and
saving lives daily. A PA was just awarded Army Flight Surgeon of the Year.
That PA practices excellent medicine. NPs and PAs can handle the problems
seen in these clinics, believe me. Furthermore, all of these clinics have
strong physician involvement.
Our emergency medicine system is in crisis. It is time someone else tried a
new approach to treating these types of problems. You do not need a doctor
give shots, treat pink eye, swimmer's ear or test for pregnancy. And to
finish his remarks with the quote, ³If you want to be a doctor, go to med
school² is undeserved and out of context. All of these clinicians are doing
what is within their training and scope of practice. All of them were
trained to do this. This is not about wanting to be a doctor.
If Gehring really thinks we are not trained well enough to do this, show us
the studies that prove it. There are none. I wonder what the real concern
here is?
DAVID MITTMAN 
Natick, Mass.