[NPInfo] Answer to Wall Street Journal

[Maureen Richards]

Thanks for your well written response!

Maureen Richards, ARNP

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Linda Marie De Zago
Sent: Wednesday, March 26, 2008 12:00 PM
To: prispunnyfnp at metrocast.net; 'NP Info'
Subject: RE: [NPInfo] Answer to Wall Street Journal

Well said!

-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of prispunnyfnp at metrocast.net
Sent: Wednesday, March 26, 2008 12:22 PM
To: npinfo at nurse.net; acc-circle at listserve.com
Subject: RE: [NPInfo] Answer to Wall Street Journal

EXCELLENT LETTER DAVE!!!! 
Thanks for taking the time to respond so eloquently.

Priscilla Merrill FNP

Original Message:
-----------------
From: David Mittman dmittman at comcast.net
Date: Wed, 26 Mar 2008 12:11:42 -0400
To: ACC-Circle at listserve.com, NPinfo at nurse.net, PAForum at mc.duke.edu
Subject: [NPInfo] Answer to Wall Street Journal


Sent to Dr. Brewer and Letters to the Editor and posted as a comment.

Dear Dr. Brewer:
I read your article on the future of primary care in today's Wall  
Street Journal with interest.
As a physician assistant (PA) with 33 years experience, I take  
umbrage with a number of comments you made. Please let me explain.
You assertion that the primary care provided by NPs and PAs is  
inferior to that of any other group of professionals who provide  
primary care is biased, unfair and unable to be substantiated. Can  
you show one study to back your opinion up? Do you have any idea how  
much professional opinions based on anecdotal information hurt  
people? To say that "you get what you pay for"regarding PA and NP  
care smacks of the type of words used in turf battles without much  
thought being given to the harm your statement can produce. The same  
was said by the internal medicine physicians about the first family  
physicians and your first residencies. Their graduates were also  
looked at with less than the proper respect and understanding they  
deserved. I am amazed you would do the same to others.
I think few would argue that a cardiologist is both trained better  
and more broadly to treat cardiac problems than a family doctor. So  
using your logic, in the case of treating hypertension or CHF, family  
doctors also provide inferior treatment. Clearly the poor patient who  
gets their CHF treated by a family physician rather than a  
cardiologist would also" get what they pay for". That thinking is  
absurd. To think that I would treat bronchitis, or otitis, or tinea,  
or hypertension or most other problems differently than all others  
who encounter them, is the same as thinking that you are not equipped  
to treat hypertension. Of course you are, of course we are.

Dr. Brewer there are close to 200,000 PAs and NPs in practice across  
America, and the care we provide is excellent. Many work with your FP  
colleagues whom I would guess are also allowing their patients to  
receive inferior care. Much of the primary care delivered to our  
servicemen and their dependents is provided by NPs and PAs, as is  
much care in the much improved VA system. I suppose all of these  
people receive poor care also. Even the President and Vice-President  
have a PA treating them. The US Army's Flight Surgeon of the Year in  
2007 was a PA!
We deserve a place in any system designed to bring more healthcare to  
the people of our country.

As another professional, I would respectfully ask that you do two  
things; one realize your comments can malign and hurt other  
professionals who are out there working hard to provide care to many  
who need it across our great country and secondly, as a man of  
science, be able to back up your assertions with at least one or two  
scientific studies.

Yours for a healthier America
Dave Mittman, PA
Secretary,
American College of Clinicians
Natick, MA

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