[NPInfo] Answer to Wall Street Journal

[David Mittman]

AnnMarie and everyone: Thanks so much. You humble me. If you want to  
pay me back, let's work together as colleagues to help rebuild this  
bizarre mess we call a healthcare system. Let's honor each other and  
please consider joining the ACC.

On Mar 26, 2008, at 7:47 PM, AnnMarie Roetzer wrote:

> Dave,
>
>   I just have to say... wow wow and wow again. That is one of the  
> best, well-written letters I have ever read and I am proud to have  
> you as a colleague.
>
>   Thank you again,
>   AnnMarie
>
> David Mittman <dmittman at comcast.net> wrote:
>   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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