[NPInfo] Answer to Wall Street Journal

willie o wdgo at yahoo.com
Thu Mar 27 05:55:18 PDT 2008


Thanks for replying on behalf of all of us with such a well written letter. 

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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    Willie Olson, MSN, RN, FNP-C
  Marysville, CA. 95901  
  530-682-8560
   



       
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