Opinion

There are valid reasons why physician is "captain of the ship"

LETTER — Posted March 21, 2005

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Regarding "NP: Physicians don't have a monopoly on concern over patient safety" (Letters, Feb. 28): I read the letter by David Kleberger, NP, Commerce City, Colo., regarding the nonphysician's role in health care with interest, as I am a supporter of ancillary health care professionals. But I must disagree with some of his points.

Mr. Kleberger says physicians' concerns over nonphysicians prescribing ability stems not from patient safety fears, but from economics. I would argue that it is economics that have allowed nonphysicians to prosper.

Specifically, less-expensive health care providers increase the bottom line. If an ER can be staffed with one MD/DO making $180,000 and five NP/PAs making $70,000, as opposed to six salaried doctors ... well, you do the math. Furthermore, an enterprising office physician can earn more from an NP/PA than if he hired another doc. Now that's economics for you.

Mr. Kleberger also states, regarding his education, that with "two bachelor's degrees, a master of science degree ... I think I'm perfectly capable of providing independent patient care." I must disagree. Just as three associate's degrees don't equal a bachelor's, a smattering of bachelor's and master's degrees don't equal a doctorate level degree.

Did we mention residencies? Social workers will never equal psychiatrists, and paralegals are not the same as lawyers, regardless of experience.

As stated earlier, I am a proponent of NP/PAs as partners in health care. But everyone should remember who is captain of the ship. More important, they should remember why.

Lee Morgentaler, DO, Blauvelt, N.Y.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2005/03/21/edlt0321.htm.

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